U.S. News & World Report Ranks Emory Among Nation's Best Hospitals for 2010

Emory University Hospital again joins the prestigious ranks of America's top medical institutions in the annual U.S. News & World Report guide to "America's Best Hospitals." Consistently ranked as one of the nation's leading academic medical institutions, this is the 20th year Emory University Hospital has made the list.

For 2010, Emory is positioned among the nation's best hospitals in 11 specialties, including garnering five top 20 rankings. Overall, Emory is one of only 152 hospitals out of more than 4,800 medical centers in the country to be named in even one of the magazine's top 50 specialty rankings - with only Atlanta's Shepherd Center joining the national ranking from Georgia.

Besides Shepherd's rehabilitation ranking, Emory University Hospital is the only hospital in the state of Georgia to have any specialties listed among the nation's elite. These Emory specialties span the spectrum from standard ear, nose and throat disorders to the most highly specialized services in cardiology and neurosurgery. The Emory Heart & Vascular Center, consistently included among the nation's top 20 institutions, has recently claimed many significant "firsts," from the first cardiac catheterization lab in Georgia to the nation's first coronary stent, the world's first minimally invasive triple off-pump bypass surgery, and Georgia's first implantable defibrillator. Such technologies and advancements continue to position Emory as a healthcare provider of choice among Georgians and the nation, as recognized in this year's comprehensive report for excellence.

This year's rankings include:

Specialty                                                   2010 Rank

Neurology / Neurosurgery                        12

Ophthalmology                                         14

Psychiatry                                                 15

Kidney Disorders                                      16

Heart / Heart Surgery                                17

Gynecology                                               22

Geriatrics                                                   23

Urology                                                      33

Ear, Nose and Throat                                 36

Diabetes / Endocrinology                          39

Cancer                                                       41



"We make a promise and a commitment to our patients and their loved ones each and every day to provide the very best care and service in a patient and family-centered environment. These rankings are but one way we measure our progress in delivering on that promise, and help us to continually improve on our service and challenge ourselves as health care professionals," says John T. Fox, Emory Healthcare president and CEO.

"Being again recognized across the board in so many different specialties, from cancer to geriatrics, and cardiology to disorders of the kidneys, makes a tremendous statement about Emory's impact on not only healing the sick, but preventing future illness. I share my thanks, appreciation and admiration with every physician, nurse, employee, volunteer and supporter who has made this honor possible today," says Fox.

"Emory's rise in the U.S. News & World Report in cancer rankings is great news for Georgia," says Walter J. Curran, MD, executive director of the Winship Cancer Institute. "As the only NCI designated cancer center in the state, we are working hard to serve as a resource for oncologists and patients everywhere, but especially in Georgia. Our emphasis on teamwork and collaboration pays dividends in exceptional care, our ability to offer groundbreaking clinical trials, and innovative research. These rankings are an important indicator of progress, and we intend to continue improving for the benefit of our patients and their loved ones."

According to U.S. News & World Report, only 152 of the 4,852 hospitals evaluated performed well enough to rank in even one specialty this year.

To be considered in any of the 12 data-driven specialties, a hospital was required to meet at least one of four criteria: be a teaching hospital, be affiliated with a medical school, have 200 or more beds, or have at least 100 beds and at least four of eight key medical technologies available - like a PET/CT scanner, and certain targeted radiation procedures.

Next, the hospitals had to meet a volume requirement- a minimum number of Medicare inpatients from 2006 to 2008 who had certain procedures and conditions in a given specialty.

Finally, as in past years, each hospital received a U.S. News score from 0 to 100 based on four basic elements: reputation, mortality data, patient safety, and care-related factors, such as nursing and patient services. The 50 top performers were then ranked for each specialty.

This year's rankings may be found online at: www.usnews.com/besthospitals and in newsstands beginning July 27.

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Consumer Reports Health: Central-Line Infection Rates in Atlanta Hospitals Vary; One Hospital Reports Rates Up to 6 Times National Average

Consumer Reports Health: Central-Line Infection Rates in Atlanta Hospitals Vary; One Hospital Reports Rates Up to 6 Times National Average; Some Hospitals Not Reporting

/PRNewswire/ -- Hospitals in the Atlanta area vary in terms of how well their intensive care units (ICUs) prevent central-line bloodstream infections, a cause of death, disability, and expense in our nations' hospitals that is largely preventable. On February 2, www.ConsumerReportsHealth.org will post hospital infection rates for 12 Atlanta area hospitals that voluntarily reported their infection rates. Bloodstream infections cause at least 30 percent of the estimated 99,000 annual hospital-infection-related deaths in the U.S. and add on average $42,000 to the hospital bills of each ICU patient who gets a central line-infection.

In the Atlanta area, only one of the 12 hospitals rated, Hamilton Medical Center, reported zero central line infections. Other hospitals with lower than average infection rates include: WellStar Kennestone Hospital reported a rate that is 61 percent better than the national average, meaning there were 61 percent fewer infections reported than the U.S. average for its mix of ICUs. Emory University Hospital reported 56 percent fewer infections than average; WellStar Cobb Hospital reported 54 percent fewer infections than average; and North Fulton Regional Hospital reported 51 percent fewer infections than average. Infection rates are for 2008.

On the other end of the spectrum, several Atlanta hospitals reported alarmingly high infection rates: Dekalb Medical Center at Hillendale reported an infection rate that is 858 percent worse than the national average, and Eastside Medical Center reported a rate that is 126 percent worse than average. Other hospitals that stand out for their poor performance include: Dekalb Medical Center (71 percent worse than average) Cartersville Medical Center (48 percent worse than average); South Fulton Medical Center (32 percent worse than average); and Emory Crawford Long Hospital (29 percent worse than average).

