Georgia Department of Community Health details managed‑care shift, PACE rollout and new state nurse‑aide proposals

The Department of Community Health told the House Human Relations and Aging Committee that a pending appeal of its care management organization procurement will delay contract changes and the movement of some Medicaid populations into managed care.

"We have an open procurement to our care management organizations for Medicaid and that is ongoing, it's under appeal," said Joe Hood, chief operating officer for the Department of Community Health. He said the appeal could take up to two years and, depending on operational readiness, it could be three to four years before some waiver and nursing‑home populations might be moved into managed care.

Hood said the first population to shift would be people who qualify for Medicaid through the Social Security Administration's SSI determination and who currently receive fee‑for‑service Medicaid. "That initial population is a Social Security SSI qualifying individuals… and those will shift from fee for service into care management," he said, adding that the move aims to increase preventive care and reduce long‑term institutionalization.

The department also provided an update on PACE, the Program of All‑Inclusive Care for the Elderly. Brandy Sylvan, director of government relations for the department, and Hood described PACE as a capitated, Medicare‑linked model that operates from community centers and is intended as an alternative to nursing‑home placement. "We expect to have that forthcoming very soon," Hood said, noting the department has worked with actuaries and contractors to set rates and prepare an RFP. He said the initial RFP rollout is expected to target several metropolitan Atlanta locations plus Savannah, Columbus and Macon, and could yield roughly six or seven centers in the first procurement round.

Hood said the department contracted with Myers & Stauffer for rate work and referenced national precedent: "PACE is in about 30 plus states in the nation already." He described business‑model constraints, saying operators generally need a sizeable population—roughly in the 250–300 enrollee range—to be financially viable and that programs often take up to two years to reach scale.

On licensing and regulatory alignment, Hood told the committee the department is preparing legislation to move behavioral‑health and community‑living licensure from DCH to the Department of Behavioral Health and Developmental Disabilities (DBHDD). He said the change aims to reduce duplicative survey and enforcement responsibilities and align federal policy areas that fall under SAMHSA with the state agency that handles behavioral‑health policy.

Hood also described recent legislation affecting certified nurse aides (CNAs). He cited House Bill 497 and Senate Bill 449 (as referenced in the presentation materials) and said the department is developing a state‑level nurse‑aide and medication‑aid program that would operate in assisted living and personal care homes but would not replace federally required CNA qualifications for nursing homes. "If we were to create a state nurse aid and a state medication aid, those would be available in our assisted living and our personal care homes, but not available in the nursing homes because they wouldn't have the same level of qualification per federal regulation," Hood said.

Hood described a proposal to reduce facility‑specific dementia training from 16 hours to 4 hours when direct‑care staff can pass a dementia‑care competency exam. He said the department has worked with the University of Georgia on modular curricula, reciprocity and portable training and that stakeholders broadly support a competency‑based compromise.

The department answered members' questions about timing and scale but repeatedly cautioned that appeals, contract transitions and federal changes could shift timelines. "I don't know exactly… we've estimated that the appeal process may take as much as 2 years to resolve," Hood said regarding the procurement appeal timeline.

The committee also heard that budget alignment is underway for the licensure shift and that surveyors and compliance specialists funded in DCH's budget would move to DBHDD if the bill advances. Brandy Sylvan offered to serve as a contact for members with constituent questions about legislative issues or services.

The presentations drew multiple follow‑up questions from committee members on timelines, the veteran pipeline for state nurse‑aide reciprocity and specifics about the dementia competency exam. Hood and Sylvan repeatedly said some details—such as final exam development, exact timelines and enrollment projections—are still being finalized and referenced ongoing contracts with consulting firms and university partners.

The department did not take any formal votes during its presentation; the session was informational.

Ending: Committee members applauded the updates and said they would continue to follow bill language and rulemaking as the department returns with formal proposals.