COVID-19 Response and Recovery

Within 48 hours of the first school closures in Georgia, Voices launched our COVID response, including a resource webpage for families and communities across the state and a State COVID-Response Dashboard. Our Dashboard tracked and advocated for the most impactful solutions to meet the needs of children and families. Today Voices continues to evaluate new guidance that comes from the federal level and other pandemic-related policies to advocate for long-term policy change.

Voices’ COVID-19 response includes:

Researching and Tracking Policy Change

The week after schools closed in March 2020, Voices launched a comprehensive, real-time tracking system across all areas of child and family wellbeing to capture the needs of communities, policies to address those needs, actions the state had implemented, as well as those that were in-process or that officials were considering behind closed doors. The COVID-Response Dashboard included Voices’ recommendations for actions the state had not yet taken.

The COVID-Response Dashboard included an analysis of federal policies and actions, and how they aligned with Georgia’s action. The tool provided a unique ability to truly target advocacy efforts and hone communications with state leadership.

By July 2020, Georgia leaders had implemented much of the public health policies available and we shifted focus to long-term solutions.

COVID-Response Dashboard

Connecting Communities with Policymakers

Voices convened an online GA-CALL policy forum, shared statewide, to connect communities with state leadership. The GA-CALL included interviews with agency leadership on their response to the crisis and actions they were considering taking in the near future.

A note: all interviews were recorded in May 2020 and contain dated information.

Commissioner Amy Jacobs
Dept. of Early Care and Learning

Director Tom Rawlings
Division of Family and Children Services

Superintendent Richard Woods
Department of Education

Commissioner Tyrone Oliver
Dept. of Juvenile Justice

Highlights of Our Work

Children and youth were uniquely impacted by the pandemic. The public health crisis that ensued created both challenges and opportunities. While the pandemic magnified the fragility, fragmentation, and inequity that long existed in Georgia’s child-serving systems, state leaders responded quickly with critical policy and practice changes that broadened access to critical supports.

Increasing Food Access During a Crisis

More than 1.1 million Georgia kids rely on free and reduced-cost breakfast and lunches at school.

When schools closed, it ripped open the safety net for tens of thousands of kids. Voices successfully advocated for improving children’s access to food through the approval of a State Pandemic-EBT (P-EBT) plan that bridged state agency central data systems so children receiving free and reduced-cost lunch could also receive food stamp benefits to use at grocery stores while school was virtual. Voices’ advocacy also resulted in the state removing the initial, arduous application process to directly issue the benefit to all eligible students.

Guiding the Administration of Federal Funding to Support Afterschool Programs

327,853 of Georgia's school-aged children participated in afterschool programs in 2020.

The Georgia Statewide Afterschool Network (GSAN), a division of Voices, is the thought leader for afterschool and summer learning programs in the state. A testament to its credibility and influence, GSAN was tapped to help guide the administration of $85 million in federal funds from the American Rescue Plan to improve the quality of and create increased equity within afterschool and summer learning opportunities. GSAN’s recommendations focus on children and communities most impacted by the pandemic to reduce the barriers to equitable access to much-needed quality programs, supports, and services.

Advocating to Make Successful Pandemic Policies Permanent

Certain federal and state policies were enacted at the start of the public health emergency that broadened access to critical supports. Focusing solely on those policies which were temporarily changed due to the pandemic, Voices for Georgia’s Children recommends that the following state and federal policies remain intact to better serve children and families in the state. We are continuing to evaluate new guidance that comes from the federal level and other pandemic-related policies (e.g., food access) to determine any additions or changes to these recommendations.

Enact legislation that would make telehealth reimbursement flexibilities permanent

Policy Recommendation:

Make permanent the telehealth reimbursement flexibilities beyond the public health emergency and develop/implement quality control measures to ensure effective and equitable telehealth practice

Flexibilities include allowing:

  • The home as an eligible originating site
  • Asynchronous store and forward (the ability to send clinical information to a healthcare site electronically)
  • Services provided by telephone
  • Psychotherapy services delivered via tele-communication

Change Mechanism:

State Plan Amendment, or Centers for Medicare and Medicaid Services (CMS) blanket waiver to maintain telehealth flexibilities; state agency directive to develop and implement quality control measures

Funding Needs:

Possible need for increased state allocation for state match cost of services, if service utilization increases; state allocation for quality control measures

Rationale:

  • Expanded telehealth practices have helped children and families continue to access needed care during the PHE, but could support a much-needed increase in access to care generally.
  • Rural Georgia suffers from a shortage of doctors; 63 counties lack a pediatrician and 11 lack a family practice physician.
  • Rural areas suffer from less access to public transportation – and approx. 35 counties lack public transit options altogether.
  • 15 states[1] allowed tele-psychotherapy services prior to COVID-19 and several states[2] have permanently adopted telehealth flexibilities since the onset of the PHE.

[1] Alabama, Arkansas, Idaho, Kansas, Louisiana, Nevada, New Jersey, North Dakota, Ohio, South Carolina, South Dakota, Texas, Utah, and Virginia
[2] 27 state Medicaid programs and the District of Columbia allow the member’s home to serve as an originating site. Pediatricians now provide some elements of well exams through telehealth. Some states allow HIPAA-compliant telephone service delivery: South Carolina (dental services); Texas (supportive encounters for behavioral health and case management); Tennessee (provider-based telemedicine).

State Action Thus Far:

  • House Bill 307, which has been approved by the Governor, authorizes health care providers to provide telemedicine services from home and patients to receive telemedicine services from their home, workplace, or school and provides clarity regarding insurance billing of such services.
  • GA Dept. of Community Health is currently collecting feedback regarding telehealth policies from providers and beneficiaries.

Extend the FMAP increase of federal funds coming to the state to cover Medicaid so it continues beyond the COVID-19 pandemic

Policy Recommendation:

Prolong the FMAP increase beyond the public health emergency as Georgians recover from economic hardship

Note: Before the public health emergency, Georgia’s Medicaid spending was matched with federal dollars at a rate of 67.03%. So for every $1 spent, the state only spent about 33 cents. The CARES Act increased the FMAP by 6.2%, making Georgia’s FY21 FMAP 73.23%. Under this enhanced FMAP the state pays only 27 cents for every $1 spent on Medicaid.

Change Mechanism:

Congressional action

Funding Needs:

Requires federal funds

Rationale:

  • Georgia’s unemployment rate remains higher than pre-pandemic, which impacts state revenues and therefore strains the state’s budget.
  • Child Medicaid/PeachCare enrollment in Georgia increased by more than 100,000 from February to August 2020, and the ongoing Medicaid disenrollment freeze means the state continues to pay for their care.
  • The increased FMAP will help to protect Georgia’s Medicaid program in the midst of state budget constraints.

Federal Action Thus Far:

  • In the American Rescue Plan Act, Congress increased the FMAP by 5% for two years for states who choose to expand Medicaid if they have not yet done so.