"Infection rates can vary widely from hospital to hospital and even within the same hospital chain or system," said John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center. "Providing patients with infection rate information enables them to identify which hospitals are making patient safety a priority and which ones are not." According to a related investigative report in the March issue of Consumer Reports, of the 926 U.S. hospitals whose infection rates were analyzed by Consumer Reports Health, 105 hospitals tallied zero central line infections (listed online at www.ConsumerReportsHealth.org).

"All hospitals should be aiming for zero infections," said Santa. "The procedures needed to eliminate ICU infections are simple, low-tech, and inexpensive, requiring a change of mindset and culture. All ICUs should be able to dramatically reduce if not eliminate these infections," continued Santa.

The Consumer Reports online ratings are based on hospitals that publicly report their infection rates as a result of state laws and hospitals that voluntarily report to the Leapfrog Group, a Washington D.C. based nonprofit, works with large employers and purchasers of health care to measure and publicly report on hospital safety and quality in 41 states in the U.S. (www.leapfroggroup.org). Citizen activists, including those working with Consumers Union, the nonprofit publisher of Consumer Reports, have helped enact laws in 27 states, forcing hospitals to publicly disclose their infection rates. To date, 17 of those states have made that information publicly available.

Georgia does not require hospitals to report data on these types of infections. "State lawmakers should mandate hospital infection reporting so all Georgians can find out whether their local hospital is doing a good job keeping patients safe from these sometimes deadly infections," said Lisa McGiffert, Director of Consumers Union's Safe Patient Project (www.SafePatientProject.org).

Consequently, the Consumer Reports ratings for Georgia hospitals are based on Leapfrog data. "It is important to recognize that many hospitals demonstrate commitment to their communities by willingly reporting safety data -- warts and all. Consumers should be most wary of hospitals that are asked to report by their patients, and refuse," said Leah Binder, CEO of the Leapfrog Group. Binder noted that several hospitals in Atlanta declined to provide their data to Leapfrog during the reporting period, including Grady Memorial Hospital and Piedmont Hospital. A complete list of non-reporting hospitals can be found at www.leapfroggroup.org/decline.

A Central Line Associated Bloodstream Infection (CLABSI) is a type of infection caused by the presence of a central line catheter. A "central line" or "central catheter" is a tube that is placed in a large vein in the neck, chest, or arm to enable the rapid administration of fluids, bloods, or medications. These long, flexible catheters empty out in or near the heart so that the circulatory system can deliver what's put in them within seconds. A bloodstream infection can occur when bacteria or other germs travel down the central line and enter the bloodstream, making the central line's biggest virtue as a quick pathway for delivering the essentials into its biggest vice.

Since the risk of infection varies substantially across different types of ICUs, the Consumer Reports ratings are using what is known as a "standardized infection ratio," taking into account the unique mix of ICU types in a given hospital by comparing the hospital infection data for each ICU to the national average for each such ICU type published by the federal Centers for Disease Control and Prevention (CDC). For instance, the average infection rate for cardiac ICUs nationwide is 2 per 1000 central line days (that's the total number of days that patients are on central lines), while surgical ICUs average 2.3 infections per 1000 central line days. So an infection rate 100% above average would be 4 per 1000 days for a cardiac ICU, but 4.6 per 1000 days for a surgical ICU.

The Consumer Reports web site (www.ConsumerReportsHealth.org) currently rates more than 3,600 hospitals in the U. S. based on several criteria including patient satisfaction, intensity of care, and steps to prevent infection. This last measure, which is different from the CLABSI infection rates, assesses how well a hospital follows correct procedures to avoid surgical infections.

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"Safety-Net" Hospitals Need Support to Survive

Health care reform may make life easier for low-income Americans in the future, but for now, it’s “safety-net” hospitals that need rescuing in order to serve the needs of millions of uninsured patients and meet the disaster response needs of communities, say experts in the June 18, 2009 New England Journal of Medicine (NEJM).

Safety-net hospitals are typically found in areas in which the uninsured are concentrated – inner-city neighborhoods and economically depressed rural communities. Private hospitals with a large base of paying patients can shift their relatively modest costs of uncompensated care onto other patients’ bills, safety-net hospitals have little capacity for shifting costs.

Nearly 30 years ago, the federal government developed a plan to partner with states to provide supplemental Medicaid payments to facilities that provided a disproportionate share of care to the uninsured and Medicaid beneficiaries. These facilities came to be called “disproportionate share hospitals (DSHs)” and the supplements were called DSH payments.

But in the years that followed, many state governments figured out how to exploit loopholes in the program to secure large federal DSH payments and direct the money to other purposes. After several cycles of reform, most of these abuses have been eliminated, but wide disparities in DSH payments persist.

“Over the years, the program has had its flaws, but the DSH funds that finally reach safety-net hospitals are vital to their survival,” says Arthur L. Kellermann, MD, MPH, professor of emergency medicine and associate dean, Emory University School of Medicine. In addition to providing ‘safety net’ care, these institutions play several vital roles in their communities.”

Kellermann and co-author Michael Spivey, JD, a principal with Spivey/Harris Health Policy Group, say in the NEJM Perspective article that four changes to the federal law would allow the DSH program to achieve its original purpose.

“First, we believe that DSH funding should be restricted to truly disproportionate providers,” the authors say. “The legislative clause that deems certain hospitals to be DSH facilities should be revised so that DSH payments can be made only to these facilities.” Currently, state governments can direct DSH payments to hospitals that provide little or no charity care if they choose to do so.

