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Georgia State Profile and Policy Report

Georgia Heart Disease and Stroke: State Profile and Policy Report

Table of Contents

Heart Disease and Stroke Burden

Georgia - State Deaths for Heart Disease and Stroke

  • More than 1 out of 4 deaths in Georgia are due to heart disease.

  • 16,478 Georgians died from heart disease in 2006 (24.3 percent of total deaths in Georgia).

  • 3,889 Georgians died from stroke in 2006 (5.7 percent of total deaths in Georgia).
    Source: National Vital Statistics Report, 2009.

 

Georgia - 2007 State Risk Factors for Heart Disease and Stroke

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Georgia - 2003 State Costs for Cardiovascular Disease

In October 2007, the Milken Institute, an independent research group, released a study, An Unhealthy America: The Economic Impact of Chronic Disease. The study details the economic effects of treatment costs resulting from chronic disease in the United States. Below is a breakdown of Georgia’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.

Georgia Annual Cost of Hypertension, Heart Disease and Stroke 

Treatment Expenditures (Direct Costs) - Total annual medical cost.

Hypertension 

$1.00 billion

Heart Disease          

$1.45 billion

Stroke                     

$.34  billion

Source: Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007. 
 

Georgia - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases

Based on Georgia's Medicaid population, economic estimates for 2007 were projected using Medical Expenditure Panel Survey data.  Medicaid spending has grown rapidly in recent years, placing a significant burden on state budgets.  To help states estimate the financial impact of cardiovascular diseases among their Medicaid beneficiaries, the Centers for Disease Control and Prevention (CDC) and RTI International developed the Chronic Disease Cost Calculator, which was used to estimate the Medicaid costs below. 

 Heart Disease

 $ 148 million

 Hypertension

 $ 467 million

 Stroke

 $ 266 million

 Congestive Heart Failure

 $ 56 million

 

Funded CDC Heart Disease and Stroke Prevention Program in Georgia

The Centers for Disease Control and Prevention funds Georgia's Heart Disease and Stroke Prevention program to increase control of high blood pressure and cholesterol; increase awareness of the signs and symptoms of heart attack and stroke and the importance of promptly calling 911; improve emergency response; improve quality of care; and eliminate related health disparities.  These efforts are informed by monitoring heart disease, stroke and related risk factors statewide.

Georgia State Highlights - Heart Disease and Stroke Prevention Program

  • Georgia is part of the Tri-State Stroke Network funded by CDC. The network, led by the North Carolina Department of Health and Human Services/Division of Public Health, also includes South Carolina.

  • The Stroke Heart Attack Prevention Program (SHAPP), which serves more than 17,000 high-risk individuals with diagnosed high blood pressure, represents the program’s major health care domain initiative focused on blood pressure control. The Georgia state office supports the program through provision of nurse protocols that are based on Joint National Commission 7 (JNC7) guidelines for hypertension management and treatment. These protocols ensure that public health nursing evidence-based approaches in SHAPP include diagnosis, management and treatment. The most recent protocol, approved in 2007, includes a smoking assessment and brief cessation counseling and referral to the Georgia Tobacco Quitline as indicated. The newest protocol also includes DASH (Dietary Approaches to Stop Hypertension) in the case management plan. Updated protocols are distributed annually for use in all county public health clinics and by other providers.

  • The LaGrange District Worksite Project was established along with health district staff and a local self-insured worksite to institute incentive-based health benefit policy changes that reward healthy lifestyles as evidenced by controlled blood pressure, healthy weight management, normal cholesterol levels and being tobacco-free. The worksite demonstrated a 20 percent reduction in absenteeism and a savings of $750,000 in health care costs over a 12-month period as a result of these changes.

State Laws and Policies

Public Awareness of Heart Disease and Stroke

GA SR 14 (2011, adopted)Recognizes Friday, February 4, 2011, as "National Wear Red Day" and encourages all citizens to show their support for women and the fight against heart disease by wearing red.

