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Lawmakers scramble for ideas on how to improve health care in rural Georgia
House Speaker Jon Burns addresses the House Rural Development Council at Georgia Southern University in Statesboro. (Credit: Office of the Speaker)
The Gist
The challenges in getting health care to rural Georgians are myriad. Hospital closings; shortages of doctors, dentists, nurses and mental health professionals; shorter life spans and higher rates of chronic illnesses and uninsured residents are just a partial list of the roadblocks residents face.
On Wednesday, state lawmakers heard from experts from across the health care spectrum about those challenges and how to deal with them.
“We’re at a crossroads in our health crisis in the state of Georgia,” Rep. Gerald Greene, co-chairman of the House Rural Development Council, told State Affairs.
The council is holding two days of hearings at Georgia Southern University in Statesboro. Thursday’s session focuses on child welfare and mental health, and juvenile justice.
What’s Happening
Rural Georgians are getting older, have few medical care options and spotty health care coverage. Those problems prompted the late House Speaker David Ralston and other state lawmakers to create the House Rural Development Council in 2017. The bipartisan council’s main goal is to focus on the needs and concerns of Georgia’s 120 rural counties.
Among those rural counties, 73 were in the bottom half for health outcomes and 74 were in the bottom half for health factors, Cindy Zeldin, vice president of Health Policy and Government Affairs at Georgia Health Initiative, told the council.
Rep. Penny Houston, an ex-officio member of the council, offered a pragmatic solution. “We’ll never get a hospital in every county. I don’t think the people realize how few people we have in some of these counties," said Houston, who lives in Nashville, a community of just under 5,000. “If we’re ever going to get service, we’re going to have to combine some rural counties because you cannot run a rural county with 3,000 people. I’m sorry, you can not.”
Measuring Success
Nonetheless, council members heard a number of initiatives making inroads to improving access to health care in rural Georgia. Among them:
The Two Georgias Initiative. This is a five-year, $10 million commitment in 11 rural communities. The program, (formerly the Healthcare Georgia Foundation ), enables communities to identify health issues they want to work on and then lead their own efforts locally. The Two Georgias program was created by the Georgia Health Initiative (formerly the Healthcare Georgia Foundation ). “What the foundation provided was structure, funding and resources to support the work that they decided was most important,” Zeldin said.
Rural Hospital Tax Credit. Last year, lawmakers expanded the tax credit to $75 million from $60 million. The state still has more than $2 million to be used before the credit ends in December 2024. The credit has helped numerous hospitals buy new, state-of-the-art equipment because of the tax credits. The credits have also helped hospitals to establish new programs, such as the radiation oncology program at Colquitt Regional Medical Center. Patients used to have to drive over 200 miles for radiation services, Anna Adams, executive vice president of the Georgia Hospital Association said.
More doctors and workers. Augusta University’s Medical College of Georgia enables students to complete medical school in three years instead of four, Dr. David Hess, dean of the medical college said. Peach State Scholars Program pays tuition for the students if they practice a primary care specialty in an underserved area in Georgia, after finishing a residency program in the state.
Officials at health care provider Kaiser Permanente urged the council to consider a program used in Virginia where military veterans with medical skills are placed in communities in need of health care professionals. Virginia has hired 564 vets — with additional post-military training — since launching its program in 2017.
More telehealth. Patients who used to have to go to large area hospitals for medical services now are staying in their communities with the help of telehealth programs. A hospital in Candler County used to see four to five patients a day, but telehealth has allowed it to increase that number to 20-25.
Why It Matters
The hearings follow a state Chamber of Commerce report released this month that found 80% of new jobs in Georgia and $20 billion of investments went to rural communities in the last year.
“The health crisis that we have in the rural areas is something that is a problem to all the rural legislators and to the state as well,” Greene told State Affairs.
