ATLANTA - The state Department of Community Health oversees every aspect of Georgia's Medicaid program except determining who is eligible for coverage.
If officials at the Department of Human Resources get their way, the health agency soon could be handling that task as well.
A preliminary draft of the DHR's fiscal 2009 budget request presented to the welfare agency's governing board Wednesday proposes saving nearly $8 million a year by turning over the state's Medicaid eligibility operation to the DCH.
DHR officials argued that the rules governing eligibility are becoming more complicated to enforce, particularly with the state crackdown on illegal immigrants that took effect this month.
Legislation adopted by the General Assembly prohibits adults who can't prove they are in this country legally from receiving certain publicly funded services, including Medicaid.
"We were using three times as much energy to do this job for the same amount of money," Mary Dean Harvey, director of DHR's Division of Family and Children Services, told board members. "In the private sector, it would be a failed business venture."
Gov. Sonny Perdue is asking agencies across state government to cut 2 percent from their fiscal 2009 spending requests and redirect that money to other priorities.
Harvey said getting rid of the Medicaid eligibility operation would meet the governor's target for DFCS.
Human Resources Commissioner B.J. Walker said it's efficient for the DHR to handle Medicaid eligibility because the agency also is in charge of determining who qualifies for welfare and food stamps.
But she said the growing complexities of acting as Medicaid's gatekeeper are overburdening DFCS caseworkers, making them more likely to commit errors.
"As we tighten the front door on who we let in, the front door gets harder to manage," she said.
While the board won't vote on the DHR's budget request until next month, the proposal drew support from board members.
"It's really DCH that administers this program," said board member Vernadette Ramirez Broyles of Norcross.
DCH spokeswoman Amanda Seals said her agency wouldn't comment on the proposal since it is preliminary.
During the same budget presentation, board members heard a more tentative suggestion to shed some of the Division of Public Health's programs either by transferring them to another state agency or privatizing them.
Division Director Dr. Stuart Brown said the Babies Born Healthy and Stroke Hypertension Heart Attack Prevention programs might be better off in other hands.
"My intention is to refocus public health's attention on things it does differently and better than someone else," he said.
Board members were less sympathetic toward losing those programs.
Board member Donald Cole of Albany said he'd rather see them left under the jurisdiction of the county-run public health offices, which are overseen by the DHR.
"In rural counties, often, the best and only delivery point (for health services) is that public health office," he said.
State agencies must deliver their 2009 budget recommendations to Perdue's Office of Planning and Budget by Sept. 1.