NAMI: Bills, Risks and Opportunities Summary and Background on the 2018 Legislative Session
As NAMI defines its priorities in seeking policies, funding, laws and regulations that benefit Georgia’s mental health community going in to 2018, it is important to understand the policy/legislative environment. Andy Lord, from Georgia Capitol Solutions, Inc, a congressional lobbyist working with NAMI Georgia, has prepared a summary of the current mental health related legislative considerations and the state of individual actions at present.
Capitol Solutions, Inc.
Full text of the report:
NAMI: Bills, Risks and Opportunities
Summary and Background on the 2018 Legislative Session:
As NAMI considers seeking appropriations, laws and regulations that benefit Georgia’s mental health community going in to 2018, it is important to contextualize the policy/legislative environment.
The upcoming legislation will convene on January 8, 2018 and will likely be one of the shorter sessions in recent memory due to the pending open seat races for Governor, Lt. Governor and a host of House and Senate seats that are being vacated to run for those and other higher offices.
An additional complication is the lingering uncertainty around healthcare reform as a whole at the state and federal levels, and specifica
lly healthcare dollars that may or may not be coming to Georgia. It is a safe assumption that Georgia will have fewer healthcare dollars available, and therefore fewer mental health dollars. As such, “expensive” items are less likely to be considered in the upcoming session, as are items that are regarded as controversial. These dynamics impact issues such as SB 40 (EMS transport) due to some controversy and opening Medicaid codes that can benefit mental health issues, due to potential financial constraints.
However, there is also opportunity. Georgia will likely submit a Medicaid waiver to the federal government, and may also end up with a “block grant” from the federal level that Georgia would then be charged with using wisely. Though there is risk here, there is also opportunity.
Lastly, the issue that is most likely to get the most traction is opioids, as the state and national epidemic remains front page news, and one of the legislatures most prominent members (Sen. Renee Unterman) is leading.
In the end, it is best that NAMI decide what issues we believe move Georgia closer to a model state for mental health policy and pursue that agenda directly.
In the meantime, there are a number of bills that remain technically active from last year and they are enumerated at the end of this document under the heading of “LIVE BILLS”. While these bills remain technically active, they are unlikely to pass for a variety of reasons. Instead, Mental Health leaders in the House and Senate have indicated that they will focus disproportionately on appropriations for MH, rather than policy changes specifically (though sometimes appropriations do drive policy changes and extension).
The issues most likely to get traction this legislative session include:
- Opioids: There may be an “omnibus” related to the hot topic of opioid abuse that could include support for those incarcerated on opioid related charges while in jail, making opioid antidotes like narcon available over the counter, and establishing therapuetic treatment opioid centers around the state. The latter of these items could be expensive, and as such may be challenging, or may have to be scaled back to a pilot type of program.
- There is also potential traction for appropriations for behavioral health services for the 0-4 year old population with a focus on early detection and intervention.
- It is less likely that SB 40 (EMS transport) will get traction this year as most regard it as in greater need of study.
- Appropriations targeting the male population ages 18-45 with dual diagnosis/opioid addiction issues is also on the table, with CSB’s being funded to provide the therapeutic services. This is the population that is regarded as having the largest gap between need and available services.
- Lastly, there is some appetite to fund a tax credit for MH providers willing to serve as preceptors, particularly in underserved/low health access areas of Georgia.
Additionally, there is interest, though few specifics on assessing what Georgia can do to better serve our military and retired military that are confronting mental illness and homelessness.
The Homelessness Task Force Committee also released their final report. The entire report can be found and viewed at http://www.senate.ga.gov/sro/Documents/StudyCommRpts/Homelessness.pdf
But the summary of the findings includes:
Based on the testimony and findings previously provided, the Committee makes the following recommendations:
- The Committee recommends that the Department of Community Health explore opportunities to leverage state funds by accessing federal Medicaid funds to support individuals who are currently or at risk of homelessness.
- The Committee recommends an increase in state funding to the State Housing Trust Fund for the Homelessness (SHTF) in order to enable DCA to expand existing homelessness programs as well as to explore additional options and opportunities to maximize federal funds to address homelessness in Georgia.
- The Committee recommends allocating funding to support DCA’s expansion of the Section 811 Project Rental Assistance Demonstration Program and mixed income properties in high density counties.
- The Committee recommends increasing funding for the availability of supported housing placements for Georgia Housing Voucher Program participants.
- The Committee recommends allocating funding for DBHDD to expand the Georgia Housing Voucher and Bridge Program to include non-settlement criteria individuals with a substance use diagnosis.
- The Committee recommends allocating funding to DBHDD for PATH, ACT, CST, and ICM services to support the provision of replacement state-issued identification for enrolled individuals transitioning from correctional facilities.
- The Committee recommends the creation of a statewide public-private partnership to serve as a clearinghouse of best practices, information, and resources that supports developing and sustaining local re-entry case planning collaboratives in every county. Such re-entry collaboratives should be designed to engage law enforcement, community service boards, legal services, the faith community, local non-profit organizations, and behavioral health providers to provide case planning for individuals exiting correctional facilities, with the goal of ending the expensive and ineffective cycle of individuals being admitted to the hospital, incarcerated, and released to homelessness.
- The Committee recommends increasing state funding for private and/or nonprofit homeless shelters to provide increased educational and psychosocial supports for homeless youth.
- The Committee appreciates the working relationship with the Georgia Apartment Association and would like to pursue new options of best practices that have worked successfully in other states. While the apartment rentals in the Metro Atlanta area are in short supply and higher costs, the Committee feels that vouchers are still a realistic option and will aid in solving the issue of adequate temporary housing for the homeless. Further, the Committee recommends that the state continue this ongoing relationship in a dedicated manner to continue to diminish homelessness in Georgia.
