GEORGIA RURAL HEALTH ASSOCIATION LEGISLATIVE AGENDA 2010

The Georgia Rural Health Association (GRHA) is a nonprofit organization established in 1981 to preserve and improve healthcare for rural Georgians. As the oldest statewide rural health organization of its kind, GRHA promotes rural health needs as a specific concern in our state, advocates for rural healthcare issues, and encourages the development of appropriate healthcare resources for the citizens of rural Georgia.

GRHA’s mission is to promote and improve rural health

In carrying out our mission, GRHA’s goals regarding rural health are designed to:

• Promote and improve Georgia’s rural healthcare systems
• Bring attention to the relationship between rural health and rural economic development
• Link consumers, community leaders, and healthcare professionals with policy makers
• Promote the exchange and distribution of information, research, and ideas whose focus is to improve rural healthcare services
• Effectively communicate healthcare issues to recipients and providers of rural healthcare 

As with former policy positions and legislative initiatives adopted by GRHA during its 29 year history, the 2010 Legislative Agenda of the Georgia Rural Health Association includes priorities and objectives designed to improve Georgia’s health. Rural Georgians experience higher rates of chronic disease than their urban counterparts and have the least resources available to manage their disease. GRHA’s 2010 Legislative Agenda typifies our message that investing in rural health is an investment in Georgia’s rural people and our state’s rural economic development efforts.

For 2010, GRHA adopts the following as primary concerns to the strength of rural healthcare in our state and we encourage our legislators to support initiatives that address these issues:

• ensure that the Department of Community Health, the newly transitioned Division of Public Health, and Department of Behavioral Health and Developmental Disabilities services are adequately funded, and those services are sufficiently available to rural Georgians   

• Continue and adequately fund PeachCare for Kids and Medicaid
• support programs specifically designed to increase our baseline supply of primary care practitioners, and to address the geographic mal-distribution of providers
• Continue support of Georgia’s Comprehensive Cancer Control Plan
• modify Georgia law to allow International Medical Graduates (IMGs) to apply for licensure upon completion of two years of residency training, permitting them to be fully licensed in their final year of residency.
• Caintain funding for Stroke and Heart Attack Prevention Program (SHAPP)
• Support the Georgia Rural Health Safety Net Program through the Georgia Department of Community Health, State Office of Rural Health, specifically for the development and sustainability of Georgia's rural health care delivery system targeting Federally Qualified Health Centers (FQHC), rural and Critical Access Hospitals (CAH) hospitals, rural health networks and other essential components of the health care delivery system
• Improve road safety by requiring seatbelt use for drivers and passengers in all vehicles, barring all forms of electronic messaging by drivers, and requiring “hands free” cell phone calls for drivers

The Department of Community Health, Division of Public Health, and Department of Behavioral Health and Developmental Disabilities, serve two significantly impact policies, programs, and the delivery of services to all Georgians.The current economic situation has made the services delivered by each of these entities increasinglyimportant to the health of Georgians across our state.Designating Licensed Professional Counselors and Marriage and Family Counselorsas Medicaid reimbursement eligible would extend mental health services to all Georgians. GRHA urges the General Assembly to adequately fund these programs and to ensure that services are available to rural residents.

Continued Funding of PeachCare and Medicaid 
Rural Georgians tend to be poorer and sicker than their urban counterparts. Thus, the payer mix in rural areas is skewed to Medicaid/PeachCare population. GRHA supports favorable reimbursement for rural providers, which will help preserve access to providers in Georgia’s 109 rural counties. 

Healthcare Workforce Distribution
Without significant resources and incentives, the inequities in geographic distribution and supply of health care professionals (including primary care, mental health, dental and vision care providers, nurses, and allied health professionals) will not change.

GRHA supports loans to physicians who have completed their medical education and allowing loans to be repaid by these physicians who agree to practice medicine in rural areas and by making grants to hospitals or other health care facilities in rural areas of Georgia to enhance physician recruitment. If no providers exist in these communities, access to care is still denied. Georgia must develop and support programs specifically designed to address the increased demand for primary care providers and geographic mal-distribution of professionals.