Second, say Kellermann and Spivey, the flexibility given to states to designate special classes of DSH providers should be eliminated. They believe that states should not be allowed to favor certain hospitals over those that provide a greater proportion of uncompensated care. DSH payments should be based on a single, uniform method.

Third, because trauma and emergency care are vital to public safety, a hospital should be required to operate an emergency department and participate in its state’s trauma system to receive DSH funds.

Fourth, large DSH hospitals that anchor their region’s disaster plan should receive supplemental funds, provided that they meet strict performance and readiness criteria. A portion of current federal DSH money - perhaps 10 percent - should be held back and awarded for this purpose through competitive grants.

“By allocating federal funds to hospitals that need them most, the reforms we propose would go a long way toward correcting the program’s deficiencies,” say Kellermann and Spivey.

The authors acknowledge that they could have gone farther with their recommendations.

“Our proposals do not correct historical inequities in the allocation of DSH funds among the states,” they concede. “Attempts to do so would probably trigger a legislative battle that would doom any chance for reform.

“Until fundamental health care reform is achieved, millions of low-income Americans will remain dependent on safety-net facilities for care,” say the authors. “Everyone - insured and uninsured alike - benefits from the specialized services, medical education, and trauma and disaster care that many safety-net hospitals provide. Today, DSH is needed more than ever. The program is broken, but we believe it can and should be fixed.”

From Woodruff Health Sciences Center News

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Saint Joseph's Launches International College of Robotic Surgery

/PRNewswire/ -- Saint Joseph's Health System announced that it has launched the International College of Robotic Surgery (ICRS), a non-profit training center for robotic surgical teams from around the world. The launch was announced during the Society for Thoracic Surgeons (STS) annual meeting in San Francisco.

"We have seen the tremendous benefits to patients from robotic-assisted surgery since we began our program in 2002," says Kirk Wilson, FACHE, president and CEO of Saint Joseph's Health System. "Robotics will become the standard of care and we want to help other surgeons and their surgical teams learn and actively use the technology so they can work with their hospitals to develop strong, viable programs for patients."

Under the leadership of two of the country's leading robotic cardiothoracic surgeons, Douglas Murphy, MD and Sudhir Srivastava, MD, ICRS will provide training for all daVinci Surgical System(R) robotic surgery specialties, beginning with intracardiac and cardiac revascularization, including TECAB.

"ICRS will provide consistent, initial and long term support for surgical teams that isn't currently available," says Dr. Murphy. "Over the last five years, I've trained many surgical teams and it has been tremendously expensive and time consuming. Alternatively, ICRS programs will be available online and using interactive, advanced communications technology with ongoing remote proctoring support until the surgeon and his team feel confident and comfortable with the robotic system."

Recognized as one of the country's top 50 hospitals, Saint Joseph's Hospital has the most comprehensive robotic surgery program in the southeast including performing the most cardiac procedures, as well as offering robotic surgery as an option for urology, thoracic, gynecology and general surgery cases.

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Governor Proposes Investments in Georgia's Future, Encourages Long-Term Perspective

Governor Sonny Perdue today delivered his annual State of the State address before a joint session of the General Assembly detailing how the state continues to fulfill its core mission through challenging economic times. The Governor’s Amended FY 2009 and FY 2010 budgets and policy initiatives continue his commitment to education, economic development and government transformation to deliver better value for the taxpayer’s dollar.

“We must not allow ourselves to be trapped in a short-term mindset where rash decisions result in dire long-term consequences,” said Governor Perdue. “Our perspective must be one of optimism even in the face of difficult economic cycles.”

Governor Perdue used his State of the State address to formally submit his Amended FY 2009 and FY 2010 budget recommendations to the General Assembly. Governor Perdue’s recommended Amended 2009 budget totals $19.2 billion and the 2010 budget stands at $20.2 billion.

The Governor thanked the legislature for working with his administration to help replenish the Rainy Day Fund, which now stands at $1.2 billion. In these budgets, Governor Perdue recommended using the maximum amount available for appropriation from the reserves, appropriating $187 million for the education midyear adjustment, $50 million in 2009 and $408 million in 2010. In 2009, a number of one-time strategies unavailable in 2010 will be implemented to balance the budget. Therefore, Governor Perdue recommended the largest portion of available reserve funds be committed to the 2010 budget.

The Governor’s 2010 budget includes a $1.2 billion bond package that will create an estimated 20,000 jobs and features projects in which both design and construction are funded in the same year.

“These projects touch every corner of the state and include new construction at our universities, technical schools, local school systems and libraries; harbor deepening at the Savannah port and needed improvements at state facilities.,” said Governor Perdue.

Governor Perdue also outlined a proposal to restructure the Department of Human Resources. Currently, $3.8 billion is spent within DHR every year. The plan calls for the creation of a new Department of Behavioral Health which will include all mental health and addictive disease programs. The bill also establishes a Department of Health, a combination of the public health and oversight programs in DHR and the current functions of DHR. Remaining social services, such as Developmental Disabilities, Aging, DFCS and Child Support, will come together under a reconstituted Department of Human Services.

Governor Perdue will also introduce legislation to ask those who receive Medicaid payments to help fund the system. This proposal takes advantage of the fact that every dollar used toward Medicaid purposes draws down almost two additional dollars from the federal government. The budget will reflect, and an accompanying bill will propose, a 1.6 percent fee on hospitals and health insurance plans to, not only fill the hole in Medicaid, but also to do what the healthcare community has asked of Governor Perdue’s administration. This proposal will significantly raise Medicaid rates, particularly for hospitals; and in conjunction with the SuperSpeeder legislation, provide $60 million for trauma to sustain and expand the state’s trauma hospitals, EMS and trauma physician infrastructure.