GA HR 569/SR 392 (2011, adopted) - Recognizes Tuesday, March 22, 2011, as “Georgia Rides to the Capitol Day” and commends the local and state officials for improving trails and promoting cycling as an alternative mode of transportation. 

GA HR 1302/GA SR 921 (2010, adopted) - Recognizes February 5, 2010, as “National Wear Red Day” at the state capitol.

GA HR 1690/GA SR 1215 (2010, adopted) - Recognizes Tuesday March 23, 2010, as “Georgia Rides to the Capitol Day.”

GA SR 142 (2009) - Recognizes February 6, 2009, as "National Wear Red Day" at the state capitol.

HR1090 (2008) - This resolution proclaims February 14, 2008, as "A Day of Hearts: Congenital Heart Defect Day at the Georgia Capitol."

SR771 (2008) - The members of the Senate recognize, Friday, February 1, 2008, as "National Wear Red Day" at the state capitol and urge all citizens to show their support for women and the fight against heart disease by commemorating this day by the wearing of the color red, increasing awareness, and empowering women to reduce their risk for cardiovascular disease.

O.C.G.A. 40-2-86.21 (2008) - Issuance of a special license plate for stroke awareness, treatment, and prevention to support programs aiding stroke victims in Georgia. Such license plate shall not include a space for a county name decal but shall instead bear the legend "Stroke Awareness" in lieu of the name of the county of issuance. The funds raised by the sale of this special license plate shall be disbursed to the Center for Telehealth of the Medical College of Georgia.  The General Assembly has determined that the issuance of special license plates to support an agency or fund or a program beneficial to the people of this state that is administered by a nonprofit corporation organized under Section 501(c)(3) of Title 26 of the Internal Revenue Code and dedicating a portion of the funds raised from the sale of these special license plates is in the best interests of the people of this state. 

HR662 (2003) - The month of May is designated as Stroke Awareness Month in Georgia. The members of the House of Representatives join in commending the outstanding efforts of the American Stroke Association, the National Stroke Association, and others.

SR521 (2005) - The members of the Senate encourage all Georgians to educate themselves about congenital heart disease and cardiovascular disease and to have regular and frequent health exams so that they can become healthier and lead more independent and productive lives.

SR320 (2005) - Last year, nearly 320,000 Georgians took the time to learn lifesaving skills from a Red Cross instructor including first aid, CPR, use of an automated external defibrillator, water safety and lifeguarding, and how to prevent the spread of HIV/AIDS; while an additional 25,000 Georgians gave their time as Red Cross volunteers and 187,500 Georgians gave "the gift of life" by donating more than 300,000 pints of blood for local patients through the American Red Cross. The members of the Senate join the President of the United States, the Governor of Georgia, and government officials across the country in proclaiming March, 2005, American Red Cross Month and call upon all citizens to support and honor this organization and recognize its proud heritage of service by taking the pledge to become partners in preparedness.

SR239 (1999) - Thursday, February 25, 1999, is Emergency Medical Services Recognition Day in Georgia, and it is fitting and proper that the first responders, emergency medical technicians, cardiac technicians, and paramedics of Georgia be recognized for their outstanding and courageous service to the people of this state. Every first responder, emergency medical technician, cardiac technician, and paramedic in Georgia is commended for outstanding service to the people of this state and that Emergency Medical Services Recognition Day be observed in honor of these lifesaving professionals by inviting them to a day at the Capitol on Thursday, February 25, 1999.  Thousands of [first responders, emergency medical technicians, cardiac technicians, and paramedics] perform their lifesaving duties through a network composed of hundreds of nonlicensed first responder providers, certified automatic external defibrillator providers, air ambulance transport providers, and in excess of 270 licensed first responder services, emergency medical services, and neonatal transport services.

Prevention of Risk Factors (Nutrition, Physical Activity and Tobacco)

Tobacco Control

Georgia does not have a state employee tobacco cessation program, nor does it meet all three CDC guidelines that include:

1) Coverage for at least four counseling sessions of at least 30 minutes; NO 
2) Access to smoking cessation agents, including prescriptions and nicotine replacement; NO 
3) Counseling and medication coverage for at least two quit attempts annually; NO  

  • Georgia has a cigarette excise tax and quit line.  The cigarette excise tax in Georgia is $.37.

