DCH quick guide : an overview of the Georgia Department of Community Health : shaping the future of a healthy Georgia by improving access and ensuring quality to strengthen the communities we serve

Georgia Department of Community Health
Through effective planning, purchasing and oversight, the Georgia Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state's uninsured and most vulnerable populations.
DCH is the lead agency for Medical Assistance Plans which oversees the Georgia Medicaid programs and PeachCare for Kids (Georgia's Children's Health Insurance Program population). DCH also administers the State Health Benefit Plan in Georgia. The department is responsible for access to health care for one in four Georgians.
With a combined annual federal and state budget of more than $15 billion, the department is one of the state's largest. It has over 1,000 employees and contractors who work at 2 Peachtree Street and across the state.
DCH is governed by a nine-member Board of Community Health. Board members are appointed by the governor and confirmed by the State Senate. The Board establishes general policy for the department, and meets on the second Thursday of each month.
DCH has three attached agencies: the Georgia Composite Medical Board, the Georgia Board for Physician Workforce, and the Georgia Drugs and Narcotics Agency.
DCH also houses the Georgia Board of Dentistry and the Georgia State Board of Pharmacy.
DCH is an agency committed to the health and prosperity of its citizens through innovative and effective delivery of quality health care programs.
Shaping the future of A Healthy Georgia by improving access and ensuring quality to strengthen the communities we serve.

Fast Facts About DCH
DCH programs provide access to health care for one in four Georgians through the Medical Assistance Plans (MAP) and the State Health Benefit Plan (SHBP).
Combined, Medicaid and SHBP provide health care coverage to more than 2.6 million Georgians.
PeachCare for Kids provides health insurance for more than 124,000 children in Georgia.
On an average business day, DCH pays out approximately $37 million for Medicaid benefits and $11.5 million for SHBP benefits.
Healthcare Facility Regulation licenses, registers, and inspects more than 24,000 health care facilities in Georgia.
The Office of Health Planning serves Georgia residents through the administration of the state Certificate of Need program and health planning functions.
The State Office of Rural Health links Georgia's 120 rural counties with state and federal resources to develop long-term solutions to address health care access and delivery issues and improve health status.
For the latest news and information about the Georgia Department of Community Health,visit www.dch.georgia.gov.

DCH March 2019

2 Peachtree Street, NW Atlanta, Georgia 30303
404-656-4507 www.dch.georgia.gov

DCH Quick Guide
An Overview of the Georgia Department of
Community Health
Shaping the future of A Healthy Georgia by improving access and ensuring quality to strengthen the communities we serve.

Medical Assistance Plans
DCH is the state agency responsible for the administration of the Medical Assistance Plans Division (MAP), which oversees the Georgia Medicaid programs and PeachCare for Kids (Georgia's Children's Health Insurance Program population). Medicaid and PeachCare for Kids members receive services through either managed care (Georgia Families or Georgia Families 360) or fee-for-service arrangements.
MAP provides the following services:
Provides overall management of the Medicaid and PeachCare for Kids programs;
Oversees member eligibility and enrollment into Medicaid and PeachCare for Kids, and enrollment into the Georgia Families Care Management Organizations (CMO) and the Georgia Families 360 CMO;
Administers the Georgia Families 360 managed care program for children in foster care, children receiving adoption assistance, and select youth in the juvenile justice system;
Oversees the seven programs offering Home and Community Based Services alternatives to long-term institutional care;
Develops and implements new programs in Medicaid and PeachCare for Kids that promotes continuity of care, care coordination and enhanced health outcomes.

Healthcare Facility Regulation
The Healthcare Facility Regulation Division (HFRD) serves Georgia residents through the statewide oversight of health care facilities.
HFRD provides ongoing monitoring of licensed health care facilities to ensure compliance with rules promulgated by DCH. The division reviews and issues decisions based on facility requests for waivers or variances to these rules. Furthermore, HFRD investigates complaints against licensed facilities, adverse events, and incidents reported by citizens and health care facilities.
The division also manages GaMap2Care, an online search tool to assist families, patients, caregivers and providers in their selection of licensed health care facilities. The site can be accessed through www.GaMap2Care. info.
To learn more about HFRD, visit www.dch.georgia.gov/hfr.

Health Planning
As required by statute, the Office of Health Planning (OHP) administers the state Certificate of Need (CON) program and Health Planning functions. CON is required before the offering of a statutorily defined new institutional health service by a health care facility.
OHP oversees the following functions:
Reviews applications for CON issuance in accordance with the state health plan, relevant statutes, rules, and regulations.
Conducts annual surveys of CON-regulated facilities and providers to obtain utilization and financial data for state health planning forecasts and methodologies as well as the CON review process.
Ensures compliance by health care facilities with indigent and charity care commitment percentages.
Conducts architectural plan reviews and site inspections for major renovations and construction projects in hospitals, nursing homes and ambulatory surgery centers.
Administers the Patient's Right to Independent Review Program which provides members of health maintenance organizations and other managed care plans the right to appeal an insurer's decision denying coverage for medical services.
To learn more about OHP, visit www.dch.georgia.gov/office-health-planning.

To learn more about Georgia's Medicaid and PeachCare for Kids programs, visit www.medicaid.georgia.gov.

State Health Benefit Plan
The State Health Benefit Plan (SHBP) provides health insurance coverage for state employees, teachers, school system employees and retirees who elected coverage (including annuitants and former employees on extended coverage), and covered dependents. SHBP is composed of three plans: the State Employees Plan, the Teachers Plan and the Public School Employee Plan. SHBP covered more than 661,000 members as of December 2018.
Health Reimbursement Arrangement, High-Deductible Health Plan and Health Maintenance Organization options are offered to SHBP members and their eligible dependents. Medicare Advantage options are also offered to eligible former employees and dependents enrolled in Medicare.
To learn more about SHBP, visit www.shbp.georgia.gov.

State Office of Rural Health
The State Office of Rural Health (SORH) works to improve access to health care in rural and underserved areas and to reduce health status disparities. SORH's office is located in Cordele, Ga.
Major programs include developing Georgia Medicaid's Telehealth policies and utilization in areas where there is a shortage of specialists, recruiting physicians to rural areas, helping sustain the state's Critical Access Hospitals, and creating and managing training programs for Emergency Medical Services personnel.
For information, visit www.dch.georgia.gov/state-office-rural-health.