This is heartbreaking and happens far too often. Stories like this are the ones that make our work here at Georgia Watch so critical. The ability of someone to afford their utility bills can result in a life or death situation.

Georgia Watch advocates tirelessly for Georgia Power’s 2.3 million customers and Atlanta Gas Light Company’s 1.5 million customers who are often put in this type of situation. We work for lower, fair utility rates, and we stand up for residential and small business customers. We speak up for everyday Georgians, not special interests. The utilities and large customers are well represented by lobbyists and lawyers in the halls of the capitol and at the Public Service Commission.

Throughout 2011, Georgia Watch achieved many victories for consumers including fighting against unjust rate increases, lessening the impact of additional charges on customers’ bills, and advocating for assistance to help low-income seniors. As a direct result of Georgia Watch’s efforts, the Public Service Commission disbursed $5 million to help people in need pay their winter heating bills. Without our voice at the table, the scales of justice would tilt heavily against consumers.

Our state and our nation are still facing economic uncertainty. Georgia continues to lead the nation in unemployment, bankruptcy, and foreclosure, and recently our state’s capitol made national headlines: “Atlanta, Georgia, has widest income gap between rich and poor of all the major US cities, the US Census reported.” According to US Census data, 1 in 15 Americans are now amongst the poorest poor; in 2010 that meant an income of $5,570 or less for an individual and $11,157 for a family of four. These are often working poor and seniors – people trying to keep their head above water.

Now more than ever, Georgians need a relentless advocate in their corner. It is vital to ensure fairness and to hold those elected accountable. Recently, citizens across the country have expressed their dissatisfaction with the big banks and greed on Wall Street. Families and businesses are hurting and feel they aren’t being represented. They’re seeking a voice and someone to hear their concerns and honestly represent their interests.

Who is the watchful eye under the Gold dome in Georgia as the average citizen goes about his or her daily life getting to work, dropping the kids off at school, and figuring out what’s for dinner? Most Georgians can’t meet with hospital leadership to ensure they’re receiving the financial assistance for medical care they need and deserve. The average citizen does not have the time to attend Public Service Commission hearings where billion dollar cases are decided that impact our state’s economy and the environment. Georgia Watch can. For the past ten years, we have been the eyes and ears looking out for the everyday Georgian.

The political noise of the 2012 elections is ratcheting up, but campaign promises are empty if they’re not kept. If there has ever been a time in our history that the people need a voice, it’s now. With 2011 coming to a close, we here at Georgia Watch ask that you support our work with a donation so we can continue serving as your voice in 2012 and beyond.

Click here to donate now. 

- Angela Speir Phelps

We recently authored a report titled “Georgia nonprofit hospitals and the vulnerable patient,” which provides an analysis of Georgia nonprofit hospitals and community benefit programs. Read the report here.

In October 2011, we issued a letter to the IRS voicing our concern over the IRS decision and its potential impact on patients. You can read the letter here.

The Georgia Hospital Accountability Project broadens accessibility to affordable, safe and effective care at the state’s hospitals for uninsured, underinsured and low-income Georgians by promoting state-level regulations, advocating for hospital policy changes and promoting consumer empowerment through research and analysis, the publication of relevant reports, the engagement of the state’s hospitals and consumer education. Georgia Watch also actively engages key state-level stakeholders, hospital representatives, community leaders and lawmakers in dialogue on these topics.

Highlighting and combating the challenges of low-income, uninsured and underinsured Georgians at hospitals has long been a top priority of Georgia Watch. Since 2007, Georgia Watch has evaluated issues of access and affordability throughout the state, and has conducted detailed analyses of fiscal practices and community benefit offerings of six of the state’s key safety net facilities. In 2009, the organization officially launched its Georgia Hospital Accountability Project.

Through this effort, Georgia Watch:

• Conducts extensive research on community benefit programs and financial assistance policies at nonprofit hospitals, and regularly meets with hospital leaders to discuss challenges to and opportunities for programs within their communities
• Often authors white papers and reports on crucial topics, including an examination of the affect of the new health law on hospitals, the cost of care in Georgia and the need for adequate language services at hospitals. In 2010, Georgia Watch released a report detailing financial access at hospitals within the metropolitan Atlanta area, which delineated other barriers to care for those who are uninsured and underinsured, such as transportation and health literacy
• Actively works with the media, and authors regular op-eds and blog posts dedicated to the project’s core topics
• Engages consumers in its work, and in 2010, surveyed approximately 900 consumers on issues of affordable access at their local hospitals
• Assists numerous consumers on their particular issues, including billing discrepancies, a denial of financial assistance and finding a health care home
• Educates lawmakers, policy makers and advocates on issues of access at hospitals
• Hosts the Health Policy Fellowship, which trains emerging policy leaders on key access and affordability issues

Georgia Watch’s Hospital Accountability Project also actively advocates for transparency and accountability in regards to patient safety at our hospitals. Georgia is one of 22 states that currently do not require public disclosure of hospital-acquired infection rates, which leaves consumers in the dark as to which hospitals are safe and which are not. Georgia Watch is leading the effort to ensure safe care by convening national, state and local stakeholders that will analyze and recommend recourses to make certain patient care is not harmful.

June 16, 2011

Georgia Watch, the Campaign for Better Care and Piedmont Healthcare are proud to host “Town Hall Conversation: Safely and Effectively Navigating Healthcare Today” on Tuesday, June 28, from 6 p.m. to 8 p.m. at the Atlanta Community Food Bank. The event will kick off the national Campaign for Better Care’s Healthy Hospital Initiative, which aims to improve patient safety at hospitals and bring about greater clarity when navigating the healthcare market.