Georgia’s Comprehensive Cancer Control Plan
Rural and medically underserved Georgians experience disparate access to cancer care and treatment options. GRHA advocates for continued support of the Georgia Cancer Coalition and the six Regional Cancer Coalitions of Excellence, who are uniquely able to initiate innovative community-based research, access to information and clinical trials, and cancer care planning on the local level. The collaboration of the Regional Cancer Coalitions of Excellence, new and leveraged investments in cancer care, and existing resources, collectively form a comprehensive cancer system for our state, which in turn improves outcomes for rural cancer patients. We urge ongoing support of Georgia’s Comprehensive Cancer Control Plan.

Licensing of International Medical Graduates
International Medical Graduates (IMGs) are playing an increasingly important role in meeting the need for primary care physicians in rural Georgia, However, current state licensing requirements, combined with the exhaustive time challenges with obtaining billing/provider numbers, create challenges for both IMGs and the rural hospitals interested in hiring these physicians. GHA supports modifying Georgia law to allow IMGs to apply for licensure upon completion of two years of residency training, permitting them to be fully licensed in their final year of residency.

Maintain funding for Stroke and Heart Attack Prevention Program
The Stroke and Heart Attack Prevention Program (SHAPP) is an education and care program which seeks to identify people at risk for their disease conditions, and to teach them how to manage their lifestyle to prevent complications. One in four adult Georgians have hypertension. Patient services are provided through the county health departments, a cornerstone of healthcare services in rural communities. These services include screening, referral to doctors, diagnosis, and treatment. Medically indigent adults are eligible for high blood pressure medications at low or no cost.

The SHAPP program has been able to provide over 15,000 uninsured and underinsured Georgians with hypertension medication and management. The SHAPP program has been highlighted by the CDC due to the high control rates that have been achieved.  Funding for the program has continued to be threatened despite 46-54% fewer adverse events among the patients and a return on investment. While there is a cost of $486 per SHAPP patient per year, if these Georgians did not receive this care they could potentially cost the state an estimated $534-$620 on average per year. This year maintaining funding and keeping SHAPP as part of the public health system of Georgia is vital for both rural and urban residents.  GRHA supports continued funding for this crucial program. 

Enhancing Georgia’s Rural Health Safety Net
We support programs that foster creative solutions to the problems of healthcare financing and delivery, and thereby strengthen the health/healthcare safety net for Georgia’s rural communities. Initiatives such as the Georgia Rural Health Safety Net Program encourage regional health planning and the creative redesign of a health/healthcare system that takes into account the needs of local healthcare consumers and the economic impact of health and healthcare. The development and sustainability of Georgia's rural health care delivery system targeting Federally Qualified Health Centers (FQHC), rural and Critical Access Hospitals (CAH) hospitals, rural health networks and other essential components of the health care delivery system can help assure a strong safety net for uninsured and underserved Georgians.GRHA urges the General Assembly to adequately fund these programs and to ensure that services are available to rural residents.

Improve Road Safety for Everyone Traveling on Georgia Roads
National data indicates the deadly consequences of texting and driving. Sending text messages and driving can be a deadly combination, especially for teen drivers. According to a 2007, AAA study, 46 percent of teens text while driving. According to NHTSA, 46% of teens report texting while driving. The following statistics are reported by AAA Traffic Safety programs: cell phone use accounts for 2,600 vehicle fatalities and 300,000 collisions, and the risk of collision increased by 400 percent when talking on a cell phone while driving. However, Georgia data has not been found, suggesting the need for more local data and state funded traffic safety programs. GRHA urges the General Assembly to require seatbelt use by all passengers and drivers in all motor vehicles to reduce the risk of injury in an accident. GRHA also urges the passage of laws to prohibit all electronic messaging and require the use of “hands free” cell phone calls by drivers. These measures will increase road safety while also making Georgia eligible for additional federal funding for transportation.