ATLANTA -- Providing health coverage to more poor Georgians, school nurses, smoking prevention and cancer research programs are among the recommendations the state's Board of Community Health approved Tuesday for spending most of the state's share of a national tobacco settlement.
Board members voted unanimously to submit 24 recommendations to Gov. Roy Barnes on how to spend an estimated $4.8 billion the state is due during the next 25 years. The first payment, expected soon, is in the range of $386 million, but it could be less if tobacco consumption drops.
The money comes from a joint lawsuit with other states against the country's major tobacco companies.
Mr. Barnes has earmarked one-third of the state's share for rural economic development and the balance for health care. The board Tuesday sent a message to Mr. Barnes that it prefers that funding for developing rural health systems and ambulance services come from the economic-development third.
Expanding eligibility for various health programs to an estimated 68,000 Georgians could cost $80 million a year.
"This is manna from heaven, but we need to think about what's going to happen when this money runs out," said board member Frank Rossiter of Savannah.
"This is tobacco money. This is manna from hell," retorted Community Health Commissioner Russ Toal.
Mr. Toal noted that Georgia lawmakers rarely change entitlement rules to remove groups of people from eligibility. The funds for the expanded coverage eventually would have to come from taxpayers, giving Mr. Barnes and lawmakers a tough decision, he said.
The board didn't rank its recommendations by priority to give the governor flexibility.
"I really think we need to be broad in what we recommend," said board Chairwoman Joyce Blevins of Thomson. "I think that the governor is going to have special interest in a lot of these areas."
Mr. Barnes has expressed interest in reducing by 33 percent the waiting lists of 4,000 people seeking a waiver from Medicaid rules making them eligible for home- and community-based health services. That idea was included in the board's proposal.
Mr. Barnes will sort through the recommendations -- along with those to be made by the Rural Economic Advisory Council on spending the rural third -- and submit a budget request to the General Assembly in January.