State legislators returning for the 2008 session of the General Assembly have some unfinished business securing the public health system that all Georgians rely upon, if only indirectly.

They should attend to that business quickly, beginning with providing more funds and staffing to the state's scandalously underfunded mental hospitals, where unexplained patient deaths over the last six years have prompted a U.S. Justice Department investigation.

Given the momentum that is finally building on the issue, they should also provide a permanent funding mechanism for the state's troubled network of trauma hospitals. That single step — recommended last year but not acted upon — would also help ensure survival of Atlanta's Grady Memorial Hospital, the state's largest public hospital, its most important training ground for new physicians and home to the state's busiest and most sophisticated trauma unit.

As is the case every year, the hardest-fought health care battles will likely come in hammering out state funding for Medicaid, PeachCare and other government health care programs. Legislators should keep in mind that better funding for these programs will help not just Grady but all public hospitals in the state, including those struggling to survive in rural and small-town Georgia.

Here's a rundown of what should be the 2008 Georgia General Assembly's top health care priorities:

Helping Grady and the trauma network. For the first time, Gov. Sonny Perdue and key legislative leaders have all endorsed plans to provide direct funding for the state's network of 14 trauma hospitals. Right now those hospitals are providing the costly service on a voluntary basis, even though that obligates them to also treat poor and uninsured Georgians who are usually unable to pay for that expensive care. Because of those costs, several hospitals have dropped out of the network in recent years and others are considering it.

A study commission on trauma funding in 2006 recommended the state raise at least $80 million annually to offset some of those unpaid bills at network hospitals. (Grady alone had to write off more than $40 million in unpaid trauma bills in 2006 — one of the major causes of its annual operating deficits.)

House Speaker Glenn Richardson proposes an annual $10 fee on vehicle license tags to raise money specifically for trauma care, which seems appropriate. Perdue last year supported increasing fines on "super speeders," those found guilty of driving at speeds well in excess of the speed limit. Combined, the two sources could raise about $100 million yearly for use by network hospitals.

The mechanism for raising the money is less important than the commitment to adequately fund trauma care, a step the Legislature has consistently refused to take. Experts believe that about 700 deaths a year in Georgia can be attributed to lack of accessible trauma care. Georgia should be looking for a consistent revenue base that would allow its trauma-care network to survive and even expand.

Securing patient care at the state mental hospitals. State government leaders, including the Legislature, talk a lot about improving Georgia's mental health system but hardly ever come through with the money and staff to do it.

This year they face a U.S. Justice Department probe prompted by an Atlanta Journal-Constitution investigation of 115 suspicious deaths at state mental hospitals from 2002 through 2006. Additionally, 194 cases of physical or sexual abuse of patients were reported at the seven state facilities during that time.

The Legislature's response in 2007 was to convene yet another panel to study the issue. While this latest commission report is likely to focus on systemwide improvements, the Legislature must act promptly on the state hospitals, where patient health is threatened by understaffing and overcrowding. There were an additional 21 suspicious deaths in 2007, even while the state was under scrutiny, according to an AJC report Sunday.

The newspaper's reporting documented a hospital system where lives are jeopardized by, among other things, failure to properly monitor adverse reactions to powerful anti-psychotic medications and other medical issues that come with treatment. The Legislature must move quickly to force Perdue and the Department of Human Resources, which runs the hospitals, to prioritize budget requests so that the hospitals are appropriately staffed. If hospitals lack the space to handle the backlog of patients, money must be set aside for payments to private psychiatric facilities to care for these patients.

Seven straight legislative sessions have concluded without funding for the ombudsman's position that was created in 2000 to oversee complaints about mistreatment and to investigate patient deaths at the hospitals.

That indifference must stop with the 2008 session. If the state fails again to step up to its responsibilities, a federal judge will eventually force much more costly action.

Medicaid and PeachCare. Perdue and the Legislature should seriously consider the significant spending increases that the Department of Community Health has proposed for these programs. Most are aimed at providing higher reimbursement levels for care of Medicaid patients. If state payments do not come closer to covering the real costs of caring for these patients, more hospitals will fall into the type of budget crisis that threatens Grady Hospital.

The Legislature may also need to set aside additional money to at least maintain current enrollment levels in the PeachCare program, which provides subsidized health insurance for children who would otherwise not be covered. The federal government, which shares the cost of the program, can't decide yet whether to fund a significant expansion of the program. Until Washington makes up its mind, the Legislature should resist any efforts to restrict enrollment or make significant changes to PeachCare benefits.

— Mike King, for the editorial board