The council is one of three legislative subcommittees meeting in Statesboro this week. The meetings will help lawmakers devise recommendations and solutions to present to the Legislature when it reconvenes in January. The House Study Committee on Fishing Access to Freshwater Resources, and the House Formula Funding & Program Access and Delivery Ad Hoc Committee are the other committees meeting in Statesboro.
What’s Next?
This week’s Rural Development Council gathering is the second of three key meetings it’s slated to hold. The council’s next meeting will be in Athens in November. “I look forward as we get ready to go into the 2024 session in just a very few months to receiving and reviewing this council’s recommendations at the end of this year,” House Speaker Jon Burns told the group Wednesday.
Health care in rural Georgia: By the numbers
Available doctors and hospitals
Physician per 100,0000 residents (statewide): 232
Physician per 100,000 resident ratio (non-rural): 217
Physicians per 100,000 residents (rural counties): 73
Counties designated as having a shortage of primary care physicians: 89
National ranking in active doctors and primary care physicians: 40th
Rural hospitals in Georgia at risk of closing: 26
Georgia’s uninsured
Uninsured adults (18-65 years old): 18%
Uninsured adults in nonrural counties: 18.5%
Uninsured adults in rural counties: 21%
Uninsured children (under 19 years old): 6.6%
Uninsured children in nonrural counties: 6.6%
Uninsured children in rural counties: 7.7%
Sources: Georgia Health Initiative; Georgia Council on Aging; Georgia Board for Healthcare Workforce, 2020; Georgia Board for Physician Workforce, HRSA; Georgians for a Healthy Future.
Have questions, comments or tips? Contact Tammy Joyner on X @lvjoyner or at [email protected].
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Header image: House Speaker Jon Burns addresses the House Rural Development Council at Georgia Southern University in Statesboro. (Credit: Office of the Speaker)
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Global bird flu disrupts Georgia exports, costing chicken producers millions
ATLANTA — A global bird flu that has rapidly spread from birds to dairy cows, milk supplies and humans has cost untold millions of dollars in lost export business in Georgia, the nation’s leading poultry producer, officials with the state Department of Agriculture and poultry industry said.
Georgia has had only three reported cases of H5N1 avian influenza since it reemerged in 2022. The last of those cases was resolved in November 2023 but ramifications of those outbreaks continue to have a big effect on the state’s ability to export chicken and chicken parts, such as chicken feet, to different countries, including China, one of Georgia’s biggest export markets for chicken feet.
In 2022, frozen chicken feet, for example, accounted for more than 85% of all U.S. poultry exported to China, according to Farm Progress, publisher of 22 farming and ranching magazines.
The $30 billion poultry industry is Georgia’s largest segment in its No. 1 industry — agriculture.
China has also placed a ban on the import of chicken products from 41 other American states. The ban on Georgia products went into effect Nov. 21, 2023. Efforts to reach the Chinese Embassy in Washington, D.C. were unsuccessful.
Georgia Poultry Federation President Mike Giles estimates the state’s loss at “well into the millions of dollars.”
“It’s a significant amount in a significant export market for us,” he said. “Poultry paws [feet] immediately lose value because of the loss of demand.”
The ban has forced Georgia poultry producers to find alternative markets for their products that would normally be headed to China.
“Some are sold domestically, some are frozen and stored, hopefully to find markets later on, and some go to other countries,” Giles said.
This isn’t the first time China has banned U.S.-produced poultry products due to a bird flu outbreak. The country instituted a ban in January 2015 which lasted until November 2019 — even though U.S. poultry products were deemed free of the disease by August 2017.
After that ban was lifted, China’s appetite for American-produced chicken products became voracious.
In 2022, U.S. producers shipped nearly $6 billion in poultry meat and related products (excluding eggs) to over 130 countries. China has emerged as the second largest destination for U.S. poultry exports, increasing from $10 million in 2019 to a record $1.1 billion in 2022, according to Southern Ag Today.
Chicken paws, for instance, are eaten in many Asian countries, including the Philippines, Thailand, Indonesia and Korea.They can also be found on Chinese dim sum menus throughout the U.S. and are also popular in Jamaica, Trinidad, Russia and Ukraine in everything from soups and curries to fried snacks.