“Georgia Watch is proud to be a key partner in these ongoing efforts to make healthcare safer and more accessible for patients,” said Holly Lang, Georgia Watch’s Hospital Accountability Project Director. “Healthcare is tremendously difficult to navigate on one’s own. We hope this event will give consumers and patients the information and resources they need to stay safe at our hospitals.”

The community event will serve as the launch of efforts by health leaders to seek pledges from area hospitals, providers and consumer groups to lower infection rates and reduce readmission rates. Called the Partnership for Patients pledge, health advocates are seeking a set of formal commitments from hospitals and providers to better engage with patients, improve provider-patient communication, and increase coordinated, patient-centered care.

Click on image to read flyer

“With billions of dollars in resulting costs accrued from hospital readmission every year, patient safety is essential to ensuring both the physical and fiscal health of Georgians,” Lang said.

Patient safety has long been a priority for Georgia Watch, as 1.7 million HAIs are reported annually, affect approximately one in every 20 patients, and result in 100,000 deaths. These disturbing statistics are particularly devastating to seniors and others who are most vulnerable to breaches in patient safety.

In addition to discussion and education focusing on patient safety, health experts will cover the consumer impact of the new federal healthcare law. The forum will include health screenings, mobile health units, and food and beverages. Joining Georgia Watch are partners Piedmont Healthcare, Campaign for Better Care, Georgians for a Healthy Future, the Center for Pan Asian Community Services, the Urban League of Greater Atlanta and the Georgia Coalition for the People’s Agenda.

If you are interested in attending or would like additional information, please contact Georgia Watch’s Hospital Accountability Project at hap@georgiawatch.org or by calling (404) 525-1085. All are encouraged to join!

Many Georgia hospitals aren’t doing enough to ensure accessibility for non-English speakers, according to a report (pdf) released this week by Georgia Watch’s Hospital Accountability Project. Most hospitals throughout the state are required to follow basic language accessibility regulations set forth by Title V1 of the Civil Rights Act, the Affordable Care Act, and the Indigent Care Trust Fund.

But too many are doing the bare minimum to lower barriers for those with limited English proficiency, if anything at all. In a recent survey of more than 90 Georgia hospital websites, only about one-sixth had information on available financial aid programs in a language other than English and Spanish. In diverse communities, such as DeKalb and Gwinnett counties, many languages are common, such as Chinese, Vietnamese and Burmese.

“Not only do we need hospitals offering translated materials in multiple languages, but we would like to see greater initiative by hospitals in providing interpreters trained to assist patients from a variety of cultural backgrounds,” said Holly Lang, Hospital Accountability Project Director. “It will not only improve care but it will also help hospital bottom lines by resulting in less medical errors and duplicated or unnecessary services and tests.”

In addition to detailing language access issues at Georgia’s hospitals, the report puts forth four main policy recommendations to help lower barriers to non-English speakers. They are:

• Compliance with existing laws: Hospitals and other providers should ensure they act in accordance with existing regulations to best serve their patients and themselves. This includes the translation of all key written materials and signage indicating the availability of financial assistance and other key hospital programs and policies.
• Education of staff on language access policies and programs: Hospital and provider staff that work with patient accounts should be made familiar with policies, laws and obligations the hospital has to the patient in regards to translation and interpretation services. Hospitals should also ensure that staff who may greet a patient – such as those at an information desk – should be well-equipped to address the language needs of a patient by either being bi- or multilingual themselves or by having immediate access to adequate language services.
• Cultural competency training: Hospitals and providers should require relevant staff to undergo cultural competency training as to best equip their staff with the necessary skills and resources to adequately address the needs of patients who know a limited amount of English.
• Thoughtful community health needs assessments: Private nonprofit hospitals should make efforts to include non-English speaking populations in their tri-annual community health needs assessments, and develop appropriate programs to address that population’s particular and unique needs.

As Georgia continues to attract a growing population of residents with limited English proficiency, Georgia Watch continues to push for increased efforts on the part of hospitals to ensure all patients are made aware of their medical and financial options.

“No matter the patient’s language, hospitals have an obligation to their communities to practice fair billing practices and equal access to care,” Lang said. “All patients deserve affordable, accessible care delivered in a manner they understand.”

To access a PDF copy of the report, click here.

In an effort to improve patient safety and reduce health care-acquired infections (HAIs), Georgia Watch is joining the national Campaign for Better Care through their Healthy Hospital Initiative. This initiative will act in support of the federal Partnership for Patients, a new public-private partnership through the Department of Health and Human Services aimed at improving the quality, safety and affordability of health care for all Americans.

Central to the mission of the Healthy Hospital Initiative is to encourage Atlanta hospitals to sign a Partnership for Patients pledge. Hospitals that sign on will set goals to reduce infections and other forms of harm that too frequently occur during a hospital stay, as well as subsequent avoidable re-admissions. Hospitals will also commit to engage with patients in order to make care safer, improve provider-patient communication, and increase coordinated, patient-centered care.

Several Atlanta hospitals are already on board with these goals, among them, Piedmont Hospital, Atlanta Medical Center and Emory University Hospital.

In our role as a partner in these efforts, Georgia Watch will provide information and resources to help health care consumers better understand the issues of patient safety and allow them to more effectively engage with their providers.

“Adverse events at our hospitals can affect anyone. We commend those hospitals that have already signed the Partnership for Patients pledge, and hope more soon join their ranks,” says Holly Lang, Hospital Accountability Project Director. “We are enthusiastic to be a part of this positive partnership between consumers, hospitals and advocates.”

