Colquitt Regional Medical Center in Moultrie was recently named a recipient of a $1 million grant to support its graduate medical education program.

ATLANTA — Georgia lawmakers have long discussed the challenges of rural health care access and workforce.

But a proposal introduced by a senator still does not seem to be the solution, according to hospital officials and groups who spoke against the bill Feb. 9.

Cumming Sen. Greg Dolezal on Feb. 6 filed Senate Bill 99, which if approved would exempt acute care hospitals looking to locate in rural counties (or counties with less than 50,000 residents) from adhering to Certificate of Need requirements.

According to Georgia Department of Community Health, which administers the Certificate of Need program, the purpose of the program is to ensure the “availability of adequate health care services to meet the needs of all Georgians, while safeguarding against the unnecessary duplication of services that perpetuate the costs of health care services.”

DCH evaluates proposals for new or expanded health care services or facilities, and the program has criteria on the number of miles between specific facilities.

More than 50 acute rural hospitals could be affected by the bill, said Dolezal, who said the bill would help expand rural health care. Acute care hospitals, according to Centers for Medicare & Medicaid Services, provide inpatient medical care and other related services for surgery, acute medical conditions or injuries usually for a short-term illness or condition.

Dolezal’s proposal came after what appears to be interest from an undisclosed entity seeking to build another hospital in Butts County where the population is less than 26,000. The county currently has an acute hospital in Jackson.

Dolezal read an excerpt from a resolution approved by Butts County Board of Commissioners last year: “Sylvan Grove Hospital is an existing 60-year-old rural 25-bed critical access hospital in Butts County that serves Butts and approximately nine surrounding counties in Georgia. The services offered at the hospital are very limited and do not meet the ever-increasing needs of our citizens.”

“That was really the impetus of this bill is not to hold on to an archaic system of anti-competition or anti-access or anti whatever you might call certificate of need,” Dolezal said at the Feb. 9 Senate Regulated Industries Committee meeting. “We probably would all call it different things but this is an attempt to deliver health care to this much needed area.”

But Leo Reichert, executive vice president and general counsel for WellStar Health System, said not only would that hospital specifically be negatively affected, but so would others around the state. WellStar operates the Sylvan Grove Hospital through a lease with the Butts County Hospital Authority.

In late 2022, WellStar closed Atlanta Medical Center — the only other Level 1 trauma center in the metro area — attributing inflation, decreasing revenue and more than $100 million in losses in 12 months to the decision to close the location.

Allowing hospitals to come into rural communities without a CON could cause stress to the existing workforce, Reichert said at the Feb. 9 hearing on the proposed bill.

“In addition to the harm that this would cause simply by taking patients away from hospitals that are already struggling financially because they’re in areas that are not growing very much economically, we all know that there’s a workforce problem in health care,” Reichert said. “We’ve got two hospitals that are struggling to find staff to meet the needs of the community. … If you drop another hospital in, they’re going to wind up all three fighting for the same staff. and they’re obviously going to take some staff away from those two hospitals.”

Reichert said the bill could also impact counties adjacent to rural counties since rural residents also use hospitals in neighboring counties.

Sen. Bill Cowsert, chair of the Senate Regulated Industries and Utilities Committee, voiced frustration as he implied that the proposal seemed to be a fix to rural health care challenges.

He said state lawmakers have been “beat up” for the last decade for not doing enough for rural hospitals.

“We’re told that (rural hospitals are) closing and we’ve got to give them the money and help them so that we can have access to medical care for people in rural areas of the state,” Cowsert said. “(In Butts County) we’ve got people offering to build for free, no cost to the public, a 100-bed hospital in an area that has a 25-bed hospital that would service a lot of rural Georgia, and yet the hospitals seem to be opposed to that.”

Tim Kibler of the Georgia Alliance of Community Hospitals reiterated Reichart’s concerns of continued staffing shortages.

“Georgia has a significant deficit. Were the state to have this proposal become law, that would be very much a case of internal providers fighting each other for staff. It’s a great fear of ours,” Kibler said. “Certainly (SB 99) is an attempt to address a specific situation that is going to have broad and far-reaching implications much beyond that specific situation.”

Anna Adams, executive vice president of external affairs for the Georgia Hospital Association, urged the committee to refrain from action on the proposal until the impact on rural hospitals could be assessed.

“If we’re going to make the argument around community harm and considering community harm, I wish that that would extend to all business decisions made by the entities that want to argue on the basis of community harm,” Dolezal said. “I think that the state could be well served with that, if that was more broadly applied instead of only applied in one direction.”