Georgia legislature passes sweeping mental health reform bill

Debate over mental health care changes has been ongoing for years, and became a cornerstone issue of the 2022 session when House Speaker David Ralston introduced House Bill 1013.

David Goldman / Associated Press

Georgia lawmakers passed sweeping changes to the state’s flagging mental health care system Wednesday after reaching Senate-House agreement on language aimed at forcing health insurers to pay for mental health and substance abuse treatment.

House Bill 1013 flew to final passage with a 54-0 vote in the Senate and a 166-0 vote in the House, then was headed to Gov. Brian Kemp’s desk for his signature or veto.

“Hope won,” House Speaker David Ralston, who spearheaded the measure, told the House as members gave him a standing ovation after the vote. “Countless Georgians will know that we have heard their despair and frustration. We have set Georgia on a path to lifting up and reforming a failed mental health care system.”

Debate over mental health care changes has been ongoing for years, and became a cornerstone issue of the 2022 session when the Republican speaker from Blue Ridge introduced the bill. But the Senate made changes to the House’s original measure, including weakening language aimed at enforcing long-existing federal requirements that health insurers provide the same level of benefits for mental health disorders as they do for physical illness.

Although only a few words were changed Wednesday in the latest version of the bill, advocates said the new wording would require insurers to follow independent standards and block them from deciding for themselves what they would pay for.

“We’ve laid the framework for parity,” said Senate Health and Human Services, a Bainbridge Republican. “State law will have to follow the federal law, which you should have been doing since 2008. Everybody’s in agreement that the state of Georgia, ranking 48th or 49th depending on how you measure us, has not had parity when in the arena of mental health.”

Ralston was more blunt, telling reporters that his message to insurers is “Do the right thing, play by the law,” when it takes effect July 1.

The compromise keeps the current standard for a police officer involuntarily committing someone into treatment, saying the person must show an “imminent” risk of harm to themselves or others. However, new language allows an officer to take someone to an emergency facility to be evaluated after getting permission from a physician. Sen. Brian Strickland, a McDonough Republican, said the change “tightened up” the House language.

The deal also made changes to how mental health patients will be transported, leaving hospitals and not local governments in charge.

The measure still requires that at least 85% of money in public-funded insurance programs goes to patient care, limiting administrative costs and profit. The measure also requires extensive data collection and reports aimed at enforcing the parity mandate.

The bill faced vocal opposition after it passed the state House. Some critics raised concerns it would create a pathway to taking away guns from people diagnosed with mental illness, while others said it would raise insurance premiums for benefits they did not desire. Others focused on language that referenced World Health Organization standards, saying it could put state government in thrall to international standards. The World Health Organization language was removed, instead referring to existing state law to define mental illness.

Rep. Philip Singleton, a Sharpsburg Republican who had led the opposition, characterized the changes as a win. “We got almost everything we asked for,” he said after voting for the measure.

Changes under the bill are projected to cost tens of millions in additional state spending. One provision aimed at boosting the state’s mental health workforce would forgive loans for people studying to become mental health professionals. Funding will be one obligation that the state has to maintain in the future.

“House Bill 1013 doesn’t solve our mental health crisis,” Strickland said. “Many parts of this bill require long-term investment in the years to come.”

The measure also tries to improve existing tools aimed at keeping people with mental health and substance abuse problems out of jail. A grant program would help identify people who should be forced into treatment.

Also Wednesday, the House voted 165-0 for Senate Bill 403 which would require the state’s 23 community service boards, which are local mental health agencies, to provide co-responders to any local law enforcement agency that wants them. Workers would respond either in-person or virtually. Police departments and sheriffs would not be required to use the service. The measure goes back to the Senate for it to concur with minor changes.

Supporters say such services are currently available in six or seven jurisdictions statewide. In Athens-Clarke County, the share of people being arrested by police responding to mental health calls fell from 90% to 10% after such a program was in place, advocates have said.

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