Georgia senators seek to base health payments on outcomes
Budget writers in the Georgia Senate want to take a different approach to spending on health care and mental health, saying they want to base payments on outcomes. That could spark debate with a House pushing for significant hikes in mental health spending.
The Senate Appropriations Committee on Wednesday approved its version of the state budget for the year beginning July 1. It would spend $53 billion overall, including $30.2 billion in state tax money and $17.7 billion in federal money.
The full Senate could vote on the budget as early as Friday, but differences will have to be settled in House-Senate negotiations before the measure can get final approval and go to Gov. Brian Kemp for his signature or veto. Those talks are likely to last until nearly the April 4 end of this year’s General Assembly session.
Many of the biggest items show no change from the House proposal. The document would continue $2,000 raises for teachers and $5,000 raises for state employees and lawmakers that will begin April 1. The 2023 budget also would pay the first cost-of-living increase in 14 years to retired state employees who draw pensions from the Employees Retirement System.
But the Senate strikes additional pay raises the House had proposed for nurses and other workers at mental hospitals, and reduces planned payments aiming to boost guard salaries at private prisons that hold Georgia inmates. It also would decrease additional House-proposed raises for prosecutors and public defenders.
The Senate would also cut a $10 million plan for a new behavioral crisis center, instead directing that existing funds be used to bring 92 beds online at Georgia Regional Hospital in DeKalb County.
Senators instead propose spending $18 million more on community service boards, the state’s local mental health providers, by rewarding them for good treatment outcomes according to metrics set by Gov. Brian Kemp’s administration.
“When we invest in mental health, taxpayers demand we provide outcomes to support mental health stability,” said Senate Appropriations Committee Chairman Blake Tillery, a Vidalia Republican.
Along the same lines, the Senate would spend $46 million more in state money to reward quality outcomes in the Medicaid program, an increase that would rise to $137 million once federal money is factored in.
Tillery said senators also want to set aside $28 million to reward K-12 schools that increase reading proficiency among third graders.
The Senate would further increase funding for programs designed to help people with disabilities avoid being sent to a nursing home or a group facility. The state normally adds about 100 slots each year to the program, which advocates say has a waiting list around 7,000 people. The House proposed 325 new slots, and Tillery said the Senate would propose 513 new slots, which he said is the maximum amount of new slots that could be created right now by disability support providers. The boosted commitment means the state would add $10.3 million to the program next year.
Senators would take another stab at pushing the Georgia Bureau of Investigation to reopen a medical examiner’s lab in Macon. South Georgia counties continue to push for such a move because of the additional time and expense it takes to transport bodies to Atlanta for autopsies. The Senate budget sets aside $2.8 million that GBI wants to use to hire three medical examiners and 13 other employees and says it can only be spent in Macon.
The Senate also seeks to shift $2.4 million to create a pay ladder for state troopers, addressing problems with trooper salaries topping out and then staying flat. Senators would slash plans to hire more troopers for the agency’s SWAT team and DUI enforcement unit, though.
Also, senators are proposing big changes to tuition equalizations grants, a subsidy for Georgia residents who attend private colleges in the state. Now, every Georgia resident who attends is eligible for $825 a year. Senators would go along with a House plan to boost that amount to $900 a year for current students, letting them continue on the current program. But the Senate would cut off the existing program for new students next year and instead subsidize students studying engineering, nursing and computer science, as well as K-12 teaching in science, technology, engineering and math.
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