It was Mental Health Day under the Gold Dome, headlined by the unveiling of Speaker David Ralston’s (R-Blue Ridge) much discussed, and anticipated, mental health parity bill. House lawmakers, members of the Behavioral Health Reform and Innovation Commission, and many stakeholders gathered today as the bill, HB 1013, was announced. This legislation is an effort to help address many concerns around access to mental health services and treatment in Georgia. Representative Todd Jones (R-Cumming) and Representative Mary Margaret Oliver (D-Decatur) will be carrying the legislation on the Speaker’s behalf. More details on the new legislation in this edition of the #GoldDomeReport.

On a lighter note, HB 1002 has been introduced to designate a state marsupial–the opossum.  Representative Tyler Paul Smith (R-Bremen) authored this dead-serious legislation, which was assigned to the State Planning and Community Affairs Committee.

In this Report:

• Speaker Unveils Mental Health Parity Bill

• Committee Reports

• New Legislation

• What’s Next

Speaker Unveils Mental Health Parity Bill

2022 has been widely described as the “year of mental health” in Georgia. It got off to its official rousing start today when Speaker David Ralston (R-Blue Ridge) held a well-attended press conference to announce he had introduced HB 1013, the omnibus mental health reform bill stemming from the Georgia Behavioral Health Reform and Innovation Commission. During the announcement, the Speaker was flanked by over 50 members of the House from both parties, the members of the Commission, and representatives of multiple mental health and substance abuse advocacy groups. Numbering the bill 1013, the form number for civil commitments of patients with mental illness to mandatory evaluation and treatment, was an ironic but effective reminder that the House wants to take the lead in reforming and rebuilding mental health services in Georgia. He expressly stated his interest in developing and funding enough services to lift Georgia out of its low-ranked national position. Representatives Todd Jones (R-Forsyth) and Mary Margaret Oliver (D-Decatur) will take the lead on the bill and both spoke of their passion to improve service. Commission Chair Kevin Tanner also issued a call to action. 

The bill is extensive and includes a state mental health parity monitoring for private insurers, Medicaid managed care plans, and the State Health Benefit Plan a requirement to offer mental health services by state regulated insurance carriers. It also permits law enforcement to take a person directly to services without charging him or her with a crime. It provides for pilot projects for outpatient treatment ordered by the probate courts and mental health workforce development efforts by training more professionals and studying rates of payment by Medcaid. The legislation includes law enforcement co-responder programs where a mental health professional and mental health consumer accompanies law enforcement as well as several provisions to reorganize the oversight of child and adolescent mental health services. The concepts involve working to improve services in several state systems where Georgians with mental illness are served, be they DBHDD, prisons, jails, or in the private sector. The proposed legislation will be accompanied by budget enhancements to increase core and crisis services in the community service boards, build capacity on the state hospitals, and increase available housing.

Wednesday’s press conference was preceded by a meeting of the newly-constituted Mental Health Caucus on Tuesday. Roland Behm of the Georgia Chapter of the American Society for Suicide Prevention presented to about 30 legislators a primer on mental health parity and described other bill provisions.

Committee Reports

Senate Health and Human Services Committee

The Senate Health and Human Services Committee, chaired by Senator Ben Watson (R-Savannah), convened to consider one bill on Wednesday:

• HB 305, authored by Representative Lee Hawkins (R-Gainesville), amends Title 43 relating to the qualification of courses and instructors for continuing education of licensed massage therapies. Specifically, the bill requires that such educational programs and instructors be approved by a national massage therapy certifying organization or entity approved by the Board of Massage Therapy.

Representative Hawkins presented the bill to the Committee, opening by noting that the bill has been reviewed and recommended by the Georgia Occupational Regulation Review Council. He explained that the legislation is born out of advice from the Georgia Attorney General’s Office and previously passed out of the Committee but failed to advance to a floor vote last year. Stan Jones spoke in support of the legislation on behalf of the Georgia Chapter of the American Massage Therapy Association.

The Committee recommended the bill DO PASS and be sent to the Rules Committee. Senator Jeff Mullis (R-Chickamauga) will carry the bill in the Senate.

Senate Education & Youth Committee

The Senate Education & Youth Committee, chaired by Senator Chuck Payne (R-Dalton), met to consider the following propositions on Wednesday:

• SB 231, authored by Senator Jason Anavitarte (R-Dallas), amends Title 20 to create a pilot program within a limited number of charter schools to provide a high school diploma pathway for individuals between the ages of 21 to 35. Last year, SB 204 was a start on this issue. According to proponents of the bill, there are barriers which remain for this population, and the legislation will expand opportunities for individuals in this age bracket in poverty and allow for wraparound services. Costs are projected at $2.1 million per center. 

