Stay ahead of the curve as a political insider with deep policy analysis, daily briefings and policy-shaping tools.Request a Demo
- 1 in 6 Georgians have mental-health needs while the state ranks 48th in access to care.
- Newly passed mental-health legislation seeks expanding care access and keeping more people in crisis out of jail and emergency rooms.
- Questions remain on how much state funding key mental-health programs will receive.
State lawmakers moved not only to expand mental-health care coverage for hundreds of thousands of Georgians who struggle with accessing it, but also to keep people with severe conditions from winding up in jail or the emergency room instead of local treatment centers.
The Mental Health Parity Act, sponsored by Georgia House Speaker David Ralston, R-Blue Ridge, proposes requiring Georgia’s insurance providers to guarantee coverage for mental health needs – a move patients and advocates say would help lift Georgia from the bottom ranks of states offering mental-health care access.
“It’s not just affecting one individual,” said Corinne Cherry, a Fulton County resident struggling with mental health and substance abuse issues. “It’s affecting everyone as human beings.”
“Now is the time for us to have parity and for us to have these services. I see people in my community that need this, now more than ever,” added Hank Arnold, a Coweta County resident recovering from substance abuse.
Ralston’s bill and related legislation also aim to bolster programs focused on keeping people with mental health issues out of jails and hospitals, such as “co-response” teams that send trained clinicians out with police officers to assess what to do with people experiencing psychotic episodes.
LaGrange Police Chief Louis Dekmar stressed the need for more non-law enforcement help to address mental-health calls. He noted one person with a mental condition in LaGrange who’s been the subject of 176 calls and arrested 31 times over the past decade – a situation Dekmar says is costly and ineffective.
“The largest mental-health facility in each county is the county jail,” Dekmar told State Affairs. “We should not be in the mental-health business.”
Why It Matters
Georgia ranks 48th among all states in residents’ ability to access timely and effective mental health services and have insurance coverage for treatment, according to the nonprofit group Mental Health America (MHA).
The Peach State also ranks 50th in the number of adults with mental health needs who do not receive treatment, as well as 47th in the number of children with depression who don’t receive care, MHA’s findings show.
More than 1 in 6 adults had a mental health condition in Georgia in 2021, including around 336,000 who face serious mental illnesses such as bipolar disorder, severe anxiety or schizophrenia, according to State Affairs’ analysis of data from National Alliance on Mental Illness’ (NAMI) Georgia chapter.
Additionally, more than 44% of Georgia adults reported symptoms of anxiety or depression in February 2021, up about 10% from when the COVID-19 pandemic started in March 2020, according to data from the nonprofit Kaiser Family Foundation (KFF). And 104,000 of the state’s children aged 12 to 17 also suffered from depression in early 2021, according to NAMI data.
As of December 2021, roughly one-third of Georgia adults who need professional mental-health care reported not receiving it, largely due to high costs, NAMI and KFF report.
Nearly half of Georgia’s 159 counties don’t have a full-time psychiatrist, and in counties where there is a psychiatrist, only 53% accept Medicaid, making it tough for many low-income residents to secure mental-health treatment, according to recent findings from the state Behavioral Health Reform and Innovation Commission.
Advocates agree the lack of care access for people with mental health issues drives up costs far beyond what it takes to treat their conditions through larger jail populations, burdening hospitals and lost productivity at work.
“We have a system that people agree is dangerously broken,” said Jeff Breedlove, spokesman for the nonprofit Georgia Council on Substance Abuse.
The Money Question
Last December, state officials tallied up around $51 million likely needed to bolster several mental-health programs in the bill, including more than $28 million to spread co-response teams across the state, which send out mental-health workers on calls with police, according to a report from the state Office of Health Strategy and Coordination.
State lawmakers have offered up around half that amount so far, proposing between $22 million and $26 million amid negotiations that kicked off this week between top House and Senate lawmakers over next year’s $30 billion budget.
Lawmakers are also poised to budget between $3.2 million and $2.2 million for court-ordered involuntary treatment programs – less than the roughly $9.2 million to $11.4 million state fiscal analysts estimated would be needed to start bolstering those programs.
Some $18 million of the amount proposed by lawmakers in this latest bill are for “value-based payments” to local mental-health groups, with few details as to how that funding would be distributed. Both chambers’ lawmakers have proposed less than $1 million for co-response teams.
With less than a week left in this year’s legislative session, budget-writing lawmakers have only settled on approving $10 million to fund cancellable student loans for primary-care physicians and behavioral-health specialists who stay in Georgia and practice in underserved areas.
Whatever happens this week, lawmakers expect to continue pumping more money into mental health in the years to come based on the blueprint from Ralston’s bill, said the speaker’s communications director, Kaleb McMichen.
“As for future funding, Speaker Ralston and the House have committed to addressing mental health care access and quality over the course of several years,” McMichen said. “We expect this issue will be part of the policy and budget discussions in 2023 and on into the future.”
It’s a sigh of relief for Breedlove, of the substance-abuse council, said other local advocates.
“We are operating with trust and confidence that they have been crunching the numbers for this,” Breedlove told State Affairs. “And we believe they have,” he said, adding that mental health advocates are confident funding will happen this year or next.
Kevin Tanner, the county manager for Forsyth County who heads the mental-health reform commission, also said he expects money to keep rolling in for mental health down the road.
“I’m very confident that we’re going to see the funding continue and that we’re going to see good decisions made,” said Tanner, a former state lawmaker.
