Georgia House Speaker David Ralston (Photo by Beau Evans)
ATLANTA – The General Assembly gave final passage Wednesday to an overhaul of the state’s mental health-care delivery system praised as “transformative” by one legislative supporter.
The Georgia Senate passed House Bill 1013 unanimously. The House of Representatives followed a short time later, also voting unanimously to agree with changes to the legislation made on the Senate side.
Georgia ranks among the lowest states in the nation for access to mental-health services.
But that dismal status should end as a result of Wednesday’s vote, an emotional House Speaker David Ralston – who made the bill his top priority for this year’s session – told House members after the vote.
“Today, hope won,” said Ralston, R-Blue Ridge, to a standing ovation from the lawmakers. “Countless Georgians will know we’ve heard their despair and frustration.”
The legislation, which now heads to Gov. Brian Kemp for his signature, requires health insurance companies to cover mental illness the same way they cover physical illness. The parity provision also would apply to Georgia Medicaid and the State Health Benefit Plan.
Care management organizations (CMOs) participating in Georgia Medicaid will have to dedicate at least 85% of their revenues to patient care.
The bill also creates a service-cancelable loan program to address a workforce shortage by offering loan forgiveness to several types of mental-health specialists as well as primary-care physicians.
The Senate left intact in the measure the current law requiring that a mentally disturbed person pose an “imminent” threat to themselves or others before they can be involuntarily committed for an evaluation at a mental-health care facility. The original House version of the bill had removed “imminent” from that provision.
“An officer may take an individual to be evaluated without having to charge them with a crime,” said Sen. Brian Strickland, R-McDonough, who carried the bill in the Senate.
The bill also includes legislation originally introduced into the House by Rep. Yasmin Neal, D-Jonesboro, authorizing the Georgia Public Safety Training Center in Forsyth to provide mental health training to police officers.
Legislative leaders have been working on mental health reform for several years. Some of the recommendations from a task force of industry experts formed in 2019 are included in the bill that passed Wednesday.
Strickland said the work the Behavioral Health Reform and Innovation Commission isn’t done. The bill authorizes the panel to keep working on mental-health reforms, setting a new deadline of June 30. 2025.
“Many parts of this bill are long-term investments,” he said. “But we’ll start the process to make Georgia not just the No.-1 state in which to do business, but the No.-1 state for mental-health services.”
Also Wednesday, the House unanimously passed a related Senate bill allowing local law enforcement agencies to develop procedures for mental-health workers to join police in responding to 911 calls.
“If [police] find a mental-health crisis, they can call in a trained mental-health worker,” said Rep. Sharon Cooper, R-Marietta, who carried Senate Bill 403 in the House. “This is the way we should be dealing with our mental-health people.”
Because of changes the House made to the bill, it must return to the Senate to gain final passage.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
ATLANTA – After years of nibbling around the edges of regulations governing how Georgia hospitals operate, the General Assembly may decide to scrap the Certificate of Need (CON) law altogether.
A state House committee approved legislation late last week that would repeal CON by 2025. It could hit the House floor on Tuesday, the Crossover Day deadline for bills to pass at least one legislative chamber to remain alive for the year.
The 1979 CON law requires applicants wishing to build a new medical facility or provide new health-care services in Georgia to show it is needed in their communities. It was enacted to comply with a federal mandate aimed at reducing health-care costs by avoiding duplication.
Instead, the law has increased the costs of care by stifling competition, House Majority Whip Matt Hatchett, R-Dublin, the bill’s chief sponsor, told members of the House Special Committee on Access to Quality Health Care.
“We’ve allowed our large hospitals to become monopolies in their communities and continue to raise prices,” he said. “The large hospitals get larger, and our small hospitals continue to struggle to survive.”
The General Assembly has reformed the CON law over the years. In 2008, lawmakers exempted physician-owned ambulatory surgery centers with a single specialty from having to obtain a CON.
In 2013, the legislature limited the filing of objections to CON applications to existing hospitals within 35 miles of a new facility seeking a certificate of need.
