As a sweeping bill aimed at increasing Georgians’ access to mental health care and addiction treatment has passed both the House and Senate and awaits the governor’s signature, advocates in north-west Georgia said the legislation is badly needed and much would benefit people in the Peach State.
House Bill 1013 passed the House of Representatives on March 8 with three no votes. On Wednesday it passed the Senate unanimously with amendments, then the amended law was unanimously adopted by the House of Representatives.
The bill would provide a credit write-off to keep more medical professionals in Georgia and also enforce parity — a federal law requiring insurance companies to treat mental health like any other medical condition.
“The #1 issue in the bill that really brought us to the table is parity. Parity is a 14-year-old federal law that the state of Georgia simply never enforced,” Jeff Breedlove, director of communications and policy for the Georgia Council on Substance Abuse, said in a phone interview.
Breedlove said the bill was the result of a two-year process by a broad coalition of mental health organizations, recovery organizations, the Georgia Medical Association, sheriffs, police chiefs, hospitals and nurses. The bill was sponsored by House Speaker David Ralston, R-Blue Ridge.
Breedlove said Georgia consistently underperforms on mental health services and this is a transformative change bill. If the state of Georgia enforces federal laws, insurance companies would make $200 million to $300 million available to pay for new mental health and substance abuse services, Breedlove said.
Many final details were worked out in the Senate Health and Human Services Committee last week after four sessions and much emotional testimony. The Senate committee added medical professionals to the list who would qualify for a program to eliminate loans to work in underserved areas.
Proponents wanted more resources for the state mental health system, consistently rated among the worst in the country, while limited opposition feared more government interference in health care and threats to civil liberties.
“There are counties in Northwest Georgia that don’t have access to services,” Bonnie Moore, a mental health attorney, said in a phone interview. “You have to go to another district because it has to do with financing, because the non-profit bodies cannot provide any [mental health care] center in each district.”
The state’s 23 nonprofit organizations provide mental health, addiction, and developmental disabilities services to uninsured Georgians. Moore said rural Georgia doesn’t have enough nurses and psychiatrists.
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Moore is president of the Rome chapter of the National Alliance on Mental Illness, which provides support, education and advocacy for those struggling with mental health and substance use disorders, although she said she doesn’t speak for the organization.
At the committee hearing, Sen. Michelle Au, D-Johns Creek, was concerned that the language in the bill would allow private insurance companies to determine what treatment was a medical necessity. The committee’s chair, Sen. Ben Watson, R-Savannah, said this could later be strengthened through new legislation if needed.
Mental health advocates were concerned that the updated bill added exceptions to the parity mandate for some policies and also removed the requirement for insurers to provide mental health and substance abuse benefits if they didn’t already offer them.
The new Senate version of the bill added primary care physicians to the health professionals who could qualify for cancellation of their student loans in exchange for working in underserved areas. That portion of the bill was supposed to cost $10.3 million annually, Sen. Greg Dolezal, R-Cumming, said in the hearing, but that number didn’t include adding family doctors to that list.
“In my opinion, the workforce here is the critical issue that we need to address, and if that’s $10 million a year that we’re going to have to spend to get adequate coverage, I’m willing to recommend that,” he said Vice Chair Sen. Dean Burke, R-Savannah, added that the bill should be updated with the additional costs.
The Senate committee also added a provision that would provide mental health training to law enforcement officials. The bill gives officials the power to refer people for a mental health evaluation, but this is separate from a hearing before a probate judge, which could result in restricted gun rights, committee members pointed out.
After the committee vote, Rep. Philip Singleton, R-Sharpsburg, an outspoken critic of the bill, described the changes to a Capitol crowd in an online video. He is one of three members of the House of Representatives who voted against the bill before it reached the Senate.
Northwest Georgia Assemblymen Mike Cameron, R-Rossville, Dewayne Hill, R-Ringgold, Steven Tarvin, R-Chickamauga, Jason Ridley, R-Chatsworth and Kasey Carpenter, R-Dalton all voted in favor of the bill.
Singleton said he opposes mandates and doesn’t think the government should get involved in health care at all, but believes “serious improvements” have been made in the bill. The civil liberties portion of the bill — which Singleton said he was most concerned about — was removed in the Senate updates, he said.
He later wrote on social media that under the previous version of the bill, someone “could be incarcerated against their will with only the reasonable assumption that they might need psychiatric treatment in the near future.”
The law still allows law enforcement to take people to an emergency room if officers have probable reason to believe the person is mentally ill and requires involuntary treatment. According to the draft law, this can only be done after personal consultation with a doctor or via a telemedicine portal, and involuntary storage is up to three days. A judge must determine a longer hold. As before, law enforcement officers can arrest people who pose a threat to themselves or others.
Moore, the Rome-based mental health advocate, conducts crisis intervention training for police, teaching officers how to identify and treat mental illness when responding to calls. She said this is a tool law enforcement needs and believes it won’t be abused.
Breedlove, of the Substance Abuse Council, said this bill is the first step in a multi-bill process to reform mental health treatment in Georgia, including creating more options for law enforcement officers rather than simply sending people to jail.
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“Virtually the biggest provider of mental health in any county or state is the prisons. And that’s a tragic shame,” Breedlove said.
About 800,000 Georgians have recovered from drug abuse, he said, and more than 1 million Georgians have been diagnosed with mental health problems, he said.
The bill also provides more funding for mental health courts, but Moore said proponents wanted a program that provides support and guidance before a crime is committed. Moore said the bill would fund a multi-jurisdictional study to determine whether assisted outpatient treatment is effective. A similar program exists, but Moore said she advocates a standardized system.
For now, Moore said, if law enforcement finds someone in northwest Georgia is threatening violence or self-harm, the closest emergency room is in Rome. The bill should provide funding for new facilities and more training for law enforcement when they encounter people in crisis situations, Moore said.
Breedlove said he thinks a good balance has been struck in the bill.
“The important point is that there is a cultural shift within law enforcement in our state that they now want to be peer-supported partners. They don’t want to send peers to jail if the peer needs medical attention and hasn’t committed a serious crime,” he said.
Don Benson, from Rome, said he became involved with Georgia’s mental health care system after being assaulted by his schizophrenic son. In a phone interview, Benson said he knew his son needed to be held accountable even if he had a mental illness, but the elder Benson also said he thought the system had let the family down because his son already did was on probation and should have received mental health care services.
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“The Chief Justice of the Superior Court, Judge [Frank C.] Mills, heard my case, and he allowed rehabilitation instead of incarceration,” said Benson in any way he could help to help or resolve people with the serious mental illness schizophrenia.”
A former IBM systems engineer, Benson said he is familiar with corporate governance and customer service, and said it was difficult to learn to navigate the state’s administrative system that governs mental health care. In the beginning, Benson said he had to learn the psychiatric system on his own.
What helped his son stay on track, Benson said, was not just clinical treatment or therapy, but peer support — help to get through the process, from someone who’s been through it.
In north-west Georgia, the group in Rome hosts the National Alliance on Mental Illness’s only support group for people living with mental illness and their family members who support them. Moore said people could attend the meeting via conference call instead of driving.
Contact Andrew Wilkins at awilkins@timesfreepress.com or 423-757-6659. Follow him on Twitter @tweetatwilkins.