Family Therapists: SB 173: Joyce Chandler (R): A BILL to be entitled an Act to amend Title 37 of the Official Code of Georgia Annotated, relating to mental health, so as to authorize marriage and family therapists to perform certain acts which physicians, psychologists, and others are authorized to perform regarding emergency examinations of persons for involuntary evaluation and treatment for mental illness or alcohol or drug abuse; to define certain terms; to provide for related matters; to provide for multiple effective dates; to repeal conflicting laws; and for other purposes. Status: Unlikely to move this session. Failed to emerge from committee last year.
School Based Education Materials (Bill) HB 77: (Rep. Kendrick) (D)-Katie Dempsey (R) is second signer: A BILL to amend Part 3 of Article 16 of Chapter 2 of Title 20 of the Official Code of Georgia Annotated, relating to student health in elementary and secondary education, so as to provide for the development of a list of training materials in mental health, behavioral disabilities, and learning disabilities; to provide that no cause of action is created; to provide that no duty of care is created; to provide for related matters; to repeal conflicting laws; and for other purposes. School Based-Education Materials (Resolution): HR 354: (Rep. Kendrick-(D): A RESOLUTION urging the Georgia Department of Education, in consultation with the Department of Behavioral Health and Developmental Disabilities and mental health experts, to develop and provide to local school systems a list of training materials that would serve to increase awareness of mental health issues and behavioral and learning disabilities; and for other purposes. Status: A non-binding resolution that will likely require an appropriation.
Mental Health Leave: HB 267 (Rep. Alexander (D): A BILL to be entitled an Act to amend Title 34 of the O.C.G.A., relating to labor and industrial relations, so as to require all employers to implement paid sick leave for employees; to provide for exceptions; to specify purposes for which paid sick leave may be taken and the rate at which paid sick leave accrues; to require advance notice of intention to use sick leave under certain circumstances; to provide for verification of the need for sick time in certain circumstances; to provide for record keeping; to prohibit discrimination against an employee for inquiring about or using paid sick leave; to make a violation of an unlawful practice subject to the jurisdiction of the Department of Labor; to authorize a civil action for any violation; to provide for related matters; to repeal conflicting laws; and for other purposes. Status: Unlikely to move due to heavy Democratic sponsorship.
Psychiatric Advance Directive: HB 607: Rep. Pat Gardner (D): A BILL to be entitled an Act to amend Title 37 of the O.C.G.A., relating to mental health, so as to provide for a psychiatric advance directive; to provide for a competent adult to express his or her mental health care treatment preferences and desires directly through instructions written in advance and indirectly through appointing an agent to make mental health care decisions on behalf of that person; to provide for construction of such form; to amend Code Section 16-5-5 and Title 31 of the O.C.G.A., relating to assisted suicide and notification of licensing board regarding violation and health, respectively, so as to include cross-references to the psychiatric advance directive and provide for consistent terminology; to provide for related matters; to repeal conflicting laws; and for other purposes. Status: Pending. Gardner is a respected State Representative that is well informed on these issues.
MH and Addiction Funding HR 627 Rep. Rakeshaw (R): A RESOLUTION creating the House Study Committee on Mental Health and Addiction Treatment Funding Mechanisms; and for other purposes. Status: Likely to be supplanted by other bills/resolutions.
Mental Health Task Force and Mental Health Waiver: SB 4: Sen. Unterman: A BILL to be entitled an Act to amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to medical assistance generally, so as to establish the Georgia Mental Health Treatment Task Force; to provide for legislative findings; to provide for the membership, duties, compensation, and expense allowances; to develop applications for a Medicaid waiver and block grant funding; to prohibit the submission of a mental health Medicaid waiver application without legislative approval; to require agencies’ cooperation; to provide for the abolishment; to provide for a short title; to provide for related matters; to provide for an effective date; to repeal conflicting laws; and for other purposes. Status: the prospects for this bill hinge on how vigorously it is pursued by the sponsor, Sen. Renee Unterman. The bill almost passed last year, but will likely be supplanted with different and additional versions of other bills that seek a similar end, but that benefitted from off-session conversations and study committee work
EMS Emergency Exams: SB 11: Sen, Rhett (D): A BILL to be entitled an Act to amend Title 37 of the Official Code of Georgia Annotated, relating to mental health, so as to authorize emergency medical technicians, cardiac technicians, and paramedics to perform certain acts which physicians, psychologists, and other persons are authorized to perform regarding emergency examinations of a person for involuntary evaluation and treatment for mental illness or alcohol or drug abuse; to provide for related matters; to repeal conflicting laws; and for other purposes. Status: Did not move as 2016 pre-file, no movement expected. Status: Off the table, will not move.
Medications: SB 188-Sen. James (D): A BILL to be entitled an Act to amend Part 3 of Article 16 of Chapter 2 of Title 20 of the Official Code of Georgia Annotated, relating to health, so as to require each local board of education to adopt a policy prohibiting school personnel from taking certain actions in regards to a parent or guardian placing, or not placing, a student on psychotropic medication; to provide for a definition; to provide for related matters; to repeal conflicting laws; and for other purposes. Status: Very unlikely to move.
EMS Transport: SB 40: Unterman (R): A BILL to be entitled an Act to amend Article 3 of Chapter 3 of Title 37 of the Official Code of Georgia Annotated, relating to examination, hospitalization, and treatment of involuntary patients, so as to provide for authorization of emergency medical services personnel to transport certain mentally ill patients under certain circumstances; to provide for reporting requirements; to provide for related matters; to repeal conflicting laws; and for other purposes. Status: The sponsor seems to have little appetite to pursue this bill in the coming year. Likely off the table