An Overview of Georgia Department of Community Health 
 
Overview 
The Department of Community Health (DCH) is the lead agency for health care planning, purchasing and oversight in Georgia. DCH is the single state agency responsible for Medicaid and PeachCare for Kids serving approximately 1.7 million Georgians. Additionally, DCH is responsible for the State Health Benefit Plan (SHBP), the health insurance program for nearly 700,000 members and their dependents. Combined, Medicaid and the State Health Benefit Plan provide health care coverage to approximately one in four Georgians. Other divisions within the Department include Healthcare Facility Regulation and Health Information Technology. 
Divisions 
Health Information Technology (HIT) leads the state's strategic initiatives for electronic health record (EHR) technology adoption and health information exchange (HIE). Both initiatives will improve health care quality and cost-effective delivery for patients, physicians and other health care providers and related stakeholders. 
Healthcare Facility Regulation (HFR) protects Georgians through the delivery of safe, accessible, affordable and quality health care services. HFR ensures that facilities are compliant with state statutes and rules and regulations adopted by the DCH Board of Community Health. HFR's Health Planning Office determines the need for facilities and services, including Georgia's Certificate of Need program. HFR's Health Care Licensing unit is responsible for licensing, monitoring and inspecting facilities and services as well as investigating facility complaints. HFR also performs federal certification inspections for Medicare and Medicaid. 
 
DCH is dedicated to A Healthy Georgia. 
DCH Vision 
DCH is committed to the realization of a Georgia that is educated, safe, healthy and thriving. 
As a results-oriented, innovative and productive state agency, DCH addresses the health care needs of all Georgians by serving as a national leader in the areas of health planning and policy, health promotion, the delivery of quality health care, health care facility regulation and health information technology. 
 
Medicaid administers health care coverage for low-income families, as well as the aged, blind and disabled populations. The division also administers the State's Children's Health Insurance Program (S-CHIP) through PeachCare for Kids. As the Department's largest division, Medicaid provides coverage to eligible residents and oversees program administration and funding for all Georgia Medicaid services. 
 
State Health Benefit Plan (SHBP, the Plan) is one of the largest state health plans in the nation. Self-funded, the Plan provides health insurance coverage to nearly 700,000 members including active and retired state employees, teachers, school personnel and dependents. 
 
continued Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507 January 2012 
 
 An Overview of DCH, Continued 
 
Offices 
 
Communications oversees all internal and external communications initiatives for the Department. This includes brand marketing and messaging, media and public relations, and both the Internet and Intranet presences for DCH. 
Financial Management is responsible for the budget and the accounting of the funds appropriated to DCH. The Office of Financial Management is comprised of the Office of Planning and Fiscal Analyses, Financial and Accounting Services, Reimbursement Services and the Budget Office. 
General Counsel provides legal advice and support to the Commissioner, the Board of Community Health and all divisions of the Department, including the State Health Benefit Plan. The Office of the General Counsel prepares contracts and amendments; drafts and monitors proposed legislation; researches and drafts health care policy regulations; processes open records requests; oversees HIPAA Privacy; and provides advice regarding ethics compliance. The Medical Legal Services section represents the Department at administrative hearings to safeguard the integrity of the Medical programs. 
 
DCH Mission 
The mission of DCH is to provide Georgians with access to affordable, quality health care through effective planning, purchasing and oversight. 
We are dedicated to A Healthy Georgia. 
Key Goals 
Improve health through preventive care, disease management and disparity elimination Improve access to affordable quality health care Provide financial solvency in DCH health plans to meet the needs of plan members Increase effectiveness and efficiency of health care program delivery 
 
Information Technology (IT) oversees the Medicaid Management Information System (MMIS); the State Health Benefit Plan's Membership Enrollment Management System (MEMS); and the 
 
Ensure DCH workforce has the capacity, skills and competencies to meet current and future demand 
 
Information Technology Infrastructure (ITI) unit and its work with 
 
the Georgia Enterprise Technology Services (GETS). The Office of 
 
IT is responsible for all IT operations, support and security and ensures HIPAA compliance for more than 1.7 million 
 
Medicaid members. 
 
Inspector General (OIG) safeguards DCH from both internal and external risks. The Office of Inspector General works to prevent and detect waste, fraud and abuse in Medicaid, PeachCare for Kids and the State Health Benefit Plan, as well as fraud and abuse associated with DCH contracts and vendors. The office operates Internal Investigations, Program Integrity, Medicaid Investigations and Audits. 
 
Legislative & External Affairs is DCH's primary point of contact for all activities regarding the Georgia General Assembly. The office analyzes bills and helps shape legislative strategies for Medicaid, PeachCare for Kids, SHBP, Healthcare Facility Regulation, Health Information Technology and more. This office also serves as the liaison to other government officials, lobbyists, consultants, associations, patient advocacy groups and others in support of DCH's mission and initiatives. Constituent Services is an integral part of this office. 
 
Operations works closely with internal and external stakeholders to support DCH's mission and initiatives. Operations consists of Vendor and Grantee Management, Non-Emergency Transportation (NET) Services, Human Resources, Support Services, Procurement Services, and the State Office of Rural Health. Operations also manages the Vendor Operations team, which is charged with overseeing performance aspects of the state's Fiscal Agent that operates the Medicaid Management Information System (MMIS). 
continued 
 
 An Overview of DCH, Continued 
The Board of Community Health 
The Board of Community Health is a nine-person board appointed by the Governor and confirmed by the Senate. The Board has policy-making authority for the Department. 
Advisory Boards & Councils 
The Georgia Drug Utilization Review Board promotes patient safety through increased review and awareness of outpatient prescribed drugs. The 20-member board, appointed by the DCH Commissioner, recommends medical criteria, standards and educational intervention methods used in the Drug Utilization Review program. 
The Medical Care Advisory Committee (MCAC) consists of a mix of board-certified physicians, other health professionals, consumer group advocates, Medicaid members, Public Health Department representatives, and additional member specialties. MCAC works collaboratively to: 1) provide input on Medicaid health policy; 2) cultivate a better understanding between the health care provider, payers, and consumers of care; and 3) partner with DCH to promote quality health care delivery to Medicaid members. 
The Rural Health Advisory Board is a 12-member board that promotes and directs federal and state resources to develop long-term solutions to improve health care access in Georgia and the health status of rural and underserved areas of the state. 
Attached Agencies 
Georgia Composite Medical Board ensures quality health care for all Georgians by licensing qualified applicants as physicians, physician's assistants, physician residents in training, perfusionists, respiratory care professionals, acupuncturists and auricular (ear) detoxification specialists. 
Georgia Board for Physician Workforce develops medical education programs to ensure that all communities are served by an adequate number of physicians.