  • A statewide public cessation program is available; coverage may vary from other programs. 

GA HR 246 (2009, adopted) - Declares Tuesday, March 3, 2009, as "Georgia Rides to the Capitol Day." Cycling increases physical work capacity, significantly reduces harmful cholesterol levels, reduces obesity, and lessens the risk of heart disease and heart attacks. The Metro Atlanta Mayors Association supports and encourages all metropolitan Atlanta cities to participate in the 2009 "Georgia Rides to the Capitol" campaign, departing from the cities of Decatur and Roswell during the 2009 legislative session. The Metro Atlanta Mayors Association passed a resolution supporting the continued development of regional bike and pedestrian trails. The creation of new trails and connectivity to existing trails; and the North Georgia Bicycle Dealers Association, Georgia Bikes, Southern Bicycle League, Atlanta Bicycle Campaign, and Bike Roswell are organizations cosponsoring the "Georgia Rides to the Capitol" event, working to improve bicycling conditions, promoting bicycling throughout the state, and striving toward giving children, the general public, law enforcement officials, and cyclists more knowledge about bicycle rights, responsibilities, and safety.

GA HR 910 (2009, adopted) - Recognizes the American Heart Association and March, 2009, as Nutrition Month at the state capitol. A healthy diet and lifestyle are the best weapons against cardiovascular disease. Simple steps can create a healthy lifestyle and can result in long-term benefits to an individual's overall health and heart health. The American Heart Association is a national voluntary health agency devoted to building healthier lives that are free of cardiovascular diseases and stroke.


Increase Early Detection and Treatment of Risk Factors

O.C.G.A. 31-43-12 (2008) - The commission on men’s health shall: (1) Adopt rules as necessary for its own procedures; (2) Develop strategies, public policy recommendations, and programs, including community outreach and public-private partnerships, that are designed to educate Georgia's men on the benefits of regular physician check-ups, early detection and preventive screening tests, and healthy lifestyle practices; (3) Focus on improving health outcomes of men in specific disease areas, including but not necessarily limited to prostate and testicular cancer; cardiovascular disease including high blood pressure, stroke, and heart attacks; depression and suicide; and diabetes; (4) Monitor state and federal policy and legislation that may affect the areas of men's health; (5) Recommend assistance, services, and policy changes that will further the goals of the commission; and (6) Submit a report of its findings and recommendations under this chapter to the Governor, the President of the Senate, and the Speaker of the House of Representatives not later than October 1 of each year.

State Employee Health and Wellness

In 2005, Georgia provided 12 plan choices including one indemnity, two Preferred Provider Organizations (PPOs), nine Health Maintenance Organizations (HMOs) and a Medicare+Choice. It was one of the first states to establish a multi-agency preferred drug list, aimed at reducing costs. The same list is applied to Medicaid recipients. The five-page "PDL list" is available to all members online.  The State Health Benefit Plan covered 664,703 people as of January 1, 2007. Teachers and school personnel represent almost 77 percent of the covered lives.

  • The state requires a $30 monthly "Spousal Surcharge" be applied to members whose spouse is eligible for coverage through his/her (non-state) employer but elects not to take the coverage. (2008)

  • Georgia initiated a smoker surcharge.  GA: State employees who smoke pay extra for insurance  Beginning July 2005, more than 54,000 people covered by the insurance plan for state employees are paying an extra $40 per month because they smoke or use tobacco. Tobacco Q & A.  A $40 tobacco surcharge applies to any member and/or one of his/her dependents who use(s) tobacco products. This surcharge is designed to encourage tobacco users to a healthier lifestyle. Smoking cessation classes are offered to members and dependents who want to stop using tobacco products. (2008)

Improve Quality of Care and Access to Care

SR496 (2006) - WellStar Health System was successful in its mission to bring cardiovascular surgery services to Northwest Atlanta, providing a complete cardiac continuum of care for the community. WellStar Health System has a distinguished history of providing comprehensive, noninvasive cardiology services, including cardiac intensive care, cardiac catheterization, and cardiac rehabilitation services. The members of the Senate recognize and commend the valuable efforts of Dr. Robert A. Lipson and WellStar Health System and express their gratitude for their continued commitment to improving the health of citizens in Northwest Atlanta.