House Bill 1547 would repeal CON as of Jan. 1, 2025, and replace it with a licensing program with the same indigent care requirements that now apply to CON applicants.
During the two years leading up to the repeal taking effect, the legislation would give multiple-specialty surgery centers the same exemption now provided single-specialty centers.
It also would limit cash reserves nonprofit hospitals would be allowed to maintain and create a new state program to aid uninsured mental health patients.
Opposition to the bill is led by organizations representing Georgia hospitals.
Monty Veazey, president and CEO of the Tifton-based Georgia Alliance of Community Hospitals, said repealing the CON law would devastate an industry already struggling to emerge from COVID-19 and saddled with a severe shortage of health-care workers, particularly nurses.
“This bill comes at the worst time for us,” he said. “Across the state, hospitals are losing millions of dollars. … When you repeal CON and allow ASCs (ambulatory surgery centers) to proliferate, it just draws paying patients from hospitals.”
Some committee members argued the CON law needs reforming but shouldn’t be repealed.
“I don’t think the answer to the CON issue is to totally eliminate it,” said Rep. Butch Parrish, R-Swainsboro.
But Rep. Sharon Cooper, R-Marietta, said the years of opposition the hospital industry and its hired lobbyists have mounted to reforming CON have convinced some lawmakers it’s time to scrap the process.
“Any time you try to get even minor changes, the answer is always, ‘No,’ ” she said. “That’s the frustration all of us are feeling. … I’m sick of it.”
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
Georgia House Speaker David Ralston (Photo by Beau Evans)
ATLANTA – A bipartisan overhaul of Georgia’s mental health system took a first step toward passage Wednesday when it cleared a state House committee.
The House Health and Human Services Committee approved the comprehensive legislation and sent it on to the House Rules Committee to schedule a floor vote.
Wednesday’s vote came after House Speaker David Ralston, the bill’s chief sponsor, urged the panel to act on what he said is the most important issue lawmakers are facing this year.
“This discussion impacts most every family in Georgia in one way or another,” said Ralston, R-Blue Ridge. “Many Georgians are suffering with mental health issues. Their families are suffering.
“They’re looking for help and either don’t know where to turn or may not have a viable option for mental-health services.”
Georgia ranks 48th in the nation in access to mental health and substance abuse services.
The Mental Health Parity Act would require health insurance companies to treat mental illness in the same way they treat physical illness. The parity provision also would apply to Georgia’s Medicaid and PeachCare for Kids programs and to the State Health Benefit Plan for Georgia teachers and state employees.
The legislation also would require care management organizations (CMOs) participating in Georgia Medicaid to dedicate at least 85% of their revenues to patient care.
To address the shortage of mental health and substance abuse workers, the bill would create a service-cancelable loan program, an initiative expected to cost $8 million to $10 million.
“Whoever can be part of growing and expanding the workforce is paramount to what we do,” said Rep. Katie Dempsey, R-Rome.
The lengthy bill underwent a series of changes as it made its way through the committee aimed at concerns mental health and substance abuse treatment advocates raised.
For one thing, it removed a proposed registry of children who have required the intervention of the state’s crisis services after complaints it would amount to an invasion of privacy.
Advocates also complained the legislation would make it too easy to involuntarily commit Georgians to mental health care.
Another sticking point has been over who should provide “subsequent transport” of patients brought to hospitals by law enforcement or emergency medical services personnel and how to pay for it.
Rep. Mary Margaret Oliver, D-Decatur, one of the bill’s cosponsors, said the state’s mental health system serves most mentally ill Georgians well but is broken when it comes to those in the most distress.
“The money we’re trying to spend in an effective way is about the folks who are not being managed well,” she said. “They end up in jails, as homeless or in our emergency room system.”
Oliver said financial help is on the way. Georgia expects to receive $600 million from a recent national opioid settlement, including $88 million that will be available in next year’s state budget, she said.
Committee Chairman Sharon Cooper, R-Marietta, said the extension work the panel has put in on Ralston’s bill has helped identify gaps in Georgia’s mental health services delivery system.