Patient safety has long been a priority for Georgia Watch, as 1.7 million HAIs are reported annually, affect approximately one in every 20 patients, and result in 100,000 deaths. These frightening statistics are particularly devastating to seniors and others who are most vulnerable to breaches in patient safety.

“With billions of dollars in resulting costs accrued from hospital readmission every year, patient safety is essential to ensuring both the physical and fiscal health of Georgians,” says Lang.

The Atlanta Journal Constitution published a troubling investigative article this weekend about the rising costs of hospital bills and the huge markups that have become routine at both nonprofit and for-profit hospitals. The piece includes a quote from Georgia Watch Hospital Accountability Director Holly Lang, who last year released a critical report detailing markups and charity care at metro Atlanta hospitals.

To read the AJC article, click here. For more information about Georgia Watch’s Hospital Accountability Project, click here.

The 2011 session was another slow-moving, drawn out session that has become typical in recent years. Once again, the state is facing declining revenues, which made setting a budget a difficult process. Overall, consumer-friendly measures saw little real action, while several potentially harmful measures moved quickly. Here is a wrap-up of some of the consumer issues that Georgia Watch was following in 2011.

EMC Transparency:
Rep. Wendell Willard introduced HB 316, which would require Electric Membership Corporation (EMC) board meetings to comply with Georgia’s Open Meetings law. It was sent to the House Energy, Utilities, and Telecommunications Committee. Unfortunately, the committee chair, Rep. Don Parsons (R-Marietta), decided that the bill was not important enough to receive consideration. After waiting for two weeks after the bill was introduced, he scheduled a hearing on March 10th before a hand-selected subcommittee, after receiving calls from constituents who are Cobb EMC customers.

The hearing went very well, as people testifying in favor of the bill far outnumbered the three EMC lobbyists supporting the measure. However, Rep. Billy Horne (R-Newnan), the subcommittee chair, declined to take a motion on a vote. No further action was taken on EMC transparency in 2011, but HB 316 will be eligible to move in 2011.

For further information on Georgia Watch’s position about the need for EMC transparency, click here.

Public Service Commission:
HB 216 would have allowed a majority of the five Public Service Commissioners to override the system of a rotating chairmanship with an elected chair. It was introduced by Reps. Roger Williams (R-Dalton) and Don Parsons (R-Marietta), and Public Service Commissioners Bubba McDonald (R-District 1) and Doug Everett (R-District 4) openly lobbied for the measure. Georgia Watch expressed concern about this bill because it would allow three of the five members of the PSC to effectively set the agenda, by shutting a minority out of the chairmanship, thereby further politicizing a regulatory panel that ideally should be apolitical.

The bill was assigned to Rep. Parsons’ committee and started moving in mid-February. It barely passed out of a subcommittee on a 5-4 vote, and passed the full Energy, Utilities, and Telecommunications Committee a few days later. On March 8th, it came to the floor of the House. Georgia Watch was the only organization lobbying on the legislation. Reps. Carl Rogers (R-Gainesville) and Karla Drenner (R-Avondale Estates) made speeches opposing the bill and a coalition of Democrats and mostly back bench Republicans delivered a crushing defeat to HB 216. The final vote was 60-103, 31 “yes” votes short of the required majority.

A similar piece of legislation, which also was being pushed by some members of the PSC, died in the Senate in 2009.

Ethics:
Georgia Watch was invited to join the Georgia Alliance for Ethics Reform, along with Common Cause, the League of Women Voters, and the Tea Party Patriots. The Alliance put together a number of planks in a platform to promote more transparency and accountability for politicians and lobbyists. The Alliance held a press conference the morning of Wednesday, February 16th, to announce their priorities. For full story and video of the event, click here.

The Alliance worked with Senator Josh McKoon (R-Columbus) on a comprehensive omnibus bill, but he ultimately decided against signing the legislation because of a warning from Senate leadership that it would not go anywhere. However, Sen. McKoon did get a concession: he will chair a special subcommittee of the Senate Ethics Committee that will examine the state of ethics laws in Georgia and how to improve transparency and accountability. Meanwhile, Sen. Steve Henson (D-Tucker) filed HB 248, which was co-signed by a number of Democrats. It would limit transfers between campaign accounts, cap gifts to elected officials, and extend the revolving door policy to two years. Unfortunately, this bill did not even receive a hearing. We look forward to substantive action from the legislature on this topic.

Utility Campaign Contributions:
Georgia Watch was joined by the Ethics Alliance in opposing SB 160, which was sponsored by Sen. Don Balfour (R-Snellville). This legislation would overturn a decades-old restriction in Georgia law that keeps monopoly utilities from making direct political contributions or setting up Political Action Committees (PACs) for their employees and contractors to give to. If this law were to pass, utilities could write checks to legislators and some statewide elected officials.

The point of Georgia’s current restriction on campaign contributions by monopolies is that utilities such as Georgia Power, Atlanta Gas Light, and EMCs are very powerful institutions. These entities have no competition for customers, and can take away land through the power of eminent domain. These unique powers are granted to utilities by the state, and the point is that the elected officials who can expand or restrict those powers should be insulated from the utilities that benefit from them.

Supported by a broad coalition of utilities, SB 160 passed out of the Senate Ethics Committee unanimously, and received yes votes from most Republicans and Democrats on the Senate floor. When it got to the House, the bill was amended in committee to include a provision that closed the lobbyist loophole allowing undisclosed gifts to staff employees of public officials. Georgia Watch and Georgia Alliance of Ethics Reform supported the amendment, but pushed legislators to attach the loophole fix to a less objectionable bill. (For more information about the amendment, click here). Despite widespread opposition by ethics watchdogs, the House passed the amended SB 160 by a vote of 162-8. The bill now awaits the Governor’s signature.

