08 LC 33
2350
Senate
Bill 395
By:
Senators Goggans of the 7th, Johnson of the 1st, Williams of the 19th, Cowsert
of the 46th, Hawkins of the 49th and others
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 8 of Title 31 of the Official Code of Georgia Annotated, relating
to the care and protection of indigent and elderly patients, so as to establish
the safety net clinic grant program; to provide for definitions; to provide for
the purpose of the grant program; to provide for eligibility; to provide for
requirements; to provide for planning grants and implementation grants; to
provide for data on safety net clinics; to provide for rules, regulations, and
procedures; to provide for statutory construction; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Chapter
8 of Title 31 of the Official Code of Georgia Annotated, relating to the care
and protection of indigent and elderly patients, is amended by adding a new
article to read as follows:
"ARTICLE
9
31-8-210.
As
used in this article, the term:
(1)
'Dental clinic' means a clinic which provides dental care, including preventive
services.
(2)
'Department' means the Department of Community Health.
(3)
'Grant' means a planning grant or an implementation grant approved pursuant to
Code Section 31-8-214.
(4)
'Indigent patient' means a person who is unable to pay the entire cost of health
care received whose family income does not exceed 250 percent of the federal
poverty level and who is without health insurance.
(5)
'Primary care clinic' means a health care clinic which provides primary care
outpatient services only, such as chronic disease management and vaccinations,
and which does not provide care or services which are considered to be primarily
emergency care and services; provided, however, that for purposes of this
article only, federally qualified health centers as defined in Section
1395x(aa)(4) of Title 42 of the United States Code Annotated shall be considered
primary care clinics.
(6)
'Program' means the safety net clinic grant program created pursuant to this
article.
(7)
'Recipient' means the recipient of a grant under the program.
(8)
'Safety net clinic' means a primary care clinic which provides an alternative to
emergency room visits for indigent patients for nonemergency medical services at
no cost or on a sliding scale basis to the patient or a dental clinic which
meets requirements established by the department.
31-8-211.
There
is created the safety net clinic grant program to be administered by the
department. The purpose of the program shall be to shift nonemergency medical
services from the high cost environment of hospital emergency rooms to lower
cost primary care clinics serving as safety net clinics and to provide access to
affordable dental care.
31-8-212.
To
be eligible for a grant under the program, a primary care clinic or dental
clinic shall:
(1)
Be operated by a nonprofit corporation established under the laws of this state
and qualified as exempt from federal income taxation under Section 501(c) of the
Internal Revenue Code; and
(2)
Provide primary care services or dental services at no cost or on a sliding
scale basis primarily to indigent and uninsured patients whose family income
does not exceed 250 percent of the federal poverty level.
31-8-213.
(a)
A primary care clinic applicant for a grant under the program shall
demonstrate:
(1)
A direct, tangible relationship with a local or regional hospital, demonstrated
by a plan to encourage nonemergency medical patients to be redirected to a
safety net clinic rather than the hospital´s emergency department, which
may be accomplished in various ways, including, but not limited to, a local or
regional hospital contributing funds or in-kind support to the safety net
clinic, a voucher system in which a nonemergency patient is given a voucher to
take to the safety net clinic to cover costs, or a referral system from the
hospital to the safety net clinic for nonemergency medical
services;
(2)
Strong community support and financial assistance;
(3)
A verifiable existing need for a safety net clinic based on current demographics
using the most recent census data, proximity to a local emergency department or
departments, lack of similar primary care clinics in the area, opportunity to
serve multiple counties, and any additional available data, studies, or other
resources from universities, foundations, research groups, or other sources on
the health status and needs of the area and its residents;
(4)
A detailed marketing campaign, including fundraising strategies, methods to
raise awareness in the community, and demonstrated ability to work with other
access points, such as emergency departments and local health departments, to
direct indigent and uninsured patients to safety net clinics for nonemergency
medical services;
(5)
A pharmaceutical component, demonstrated by a long-term plan to provide or
assist in providing patients access to medications related to primary care
medical issues, chronic disease management, and disease prevention;
(6)
A case management component, demonstrated by a long-term plan that addresses
such issues as assistance in medication counseling, proactive steps to make
future appointments for ongoing disease management, paperwork assistance, and
general medical information;
(7)
A fraud prevention and income verification component, demonstrated by a plan to
prevent abuse and misuse of the free and reduced cost clinic environment and
adherence to the requirement that the safety net clinic provides services
primarily to uninsured and indigent patients whose family income does not exceed
250 percent of the federal poverty level; and
(8)
Nonprofit status, as required by Code Section 31-8-212.