Senator Anavitarte presented the bill to the Committee, and Michael Winkler of Goodwill in Southeast Georgia spoke to the Committee about their training efforts to get folks in sustainable wage jobs. There are 311,000 folks in ages 21-35 without a high school diploma - two of three of them live in poverty and their children stand a higher risk of dropping out.  $2 million for buildout for up to 300 students is proposed to be provided by Goodwill for this. Tutoring, child care, and transportation will be provided by Goodwill to remove obstacles for individuals to participate in the program.  

Senator Freddie Powell Sims (D-Dawson) asked about the annual fiscal note for the state - up front cost is $2.1 million for each school to be established in the pilot. There would be schools in Savannah, Macon and LaGrange (potentially). This funding would come from the State Charter School Commission. The Department of Education was posed questions around accountability. Senator Elena Parent (D-Atlanta) noted the difference with this program was the proposed wraparound services - she suggested efficiencies rather than duplication. Mr. Winkler said this goal was to award a high school diploma to help these 311,000 individuals; these students are in an “academic purgatory” and will help them prepare for the TCSG program.

Senator Lindsey Tippins (R-Marietta) asked for clarification on funding. Facilities will be provided by Goodwill - $2 million of its money to build out and $500,000 plus for the childcare facility, childcare providers, and wrap services. These funds are Goodwill commitments.  $2.1 million is the formula - $6800 per student times 300 students. There are five states and District of Columbia which have these programs - graduates are earning 50 percent more prior to getting the high school diploma. 

The Committee recommended the bill DO PASS and be sent to the Rules Committee.

• SB 257, authored by Senator Kay Kirkpatrick (R-Marietta), amends Title 20 to provide military students with the discretion to select adjacent school districts for attendance. Specifically, the bill allows a military student to attend any school in the district where the student resides or any school within 50 miles of where the student resides (on a space available basis).

Senator Kirkpatrick presented the bill to the Committee, explaining that this legislation was being brought to address a constituent issue for Senator Blake Tillery (R-Vidalia). Senator Lindsey Tippins (R-Marietta) noted that he would want to make sure that the local share of educational funding is addressed for students who come from outside of a county. Justin Pauly of the Georgia School Board Association expressed appreciation fo the support of military students and asked for several clarifications in the existing language.

There was a question about whether the legislation needed to clarify that a student must be a Georgia resident to be eligible, to which Legislative Counsel suggested that Georgia residency is implied in Code but clarification could be helpful. Senator Matt Brass (R-Newnan) proposed an amendment to LC 48 0500 to define “military student” as “a school age child of a military service member who resides in Georgia and is on a base or off a base in military housing” and add “eligible” to line 16 before “students.” Due to a lack of clarity among members, Senator Kirkpatrick suggested that the Committee hold the bill and allow her to work on a substitute with Senator Tippins. The Committee took no action on the bill.  

House Judiciary Non-Civil Committee

The House Judiciary Non-Civil Committee, chaired by Representative James Burchett (R-Waycross), met on Wednesday to consider two bills:

• HB 478, authored by Representative Bonnie Rich (R-Sugar Hill), amends Title 24 to include all types of proceedings in the state's expert witness requirements. Specifically, the bill requires that the current reliability standard for expert testimony in civil cases be extended to criminal cases.

Representative Rich presented the bill to the Committee, and Jill Travis of the Georgia Association of Criminal Defense Lawyers spoke in support of the legislation. Robert Smith of the Prosecuting Attorneys Council also spoke in support of the legislation.

The Committee unanimously recommended the bill DO PASS and be sent to the Rules Committee.

• SB 226, authored by Senator Jason Anavitarte (R-Dallas), amends Title 20 to require that each local board of education adopt a complaint resolution policy to address complaints by parents and guardians to address complaints submitted by parents or guardians alleging that material that is harmful to minors has been provided or is available to students. The Committee was slated to hear this bill, but Senator Anavitarte had a conflict and could not attend the meeting. As such, consideration was delayed until the Committee’s next meeting.

House Rules Committee

Chairman Richard Smith (R-Columbus) opened the meeting with discussion on HB 841 (LC 47 1445 S) by Representative Matt Dollar (R-Marietta). Representative Dollar presented the bill, which would allow a local referendum to incorporate the City of East Cobb. Questions were asked on whether all the legal requirements had been met regarding incorporating new cities. The substitute had two changes. One was that the election date of the referendum would be changed. Instead of having a special election, it would coincide with the current election dates scheduled. The second change was on the composition of city leadership. In earlier versions, city leadership consisted of 6 council members with a chairman included, which locals found confusing. Constituents requested a six-person council elected citywide with a citywide elected mayor. Additional concerns were raised on the impact on the county's finances. Representative Dollar mentioned the legislation had been open to public comment. Representative Darlene Taylor (R-Thomasville) added that an impact study was completed, and no issues were raised regarding this subject.

The Committee added the substitute to HB 841 to the House Rules Calendar for Legislative Day 8 under modified structured rule and limited floor debate at the discretion of the Speaker to one hour.