Health Insurance:
In an attempt to evade consumer protections on health insurance, HB 47 was introduced by Rep. Matt Ramsey (R-Peachtree City) to allow individual plans from out of state to be sold in Georgia. These plans would not have to comply with Georgia requirements on minimum coverages for certain screenings and procedures. For example, a policy could be sold from a state which does not require screenings for certain types of cancer. Someone who needs such a screening would have to pay for it out of pocket, and would be much less likely to get checked for cancer, leading to unnecessary pain and higher costs down the road.

Georgia Watch opposed this legislation and met with the bill sponsor to express our concern. By allowing out of state plans to be sold to individuals in Georgia it is substituting the consumer protections that our legislature has enacted for those of another state. HB 47 moved out of the House with opposition only from Democrats. On April 12, the Senate followed and passed the bill largely along party lines, 37-17. HB 47 now needs only the Governor’s signature to become law.

Throughout session, Georgia Watch supported an alternative approach to HB 47. Senate Bill 17 sets up a commission to look at required health insurance coverage on a case-by-case basis and make recommendations on whether each item or proposed item would be beneficial to Georgia consumers. Adopting only SB 17 would have allowed for a cost-benefit analysis of each different requirement instead of throwing them all out at once. SB 17 passed both the Senate and House easily and is awaiting signature from the Governor.

Holly Lang, Georgia Watch’s Hospital Accountability Project Director, appeared last week on GPB’s Lawmakers to discuss current health-related state legislation, as well as the impact of the new federal healthcare law on Georgians.

For more information on Georgia Watch’s Hospital Accountability Project (HAP), click here. For additional information on HAP-related legislation, click here.

A recently filed bill poses a real threat to the consumer protections that exist in the Georgia market for health insurance. House Bill 47, which was introduced by Representative Matt Ramsey (R-Peachtree City), would permit out of state insurance policies to be sold in Georgia. By allowing out of state insurance policies, we’re substituting the laws that our legislature has enacted and our insurance commissioner enforces with regulations from another state where Georgia voters have no say.

In short, this bill is nothing more than a backdoor attempt to erode consumer protections on health insurance. HB 47 threatens the economic stability of our health insurance market. While healthy individuals might move to an out-of-state plan to save a few dollars, in-state plan premiums will skyrocket in order to pay for the higher claims of a costlier insurance pool. In addition, if a consumer has a claims dispute, it is unclear whether Georgia law would apply. An aggrieved health insurance consumer might have to go to court in another state to address wrongdoing by an out-of-state insurer.

The risks posed to individuals who move to out-of-state plans are serious as well. Someone who does not have a plan that covers screenings for chronic diseases is far less likely to get checked out. Early detection is key in the fight against potentially terminal diseases, such as cancer and heart disease. Those who find out late about such a malady face a significant risk of death or disability and may be uninsurable as a consequence. In fact, the bill authors acknowledge as much in that HB 47 requires a disclosure that someone who leaves Georgia health insurance for an inferior product from out-of-state may become uninsurable as a result of not getting screenings that would not be covered in a plan from another state. Coverage for screenings is important because without it people are much less likely to catch serious illnesses in early, treatable stages. The result is a lot of unnecessary pain and much higher costs, which are often shouldered by taxpayers.

A similar measure passed the House in 2010, but was held up in the Senate after concerns were raised about a lack of coverage for key women’s health screenings. HB 47 will most likely be a polarizing piece of legislation in 2011, as there appears to be little room for compromise between opponents and supporters. We’ll keep you posted on the status of this bill during the remainder of the 2011 General Assembly.

We here at Georgia Watch are concerned about recent attempts by state leaders to scale back vital health care programs for our most vulnerable citizens at a time when they are critically needed.

The move began with Arizona Governor Brewer’s request to the federal government for a waiver from stability protections that prevent states from restricting eligibility levels for the Medicaid program. In response, Georgia Governor Nathan Deal’s spokesperson was quoted by Bloomberg news organization earlier today that while the Governor has not offered specific cuts, he “would happily work on such a proposal.”

“Rolling back eligibility among those already enrolled in our state Medicaid program essentially would strip medical coverage for those who are the youngest, oldest, and the sickest within our state,” stated Joann Yoon, Associate Policy Director for Child Health with Voices for Georgia’s Children.

“Medicaid especially is essential at a time like the present when many face unemployment, which also means a loss of employer-sponsored coverage.”

Medicaid not only provides essential health care services for vulnerable Georgians, but is also an integral part of our state’s health care economy.

“Cutting health care coverage for consumers and patients would mean more difficulty accessing primary care and managing chronic conditions, resulting in poorer health outcomes for our citizens and greater costs down the line,” stated Cindy Zeldin, Executive Director of Georgians for a Healthy Future. “These cuts also would exacerbate the economic downturn in Georgia, negatively impacting the doctors, pharmacies, and hospitals who rely on Medicaid reimbursement funds.”

We recognize that Georgia faces serious fiscal challenges and that our budget crisis warrants thoughtful and creative solutions, but we can think of no worse way to address such challenges than by opening up the floodgates to a series of cuts in health care coverage.

“We urge all Georgians to strongly oppose any efforts to weaken a system meant to be a safety net for our most vulnerable citizens,” said Holly Lang, Hospital Accountability Project Director at nonprofit consumer watchdog Georgia Watch. “We welcome the opportunity to work with Governor Deal and our lawmakers to find smarter, more efficient ways to tackle our state’s budgetary issues.”

