Fact sheet: Georgia Department of Community Health [Nov. 2013]

Fact Sheet

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 1.8 million Georgians. Additionally, DCH is responsible for the State Health Benefit Plan (SHBP), the health insurance program for nearly 634,000 members and their dependents as of December 2013. Combined, Medicaid and the SHBP provide health care coverage to approximately one in four Georgians. Other divisions within the department include Healthcare Facility Regulation (HFR) and Health Information Technology (Health IT).

DCH is dedicated to A Healthy Georgia.

Divisions
Health Information Technology (Health IT) leads the state's strategic initiatives for health information technology, including ePrescribing and electronic health

DCH Vision DCH is committed to the realization of a Georgia that is educated, safe, healthy and thriving.

record (EHR) technology adoption, statewide health information exchange (HIE), widespread interoperability, consumer and patient engagement, and more. These initiatives focus on closing the patient information gap that exists across care settings by electronically connecting disparate systems and data sources. This connectivity will improve quality of care, better health outcomes, and

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

reduce cost.

delivery of quality health care, health

Healthcare Facility Regulation (HFR) protects Georgians by overseeing the safety and accessibility of

care facility regulation and health information technology.

health care facilities and services. HFR ensures that

facilities are compliant with rules and regulations adopted

by the DCH Board of Community Health. HFR's Health

Planning Office determines the need for facilities and

services through the administration of Georgia's Certificate

of Need (CON) 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.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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Fact Sheet

An Overview of the Georgia Department of Community Health

DCH's Medical Assistance Plans Division 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, Medical Assistance Plans provides coverage to eligible residents and oversees program administration and funding for all Georgia Medicaid services.
The State Health Benefit Plan (SHBP) is one of the three largest state health plans in the nation. It offers health and prescription drug coverage to nearly 634,000 members including qualified public employees, retirees, teachers, school personnel and their eligible dependents. As of 2014, SHBP's wellness program initiative is the largest state wellness program in the nation. The Georgia Department of Community Health (DCH) serves as the state's plan sponsor and plan administrator through the SHBP.
Offices
Communications and Legislative Affairs oversees all internal and external communications initiatives for the department and serves as the initial point of contact for all activities related to the Georgia General Assembly and the media. The office also manages the department's Constituent Services program.

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.
Ensure DCH workforce has the capacity, skills and competencies to meet current and future demand.

Financial Management is responsible for the budget, the accounting of funds appropriated to DCH, administration of the DCH data warehouse, and reimbursement management of external Care Management Organizations (CMOs). Financial Management is composed 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. This office further supports the legal needs of the department from preparing contracts and fulfilling open records requests to assisting with statutory, regulatory and policy implementation. Also, the Legal Services section within the Office of General Counsel represents the department at administrative hearings to ensure appropriate administration of the Medical Assistance Plans programs.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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An Overview of the Georgia Department of Community Health
Information Technology (IT) oversees the Georgia Medicaid Management Information System (GAMMIS); the State Health Benefit Plan's Membership Enrollment Management System (MEMS); and the Information Technology Infrastructure (ITI) unit and its work with 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 1.8 million Medicaid members.
Office of Inspector General (OIG) safeguards DCH from both internal and external risks. OIG works to prevent and detect waste, fraud and abuse in Medicaid, PeachCare for Kids and SHBP, as well as fraud and abuse associated with DCH contracts and vendors. The office operates Internal Investigations, Medicaid Program Integrity, SHBP Program Integrity, Provider Enrollment and Audits.
Operations consists of Vendor and Grantee Management, Human Resources, Support Services, Procurement Services and the State Office of Rural Health. Operations also oversees the performance aspects of the state's Fiscal Agent (Hewlett-Packard Enterprise Services) that operates the Georgia Medicaid Management Information System (GAMMIS).
The Board of Community Health
The Board of Community Health is a nine-person board appointed by the governor and confirmed by the Georgia State Senate. The board has policy-making authority for the department.
Advisory Boards and Councils
The Georgia Drug Utilization Review Board (DURB) 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, Public Health Department representatives, and additional provider 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 enrolled 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.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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An Overview of the Georgia Department of Community Health
Attached Agencies
The 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. The Georgia Board for Physician Workforce develops medical education programs to ensure that all communities are served by an adequate number of physicians.
The Georgia Board of Drugs and Narcotics protects the health, safety and welfare of Georgia citizens by enforcing Georgia laws and rules pertaining to manufactured or compounded drugs and ensuring that only licensed facilities or persons dispense or distribute pharmaceuticals.
Independent Boards
Georgia's dental and pharmacy boards became divisions of the Department of Community Health (DCH) in 2013. By law, these boards are granted a high degree of autonomy with respect to operating independence. The boards are administratively attached to DCH's Financial Management office.
The Georgia Board of Dentistry is an 11-member board appointed by the governor. Its mission is to protect the public health in the practice of dentistry by regulating and enforcing the standards of practice. It is also responsible for licensure of dentists and dental hygienists in Georgia. The Georgia State Board of Pharmacy is an eight-member board appointed by the governor to protect, promote and preserve the public health, safety and welfare of the citizens of Georgia. The board is responsible for the regulation and licensing of pharmacists and pharmacies in Georgia.
For More Information
Visit www.dch.georgia.gov.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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