The Governor asked the General Assembly to carefully consider the consequences of cutting healthcare coverage.

“I implore you, do not rush into a short-sighted cut that would have long-term consequences for Georgia’s most needy,” the Governor said.

Governor Perdue highlighted the efforts by Gwinnett County schools to increase student achievement. Last week, the State Board of Education approved an IE2 contract and committed to be held accountable for increased student achievement above and beyond state and federal requirements.

For the 2009 session, Governor Perdue is proposing merit pay legislation that will award teachers who show evidence that their classroom instruction leads to increased student achievement. Governor Perdue is also proposing differentiated pay for math and science teachers. Additional legislation will ensure every student in Georgia has the benefit of responsible leadership at the school system level. This legislation will clearly define what citizens expect from Georgia’s school board members, and it will give the state the ability to replace board members who aren’t serving in the best interests of their students.

“Education means opportunity,” said Governor Perdue. “We spend more than half of our state budget on education because we know that opportunity is discovered in Georgia’s classrooms.”

Governor Perdue’s encouraged legislators and all Georgians to remember the resiliency of our great state, and while we confront the short-term challenges of today we will continue to prepare to take advantage of future opportunities.

“As I think about the American promise of freedom and economic opportunity, I know that rich promise will mean great things for Georgians in the years to come. The soil has proven too rich to dare believe anything else,” the Governor said. “As I look within, I find something within the human constitution that bounces back, something within this collective American spirit that rebuilds. This is the time to continue building our state, to prepare for the future, to plant the seeds that will enrich our children’s inheritance. Together, we will do just that.”



The text of the Governor’s State of the State speech is below…

Mr. President, Mr. Speaker, President Pro Tem Williams, Speaker Pro Tem Burkhalter … Members of the General Assembly. Constitutional officers and members of the judiciary. The Consular Corps and other distinguished guests. And, most of all, my fellow Georgians.

I want to begin this morning with the story of a young Georgian who embodies the resiliency of our state.

Just three years ago, Jeremy Lee was a 14-year old student from Clayton County on his way to the Ireland Youth Development Campus in Milledgeville because he and some friends made a bad decision.

He could have seen this as an indictment not only of his crime, but of his potential. He could have settled for a life marked by disappointment.

But Jeremy made a life altering decision, one that will benefit the lives of others for years to come. He chose to focus on what he could be, not wallowing in the self-pity of tough times, and invested his time and energy in preparing himself to emerge from that campus a better person.

Last summer, Jeremy walked out of those gates with a high school diploma and is now enrolled at Morehouse College.

Jeremy is now pursuing his goal to be a doctor, and that pursuit is a testament to his inner-resilience. I am pleased that he could join us this morning. Jeremy, please rise so we can recognize your efforts.

It’s Jeremy’s resilience and the resilience of thousands like him across our state that gives me confidence that we will emerge from these challenging times stronger.

This is a pivotal moment in our nation’s history. It is a moment in which we are asked to see beyond what George Will calls the “tyranny of the short-term,” beyond the circumstances of the moment, to the big picture – a picture that is informed by our history, bolstered by our character and steeled by our will to succeed.

Despite the stresses of a moment like this, we must not allow ourselves to be trapped in a short-term mindset where rash decisions result in dire long-term consequences. We must remain focused on the big picture … Our perspective must be one of optimism even in the face of difficult economic cycles.

… I look forward to attending President-elect Obama’s inauguration next week and I am confident that he and the new administration will do everything in their power to meet the challenges that face this nation.

However, we cannot plan by relying on the unknown, and the budgets I present to you today are balanced and do not assume money from Washington. Our latest revenue estimate for this fiscal year shows a decline of $2.2 billion, resulting in a $19.2 billion amended budget.

Political mantras aside, cutting more than 10 percent from a budget cannot be achieved by simply cutting waste. While we have worked for six years to do more with less, at some point, in business or in government, it becomes less with less.

The job of budgeting is hard right now, but it’s not because the directions are complicated. Like families sitting around their kitchen tables all over Georgia, we are doing what is necessary to balance our checkbook.

… I want to thank the legislature for working with us to replenish the Rainy Day Fund, which now stands at $1.2 billion. As you all know, at my request, you wisely passed legislation requiring us to retain at least four percent of previous year’s revenue in the reserve fund for balancing the budget at the end of the year if needed.

So I have recommended using the maximum amount available for appropriation from the reserves, appropriating $50 million this year and $408 million next year, as well as $187 million for the midyear education adjustment. We are using some one-time strategies to help balance this year’s budget that won’t be available next year. Therefore, I have recommended that the largest portion of available reserve funds be committed to next year’s budget, which stands at $20.2 billion.

I want to applaud our department leaders -- men and women who are on the ground, who know their mission, their people and their customers. This past spring, agencies willingly responded to my call for restrained spending and returned over $200 million to our state’s Rainy Day Fund at the end of last year.

And then this summer, when I asked them to identify potential budget reductions, their response was thorough and strategic. They were able to find the cuts and maintain the ability to execute their core missions.

That is a testament to those leaders and to the culture change we’ve made in state government!

In six years, we have transformed government making it more efficient and more accountable by instilling a customer-focused culture of public service.

Sometimes this difference isn’t seen in a budget document. But even then, it often impacts thousands of Georgians, who spend less time waiting on government and more time doing what they want to do.