Spurred by poor health indicators that show a need for Georgia to re-evaluate its public health priorities, the Public Health Commission recently concluded that an independent Department of Public Health should be formed, and its primary charge would be overseeing the health of all Georgians. The commission, a nine-member panel of industry professionals, was convened through an act of legislation passed in 2009, and its recommendations were presented through a report to the governor, lieutenant governor and state General Assembly.

Georgians remain near the bottom in national measures of overall health, as they have for the past forty years. Thirty Georgia counties have a life expectancy lower than 73 years, which is younger than that of individuals living in the Gaza Strip, El Salvador, the Dominican Republic and Thailand. Smoking and obesity is common among Georgians, both of which contribute to the shorter life expectancy. Georgia infants are faced with high infant mortality rates and are more likely than babies born in 45 other states to be born at a dangerously low weight.

Effective public health campaigns would address these issues; however, efforts are stymied by a cumbersome bureaucracy and shrinking budgets. Even though the state population has increased by 20 percent since 2000 and health care expenditures have increased by 100 percent, the state’s public health budget has declined by 20 percent. As it stands, the Division of Public Health is housed within the Georgia Department of Community Health, a department that to a large extent is concerned with issues of health insurance and financing. Consequently, core public health functions of assessment, policy development and assurance are not being implemented effectively.

The commission’s report included the following recommendations:

• The Division of Public Health should become an independent state agency – the Georgia Department of Public Health, which would be led by a commissioner who reports directly to the governor and would act as the state’s chief health officer. This person should be a physician, and should have extensive public health knowledge.
• The Office of Health Improvement should become part of this department, as should the Office of Emergency Preparedness and the Georgia Trauma Care Network Commission, with the last of which being an attached agency, while the other two would be wholly contained within the Department of Public Health.
• A Public Health Study Commission should be appointed every three years to study the effectiveness of public health efforts in the state. This commission will provide to the governor and the Georgia General Assembly progress reports on the health of Georgians.

Through this restructuring, public health professionals will be granted greater autonomy, enabling them to respond more quickly to crisis situations, rather than having to obtain layers of approvals in order to act. This autonomy will also allow the Department of Public Health to set appropriate priorities and craft a comprehensive mission, distinct from issues of health care finance and Medicaid. By directly reporting to the governor and having significant access to the legislature, the state health officer will have a better chance of achieving the agency’s goals. Greater visibility as an independent agency will both raise awareness of the importance of public health, as well as increase transparency.

It has often been difficult for public health to get the attention and resources necessary to raise the health indicators of all Georgians. State budgets are always tight, especially during a recession, and health care costs are escalating, including those related to Medicaid and the State Children Health Insurance Program, or PeachCare as it is known in Georgia. Most importantly, when prevention is successful, the mechanisms which safeguard public health become invisible, reducing the sense of urgency.

For example, when food remains safe, the activities involved in monitoring food supplies and enforcing safe food regulations becomes invisible. It is only when the function fails and a salmonella outbreak occurs that we remember the importance of public health functions. This “out of sight, out of mind” approach can, in turn, lead to a false reality in which both citizens and the lawmakers who represent them wrongly believe that the state of public health in Georgia is much better than statistics indicate.

But public health touches all areas of our lives, and through efforts that emphasize prevention and wellness, health will improve and disparities will decline. Effective assessment will provide for the surveillance of new or potential health concerns (such as emerging flu strains) as well as the evaluation of causes of illnesses and death (such as HIV infection and cancer), and lead to effective prevention strategies. When assessment is done well, policy recommendations that improve the health of citizens are developed. Once sound policy is proposed and, ideally, implemented, public health agencies are able to assure that our state is working to the best of its ability to ensure good health for all Georgians.

The Public Health Commission believes this is possible primarily through the establishment of the Department of Public Health. It is now up to the governor, lieutenant governor and General Assembly to agree.

On Tuesday, Georgia Watch partnered with Tift Regional Medical Center to host a consumer workshop entitled “Affording Hospital Care,” aiming to educate patients and their families on the best ways to manage their hospital debt.

Two sessions were held: a lunch session at noon and an evening session at 6 p.m. At each session, consumers were given information on the best ways to afford their hospital care and financial assistance available to them from the hospital.

Georgia Watch Hospital Accountability Project Director Holly Lang emphasized the importance of being aware of all available options.

“Medical debt is something that can affect any of us at any time. We’re excited to have the opportunity to team with Tift Regional to talk with patients and residents about ways to navigate the hospital’s financial assistance system in addition to other relevant health issues that are important to everyone, regardless of whether you have insurance,” Lang said.

Lang presented a slideshow with information on ways to help consumers minimize their costs.

Georgia Watch Deputy Director Danny Orrock also spoke and provided information on alternatives to using predatory loans to help pay for hospital visits. He stressed that such debt traps should be a last resort for paying hospital debt.

In general Orrock said to avoid title pawns because they are expensive and risky. He also warned of payday loans. Payday loans are illegal in Georgia but some lenders still offer them under various disguises. Georgia Watch is working to rid the state of payday lending for good. You can help by reporting payday lenders to your District Attorney and Georgia Watch.

In addition, Georgia Watch Consumer Outreach Director Ashley Wilson spoke about the Low Income Home Energy Assistance Program (LIHEAP). LIHEAP assists low income households who use a large amount of their income to pay for energy. For more information on LIHEAP, click here.

