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Department of Community Health outlines PACE rollout, CMO procurement timeline and new state nurse‑aide proposals
Summary
Department of Community Health officials told the Human Relations & Aging Committee that an open Medicaid care‑management procurement is under appeal, a PACE program RFP is planned, and the department is developing state nurse‑aide and medication‑aid pathways and a proposed transfer of certain behavioral‑health licensures to DBHDD.
Officials from the Department of Community Health told the Human Relations & Aging Committee that several long‑term care initiatives are underway, including an open care management organization (CMO) procurement that is under appeal, a planned PACE program, proposed licensure transfers to the Department of Behavioral Health and Developmental Disabilities (DBHDD), and development of state‑level nurse‑aide and medication‑aid programs.
Joe Hood, chief operating officer for the Department of Community Health, said the CMO procurement for Medicaid care management is in the initial intent‑to‑award stage and is under appeal. Until appeals and operational readiness are resolved, new CMO contracts will not be implemented. Hood said the appeal process could take as long as two years; if followed by two contract years before additional populations are moved, the department estimates a three‑to‑four year timeframe before elderly and waiver populations could shift into managed care, although exercising the option remains at the state’s discretion.
Hood outlined the immediate planned shift: Social Security Administration (SSA) SSI‑eligible Medicaid enrollees who currently receive fee‑for‑service Medicaid would move to CMO enrollment once contracts are in place. Hood estimated that population at roughly 200,000 individuals "depending on the point in time". Other groups — such as waiver recipients and nursing‑home populations — are potential candidates to move into managed care only after the state has operational experience with the initial population and two full contract years, the department said.
Hood also described the department’s work to establish Programs of All‑Inclusive Care for the Elderly (PACE). The department has contracted with Myers & Stauffer and with National PACE consultants to develop rates and an RFP. Hood said the department expects to authorize several PACE centers in an initial rollout: three locations in metropolitan Atlanta plus proposed centers in Savannah, Columbus and Macon, estimating six or seven centers in the first round. The PACE model uses a capitated Medicare/Medicaid rate and requires a sizable site (roughly 10,000 square feet) and an interdisciplinary team; Hood said applicants will propose specific center locations and ZIP‑code coverage in response to the RFP and that awarded ZIP codes will then go to CMS for federal sign‑off.
On licensing, Hood told the committee the department intends to move certain state licensures related to behavioral health and community living from DCH to DBHDD to align state licensing with federal policy under SAMHSA and to reduce duplicative survey and enforcement activities. The department said budget adjustments will accompany that transfer to move surveyors and compliance staff to DBHDD.
Hood also reviewed statutory changes and initiatives affecting direct care staffing. He described work arising from House Bill 497 (2023) requiring reciprocity for nurse aide applicants who pass a CMS competency exam, and Senate Bill 449 (2023) authorizing provisional reciprocity for certain military medical personnel. To address staffing in assisted living and personal care homes — which are not subject to the same federal nursing‑home rules — DCH has explored a new state nurse‑aide and state medication‑aid track that would be eligible in assisted living and personal care homes but not in CMS‑regulated nursing homes. Hood described a proposed competency exam that could reduce dementia‑training hours from 16 to four for staff who pass the exam, while preserving hour‑based training for those who do not pass the competency assessment.
Hood said the University of Georgia has been contracted to help develop modular training curricula and competency assessments; the department has also worked with advocacy groups and with Georgia Department of Veterans Services to identify eligible military medical personnel for potential reciprocity under a state program.
Committee members asked for timelines and counts. Hood reiterated the uncertainty caused by appeals (two years estimated) and said exact timelines for the new state nurse‑aide program and related exams were not finalized. Brandy Sylvan, director of government relations for DCH, provided contact and legislative‑relations support for members seeking follow‑up.
