Gov. Brian Kemp’s fiscal year (FY) 2023 budget proposal increases funding for the Department of Behavioral Health and Developmental Disabilities (DBHDD) by $129 million compared to FY 2021, an 11 percent increase in state funds.[1] The FY 2023 budget proposal is a $96 million increase over FY 2020, representing a total increase of 8 percent over the state’s pre-pandemic budget. With Georgia ranking last among states for access to mental health services, these budget increases come at a critical moment, helping Georgians heal from the continuing trauma of the pandemic.[2],[3] Making mental health a funding priority also helps illuminate how the pandemic has both affected and been processed by Georgia communities along disparate yet predictable patterns shaped by historical and systemic racism.[4]
In addition to its low rank for mental health access, the odds are higher that a Georgian with serious mental illness will end up in prison as opposed to receiving needed medical treatment in a hospital.[5] This happens in a state where Black individuals are overrepresented among those caught up in the criminal legal system, which means that mental health needs and access to care have a deep racial equity component.[6] Given these factors, mental health must remain a standing priority for Georgia, with policymakers committing to permanent investments to help the state meet future public health emergencies through fully expanded Medicaid and other attainable and racially equitable funding supports.[7]
Funding for the State’s Behavioral Health Safety Net System
The department consists of the Division of Behavioral Health and the Division of Developmental Disabilities. The behavioral health division provides mental health services to children, adolescents and adults at five state hospitals and through community partners at Community Service Boards and other providers. This division also provides services for Georgians of all ages with substance use disorders. These services are core to the state’s behavioral health safety net system that primarily serves the uninsured and low-income residents who receive Medicaid coverage. Below are highlights from the amended FY 2022 and FY 2023 budgets.
Amended FY 2022 Budget
- $56.4 million increase over the FY 2022 enacted budget, a 4.7 percent increase in state funds.
- $56.3 million to fund $5,000 cost-of-living increases, with the largest share ($36 million) going to state employees working in Adult Mental Health Services, in part, to address high turnover rate in the workforce and a high vacancy rate.[8]
FY 2023 Budget
- $77.8 million to fund $5,000 cost-of-living increases.
- $6 million to offset the reduction in the traditional Medicaid match from 66.85 percent to 66.02 percent.
- $3.9 million to fund 200 new slots for the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP), two Medicaid waivers that provide services for people with intellectual and developmental disabilities; there are about 7,000 people on the waitlist for these services.[9]
- $1.4 million to increase funds for the Georgia Housing Voucher Program to support the requirements of the Department of Justice (DOJ) Settlement Agreement, which required the state to move more individuals with developmental disabilities out of state hospitals and support them in their communities.[10]
Endnotes
[1] The information in this overview is derived from GBPI analysis of data from the Governor’s Office of Planning and Budget. (2021). The governor’s budget report amended fiscal year 2022 and fiscal year 2023. https://opb.georgia.gov/document/governors-budget-reports/afy-2022-and-fy-2023-governor-budget-report/download
[2] Mental Health America 2021. Access to care ranking: Georgia. https://www.mhanational.org/issues/2021/mental-health-america-access-care-data#one
[3] Williams, D. (2022, January 26). “Ralston unveils comprehensive bill to boost mental health services in Georgia.” The Current. https://thecurrentga.org/2022/01/26/ralston-unveils-comprehensive-bill-to-boost-mental-health-services-in-georgia/
[4] Khalfani, R. (2021, April 20). State of working Georgia: Pandemic job numbers are improving, but inequitably. Georgia Budget and Policy Institute. https://gbpi.org/state-of-working-georgia-pandemic-job-numbers-are-improving-but-inequitably/?mc_cid=e2f9170216&mc_eid=fb113e19b7
[5] Mental Health America of Georgia. 1 in 5. https://www.mhageorgia.org/
[6] Khalfani, R. (2021, December 16). Unjust revenue from an imbalanced criminal legal system: How Georgia’s fines and fees worsen racial inequity. Georgia Budget and Policy Institute. https://gbpi.org/unjust-revenue-from-an-imbalanced-criminal-legal-system/; Angel, S. (2020, August 24). COVID-19 has exacerbated the inequities inherent in incarceration. Georgia Budget and Policy Institute. https://gbpi.org/covid-19-has-exacerbated-the-inequities-inherent-in-incarceration/
[7] Harker, L. (2021, March 17). Medicaid is now an even better deal for Georgia. Georgia Budget and Policy Institute. https://gbpi.org/medicaid-is-now-an-even-better-deal-for-georgia/; The Center for Budget and Policy Priorities. (2021, July 8). The Medicaid coverage gap in Georgia. https://www.cbpp.org/sites/default/files/7-8-21tax-factsheets-ga.pdf (highlighting that 58 percent of those in Georgia’s coverage gap are people of color)
[8] DBHDD budget presentation. (2022, January 20). At the presentation, Commissioner Judy Fitzgerald referenced statistics from the Service Providers Association for Developmental Disabilities, 2021, and other sources underscoring turnover rates within the department and within the profession; see 2:16:10 and 2:21:00 time marker: https://www.gpb.org/lawmakers/2022/01/20/budget-hearings?emci=bf2a0008-2c7a-ec11-94f6-c896650d4442&emdi=f8176862-287d-ec11-94f6-c896650d4442&ceid=11215977
[9] Lucas, L. (2021, December 10). They deserve a good life: Georgia families, advocates push for more funding to support people with disabilities. https://www.msn.com/en-us/news/us/they-deserve-a-good-life-georgia-families-advocates-push-for-more-funding-to-support-people-with-disabilities/ar-AARGvk3
[10] Georgia Department of Behavioral Health and Developmental Disabilities. US DOJ v. Georgia Americans with Disabilities settlement agreement, provisions related to persons with serious and persistent mental illness (slides 24 et seq.). Georgia Department of Community Affairs. https://www.dca.ga.gov/sites/default/files/dbhdd_office_of_adult_mental_health_and_doj_settlement_dr_timberlake.pdf; see also United States of America v. The State of Georgia et al. Settlement Agreement. (October 2010). N.D. Ga Civ. Action No. 1-10-CV-249-CAP. https://www.ada.gov/olmstead/documents/georgia_settle.pdf