If you’d like to read more about the workshop, The Tifton Gazette covered the event. You can find the article here.

Last Tuesday, a ballot measure that would have infused an estimated $80 million into the state’s trauma network failed by a narrow margin – 53 percent to 47 percent.

Passage of this measure would have dedicated funding from annual car tag fees to beefing up emergency care at hospitals around our state. The proposed amendment to our state’s constitution would require a $10 fee to be included with other charges during annual registration of certain motor vehicles. The failure of this amendment’s passage could tip the balance between life and death for any Georgian.

Each year, in our state, about 40,000 cases of major trauma occur, each needing high-level care that is only available at certain accredited facilities. Of those 40,000 trauma cases, an estimated 700 Georgians will die because that crucial elevated degree of care wasn’t available in time. For those in south Georgia, the chance of survival in the aftermath of a traumatic injury is even more narrow given that the pursuit of appropriate medical attention is truly a race against the clock. There are very few trauma centers south of Macon, and it becomes nearly impossible for a patient to receive care within the “golden hour” – the first 60 minutes following a traumatic injury that can determine whether a patient lives or dies. For children, that window of time is only a grim 30 minutes.

While it is easy to assume that every hospital emergency room is equipped to handle traumatic injuries, unfortunately that is not the case. The reality is that the vast majority of Georgia hospitals are ill – equipped to handle traumatic injuries. There are more than 150 acute care hospitals in Georgia but only 16 of those hospitals have trauma centers. Of those 16, only four – located in Atlanta, Macon, Augusta and Savannah – are Level I certified, meaning they are best able to handle the most daunting injuries. There are ten Level II centers, no Level III centers and two Level IV centers.

In short, Georgia’s existing trauma system is woefully inadequate.

Many came out in support of the amendment’s end goal to improve emergency care in Georgia. While acknowledging the need for additional funding to support and expand the state’s trauma network, the oft-quoted objection labeled Amendment 2 simply as a tax, claiming the state should instead allocate funds to this effort. But in a state that already has such deep holes in its budget, it’s unclear how the state would find the money to fund trauma efforts. To many, an effort such as Amendment 2 was one of the only real viable options.

Trauma care should be a priority. Hopefully, the failure of Amendment 2 won’t be seen by lawmakers as a sign of voters’ disinterest in supporting a trauma network, and future efforts will emerge to help this important cause. Georgia Watch will continue to work to make timely and necessary emergency care accessible for all Georgians.

Georgia Watch and Tift Regional Medical Center have joined together to sponsor “Affording Hospital Care,” a free consumer workshop to be held on Tuesday, November 16 at the Neighborhood Services Center in Tifton.

The event aims to empower consumers on how best to approach a hospital visit and keep in check rising healthcare costs. Also at the workshop, consumers will learn the latest health news, including the potential impact of the recently passed federal healthcare law.

“Medical debt is something that can affect any of us at any time,” Georgia Watch Hospital Accountability Project Director Holly Lang said. “We’re excited to have the opportunity to team with Tift Regional to talk with patients and residents about ways to navigate the hospital’s financial assistance system in addition to other relevant health issues that are important to everyone, regardless of whether you have insurance.”

At the event, Lang and Georgia Watch deputy director Danny Orrock will discuss how to: navigate hospital financial assistance programs; discover additional cost-saving options that make hospital expenses more manageable; and avoid predatory lending and high-interest loans for medical expenses. Representatives from Tift Regional will be on hand to answer questions about bills and any other inquiries related to financial services.

The day will be broken into two workshops: a lunch session at noon and an evening session at 6 p.m. The event is free and open to the public, and includes a complimentary meal. Seating is limited so advance registration is recommended. Register online at Tift Regional’s website in the “Calendar of Events” section (click here) or call 229-353-6318 or toll free 800-648-1935, ext. 6318.

The Neighborhood Services Center is located in Tifton at 2731 South Central Avenue, immediately near the Tifton Community Health Center.

About Tift Regional:

With a reputation as an innovative provider of quality care, Tift Regional Medical Center is a not-for-profit, 191-bed regional hospital serving 12 counties in South Central Georgia.  Located in Tifton, the hospital’s medical staff includes more than 95 physicians with the majority board-certified in over 30 specialties. Tift Regional provides a wide-range of services, including six Centers of Excellence offering advanced, expert care in oncology, cardiology, neurology, surgery, women’s health and emergency medicine.

On November 02, Georgia voters will be asked to choose whether the state constitution should be amended to require an annual $10 fee for certain motor vehicles, with an estimated $80 million in resulting revenues to go directly to fund trauma centers across the state. With Georgia leading the nation in unemployment and bankruptcy, increased fees of all kinds are receiving extra scrutiny from citizens struggling to make ends meet. In deciding how they will cast their vote on Amendment 2, some voters may be asking, “Why is this important for me and my family?”

While it is easy to assume that every hospital emergency room is equipped to handle traumatic injuries, unfortunately, that is not the case. In short, Georgia’s existing trauma system is woefully inadequate. An infusion of resources is vital if the state wants to improve emergency care and save countless lives. There are, on average, 40,000 cases of major trauma that occur in Georgia each year. Of that number, an estimated 700 Georgians lose their lives every year as a direct result of our state’s weak trauma network, a figure that is 20 percent above the national average.

The reality is that the vast majority of Georgia hospitals are ill-equipped to handle traumatic injuries. Of the 152 acute care hospitals in Georgia, only 15 have trauma centers. Of those 15, only four—located in Atlanta, Macon, Augusta and Savannah—are Level I certified, meaning they are best able to handle the most daunting injuries. The importance of access to a Level I trauma center cannot be underestimated; a patient’s chances of survival improves by an estimated 20 to 25 percent when treated at a Level I trauma center.