That confidence is shared by Melanie Dallas, chief executive officer of the Highland Rivers Behavioral Health community service board. Her group, which covers counties in North Georgia from Fannin down to Cobb, said its co-responder teams and case workers have managed to keep 97% of people out of jail and 60% from ER visits since 2019.
“There is so much that we need to do,” Dallas said. “I am not going to shrug my shoulders at any amount of money.”
Join the Conversation
What do you want to know about mental health and state government in Georgia? Share your thoughts/tips by emailing: [email protected].
Want to contact your local state legislator about this issue? Find your legislator here.
Follow key players for this story:
Georgia Crisis and Access Line: 1-800-715-4225
National Suicide Prevention Line: 1-800-273-TALK (8255)
A study committee of Georgia senators took a decisive step Tuesday toward ending a longstanding and contentious law that regulates how and where new medical facilities are located in the state.
The committee’s decision centers on the 44-year-old Certificate of Need law. It was created to control health care costs and cut down on duplication of services and unnecessary expansions. It determines when, where and if hospitals need to be built. Opponents have said the law prevents competition and enables big hospitals to have a monopoly, often shutting out small and private medical outlets.
On Tuesday, the Senate Study Committee on Certificate of Need Reform effectively said the law needs to be repealed. The committee approved, in a 6-2 vote, nine recommendations.
“Based upon the testimony, research presented, and information received, the Study Committee on Certificate of Need Reform has found that the problem Georgia’s CON law was intended to combat no longer exists,” the report said.
However, the head of the Georgia Alliance of Community Hospitals said Tuesday that repealing the law would be a bad idea.
“It would have a devastating financial impact on hospitals and the quality and access to health care,” Monty Veazey, the alliance’s chief executive, told State Affairs.
Veazey said he has not seen the recommendations yet but his organization has sent its own set of recommendations to the senate and house study committees.
“We believe that the certificate of need really does need some modernization and we look forward to working with the committee to work through those recommendations and see if we can reach a compromise position during the upcoming legislative session,” Veazey said. “We still want to see what the House committee recommends before moving forward.”
Here’s what the senate study committee recommends, according to a draft:
- Repeal CON requirements for obstetrics services, neonatal intensive care, birth centers and all services related to maternal and neonatal care across Georgia.
- End requirements for hospital-based CON on Jan. 1, 2025.
- Reform CON laws to eliminate CON review for new and expanded inpatient psychiatric services and beds that serve Medicaid patients and the uninsured.
- Repeal all cost expenditure triggers for CON.
- All medical and surgery specialties should be considered a single specialty, including cardiology and general surgery.
- Multi-specialty centers should be allowed, particularly in rural areas.
- Remove CON for hospital bed expansion.
- Revise freestanding emergency department requirements such that they must be within 35 miles of an affiliated hospital.
- Remove CON for research centers.
The committee will present its recommendations to the Georgia General Assembly when it reconvenes in January.
And subscribe to State Affairs so you do not miss an update.
ATLANTA — The first step in the 2023 electoral redistricting process occurred Monday when Sen. Shelly Echols, R-Gainesville, chair of the Senate Reapportionment and Redistricting Committee, released a draft proposal of new Senate district maps.
Last month, U.S. District Judge Steve Jones ordered Georgia to redraw its state House, Senate and congressional district maps, adopted in 2021 by a majority-Republican-led Legislature, after finding they violated the Votings Rights Act by diluting the power of Black voters. The Georgia General Assembly is charged with submitting new maps to comply with Jones’ order by Dec. 8, and will be meeting in an eight-day special legislative session to do so, starting on Wednesday.
The proposed Senate maps would create two Black-majority voting districts while eliminating two white majority districts in metro Atlanta now represented by Democrats. The districts of state Sen. Elena Parent, chair of the Senate Democratic caucus, and Democratic Sen. Jason Esteves, a freshman, would become majority-Black if the redrawn maps make it through the redistricting process, a change that could invite considerably more primary challenges.
The proposed maps do not significantly alter the district lines for Sen. Valencia Seay, D-Riverdale, and Sen. Marty Harbin, R-Tyrone, whose districts Jones ruled did not comply with the Voting Rights Act. It will be up to Jones to decide if the new maps pass muster.
As it stands, the proposed Senate map will leave Republicans with a 33-23 advantage in the Senate.
On Wednesday legislators will plunge into their redistricting work during a special session at the Capitol. In addition to the state Senate maps, lawmakers must also redraw electoral maps to create Black majorities in one additional congressional district in west-metro Atlanta, and in five additional state House districts in Atlanta and the Macon-Bibb County area.
The proposed Senate maps (and all proposed maps to be submitted by legislators) are available on the Legislative and Congressional Reapportionment Office’s website. Written comments can be submitted (and viewed) by the public through the portal available on the Georgia General Assembly website. Most of the reapportionment and redistricting committee’s hearings are open to the public; the daily legislative schedule is available here.
“The committee encourages public participation and values the input of the community in this vital democratic process,” Echols said in a statement released on Monday.
Subscribe to State Affairs so you will have unlimited access to all of our stories.
Veteran government and political aide Lauren Curry has been named Gov. Brian Kemp’s chief of staff, becoming the first woman in Georgia’s 235-year history to hold that title. Curry, currently the deputy chief of staff, assumes her new role on Jan. 15. She succeeds Trey Kilpatrick who has accepted a job with Georgia Power as …
ATLANTA — An invitation-only tribute service for former first lady Rosalynn Carter will be held at 1 p.m. today on the campus of Emory University at Glenn Memorial United Methodist Church. Former President Jimmy Carter, who has been receiving hospice care at home in Plains since February, is expected to attend, along with other Carter …