Three Georgia counties have reported H5N1 outbreaks since 2022. The most recent case was late last year. Henry, Sumter and Toombs counties each reported one case of H5N1 bird flu. Those outbreaks are resolved, poultry and state agriculture officials say.
“When HPAI cases are found in any state, that state is given a designation that could lead to foreign countries halting trade on poultry products from that state,” Georgia Department of Agriculture spokesman Matthew Agvent told State Affairs.
Not since 2016 has the United States experienced such a fast-moving case of the H5N1 avian influenza. In the last two months, the virus has spread in parts of the United States from birds to dairy cows, some milk supplies and humans. Two people — a Texas dairy worker and a prison inmate in Colorado who was killing infected birds at a poultry farm — are reported to have caught the virus, according to news reports. The outbreak is the largest in recent history, impacting both domestic poultry and livestock as well as wild birds and some mammal species.
State officials are continuing to monitor the national outbreak and its impact on Georgia.
Georgia’s poultry & egg industry: At A Glance
Annual economic impact: $30.2 billion
Percentage of the Agriculture industry: 58% *
Jobs: 87,900
Counties involved in poultry & egg production: 3 out of 4
National ranking in chicken broiler production: No. 1
Daily production of table eggs: 7.8 million
Daily production of hatching eggs: 6.5 million
Pounds of chicken produced daily: 30.2 million
Pounds of chicken produced annually: 8 billion
Number of chicken broilers processed each day: 5 million
Counties involved in poultry & egg production: 3 out of 4
Source: Georgia Poultry Federation; The Center for Agribusiness & Economic Development, University of Georgia, Ag Snapshots 2024; Georgia Poultry Federation.
Have questions? Contact Tammy Joyner on X @lvjoyner or at [email protected].
Is it safe to eat chicken and eggs and drink milk? Answers to your most pressing questions about the latest bird flu outbreak
A two-year-old strain of bird flu has heightened concerns in Georgia and the rest of the country after the virus recently spread to dairy cows. Here’s what you need to know about the virus and its impact on Georgia and the rest of the country. What are the symptoms of this flu in humans? Eye …
Kemp signs bills on education, health care, taxes
Gov. Brian Kemp signed a slew of bills over the past week or so, including the private school voucher bill long sought by Republicans and a bill that will ease regulations over the construction and expansion of medical facilities in rural areas.
His bill-signing events were clustered into themes: education, health care, military members, human trafficking and Georgia’s coastal communities.
Education
Among the education-related bills Kemp signed was Senate Bill 233, also known as the Georgia Promise Scholarship Act, which provides the families of Georgia students enrolled in underperforming school districts with $6,500 scholarships that can be used toward private school or homeschooling expenses, including tuition, fees, textbooks and tutoring.
“Georgia is affording greater choice to families as to how and where they receive their education, while also continuing our efforts to strengthen public schools, support teachers, and secure our classrooms,” Kemp said, and thanked leadership in the House and Senate for prioritizing passage of the bill, which had failed in a close vote in 2023.
Democrats and many public education advocates who opposed the bill argued it will drain resources from public schools and primarily benefit students from wealthy families.
Kemp also signed Senate Bill 351, sponsored by nine Republican senators, which will require social media companies, as of July 1, 2025, to verify their users are at least 16 years old unless they receive approval from a parent.
House Bill 409, sponsored by Rep. Lauren Daniel, R-Locust Grove, directs school systems to consider not having bus stops where a student would have to cross a roadway with a speed limit of 40 mph or greater. The bill also increases the penalty for passing a stopped school bus to $1,000 from $250.
Kemp noted that Ashley Pierce, the mother of Addy Pierce, an 8-year-old who was fatally struck by a motorist as she boarded her school bus, “passionately advocated for and was instrumental in the passage of this legislation.”