Particularly for those in southwest Georgia, care for a life-threatening injury is truly a race against the clock, as the first 60 minutes following a traumatic injury are the most crucial in determining a life or death outcome. For children, that window of time is only a grim 30 minutes.

“Many Georgians live at least two hours away from the closest trauma center,” said Michelle Putnam, executive director of HealthSTAT, an Atlanta-based nonprofit health advocacy organization. “Realistically, we need 30 trauma centers in our state, staffed with trained nurses and specialty physicians that are able to handle serious traumatic accidents. Every county needs enough ambulances and emergency medical technicians and the ability for them to communicate with each other. However, we currently have no sustainable source of funding that’s dedicated solely toward establishing a statewide trauma network, which is why passing Amendment 2 is so important.”

There is some understandable concern among voters about where the funds received through Amendment 2 will go and whether the standard of trauma care in Georgia will actually improve. Generally, when Georgia’s state legislature passes a law that generates revenue, the collected money goes straight into Georgia’s general fund. For better or worse, the general fund depends on political compromise and is distributed as legislators see fit. Fortunately for Georgians, Amendment 2 gives voters the chance to bypass this option and amend the state constitution, creating a dedicated funding source that isn’t subject to party politics. When the Georgia constitution indicates a specific use for state funds, those funds must be used for that purpose alone. Georgians wondering if their money will help save lives can know with certainty that every cent will be used to build up the state’s trauma care capacity.

When you vote on November 02, you will be asked, “Shall the Constitution of Georgia be amended so as to impose an annual $10.00 trauma charge on certain passenger motor vehicles in this state for the purpose of funding trauma care?” If Amendment 2 passes, it means that upgrades at hospitals across the state will be fully funded to help protect the lives of people who have been critically injured. When you go to the polls, Georgia Watch and the Hospital Accountability Project urge you to consider the value and importance of a statewide trauma network for the relatively small price of $10.

For a full interview with Michelle Putnam on trauma care in Georgia, check out the Georgia Watch Hospital Accountability Project website by clicking here.

“The very existence of the caps, in any amount, is violative of the right to trial by jury,” wrote Chief Justice Carol Hunstein. “[The cap] clearly nullifies the jury’s findings of fact regarding damages and thereby undermines the jury’s basic function.”

The ruling effectively struck down the centerpiece of Georgia’s sweeping 2005 tort reform law, Senate Bill 3, which capped noneconomic awards – including those for pain and suffering – at $350,000.

At the time SB 3 passed, supporters said it would reduce medical malpractice insurance premiums and attract doctors from across the country. However, between 2005 and 2008, premiums fell only 7 percent and the number of physicians per capita remained essentially the same.

“In simplest terms, SB 3 limited accountability for medical negligence and padded the profit margins of large insurers,” said Georgia Watch executive director Angela Speir Phelps. “This ruling stops the government from trampling on the rights of malpractice victims and our citizen juries.”

The court’s decision upholds a $1.265 million jury award to Betty Nestlehutt, a Marietta real estate agent. Nestlehutt, now 75, was left permanently disfigured after a plastic surgeon with Atlanta Oculoplastic Surgery botched what should have been a routine face-lift procedure. Nestlehutt was so severely injured that her lawyer, Adam Malone, said she had trouble leaving her house.

Nestlehutt was awarded $900,000 for pain and suffering by a Fulton County jury. Atlanta Oculoplastic Surgery appealed that amount on grounds that it violated SB 3. The trial judge sided with the jury award and declared the $350,000 cap unconstitutional, setting the stage for the high court ruling.

Georgia Watch deputy director Danny Orrock says the Supreme Court decision protects patients and their constitutional rights.

“It restores the promise of justice for all and the rights of all Georgians – young and old, rich and poor – to access the courts,” says Orrock.

The Nestlehutt decision likely means legislators will renew efforts to impose restrictions on malpractice victims. Lawmakers are already discussing the possibility of a constitutional amendment addressing caps on damages, similar to one Texas passed in 2003.

In any case, much of SB 3 remains intact. The Supreme Court has recently upheld two key provisions of the law. The first makes it nearly impossible for patients to recover damages in cases involving emergency room care by requiring that no physician or health care provider shall be held liable unless it is proven by clear and convincing evidence that the physician or health care provider’s actions showed gross negligence. The second forces the losing side in a lawsuit to pay the other side’s legal fees, a practice that can discourage victims from bringing legitimate claims to court.

Georgia Watch remains strongly opposed to any legislation that impedes access to the courts, including measures that limit the amount an attorney can collect from a settlement.

We remain firmly committed to protecting malpractice victims and fighting for greater access to the courts.

When you think about health care, the US Internal Revenue Service might not spring to mind. But the IRS took an important step last month that could make health care more affordable for millions of Americans, including many right here in Georgia. The agency began a process, established by the Affordable Care Act, to improve protections for consumers who get care at nonprofit hospitals throughout the country, including the more than 120 here in Georgia. Whether they follow through depends on us and Georgia’s congressional leaders.

Nonprofit hospitals serve a critical and unique role. Federal law exempts these hospitals from taxes. In
exchange, they are expected to provide health services that benefit the community. One example is
charity care: by providing necessary care at little or no cost to the uninsured and others who cannot
afford to pay, they protect everyone’s health. The IRS is charged with overseeing these “community
benefits.”