“It will help us see how we need to change the system to make it more efficient,” she said.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
ATLANTA – Bipartisan legislation aimed at improving the delivery of mental health and substance abuse services in Georgia got its first hearing in the General Assembly Wednesday.
The 75-page Mental Health Parity Act would require health insurance companies to treat mental illness in the same way they treat physical illness. The parity provision also would apply to Georgia’s Medicaid and PeachCare for Kids programs and to the State Health Benefit Plan for Georgia teachers and state employees.
“If you’re covering physical, you’ve got to cover mental,” state Rep. Todd Jones, R-South Forsyth, one of the bill’s cosponsors, told members of the House Health and Human Services Committee.
The legislation, a major priority of House Speaker David Ralston, also would require care management organizations (CMOs) participating in Georgia Medicaid to dedicate at least 85% of their revenues to patient care.
And the bill contains a workforce development component in the form of a service-cancelable loan program aimed at recruiting mental health and substance abuse workers. The initiative is expected to cost $8 million to $10 million.
“Our biggest issue is workforce,” said Rep. Mary Margaret Oliver, D-Decatur, another one of the bill’s cosponsors and a member of a commission formed in 2019 that included mental health, substance abuse and criminal justice experts. “Workforce issues are critical all across Georgia.”
The state has a long way to go to improve its mental health and substance abuse care system. In 2019, Georgia ranked 48th in access to mental health and substance abuse services.
”This is an opportunity for Georgia to pick up … and hopefully leap into the top five,” Jones said.
A key reality holding Georgia back is that many people with mental illness or substance abuse issues are behind bars rather than in treatment facilities.
“We’ve criminalized mental illness,” said LaGrange Police Chief Lou Dekmar, also a member of the Behavioral Health Reform and Innovation Commission. “The largest mental health facility in each county is the county jail.”
The bill drew strong support Wednesday from many mental health- and substance abuse-care advocates, particularly the parity provision that gives the legislation its name.
“Lack of parity leads to insurance companies denying coverage, long waiting lines, [patients] not receiving early treatment and families paying out of pocket,” said Helen Robinson, associate director of public policy at The Carter Center’s Georgia Health Parity Collaborative.
But others objected to a provision in the bill that would make it easier for police officers to forcibly take into custody a person in mental health crisis who has not committed a crime.
Another sticking point was over a registry the bill would create as a database to give mental health professionals a better idea of where to target services. Some speakers raised concerns the registry could invade patients’ privacy and subject them to the stigma associated with mental illness.
But committee Chairman Sharon Cooper, R-Marietta, said the heart of the bill would address that issue
“If we do nothing else … passing parity will help decrease the stigma,” she said. “We as a legislature will be saying, ‘Having mental illness is no different from having a medical illness.’ “
Cooper said lawmakers will work on incorporating some of the changes in the bill advocates have suggested and return with a new version of the legislation as early as next week.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
ATLANTA – Veteran Georgia Rep. Matt Dollar of Marietta resigned from the House Tuesday to take a job as deputy commissioner of the Technical College System of Georgia.
Elected in 2002 at age 24, the Republican went on to become the youngest committee chairman in the General Assembly.
Until Tuesday, he was serving as chairman of the House Creative Arts and Entertainment Committee. In that role, he steered legislation through the House two years ago that brought Georgia’s popular film tax credit under greater scrutiny, a move aimed at strengthening the credit by responding to arguments that the program was vulnerable to abuse.
This year, Dollar is the chief sponsor of legislation calling for a referendum to create a city of East Cobb. The measure cleared the House last week and has moved over to the state Senate.
In an emotional farewell speech Tuesday, Dollar said he’s sad to be leaving his friends in the House, including many from the other side of the aisle.
“Some of my closest friends have been Democrats,” he said. “I don’t apologize for that. … This place has taught me that those who show the most respect are the most respected.”
The new House map drawn by the Republican-controlled General Assembly last fall put Dollar in the same House district as Health and Human Services Committee Chairman Sharon Cooper, R-Marietta. Dollar’s departure clears the way for her to seek reelection without a divisive primary against a fellow GOP incumbent.
At the technical college system, Dollar will be in charge of working on economic development issues.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