Over the last three years, Joe Doyle and his team at the Office of Customer Service have led this culture change. For example, in Child Support Services, the time between a parent’s initial contact with the agency and meeting with a case worker, has gone from a 30 day wait to same-day service.

A year ago, when a prospective teacher seeking certification called the Professional Standards Commission, they waited nine minutes, on average, to speak with a person … 37 percent just hung up out of frustration. Now, those folks wait eight seconds.

The wait for a new driver’s license has gone from two hours to six minutes and the Medicaid approval process has gone from nine weeks to twelve days, with half of all applicants getting same day approval. And those changes didn’t cost a penny!

This year, we experienced a historic early voter turnout and this same group partnered with the Secretary of State’s to assist 13,000 voters: telling them where and how to voter early. They will continue their work with projects ranging from improving financial aid response times to speeding up DCH’s approval process for children with special needs.

Ladies and gentlemen, I want you to help me recognize Mr. faster, friendlier and easier … Joe Doyle.

We are working in every area of government to ensure that we are getting the best possible value for our investment and that we are providing the best possible service to every Georgian.

To that end, in February, I signed an executive order forming a task force to look at a possible restructuring of the Department of Human Resources. Folks, we spend $3.8 billion within DHR every year – an agency that hasn’t undergone major change since it was formed over three decades ago.

After a thorough review by the Health and Human Services Task Force, we have determined a course of action that will re-orient our approach to healthcare by shifting the focus from inputs to results.

First, we are proposing the creation of a new Department of Behavioral Health which will include all mental health and addictive disease programs. This will improve our responsiveness to mental health needs and will make funding more transparent.

We will continue to improve care by moving towards a community-based delivery system. I know some folks will be concerned with how this might affect jobs in their area, but when it comes to mental health, I believe we have an obligation to provide services to Georgians as close as possible to where they live.

Second, the bill would establish a Department of Health – a combination of the public health and oversight programs in DHR and the current functions of DCH. This agency, which will be led by Dr. Rhonda Medows, will deliver workable solutions on the key healthcare issues we face …

Issues affecting Georgians like how to best facilitate and finance healthcare coverage and how to provide needed access.

Preventative medicine will play a bigger role, inefficiencies and redundancies will be eliminated and every stakeholder in Georgia’s healthcare system – from county boards of public health to Medicaid providers – will work as part of a more coordinated effort.

The remaining social services – Developmental Disabilities, Aging, DFCS and Child Support – will come together under a reconstituted Department of Human Services led by Commissioner B.J. Walker.

We have made progress in the delivery of these safety-net services to our critical populations: we have improved from 50th to 5th in the nation for moving people from state hospitals to community facilities; DFACS has reduced out-of-home placements by 21 percent, and recurring child abuse rates have dropped from 9 percent to 3 percent in the last two years, 2 percent below the national average. I believe a more targeted focus on these programs will lead to even further improvement.

We know that improved lines of communication and enhanced coordination are critical, and I fully expect that these agency heads will meet regularly to coordinate policy and cross-agency service delivery.

I have charged the affected agencies to make this transition within their current budgeted amounts and, in the long term, we believe this reorganization will bring greater efficiency and greater value for the taxpayer dollar.

I want to thank all those who have helped make this happen, particularly the legislative members of the task force: Senators Jack Hill and Renee Unterman, and Representatives Ben Harbin and Mark Butler.

I look forward to working with the legislature and health and human service leaders and providers throughout this state to improve healthcare delivery for every Georgian.

When I came into office, Medicaid was growing annually at rates as high as 17 percent. Over the last four years, growth averaged just 3.4 percent, saving the state a staggering $4.7 billion. Those are numbers that any business would envy.

Even though we have controlled the growth of our Medicaid budget, we faced some very difficult choices this year. The federal government has told states that we can no longer fund Medicaid as we have since 2006. That decision could not have come at a worse time. Washington, in its infinite wisdom, has decided that if we assess a fee against our Care Management Organizations as we currently do, we must impose it on all commercial health plans.

We had to choose: everyone or no one. If we said “no one,” it would have cost Georgia $96 million in state Medicaid funds.

While I’m recommending cuts to many agencies and programs above ten percent, even a five percent cut to the state Medicaid budget would mean an additional $112 million reduction.

That one-two punch of federal mandates and declining revenues means we faced a $208 million hole in the state’s Medicaid budget. To be clear, this $208 million represents the funds paid to providers on behalf of Georgia’s most needy.

To ensure these needed services continue, I had to choose between some tough options. The first option was to eliminate discretionary Medicaid programs – the ones that the federal government does not require us to fund.

This would mean eliminating the medically needy category for eligibility, which serves 7,100 Georgians; eliminating the Katie Beckett Program for 3,100 Georgians; eliminating dental benefits for the 60,000 pregnant women that were covered last year; and eliminating Medicaid coverage for foster children over the age of 18.

In PeachCare, we would have had to eliminate dental benefits, freeze enrollment and reduce the enrollment cap, as well as increase premiums and – for the first time – impose premiums on children between the ages of two and five. All of those cuts combined would still have left a gap exceeding $150 million.

A second option, I could have cut reimbursements to our providers by $208 million. Providers have consistently told us – rightly or wrongly – they believe even our present reimbursement rates are already too low.

A third option would have been to impose the same 4.5 percent fee on commercial and Medicaid managed care and preferred provider plans, that we currently impose only on CMOs. While that remains an option, I prefer a broader based approach that spreads the burden.

I chose to ask those who receive Medicaid payments to help fund the system. This proposal takes advantage of the fact that every dollar we send to Washington for Medicaid draws down almost two additional dollars.