Address and Eliminate Disparities

No policy listed at this time

 

Emergency Medical Services (EMS) and Automated External Defibrillators (AED)

GA SR 590 (2011, adopted) - Encourages the Georgia Department of Education to implement cardiopulmonary resuscitation (CPR) classes in public schools.

O.C.G.A. 20-2-775/HB 1031 (2008) - No later than July 1, 2008, each public high school in this state which has an interscholastic athletics program shall have at least one functional automated external defibrillator on site at such school at all times and easily accessible during any school related function, including athletic practices, athletic competitions, and other occasions where students and others will be present, for use during emergencies. Each high school possessing and maintaining an automated external defibrillator shall: (1) Ensure that expected users of the automated external defibrillator receive American Heart Association or American Red Cross training in cardiopulmonary resuscitation and automated external defibrillator use or complete an equivalent nationally recognized course; (2) Notify the appropriate emergency medical services system of the existence and location of the automated external defibrillator prior to said automated external defibrillator being placed in use; (3) Ensure that the automated external defibrillator is maintained and tested according to the manufacturer's operational guidelines; (4) Ensure that there is involvement of a licensed physician or other person authorized by the composite board in the site's automated external defibrillator program to ensure compliance with requirements for training, notification, and maintenance; and (5) Ensure that designated personnel activate the emergency medical services system as soon as reasonably possible after any person renders emergency care or treatment to a person in cardiac arrest by using an automated external defibrillator and reports any clinical use of the automated external defibrillator to the licensed physician or other person authorized by the composite board who is supervising the program.

O.C.G.A. 31-11-53.1 (2008) - (1) It is recommended that all persons who have access to or use an automated external defibrillator obtain appropriate training as set forth in the Rules and Regulations of the Department of Human Resources Chapter 290-5-30. It is further recommended that such training include at a minimum the successful completion of: (A) A nationally recognized health care provider/professional rescuer level cardiopulmonary resuscitation course; and (B) A department established or approved course which includes demonstrated proficiency in the use of an automated external defibrillator. (2) All persons and agencies possessing and maintaining an automated external defibrillator shall notify the appropriate emergency medical services system of the existence and location of the automated external defibrillator prior to said defibrillator being placed in use. (3) All persons who use an automated external defibrillator shall activate the emergency medical services system as soon as reasonably possible by calling 9-1-1 or the appropriate emergency telephone number upon use of the automated external defibrillator. (4) Within a reasonable period of time, all persons who use an automated external defibrillator shall make available a printed or electronically stored report to the licensed emergency medical services provider which transports the patient.

O.C.G.A. 31-11-53.2 (2008) - (a) As used in this Code section, the term "lay rescuer" means a person trained to provide cardiopulmonary resuscitation and to use an automated external defibrillator, as defined in Code Section 31-11-53.1, and who is participating in a physician or medically authorized automated external defibrillator program.

O.C.G.A. 51-1-29.3 (2008) - (a) The persons described in this Code section shall be immune from civil liability for any act or omission to act related to the provision of emergency care or treatment by the use of or provision of an automated external defibrillator, as described in Code Sections 31-11-53.1 and 31-11-53.2, except that such immunity shall not apply to an act of willful or wanton misconduct and shall not apply to a person acting within the scope of a licensed profession if such person acts with gross negligence.  Nothing in this Code section shall be construed so as to provide immunity to the manufacturer of any automated external defibrillator or off-premises automated external defibrillator maintenance or service providers, nor shall it relieve the manufacturer from any claim for product liability or failure to warn.

