State agency leaders spent this week testifying to members of the House and Senate budget committees about what those cuts meant.

One of the most gripping reports came from Fitzgerald, whose agency administers massive mental health and substance abuse programs.

State Rep. Katie Dempsey, R-Rome, the chairwoman of the House Appropriations subcommittee that oversees Fitzgerald's budget, called the cuts "life-changing, life-robbing." She quoted from budget impact documents predicting an increase in "suicidality, substance abuse disorders and demands on our crisis services that we cannot meet."

“As we look at these cuts … we look at those places where services are delivered to our people, real people who are fighting for their lives,” Dempsey said. “The loss of services — it’s hard to even imagine right now and how we’re going to deal with this.”

Fitzgerald said her agency prioritized serving Georgians who are already in those programs and providing crisis psychiatric beds. The problem is that mental health and substance abuse problems are skyrocketing and the agency needed to increase its services to meet the increased need. The Legislature had budgeted an increase for that, they said. Instead, the extra money the General Assembly allocated is being redirected to plug holes caused by Kemp’s call for budget cuts.

“I can’t tell you how painful it is to hand this back,” Fitzgerald said.

Legislators said the funding fight isn’t over. In fact, the hearings this week were only the beginning of the General Assembly’s work on Kemp’s proposed $28.1 billion budget.

"We need to go back and look at this because this is just not going to work," said state Rep. Darlene Taylor, a Republican from Thomasville and the vice chairwoman of the House Appropriations subcommittee that deals with health issues, adding that there were already too many unmet needs in mental health and substance abuse programs. "We're not going to become a state that lets people wander in the streets."

Other health agencies seeing cuts include the Department of Human Services, where caseworkers who process applications for Medicaid and other benefits are housed. The department would eliminate just over 100 open positions for eligibility caseworkers. Many have been vacant for years as the agency struggles to fill the spots, which start at $27,000 per year, below the poverty level for a household of five.

At the Department of Public Health, Commissioner Kathleen Toomey said despite millions of dollars in cuts there would be minimal or no reduction in services.

The largest cuts were grants to county public health departments, which can sometimes be the only health care presence in a rural county. Toomey said the counties have “flexibility on their end to adapt” financially.

Legislators questioned that.

House Appropriations Committee Vice Chairman Clay Pirkle said Toomey put "a pleasant face on a really tough subject matter."

“I mean I see $15 million in cuts to the county boards of health,” said Pirkle, a Republican from Ashburn. “If we’re going to transfer some of the responsibility onto the counties, to maintain those from the state — some of these counties have a difficult time keeping their lights on.”

Stae Rep. Mary Frances Williams, D-Marietta, said she and others worked seven years to get a bump in public funds for county public health departments, and it appeared that they were back to square one. She doubted the reduction in money would leave services to the public unaffected, despite Toomey's optimism.

“I mean she can’t say that,” Williams said, saying it would be bad publicity and Toomey could face criticism from the governor’s office. “But there’s no way.”

Broce, the governor’s spokeswoman, backed up Toomey, saying the commissioner was well respected and that state budget officials agreed with her conclusions.

DPH officials pointed to the experience of the district that includes Gwinnett County, which has an array of ongoing sources of income, including charity grants that the administrators apply for, fees they collect from patient visits and inspections, and county money. In the proposals so far the district would lose about $386,000 from funds for Gwinnett and $36,000 each for Newton and Rockdale counties, said the director of that district, Dr. Audrey Arona.

Arona said the district will apply for more grants, and that it’s holding off on filling some vacant positions. “We need these positions,” she said.

She added, however, “When there’s a budget cut you do what you can.”

Toomey listed the unusual outbreaks of disease her department dealt with last year and warned that others are already killing Georgians this year, including flu and illnesses associated with vaping. Coronavirus is also considered a threat.

After Toomey left the hearing room, she was surrounded by legislators lined up to voice their concerns about cuts to funds in their counties.

As Toomey noted in her presentation, the department touches every Georgian.

Its employees inspect restaurants, investigate disease outbreaks and fight epidemics by traveling in the community to give information and vaccinations. It has set as its three main priorities maternal mortality and sickness, infant mortality and sickness, and HIV prevention and care.

On top of that, a legislative study committee also recommended that county health departments across the state be beefed up to provide prenatal care. Toomey said afterward that that is a multiyear endeavor in planning stages.

LEGISLATIVE COVERAGE

The Atlanta Journal-Constitution has the largest team covering Georgia's Legislature and offers expertise on issues that matter to taxpayers. Get complete daily coverage during the legislative session at www.ajc.com/politics.

STATE OF HEALTH

Several Georgia agencies with work related to health testified Thursday in hearings on the proposed budget of Gov. Brian Kemp. This is some, but not all, of the work they do.

Department of Behavioral Health and Developmental Disabilities: Treats and runs state hospitals for patients with psychiatric, substance use or developmental issues, including court-mandated patients. Is under court-ordered federal supervision.

Department of Community Health: Runs Medicaid, regulates hospitals.

Department of Human Services: Caseworkers within the department process applications for Medicaid.

Department of Insurance: Regulates health insurance in Georgia.

Department of Public Health: Epidemiology work to stop outbreaks, vaccinations, public information; restaurant inspections.