Senate Bill 395, sponsored by Sen. Clint Dixon, R-Gwinnett, states that no school visitor or personnel can be prohibited from possessing an opioid reversal drug such as Narcan and directs schools to maintain a supply. It also allows opioid antagonists to be sold in vending machines and directs certain government buildings to maintain a supply of at least three doses.
Senate Bill 464, also sponsored by Dixon, creates the School Supplies for Teachers Program to financially and technically support teachers purchasing school supplies online. It also creates an executive committee of five voting members within the Georgia Council on Literacy and limits the number of approved literacy screeners to five, one of whom must be available to schools for free.
Health care
The governor chose his hometown of Athens as the venue to sign several bills aimed at improving health care in rural and underserved communities.
Among them was House Bill 1339, sponsored by Rep. Butch Parrish, R-Swainsboro, which revises the Certificate of Need process by which the state determines if and how new medical facilities can be built or expanded. The bill provides for several new exemptions, including psychiatric or substance abuse inpatient programs, basic perinatal services in rural counties, birthing centers and new general acute hospitals in rural counties. It also raises the total limit on tax credits for donations to rural hospital organizations to $100 million from $75 million.
Senate Bill 480, sponsored by Sen. Mike Hodges, R-Brunswick, establishes student loan repayments for mental health and substance use professionals serving underserved youth in the state or in unserved geographic areas disproportionately impacted by social determinants of health.
House Bill 872, sponsored by Rep. Lee Hawkins, R-Gainesville, chair of the House Health and Human Services Committee, expands cancelable loans for certain health care professionals to dental students who agree to practice in rural areas.
Senate Bill 293, sponsored by Sen. Ben Watson, R-Savannah, chair of the Senate Health and Human Services Committee, reorganizes county boards of public health and opens the qualifications for the CEO of each county board of health to include either licensed physicians or people with a master’s degree in public health or a related field.
Military members and veterans
Kemp on Wednesday focused on bills to improve military recruitment and provide more work opportunities for veterans and military family members.
House Bill 880, sponsored by Rep. Bethany Ballard, R-Warner Robins, allows spouses of military service members to work under a license they hold in good standing in another state while under the supervision of an existing Georgia medical facility or provider.
Senate Bill 449, sponsored by Sen. Larry Walker, allows military medical personnel to practice for 12 months while a license application is pending, including working as a certified nursing aide, certified emergency medical technician, paramedic or licensed practical nurse. The bill also creates a new advanced practice registered nurse license and makes it a misdemeanor to practice advanced nursing without a license.
Human trafficking
The governor on Wednesday was accompanied by first lady Marty Kemp and other members of the GRACE Commission for the signing of an anti-human trafficking package. It includes Senate Bill 370, which adds certain businesses to the list of organizations that must post human trafficking notices, including convenience stores, body art studios, businesses that employ licensed massage therapists and manufacturing facilities.
Sponsored by Sen. Mike Hodges, R-Brunswick, the bill also allows the Georgia Board of Massage Therapy to initiate inspections of massage therapy businesses and educational programs without notice and requires massage therapy board members to complete yearly human trafficking awareness training.
House Bill 993, sponsored by Rep. Alan Powell, R-Hartwell, creates the felony offense of grooming of a minor and creates new penalties for offenses relating to visual mediums depicting minors engaged in sexually explicit conduct.
House Bill 1201, sponsored by Rep. Houston Gaines, R-Athens, allows human trafficking survivors who received first offender or conditional discharge status to vacate that status for certain crimes, as long as the crime was a direct result of being a victim of human trafficking.
Coastal communities
Earlier today in Brunswick, Kemp signed legislation impacting Georgia coastal communities, including House Bill 244, which amends the laws around how wild game can be hunted and how seafood dealers operate, and House Bill 1341, which designates white shrimp as the state’s official crustacean.
Taxes
Earlier this month Kemp signed several bills related to taxation, including House Bill 1015, sponsored by Rep. Lauren McDonald, R-Cumming, which lowers the state income tax for tax year 2024 to 5.39%, accelerating a multiyear drop in state income taxes that started at 5.75% in 2023 and will continue through 2029.