So my budget will reflect, and an accompanying bill will propose, a 1.6 percent fee on hospitals and health insurance plans to fill the hole in Medicaid, and to do what the healthcare community has asked of us for so long: one, to significantly raise reimbursement rates for providers, particularly for hospitals; and two, in conjunction with SuperSpeeder legislation, provide $60 million to sustain and expand the state’s trauma network.

Like most things we address here at the Capitol, this plan will not be universally acclaimed, but I have arrived at this solution after thoughtful, careful deliberation. I implore you … Do not rush into a short-sighted cut that would have long-term consequences for Georgia’s most needy.

Finally, for those that would wait for Washington … we have waited before. And while I am hopeful that we may receive additional federal funds, when I put the budget together, I did not have the option to budget for money that may never materialize.

… We all say, whether it’s in a campaign or a State of the State speech like this, that education is our number one priority. But what does that mean? To me, it means providing opportunity. We spend more than half of our state budget on education because we know that opportunity is discovered in Georgia’s classrooms.

In these budget times, there are certain things we can do to help our local school systems. We have already informed schools of our intention to relax expenditure controls, giving them additional flexibility. This move will allow those closest to the students to manage funds in the most efficient way.

… Last year, I proudly signed IE2 legislation. Let me boil it down for you … this is true local control with real accountability! In exchange for this flexibility, systems entering into a contract with the State Board of Education are held accountable for increased student achievement above and beyond state and federal requirements. And they will face serious consequences if they fail to meet those goals.

It’s exactly the kind of clear, straightforward and results-driven program local school districts have asked for since I came into office. And, just last week, the State Board of Education approved the first IE2 contract with Gwinnett County.

This means that ten percent of the students in Georgia will be under a performance contract to increase student achievement. I commend Alvin Wilbanks and the Gwinnett County School Board for continuing to lead by example.

In the weeks and months to come, I believe you’re going to see progressive school systems from all around the state sign on, and if you’re in a parent in Georgia, that’s something to be excited about!

As I outlined yesterday, I am proposing legislation that will ensure that every student in Georgia has the benefit of responsible leadership at the school system level.

Most local school board members in this state are in that position for all the right reasons and they do a great job for our students, but unfortunately, that isn’t universal. And we must take action, because when a school board is failing, every student that depends on them is cheated.

This legislation will clearly define what citizens expect from school board members and it will give the state the ability to replace board members with responsible, local citizens when accreditation is threatened. Never again, do I intend for the state to be handcuffed by our current law and powerless to help students who are being failed by the adults in their community.

Also, I will propose legislation to establish a high school principal incentive pay program for those principals who increase student achievement – raising graduation rates and improving SAT and End of Course Test scores.

I am proposing merit pay legislation that will award teachers who show evidence that their classroom instruction leads to increased student achievement. Currently, extraordinary teachers are locked into a compensation model that fails to reward excellence. This is the next step in moving education from a culture of compliance to one based on performance.

We are also proposing differentiated pay for math and science teachers. It astonishes me that this state produced just three physics teachers last year. We must introduce a market dynamic into the salary schedule to address these critical needs areas. Some may be surprised to hear these ambitious plans in these times, but, this more than any other period, is a time to continue improving education and the basic institutions of government.

We are fortunate to live in a state where people want to be. Last year, Georgia was the fourth fastest growing state in the nation. And in the last eight years, we have added 1.5 million people.

Not only do people move here, they stay here. Georgia ranks third in the nation for keeping our native-born population, with over 69 percent of people who were born in Georgia still living here. I don’t say all this just to share statistics, there is a story there, and it’s a story about Georgia’s competitive advantages and a great quality of life.

This enormous growth brings its own challenges … I call those the “problems of prosperity.”

We continue to work to protect our most precious natural resource … water. Last year, I signed into law Georgia’s first Comprehensive Statewide Water Management Plan to help our state balance water use and growth.

I want to, again, thank all of you for participating in what I consider to be the most inclusive piece of legislation we’ve worked on since I’ve been Governor.

The Lieutenant Governor, Speaker and I will soon announce our appointments to the Regional Water Councils. We are working to ensure that those selected will represent a good cross-section of Georgia talent – both in their personal experiences and geographically. These councils are going to put our Statewide Water Plan in action.

I am confident the rains will come, and I am encouraged by the fact that our new management plan will make us better stewards, both now and over the long term.

Our experience in working together on the water plan will be needed again as we address our transportation needs. A growing Georgia will depend upon a transportation network that supports mobility and commerce. Like most government programs, the money available is short of what our needs are, so we must guard every dollar that is spent to make sure we maximize its value. Reforming DOT has been one of the toughest challenges my administration has faced, and we are not through yet.

Last summer, I commissioned Investing in Tomorrow’s Transportation Today, or IT3, so that we as policymakers could understand the value of additional investment, while we continue to bring our transportation planning, funding and building policies up to date.

Transportation improvements providing access to markets, reliable and stress-free commutes and speedy freight movements can be the catalyst that propels our economy forward, just as we have seen over our state’s history.

The Lieutenant Governor, Speaker and I share a mutual commitment to address our transportation needs, and we will continue reforming DOT with a goal of standing up a system that can take that funding and provide the value Georgians deserve. Once I feel certain that we can deliver transportation value to Georgia citizens, I will support responsible measures to raise additional revenues.

… As Georgia grows, so do our energy needs and Georgia is meeting this challenge by creating a fertile environment for alternative energy production. Those efforts have been rewarded with $2.4 billion of investment over the last two years. That investment means new jobs for Georgians.

