By Andy Miller and Rebecca Grapevine
The state Senate unanimously approved landmark legislation Wednesday that aims to improve services for Georgians who have mental health and addiction problems.
The Senate version of House Bill 1013 closely mirrored major provisions originally contained in the legislation, sponsored by House Speaker David Ralston (R-Blue Ridge), who took an unusually strong personal role in advocating for the overhaul.
Ralston, hearing of the Senate vote, reacted emotionally in telling his chamber of the outcome.
Later Wednesday, the House unanimously approved the Senate version of the bill, sending it to Gov. Brian Kemp for his signature. The legislative session ends Monday.
After the House vote, Ralston told his chamber, “Countless Georgians will know that we have heard their despair and frustration.”
“Few of you will ever cast a vote as consequential as your vote to pass House Bill 1013, and today it was you who gave hope to many, many Georgians,” he added.
“Georgia is taking on mental health reform,’’ said Sen. Brian Strickland, a McDonough Republican, in presenting the bill to the Senate. “We heard from people around this state,’’ he said. “We heard many stories from people that moved us.”
The bill contains basic mental health parity language – requiring insurers to cover behavioral health problems on a level equal to that of physical ailments. The Senate version does, though, provide exceptions to those health plans that don’t offer behavioral benefits.
The Senate version echoes the House requirement that Medicaid managed care insurers spend at least 85 percent of the dollars they get in premiums on medical care and quality improvements. GHN and Kaiser Health News reported that Georgia is one of only a few states that don’t require a minimum level of medical spending and quality improvements for Medicaid insurers.
The new version contains incentives for the training of mental health professionals, and facilitates grants for collaborations between mental health providers, courts and law enforcement in dealing with people in crisis.
Sen. Michelle Au, a Johns Creek Democrat, cited Georgia’s low ranking among states in access to mental health services. “We can and must do better,’’ she told senators before the vote. She called the legislation “a bipartisan commitment to the people of Georgia that we recognize care for mental health and substance use disorder is essential as treatment for medical/surgical care.”
Added Republican Lt. Gov. Geoff Duncan after the vote: “This is a great day for Georgia.”
The bill was fast-tracked after it passed the Senate Health and Human Services Committee on Monday.
Roland Behm, an adviser to the House sponsors of the bill, said the legislation had undergone another revision since the committee vote, with sponsors beefing up the ability of health care providers to determine medically necessary treatments. The changes, he said, “are designed to ensure that medical professions, not insurers, are the decision-makers on standards of care.”
“This is a really big day,’’ he told GHN. “Extraordinary.”
The Senate version shifted the House’s standard on involuntary commitment back to what’s in current Georgia law: that mentally ill people must show an “imminent” risk of harm to themselves or others before they can be committed for outpatient treatment.
House Bill 1013 attracted grass-roots opposition after it was introduced, with concerns expressed about the legislation’s reach. A House member who voted against that bill, in an unusual move, spoke to a jammed Senate meeting room Monday before the committee convened.
The Senate version jettisoned references to the World Health Organization (WHO) and its definitions for mental health conditions. The WHO references had sparked outrage among some conservative activists.
And the Georgia Budget and Policy Institute noted that the Senate also removed language on providing support for culturally and linguistically tailored services that would expand access to behavioral health services to more immigrants.