House Appropriations Committee - General Government Subcommittee

Chairman Sam Watson (R-Moultrie) convened to hear reports from three departments on the proposed FY2021 Amended Budget.

• Commissioner Rebecca Sullivan from the Department of Administrative Services reported on two requests. Both requests fall under Risk Management.  The first is to meet excess insurance and claims expenses. The Department asks for $18 million to correct this issue. The second request was $150 million in the Workers Compensation Program to settle roughly 700 cases.

• The Department of Audits and Accounts reported the turnover rate within their department. While appreciative of the raises, the Commissioner added that it would not be competitive enough with current pay rates in the private sector.

• Commissioner Mark Williams from the Department of Natural Resources thanked and supported the pay raises. He also identified further budget requests for 42 vehicles and the Wildlife Endowment Trust Fund.

• The Department of Labor Commissioner Mark Butler reported on the current affairs of the Department, specifically on opening local offices. Commissioner Butler identified errors in the pay raises in the proposed FY22 Amended Budget and provided corrections.

House Appropriations Committee - Health Subcommittee

Chairman Butch Parrish (R-Swainsboro) and his Subcommittee took a deeper dive into the FY 2022 Amended budgets for the Department of Community Health and Department of Public Health as well as attached agencies. 

• Department of Community Health - Commissioner Caylee Noggle outlined her agency’s items proposed by Governor Kemp.  The Commissioner talked about the Department’s updated strategic plan which now contains key performance indicators - looking more closely at executing contracts (both management and administration) and getting payments out to providers.  Commissioner Noggle noted that there are incentives as the Department moves towards value-based purchasing.  She accented a number of items including the $5,000 pay raises for full-time employees, changes to replace the Department’s MMIS (Medicaid claims system as required changes are necessary to meet CMS requirements), the inclusion of funds for the All Payor Claims Database of $2.8 million (which funds actually are shared with the Office of Planning and Budget through a memorandum of understanding), DSH true up costs in the Indigent Care Trust Fund, added funds for the aged-blind-disabled and low-income Medicaid programs, and funding for clinical trials as now permitted for routine costs.

  • Representative Jesse Petrea (R-Savannah) asked questions about the home and community based services changes the General Assembly made last year.  In particular, he asked the status of the hold up on increases which were to be effective on July 1, 2021.  Commissioner Noggle indicated that the changes had been forwarded to CMS for approval; CMS had raised questions on actuarial rate studies.  He also inquired about a question which Representative Penny Houston (R-Nashville) had asked him about - it was around non-emergency transportation which has historically had “quality” issues.  The Department’s non-emergency transportation utilizes brokers (there are three) which have contracts with local providers.  The Department has found that contracts have not been reviewed; a re-procurement for the brokers has been initiated and the Department intends to award a contract in early spring 2022.  It will address contract management and include liquidated damages as well as notice requirements.  Presently, there is a cap on liquidated damages; that will be removed so the Department can go after those who do not meet quality or standard requirements.

  • Representative Carolyn Hugley (D-Columbus) asked about pediatric dentistry services.  She asked if the Department might consider increasing select dental codes and finding a way for pediatric dental surgeons to participate.  Commissioner Noggle responded that the Department could look more into these concerns.

• Department of Public Health - Commissioner Kathleen Toomey accented two items in her agency’s FY 2022 Amended Budget.  Those include the $5,000 pay raise which she indicated would help greatly with recruitment and retention of employees.  She also discussed the shortfall in Georgia’s ADAP program funding (this is the Ryan White funding for HIV/ADS).  The Governor proposed inclusion of $9.9 million which will help the Department meet the needs of its clients and eliminate the waiting list.  The south has the greatest number of individuals with HIV - she stressed that prevention is treatment.

  • Representative Debbie Buckner (D-Junction City) asked about whether the Department had the capability of doing a pay scale evaluation to compare the wages of its employees with counterparts in the private sector or other healthcare settings.  Commissioner Toomey indicated that her agency has that information - noting in particular epidemiologists’ pay (DPH’s pay is $16,000 less than in other settings).

• Georgia Board for Physician Workforce - The interim director only accented the pay raise of $5,000 proposed for the agency’s staff.

• Georgia Trauma Commission - Liz Atkins, the Executive Director, accented work that the Commission has undertaken to look at benchmarking outcomes of the trauma facilities.  In particular, she mentioned the work the Commission has done with the American College of Surgeons which sets trauma standards as well as provides consulting services (now focusing on rural areas) so as to provide national benchmarking.  Readiness funding is approximately $.07 for every $1.00; Georgia does not know, however, how much it costs to become a trauma facility.

New Legislation

The following legislation of interest has been introduced in the House:

The following legislation of interest has been introduced in the Senate:

What’s Next

The General Assembly will reconvene for Legislative Day 8 on Thursday, January 27. The House will convene at 10AM, and the Senate will convene at 1PM.