In November, Norcross-based Suniva, birthed right here in one of our research universities, began fabricating the most advanced solar technology in the world.

This summer, we will host more than 15,000 energy innovators for the biggest bio-lifescience conference in the world – BIO 2009. This is an outstanding opportunity to showcase Georgia’s progress in life sciences, and our potential to help heal, fuel and feed the world.

As we continue to attract new investment in biotechnology, we can secure our position as a leader in this industry by enacting laws that respect the role of the federal Food and Drug Administration as the regulator of the safety of drugs and medical devices.

But the best incentive we can offer an employer is a talented workforce that is ready to meet their needs, and our Work Ready program does just that.

We began Work Ready two years ago and Georgia workers have responded. There are now 111 counties – 70 percent of the state – working toward Certified Work Ready Community status.

As Georgia workers compete with peers as far away as China or as close as South Carolina, Work Ready puts them a step ahead. That is certainly the case with Joy Anthony.

Joy’s Work Ready Certificate distinguished her and gave her the edge she needed in her job search. Her employer was impressed by the skills Work Ready identified and they have designated her as a “Rising Star” in their company.

Joy is one over 35,000 Georgians to take control of their future, making themselves more marketable to employers looking for a talented workforce.

Ladies and gentleman, Georgia is ready to take advantage of our workforce and our strong balance sheet. We remain one of seven states with a triple-A bond rating and we will invest in projects that will be of long-term value to Georgians.

This year’s bond package, totaling over $1.2 billion in new investment, will put Georgians to work and build critical infrastructure. In the past, we have often funded the design phase of a project one year and construction at some later date. This year’s package will feature many projects in which both design and construction are funded in the same year, ensuring their timely completion.

In a time that we have trimmed our budget in other areas, we are aggressively increasing our bond package by a full twenty percent over last year. This will take advantage of low construction costs and create an estimated 20,000 new jobs in an industry that is ready to go to work.

These projects touch every corner of the state and include new construction at our universities, technical schools, local school systems and libraries; harbor deepening at the Savannah port and needed improvements at state facilities.

As I said at the outset today, we’re going to maintain a long-term perspective – we are not going to panic and make knee-jerk decisions that will have negative long-term consequences.

We stand at a crossroads, and as a father and a grandfather ten times over, I can say, we all recognize how important it is to the next generation that we get it right … right now.

Don’t hear me dismissing the scope or severity of this downturn. But, more importantly, don’t leave failing to hear the message that we need to look beyond this downturn.

Think about it, you don’t get anywhere in life without a long-term perspective and a long-term plan. You have to weather the turbulence - that’s true in a career, that’s true in the history of every successful marriage. Isn’t that right, Mary?

When the economy takes a downturn, you don’t give up on the economic promise of America that has proven true over the centuries. You don’t discard the promise … you build for the future with that promise in mind.

There is much to do in Georgia in this coming year but it can be summarized in that overarching mission to continue executing on the fundamentals of good government; to improve our competitive advantages, to make Georgia a better place to live and a better place to do business.

As I look back and think about our history, I am certain that this is not the tallest mountain we’ve been asked to climb.

As I think about the American promise of freedom and economic opportunity, I know that rich promise will mean great things for Georgians in the years to come. The soil has proven too rich to dare believe anything else.

As I look within, I find something within the human constitution that bounces back, something within this collective American spirit that rebuilds.

I’ll never claim to be a Nehemiah; but the prophet’s call, “Let us rebuild the walls,” rings true today. This is the time to continue building our state, to prepare for the future, to plant the seeds that will enrich our children’s inheritance. Together, we will do just that!

Thank you! God bless you. God bless America … and may God bless the great state of Georgia!

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Emory Crawford Long Hospital Celebrates 100th Anniversary

Crawford Long Hospital opened on October 21, 1908 with 26 beds near the present-day Turner Field.

Join Emory Crawford Long Hospital as it celebrates its 100th anniversary in Atlanta. Register for the tours at 404-778-2000.


Tuesday, October 21, 2008
Conservatory
• 7:30 a.m. Historic Tour
• 11:30 a.m. Historic Tour
• 2 – 4 p.m. Cake and Ice Cream
• 3:30 p.m. Time Capsule
Burial Ceremony
• 4 p.m. Historic Tour

Wednesday, October 22, 2008
Outside Seasonings Café
• 2 – 4 a.m. Cake and Ice Cream
Saturday, October 25, 2008
Outside Seasonings Café
• 2 – 4 p.m. Cake and Ice Cream
• 6 – 8 p.m. Cake and Ice Cream

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Awards Ceremony Photos for The DAISY Award for Extraordinary Nurses at Children’s Healthcare of Atlanta in Georgia

GFP Note: Congratulations to the nurses recognized at Children's Healthcare of Atlanta! You are truly a wonderful group of angels on earth.

BUSINESS WIRE --Photos from an awards ceremony for The DAISY Award for Extraordinary Nurses at Children’s Healthcare of Atlanta in Georgia, presented by UnitedHealthcare and The DAISY Foundation, are available to view.

The unique recognition program is part of many hospitals’ recruitment and retention programs, helping to offset the acute shortage of nurses nationwide. Each month, nurses are selected by their nursing administration and peers to receive The DAISY Award. The honorees receive a certificate commending her/him for being an “Extraordinary Nurse.” The certificate reads: “In deep appreciation of all you do, who you are, and the incredibly meaningful difference you make in the lives of so many people.”

Click here for photo of Rick Elliott, President and CEO, United Healthcare of Georgia and Tena Barnes Carraher, The DAISY Foundation, present The DAISY Award to Bobby Patterson, RN, Children's Healthcare of Atlanta (Photo: Business Wire).

