Gov. Kemp’s budget proposal for Fiscal Year (FY) 2024 provides Georgia’s behavioral health and developmental disabilities safety net with $1.4 billion in state general funds, a $69 million or about five percent increase above current funding. The proposal includes a $2,000 cost-of-living increase for full-time staff. The proposal also increases funding to expand home- and community-based services for individuals with intellectual and developmental disabilities and strengthen the state’s behavioral health crisis system.
By the Numbers
Amended Fiscal Year 2023 Budget
- An additional $9.9 million to renovate the kitchen at Atlanta’s Georgia Regional Hospital, which provides adult mental health services, forensic program services, and skilled nursing services for adults with developmental disabilities
- A transfer of $1.6 million from Adult Developmental Disabilities Services to a Special Project fund to consolidate funds for respite services for individuals with intellectual and developmental disabilities
Fiscal Year 2024 Budget
- About $31 million to provide a $2,000 cost-of-living increase for full-time, benefit-eligible employees of the Department and its attached agencies
- About $14.4 million to enhance services and supports for individuals with intellectual and/or developmental disabilities that enable them to live and/or participate independently in their community. Services might include supported employment, residential services, behavioral support services, or specialized medical equipment and supplies.
- Annualize the cost of 513 slots for the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP)
- Fund 250 additional slots for NOW and COMP
- About $13 million to support behavioral health crisis centers (BHCC)
- Annualize operation cost of a BHCC in Augusta
- Fund a BHCC in Fulton County
- Convert a crisis stabilization unit to a BHCC in Dublin
- About $6.3 million to increase funds for additional mobile crisis teams
Continued Workforce Shortages Constrain DBHDD’s Ability to Serve Georgians in Need
Continued staffing challenges restrict the Department’s ability to unleash its full potential and provide access to services for Georgians in need. According to the most recent workforce report, the Department experienced a 34.5 percent turnover rate from July 2021 – June 2022, which was substantially higher than the state’s average of about 25 percent.[1] The workforce at the Department’s five state hospitals has been hit particularly hard over the past several years, experiencing a net loss of more than 1,200 employees from January 2020 through June 2022.[2] To augment hospital staffing and ensure hospital beds can stay open, the Department is currently contracting with Jackson Healthcare at a rate of about $1.6 million per week—the majority of which goes toward staffing nurses.[3]
The salary adjustments and cost-of-living increases included in the FY 2023 budget have helped stem the tide of net hospital worker losses, and the FY 2024 cost-of-living increases can help employees keep up with rising costs resulting from inflation. However, the omission of additional salary adjustments in the FY 2024 budget means that the Department will continue to rely on expensive contracted staff at a greater cost to the state. Without the staff to meet growing demand for behavioral health and developmental disabilities services, Georgians with lower incomes have limited opportunities for the treatment, recovery, and healing that they deserve. If in crisis, they may seek care in the emergency room, or their behavior may be criminalized, resulting in stigmatizing and harmful interactions with the criminal legal system.[4]
Opioid Settlement Funds Missing from Budget
Georgia can tap into millions of dollars to address the drug overdose crisis thanks to settlements of lawsuits against pharmaceutical companies and others involved in the distribution and sale of prescription opioids, including $636 million from the 2022 settlement with Cardinal, McKesson, AmerisourceBergen and Johnson & Johnson. However, the FY 2024 budget does not reflect any of that funding. The Attorney General’s office is still working to establish the trust where the funds will be held. Public announcements have yet to be made about the advisory body that will consult with the Governor-appointed trustee to manage the funds.[5]
Other states are further along in the process; for example, North Carolina began distributing these opioid settlement dollars to local communities as early as 2022, and South Carolina has established an Opioid Recovery Fund Board to oversee fund disbursement.[6],[7] The slower pace at which Georgia’s plans are developing and the lack of full transparency are not commensurate with the rapid and evolving drug overdose crisis. In Georgia, drug overdose was a leading cause of early death in 2021 and continues to take the lives of thousands of Georgians every year.[8]
End Notes
[1] Georgia Department of Administrative Services (2022). Fiscal Year 2022 workforce report. https://doas.ga.gov/human-resources-administration/hr-tools/workforce-reports
[2] Tanner, K. (2023, January 19). Department of Behavioral Health and Developmental Disabilities budget overview [Testimony for House Human Resources Appropriations Sub-Committee starting at 1 hour 56 minutes]. https://vimeo.com/showcase/8988933?video=790904618
[3] Ibid [starting at 1 hour 59 minutes].
[4] National Alliance for the Prevention of Mental Illness. (n.d.) Criminalization of people with mental illness. https://www.nami.org/Advocacy/Policy-Priorities/Stopping-Harmful-Practices/Criminalization-of-People-with-Mental-Illness
[5] Thomas, G. (2022, October 26). Governor’s Office of Health Strategy and Coordination update [PowerPoint presentation]. Substance Abuse Research Alliance meeting. https://opb.georgia.gov/ohsc/national-distributor-and-janssenjohnson-johnson-settlement
[6] CORE-NC: Community Opioid Resources Engine for North Carolina. (2022, July 18). Data dashboard – NC payment schedule. https://ncopioidsettlement.org/data-dashboards/payment-schedule/
[7] South Carolina Opioid Recovery Fund Board. (n.d.). About us. https://scorf.sc.gov/about-us
[8] Georgia Department of Public Health (2023). Leading causes of premature death, 2021. Online Analytical Statistical Information System. https://oasis.state.ga.us/
