by Jill Nolin, Georgia Recorder [This article first appeared in the Georgia Recorder, republished with permission]

March 14, 2023

This year’s House plan to build on last session’s bipartisan mental health bill is receiving a cool reception in the state Senate, where lawmakers have raised concerns about the potential cost.

Sen. Kay Kirkpatrick, a Marietta Republican who is leading the review of the bill, said a substitute bill will likely emerge.

Conservative activists are also once again pushing state senators to reject the bill, raising concerns about the lack of clear definitions while also lodging claims supporters have flagged as conspiracy theories.

The meeting room for a hearing on the bill Monday was packed with both supporters and critics of the bill.

“My inbox probably should have crashed today with the volume of emails from both sides,” Kirkpatrick said after the meeting Monday.

The measure would streamline data sharing among state agencies, study the state’s crisis bed space capacity and expand a loan repayment program meant to grow the behavioral health workforce. It cleared the House early this month with a 163-to-3 vote.

An analysis of the bill’s cost released Monday puts the price tag at as much as nearly $72 million annually and one-time expenses of up to $3.7 million for the studies outlined in the measure, including a critical look at the state’s crisis bed capacity and needs. The fiscal note projecting the estimated cost was not available at the time the Senate committee held Monday’s hearing. 

The most expensive recurring item is for health-related social supports – like for housing and employment – for eligible Medicaid recipients under the age of 19. Such a change would require federal review and cost the state treasury $45 million with an additional $90 million federal match.

Opponents have decried the bill’s Medicaid provisions as an attempt to expand the state’s insurance program for the poor and disabled.

Rep. Todd Jones, a South Forsyth Republican and co-sponsor of the bill, dismissed the criticism as “conjecture” Monday. The proposal, he said, targets specific services and will not add anyone new to the Medicaid rolls.

Jones argued the change could save the state money in the long run.

“If we have a better understanding of what that individual’s challenge is, we can come up with a better treatment plan and hopefully that individual is able to get better or at least get stabilized in a shorter amount of time, hence reducing the amount of resources that the state has to pay for that,” Jones said.

Much of this year’s bill is focused on studies that could provide the foundation for future decision-making, such as one that would assess the gaps in Georgia’s behavioral health workforce. 

But some provisions of the bill would increase local aid directly in the near term. For example, one part would create county-based coordinators who would collaborate with a local criminal justice system and that community’s behavioral health providers to ensure the available resources are being used.

It would cost about $2.3 million to hire a dedicated coordinator for each of the state’s 26 community service boards, according to the fiscal note.

Opponents have fired off wide-ranging accusations, alleging the bill allows for “TikTok like” monitoring and that it is also a backdoor for abortion services.

Mallory Staples, state director for the Georgia Freedom Caucus, panned the bill for growing government in Georgia and said it burdens taxpayers with an issue that should be left to the private sector to handle.

“We don’t want more government,” she said.

Brant Meadows, a Cumming resident who referred to the bill as “mental health equity 2.0,” said this year’s measure left too much to the discretion of “a few elite mental health czars.”

Roland Behm, who serves on the board for the Georgia chapter of the American Foundation for Suicide Prevention, countered that the bill attempts to map out a more effective way to ease the strain on Georgia’s behavioral health system.

“Georgia is at the beginning of a journey to transform mental health and substance use care in the state,” Behm said. “The studies and task forces will create the map for that journey. Absent a map, George’s journey will be aimless and costly, both in terms of individual health outcomes and taxpayer funds.”

Jeff Breedlove, chief of communications and policy with the Georgia Council for Recovery and who also co-leads the broad coalition of advocacy organizations, dismissed some of the criticism flooding lawmakers’ inboxes as “conspiracy theories.”

“It requires the willing suspension of disbelief to take the position that the people who worked on the commission, that the advocates who have worked for a year, that 163 members of the House care any less about kids and families, and civil liberties and constitutional rights then people sitting behind a keyboard, sending inaccurate stigmatizing emails,” Breedlove said Monday.

Aside from the potential cost, senators have also expressed unease with a portion of the bill directing state agencies to settle on a shared definition for serious mental illness by the end of the year. Sen. Ed Setzler, an Acworth Republican, called it a concerning “delegation” to state agencies when there is a lot potentially riding on the definition.

Kirkpatrick seemed to share the discomfort, saying “we’re pretty protective in the General Assembly about defining things.”

Georgia Recorder is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Georgia Recorder maintains editorial independence. Contact Editor John McCosh for questions: info@georgiarecorder.com. Follow Georgia Recorder on Facebook and Twitter.