Click here for photo of Joyce Ramsey Coleman, CNE, Children's Healthcare of Atlanta, Missy Gilford, RN, DAISY Award winner, Donna Hyland, CEO, Children's Healthcare of Atlanta, Bobby Patterson, RN, DAISY Award winner, Jennifer Tomasini, RN, DAISY Award winner, Rick Elliott, President and CEO, United Healthcare of Georgia, Tena Barnes Carraher, The DAISY Foundation (Photo: Business Wire)

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Orthopaedics & Spine Hospital Opens Sept. 16 at Emory University

Fulfilling its mission to meet the increasing demand for orthopaedics and spine care, Emory Healthcare today announced the opening of the Emory University Orthopaedics & Spine Hospital. The hospital, an extension of Emory's acute care hospital on Clifton Road, will open Tuesday, Sept. 16.

Located at the intersection of Lawrenceville Highway and I-285 in Tucker, Emory University Orthopaedics & Spine Hospital was created to provide high-quality care in the delivery of general acute care services while primarily focused on a specific service line. Emory purchased an existing hospital facility in January 2007, and has now completely renovated it to provide patients with access to the most advanced, sophisticated technology in a patient-and-family friendly environment.

"Emory continues to uphold a promise and commitment to our patients — to provide a quality experience defined by impeccable clinical outcomes, patient safety and patient service," says Fred Sanfilippo, MD, PhD, executive vice president for health affairs at Emory University and chairman of Emory Healthcare.

"This hospital will combine exceptional service with pioneering vision, education, teaching and ideas, and Emory will apply its strategic vision to ensure that we are serving the needs of our patients and their families. This new facility underscores that commitment and vision."

In addition, Emory University Orthopaedics & Spine Hospital is implementing an innovative nursing model where caregivers partner with patients and their families to collaborate on decisions and care. By primarily concentrating orthopaedic surgical services at one location, Emory physicians and staff will be able to focus on the unique needs of the orthopaedic patient population, which translates to quick recovery times, increased safety and greater patient satisfaction.

"The creation and opening of Emory University Orthopaedics & Spine Hospital is an important achievement for Emory Healthcare on behalf of the communities and patients we serve," says John T. Fox, CEO of Emory Healthcare. "Starting from a blank sheet of paper and seeking patient input, we were able to establish a clear vision of the best structure and culture for the new facility, and we worked tirelessly to bring our patients the care they deserve.

"Additionally, and perhaps even more exciting, Emory University Orthopedics & Spine Hospital will embody the collaborative and innovative culture-of-care elements that will help set the future course of patient care across the country, including patient-and family-centered care, shared decision making, a fair and just culture, transparency, and cultural competency and diversity," says Fox. "These attributes are embedded in our decision-making process and, more importantly, are evident in our provision of care."

In addition to offering orthopaedics and spine services in a focused capacity, Emory University Orthopaedics and Spine Hospital will also continue to offer general acute care services for patients with non-surgical needs. A team of Emory University Hospital-based physicians will treat a wide variety of non-critical patient medical conditions, while providing a seamless link to all other specialists located at other Emory hospitals.

"This innovative combination gives patients the benefits of a higher level of care with all the attributes of a major university medical center — research, technology and sub-specialists," says Scott Boden, MD, professor of orthopaedic surgery and director of the Emory Orthopaedics & Spine Center.

"This type of facility is proven to have better outcomes because all physicians and staff are focused on one type of patient problem," says Boden. "By concentrating the orthopaedic surgical services at this location, we will gain a special opportunity to create standardized processes whereby all our physicians and staff are focused on the unique needs of the orthopaedic and spine surgery patient population."

Dr. James R. Roberson, chair of the Department of Orthopaedics and professor of orthopaedic surgery, Emory University School of Medicine, says, "The carefully selected faculty members of Emory's Department of Orthopaedics are some of the most talented and skilled medical professionals in the country and around the globe. These specialists work in tandem with physicians throughout Emory's network to collaborate on diagnosis and treatment of our patients, as well as mentor future orthopaedists and orthopaedic surgeons."

Facts about Emory University Orthopaedics & Spine Hospital and Emory Orthopaedics & Spine Center

Hospital: The Emory University Orthopaedics & Spine Hospital, an extension of Emory University Hospital, is staffed exclusively by Emory physicians. The facility is six stories and has 208,000 square feet of space which includes a medical office building.

It provides complete MRI and radiology capabilities as well as on-site inpatient and outpatient physical therapy. Furnishings and furniture in the new facility are customized for total joint and spine patients, and there are newly appointed private suites (most private suites have a pullout bed for family members).

The facility has a dedicated orthopaedics and spine patient floor, as well as general medicine services. Because there is unrestricted visiting hours, families can stay with patients all of the time. A restaurant and in-room dining are available 7 am-7 pm.

There will be no emergency room located at Emory University Orthopaedics & Spine Hospital. All emergency and trauma traffic will be diverted to the nearest appropriate facility.

Outpatient Center: The Emory Orthopaedics & Spine Center is a state-of-the-art outpatient facility located at Executive Park, which offers a comprehensive approach to all musculoskeletal problems. The Center has reinvented orthopaedic and spine care by bringing all aspects of diagnosis, treatment and rehabilitation together in one location.

More than 40 specialists work together under one roof [95,000 square feet] to provide the full range of outpatient orthopaedic, spine, neurosurgery, sports medicine and physical therapy care. The Center at Executive Park is about 7 miles from Emory University Orthopaedics & Spine Hospital.

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