(b)
Favorable consideration may be given to a primary care clinic applicant for a
grant under the program which demonstrates, in addition to the requirements in
subsection (a) of this Code section:
(1)
That the clinic has an administrator or executive director who manages and
oversees the daily operation of the clinic, including management of the
financial aspects and oversight of the medical aspects;
(2)
A plan to establish a specialty physician network to recruit and maintain a
network of specialty physicians, such as cardiologists, pediatricians,
ophthalmologists, and mental health professionals, designed to address patient
needs in areas of acute care and chronic disease management;
(3)
Access to laboratory and radiology services, either onsite or through agreement
with other medical facilities; and
(4)
Access to dental care, including preventive and other dental needs.
(c)
Dental clinic applicants shall demonstrate such requirements as determined by
the department in accordance with the goals of this article.
31-8-214.
(a)
Subject to appropriations by the General Assembly or other available funding,
the department shall be authorized to disburse:
(1)
Planning grants up to $30,000.00 per year for a maximum of one year;
and
(2)
Implementation grants for one year up to $150,000.00 with an option for a second
year of funding not to exceed $50,000.00
to
primary care clinics and dental clinics which meet the requirements of this
article and department guidelines to serve as safety net clinics.
(b)
Planning grants may be approved by the department for entities which can
demonstrate the ability to establish a primary care clinic or dental clinic to
serve as a safety net clinic and which already have established community
support for such clinic. Funds from planning grants may be used for items
including, but not limited to:
(1)
Hiring an administrator or executive director for the clinic; and
(2)
General startup or other overhead costs.
(c)
Implementation grants may be approved by the department for primary care clinics
and dental clinics which are already in existence to serve as safety net
clinics. Funds from implementation grants may be used for items including, but
not limited to:
(1)
Expanding operating hours into late nights and weekends to correspond to peak
emergency room utilization hours;
(2)
Expanding patient capacity;
(3)
Adding necessary staff, such as a nurse practitioner or other appropriate staff,
to meet administrative or clinical needs;
(4)
Purchasing or leasing equipment or software; and
(5)
Marketing purposes.
(d)
Grants provided pursuant to this Code section shall not be used for
reimbursement of services where other means of reimbursement are available, for
any other uses which are deemed prohibited by the department, or for
construction costs.
(e)
An applicant shall not be required to apply for or receive a planning grant to
be eligible for or receive an implementation grant.
(f)
Grants provided pursuant to this Code section shall be disbursed in accordance
with any applicable guidelines, policies, and requirements established by the
department.
(g)
Prior to the renewal of a grant, the department shall be authorized to require
that a recipient conduct an audit of its clinic operations and finances, which
may include site visits.
(h)
The department or its designee shall be authorized to conduct one or more site
visits prior to renewal of a grant to assess the recipient´s operations and
quality.
31-8-215.
(a)
Recipients of grants under the program shall be required to maintain and make
available nonidentifying patient data and related information, including, but
not limited to:
(1)
Emergency room admissions in the associated hospital; provided, however, that
this paragraph shall apply only to primary care clinics;
(2)
Referrals to the safety net clinic, including vouchers from an emergency
department or local health department, if applicable;
(3)
Trends in patient visits to the safety net clinic; and
(4)
Physician and other health care professional volunteerism.
(b)
Recipients of grants under the program shall be required to maintain and make
available financial data and related information, including, but not limited
to:
(1)
Funding received from community and other sources, including, but not limited
to, individuals, businesses, and nonprofit and charitable
organizations;
(2)
Federal and state funds received and continuing efforts to obtain further
funds;
(3)
Plans for long-term financial stability; and
(4)
An analysis of the efficiency of the clinic, comparing funds received and
utilized to the value of the medical and dental services provided by the safety
net clinic.
(c)
Recipients of grants under the program shall make available the data and
information required under this Code section in such format and at such times
and locations as may be required by the department.
31-8-216.
The
program shall be administered by the department in accordance with such rules,
regulations, and procedures as it shall deem necessary for the effective
administration of such programs. To the extent practicable, the department may
utilize for this program existing procedures it utilizes for administering
similar grant programs.
31-8-217.
(a)
In no way shall this article be construed to impair or alter any obligations
required by federal or state laws or regulations, including but not limited to
the provision of health care in emergency situations.
(b)
In no way shall this article be construed to require a recipient or an applicant
for a grant to provide any health care information or other data in violation of
the federal Health Insurance Portability and Accountability Act of 1996, P.L.
104-191."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.