But until the recently-enacted Affordable Care Act, the IRS had never set clear and concrete standards
for acceptable community benefit policies. The consequence: some hospitals with a strong
commitment to serving the public invest in protecting consumers, while others that enjoy the same tax
benefit are not delivering the same public benefit. In fact, IRS data shows that only 25 percent of
nonprofit hospitals are providing 80 percent of the nation’s charity care.

The least-conscientious hospitals actually employ policies that can harm consumers. Some of the most
egregious: charging uninsured and self-pay patients as much as triple what they charge insurance
companies for the same care; requiring significant out-of-pocket payments before providing treatment;
employing aggressive collection practices like property liens or garnishing wages; selling consumers’
debts to other lenders who charge interest rates as high as 18 percent; and, failing to direct the
uninsured and underinsured to Medicaid or the hospital’s own financial assistance programs.

For example, in a recent survey of 24 nonprofit hospitals in the immediate metropolitan Atlanta area,
only 11 had signage up that even indicated financial assistance was available. Such signage is required
by Georgia’s Indigent Care Trust Fund. For less than half of these hospitals to be in compliance with
state regulations is unacceptable.

These unfair practices contribute to one of the leading causes of personal bankruptcy – medical debt.
And with the recession costing Americans both jobs and health insurance at an alarming rate, the need
for affordability and fairness is greater now than ever.

We commend the IRS for initiating the process with a request for input on appropriate standards for
charity care. But we note that this is just the beginning; the stakes are too high to allow this important
reform to become delayed or derailed.

We challenge the IRS to swiftly institute regulations that meets three key consumer protection criteria.
First, it must ensure that there are clear charity care guidelines and streamlined application processes
available for its patients. Second, it must require hospitals to help consumers make informed decisions
by notifying them – in every case – when charity care is available. Third, it must promote affordability,
by requiring that hospitals charge uninsured and other self-pay patients no more than they would
charge Medicare for the same care.

Our leaders in Congress will be home in Georgia during the August congressional recess. Whether it is
through town meetings, consumer group forums or other public debates, families need to know that
their leaders in Washington are playing a leadership role to make health care more affordable.

The IRS has gotten this important process off to a strong start, but we can’t stop here. We must push
for a final rule that ensures you can depend on nonprofit hospitals to deliver the care you need on fair
terms, at an affordable price that is accessible to all.

The findings are the result of an 18-month study through the organization’s Metropolitan Atlanta Hospital Accountability Project, or HAP, which focuses on financial aid programs for low-income, uninsured and underinsured patients at general hospitals in the 21-county metro area. National nonprofit advocacy organization Community Catalyst, a national not-for-profit, provides funding for this project.

In its research, Georgia Watch representatives visited all hospitals studied to see if signage was posted advertising the availability of free or reduced cost care, and if financial assistance policies were made available to the public. In addition, the HAP team surveyed 900 low-income, uninsured, or underinsured individuals about their financial experiences at area hospitals. HAP collaborated with coalition partners WonderRoot, Concerned Black Clergy and area clinics to conduct the interviews, which were conducted in both English and Spanish.

Among the findings of the research:

· In 2008, metropolitan Atlanta hospitals marked-up their costs an average 235 percent increase, though price hikes at some facilities reach as high as 714 percent;

· That year, the two most expensive hospitals in the metropolitan area were North Fulton Medical Center and Cartersville Medical Center, and the two most affordable were Walton Regional Medical Center and Grady Memorial Hospital;

· Grady Memorial Hospital and Barrow Regional Medical Center provided the highest level of free care for poor people, while Piedmont Hospital and North Fulton Medical Center were among those who provided the least;

· Only a little more than one-third of the 34 hospitals examined had clear signage placed at some part of the hospital advertising the availability of free or reduced-cost care for uninsured and/or low-income persons;

· Eighty percent of the approximately 900 consumers surveyed for this project said they had no form of insurance, and two-thirds of those individuals said they had no regular source of care; and,

· 72 percent of the consumers surveyed who identified themselves as underinsured said they often delay preventive and other care due to the fear of the cost, as they are uncertain whether they can pay their part of a hospital bill.

“Hospitals owe to their communities access to care and fair billing practices, no matter your income level,” said Holly Lang, Hospital Accountability Project Manager. “Through programs that help lower barriers to health care access and by advertising the availability of available financial assistance, hospitals give consumers the chance to better their physical – and fiscal – health.”

While all hospitals should maintain the patient’s best interest, the report discusses the unique obligations of nonprofit hospitals, which are obligated through their tax-exempt status to provide services meant to boost its area’s health through community benefit programs.

“Nonprofit hospitals have an even heightened responsibility to its community, as they are exempt from many of the taxes most companies and individuals pay,” Lang said. “We want to see these hospitals using our forgone tax dollars in a way that helps all patients, especially those vulnerable because they are uninsured, underinsured or live on a limited income.”

Nonprofit hospitals Piedmont Hospital and Henry Medical Center stood out among area hospitals for providing the least amount of free care – less than a fourth of what a nearby for-profit hospital provided.

The report also notes the barriers that patients are facing once they step into a hospital.

“Too many facilities aren’t mentioning available financial aid programs, and many don’t have staff on hand to serve non-English speaking patients,” Lang said.

Also included in the report are policy recommendations, which include increased oversight of hospitals participating in state and federal programs, as well as requiring appropriate financial counseling and fair patient billing practices.

Data found in the report, such as statistics and hospital charity care offerings, comes from publicly available sources, such as the Department of Community Health and Internal Revenue Service filings, as well as Centers for Medicaid and Medicare Services and Kaiser Family Foundation.

Click here to read the report.