HR412 (sub) (2007) - There is created the House Study Committee on Layperson Training in CPR and Automated External Defibrillators to be composed of three members of the House of Representatives to be appointed by the Speaker. The funds necessary to carry out the provisions of this resolution shall come from the funds appropriated to the House of Representatives. In the event that the committee makes a report of its findings and recommendations for proposed legislation, such report shall be made no later than December 31, 2007. The committee shall stand abolished on December 31, 2007.

SR934 (2002) - A Senate Study Committee on Automated External Defibrillators is created to evaluate the relevant issues relating to the availability and use of automated external defibrillators in the state; to assess the need for the establishment of a state-wide registry to serve as a centralized data base tracking the sites at which automated external defibrillators are located throughout the state; and to determine the need for a state-wide reporting system to document usage of automated external defibrillators and to record the results of such usage. The committee will be composed of three members of the Senate and seven advisory members to be appointed by the President of the Senate. The funds necessary to carry out the provisions of this resolution shall come from the funds appropriated to the Senate. In the event the committee makes a report of its findings and recommendations, with suggestions for proposed legislation, if any, such report shall be made to the Governor and General Assembly on or before December 1, 2002. The committee shall stand abolished on December 1, 2002.

Stroke Systems of Care

SR30 (2008) - There is created the Joint Study Committee on State Stroke System of Care to be composed of five members of the House of Representatives to be appointed by the Speaker of the House of Representatives and five members of the Senate to be appointed by the President of the Senate. The Speaker of the House of Representatives shall designate a member of the House and the President of the Senate shall designate a member of the Senate who shall serve as cochairpersons of the committee. The committee shall meet at the call of the cochairpersons in conjunction with the Georgia American Stroke Association, a division of the American Heart Association. the committee shall undertake a study of the system of stroke care in Georgia in regards to primary prevention, notification/response of EMS, acute treatment of stroke, subacute treatment of stroke, rehabilitation of stroke patients, and the disparities in recognition of, as well as treatment in, minority communities.

O.C.G.A. 31-11-110-119/SB 549 (2008) - The [same state agency or state board which regulates emergency medical services personnel and providers] shall identify hospitals that meet the criteria set forth in this article as primary or remote treatment stroke centers. A hospital shall apply to the department for such identification and shall demonstrate to the satisfaction of the department that the hospital meets the applicable criteria set forth in Code Section 31-11-113. The department shall identify as many hospitals as primary or remote treatment stroke centers as apply for the identification, provided that each applicant meets the applicable criteria set forth in Code Section 31-11-113. The department may suspend or revoke a hospital's identification as a primary or remote treatment stroke center, after notice and hearing, if the department determines that the hospital is not in compliance with the requirements of this article.

SR788 (2008) - There is created the Senate Study Committee on Brain Injury Related Neurobehavioral Issues in Georgia to be composed of five members of the Senate appointed by the President of the Senate. The President of the Senate shall designate a member of the committee as chairperson of the committee. The chairperson shall call all meetings of the committee. In addition, the committee membership shall include five nonlegislative members to be comprised of the following: one person or the immediate family member of a person with neurobehavioral issues caused by brain injury, one provider of neurobehavioral services, one commission member of the Brain and Spinal Injury Trust Fund Commission, one member from the Department of Community Health, and one member from the Department of Labor. All nonlegislative members shall be appointed by the chairperson of the study committee. The committee shall undertake a study of the conditions [including stroke], needs, issues, and problems mentioned above or related thereto and as described in the Brain and Spinal Injury Trust Fund Commission´s report for the purpose of determining the infrastructure and funding necessary to develop and implement a coordinated system of care for people with brain injury related neurobehavioral issues and to recommend any action or legislation which the committee deems necessary or appropriate to accomplish this. In the event the committee makes a report of its findings and recommendations, with suggestions for proposed legislation, if any, such report shall be made on or before December 31, 2008. The committee shall stand abolished on December 31, 2008.

SR435/HR675 (2005) - The resolution urges the State of Georgia to work toward passage of legislation that will establish a system of stroke care for all state residents who have suffered a stroke. The Secretary of the Senate is authorized and directed to transmit appropriate copies of this resolution to Governor Sonny Perdue and the American Stroke Association.

 

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