The Governor’s Office of Planning and Budget estimates the tax cut acceleration will save Georgia taxpayers approximately $1.1 billion in calendar year 2024 and about $3 billion over the next 10 years.
Kemp also signed House Bill 1021, sponsored by Rep. Lauren Daniel, R-Locust Grove, which increases the state’s income tax dependent exemption to $4,000 from $3,000.
House Bill 581, sponsored by Reps. Shaw Blackmon, R-Bonaire, and Clint Crowe, R-Jackson, enables a constitutional amendment (House Resolution 1022) to let voters decide whether counties can provide a statewide homestead valuation freeze, which limits the increase in property values to the inflation rate.
The governor has until May 7 to sign or veto bills passed during the legislative session that ended on March 28. Those he takes no action on will automatically become law.
Legislation signed by Kemp is posted on the governor’s website.
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Incumbent candidates for local, federal races likely to be no-shows at this weekend’s primary debates
ATLANTA — One of Georgia’s prominent media organizations is pleading with incumbent state and congressional candidates to participate in its primary election debates slated for Sunday.
For the first time in The Atlanta Press Club’s 30-year debate history, incumbents facing challengers in the May 21 primary have either declined or not yet committed to participating in the organization’s well-known debate series. The possible no-shows include candidates in four Congressional races as well as the Georgia Supreme Court, and the Fulton County District Attorney races.
“This is the first time that we’ve had so many [incumbents] not participate,” debate organizer Lauri Strauss told State Affairs. Strauss declined to speculate why candidates aren’t participating.
Hoping to encourage more participation, the organization issued the following statement:
“The Atlanta Press Club believes it is the responsibility of people running for public office to answer questions from their local media that will help inform voters before they cast their ballots. If a candidate is running for public office, the candidate should be willing to participate in the democratic process, which includes attending debates and fielding questions from journalists and opponents.”
Candidates have until Friday to RSVP.
Strauss said candidates who fail to appear will be represented on stage by an empty podium during the debate.
District Attorney Fani Willis has declined to participate and Democratic U.S. Reps. Lucy McBath and David Scott have yet to RSVP. Strauss said the organization is still in talks with Georgia Supreme Court Justice Andrew Pinson’s staff about his appearance in the debate.
Willis, declined earlier this week to participate, citing constraints around talking about sensitive cases like the criminal prosecution of former President Donald Trump.
McBath currently represents the 7th Congressional District and is now running in the newly drawn 6th Congressional District against two Democratic challengers, Jerica Richardson and Mandisha Thomas. McBath declined to participate in the press club’s general election debate in 2022, forcing her Republican challenger Mark Gonsalves to debate with an empty podium. McBath won with 61% of the vote.
The debates will air live on April 28 on GPB.org, on The Atlanta Press Club’s Facebook page (www.fb.com/TheAtlantaPressClub). It will be rebroadcast in early May on WABE.org.
| Race | Tape and Livestream Sun. April 28 |
GPB-TV Broadcast | WABE Broadcast |
| Congressional District 6 Democrats | 10:00 a.m. | April 29 at 7:00 p.m. | May 1 at 4:30 p.m. |
| Congressional District 13 Democrats | 11:15 a.m. | April 28 at 4:00 p.m. | May 1 at 5 p.m. |
| Congressional District 3 Republicans | 1:00 p.m. | April 28 at 5:00 p.m. | May 2 at 3:30 p.m. |
| Congressional District 2 Republicans | 3:00 p.m. | April 29 at 5:00 p.m. | |
| Georgia Supreme Court | 4:45 p.m. | May 2 at 4:30 p.m. | |
| DeKalb County CEO | 5:45 p.m. | May 2 at 5:15 p.m. | |
| Fulton County District Attorney | 6:45 p.m. | May 1 at 4 p.m. |
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