Budget hearings at the start of Georgia’s legislative session saw state departments dive into Gov. Brian Kemp’s proposed budget and make a case for funding priorities.
Appropriations for the state’s four major health departments next fiscal year include more than $7 billion for mental and behavioral health services and an expanded HIV prevention program.
But a big concern this year is the unwinding of a pandemic-era policy that has kept people on Medicaid without interruption and that will expire in April. The federal policy, called continuous coverage, has led to a 25% growth in Medicaid enrollment since the start of the pandemic, five times more than what is estimated under normal circumstances, said Cayee Noggle, commissioner of the Department of community health, said.
DCH will work with the Department of Human Services to reevaluate more than 2 million adults and children in Georgia through next year. More than half a million are estimated to lose Medicaid coverage in the process.
The FY 2023 budget includes $8.4 million dollars to fund additional caseworkers and administrative support for recreation, with an additional $3 million for FY 24. But DHS says their staff will likely see caseloads increase by more than 200%.
“We’ve retrained current employees, and we’re aggressively hiring new ones,” DHS Commissioner Candice Broce said during budget hearings. “Keep in mind that while we are re-determining Medicaid cases, we will continue to receive new benefit applications, process renewals and handle appeals.”
With a launch date set for July 1, $52 million in the budget will cover the implementation of Kemp’s Medicaid waiver, Pathways to Coverage. An estimated 200,000 people already on Medicaid could qualify for that waiver and be automatically switched during redeterminations, according to DCH, but that leaves thousands more to determine eligibility under the partial expansion program.
“The next 12 months there is going to be so much movement of members arriving and members coming off,” Noggle said.
One of the department’s first moves is to reopen 158 offices across the state to shift from remote work to providing in-person assistance. This includes the reopening of all offices under the Department of Family and Children’s Services, with plans to hire more staff and open more frequently in the months ahead.
Broce teased legislation on another major issue, saying DHS is committed to ending the so-called hoteling of foster children and “fixing statutory loopholes” in the foster care system.
“You can’t make progress with your foster care cases if you’re supervising a high-needs child in the office or a hotel room,” Broce said.
Broce said the demand, meaning the number of children with complex problems who need placement, “far exceeds the supply.” A lack of available caseworkers or foster families for children with high needs means an average of 60 foster children sleep in local offices or hotels every night.
Even if children in the foster care system need psychiatric care, it is often not available to them.
Department of Behavioral Health and Disabilities Commissioner Keven Tanner said state psychiatric hospitals lost 1,200 employees during the COVID-19 pandemic. Although recruiting has improved since then, hospitals still spend millions on temporary contract workers.
“These contract staff are expensive,” Tanner said. “We want to replace them with DBHDD personnel who are not only more cost-effective, but they are also more committed to the mission of the department.”
The budget includes $2,000 in cost-of-living adjustments for full-time state employees. Additional federal funds aim to address staffing shortages across the health care system.
As the budget stands, more than $14 million dollars for DBHDD will help more people living with intellectual and developmental disabilities to be institutionalized. That money would be both annual and fund additional slots for the new options waiver and comprehensive support waiver programs, which provide home and community-based care for more than 700 people.
The budget also includes increased funding in FY 24 for mobile crisis response units and more than $13 million for three behavioral health crisis centers in Augusta, Dublin and Fulton County.
The Department of Public Health plans to focus on maternal deaths this year, Commissioner Kathleen Toomey said.
“I think that addressing maternal and child health in a very proactive way is probably going to be my top priority,” Toomey said.
But there are no new allocations specifically for maternal deaths in the budget.
Leah Chan is a senior health analyst for the Georgia Budget and Policy Institute. She said that while DPH is well positioned to address the maternal mortality crisis, new appropriations do not reflect that priority.
“A budget is a moral document,” Chan said. “And to me that speaks volumes of what the governor values. We have the solutions. This is a preventable problem. And it’s really just a matter of urgency and investment. So I really think that’s a missing piece in our budget.”
Last year, DPH received funding for two rural-focused pilot projects and one at Augusta University to monitor prenatal and postpartum mothers, and Toomey says those projects are ongoing. Lawmakers also approved Medicaid coverage up to one year postpartum during last year’s session.
Toomey said a report in February will provide more information on maternal deaths and that the public will likely see higher cases as a result of the pandemic.
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This article appears on Now Habersham through a news partnership with GPB News
