Georgia’s 2023 mental health bill on the ropes

There’s a line in the 1980s film “The Princess Bride” where Billy Crystal’s character declares that the protagonist is “mostly dead.”

That appears to be the status of this year’s legislation to expand on a mental health overhaul the Legislature passed last year, a priority of then-House Speaker David Ralston, who died in November.

Current House Speaker Jon Burns, R-Springfield, has put his support behind House Bill 520 and the bipartisan team of lawmakers who ushered last year’s measure to the governor’s desk.

This year’s bill focuses on addressing a shortage of mental health providers and streamlining the way agencies share information about patients. It also aims to create a way for state agencies to share information that could help address what the bill calls “familiar faces” that law enforcement and mental health providers see time and time again.

But after overwhelmingly passing the House earlier this month, progress has slowed in the Senate.

The Senate Health and Human Services Committee discussed changes to HB 520 but did not vote on the bill before that chamber’s deadline for a panel to pass legislation and still have it be considered for the Senate floor this year. That deadline was Thursday, before the Senate convened at 1 p.m.

The Senate’s version of SB 520 trims down the bill that passed the House, removing sections dealing with policies that address housing access for people with a criminal background due to mental illness-related arrests and an expansion of health-related social supports such as employment training for young people who receive Medicaid.

“I’m happy that through the work of the Health and Human Services Committee we have a bill the entire Senate can be proud of,” said state Sen. Brian Strickland, a McDonough Republican.

Part of the holdup seems to be the butting of heads between Burns and Lt. Gov. Burt Jones. Jones had been pushing House leaders to support a measure that would pave the way for more hospitals to be built in less-populated counties as part of a pending overhaul of health care rules that could financially benefit his family’s business.

Senate Bill 99 would allow the construction of new hospitals in counties of fewer than 50,000 people without what is known as a “certificate of need” from state regulators, even if they’re close to existing hospitals.

That would benefit a proposed private hospital with 100 beds that could be fast-tracked for Jones’ native Butts County if the measure is adopted. It’s not clear where the hospital would be built, but some local and state health care officials expect it to be located on land the lieutenant governor’s father, Bill Jones, owns near the sprawling River Park development along I-75 in the Middle Georgia county.

On Saturday, Jones indicated he was abandoning his effort to rewrite health care regulations this year.

“While SB 99 will not get a final vote this session, I will not stop fighting to enable rural communities to have a voice in bringing quality health care to their citizens,” he said.

House leaders had not expressed interest in passing SB 99 — the certificate of need bill — and Gov. Brian Kemp had indicated he doesn’t support the legislation.

State Rep. Mary Margaret Oliver, a Decatur Democrat and one of the sponsors of HB 520, said the version of the bill that the Senate panel proposed was “very close to being acceptable.”

“The message that keeps coming back to us from the Senate is that the lieutenant governor wants his certificate of need bill,” she said Friday. “I don’t know what’s going to happen. I am discouraged.”

Strickland called HB 520 “too important” not to be approved. He said the best way forward may be to insert pieces of the bill into similar legislation.

“There is a way we could piecemeal some of the bill together,” he said. “We can do certain parts of the bill through the departments without legislation and then hopefully come back next year and take on the other pieces of the bill we can’t get to this year.”

Jones spokeswoman Ines Owens pointed to a nearly $72 million price tag that the Georgia Department of Audits and Accounts said it would cost annually to implement HB 520 as it passed the House.

“That cost plus the limited Medicaid expansion in the initial bill have major implications on the state and need more time to be fully evaluated,” she said. “The legislative session is a two-year process.”

But Burns spokesman Kaleb McMichen said they want the bill to pass this year.

“We know our friends in the Senate share the House’s commitment to meaningful mental health reforms and trust they will act to ensure House Bill 520 is passed,” he said.

Mental and behavioral health advocates such as Jeff Breedlove, a lobbyist for the Georgia Council for Recovery, say they, too, are trying to remain hopeful as they head into the last two legislative days.

“We continue to be optimistic that over the weekend and on Monday the lieutenant governor and the speaker will work together to make certain that HB 520 doesn’t get caught up in the politics of the Georgia Legislature,” he said. “We understand there’s a tradition of taking certain bills hostage for various reasons. We also understand that they traditionally don’t kill the hostage.

“I hope they remember that there are millions of families across the state who are relying on them to fix a broken behavioral health care system.” Breedlove said. “Lives are literally at stake here.”