Among a range of duties, the Department of Behavioral Health and Developmental Disabilities operates five state psychiatric hospitals, provides evaluation and treatment for individuals under the jurisdiction of the court system to determine their competency to stand trial, and provides community-based services to Georgians living with mental health conditions, substance use disorders and developmental disabilities. Governor Kemp’s Fiscal Year (FY) 2025 budget proposal provides the Department with $1.6 billion in state funds. The proposal increases the Department’s state funding by $139 million, or 9%, above the original fiscal year 2024 budget. More than half of the proposed state funding increase unlocks more home- and community-based services for Georgians with intellectual and developmental disabilities and increases compensation for their providers. In addition, the proposed one-time $1,000 bonuses and cost-of-living adjustment would support ongoing efforts to fill vacancies, decrease the turnover rate and address what Commissioner Tanner called in the joint appropriations hearing “a state of emergency when it comes to our state workforce”.[1]
Budget Highlights*: By the Numbers
Amended Fiscal Year 2024 Budget
- $60 million increase to address urgent physical repairs and improvements at the five state psychiatric hospitals
- $9.9 million increase for one-time, $1,000 bonuses for full-time staff at the Department and its attached agencies
Fiscal Year 2025 Budget
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$92 million increase to expand home- and community-based services for individuals with intellectual and developmental disabilities
- $80 million increase to raise provider rates by 40% on average
- Paying providers a living wage has been a primary barrier to filling additional waiver slots[2]
- $9.4 million increase to annualize 500 New Option Waiver (NOW) and Comprehensive Support Waiver Program (COMP) slots
- $2.3 million increase to add 100 NOW/COMP slots
- Currently, about 13,000 individuals are served by NOW/COMP with more than 7,300 people still on the planning list[3]
- $80 million increase to raise provider rates by 40% on average
- $27 million increase for 4% cost-of-living adjustments for full-time staff (not to exceed $3,000 each) at the Department and its attached agencies
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$22 million increase to implement a 30% average increase in provider rates for community-based behavioral health providers as part of the Community Behavioral Health Rehabilitation Services rate study for uninsured Georgians
- An additional $4 million increase in state funds to implement this rate study was also included in the Department of Community Health’s proposed budget
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$16 million increase for behavioral health crisis centers (BHCC), which provide assessment, intervention, and counseling for individuals dealing with a mental health or substance abuse crisis
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- $9.5 million increase for BHCC in North Georgia
- A bed capacity study found the greatest need for adult behavioral health beds is concentrated in Northwest Georgia[4]
- $6.6 million increase to annualize the operations of BHCCs in Fulton County, Dublin, and Augusta
- $9.5 million increase for BHCC in North Georgia
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- $11 million decrease for core mental health services to reflect 1) workforce shortages at the community-service boards, which results in decreased capacity to provide services and 2) a reduction in utilization of private psychiatric beds due to increased capacity at state hospitals
If the State Fully Expands Medicaid, the Department’s Budget Stands to Benefit
As funded under the ‘Adult Mental Health Services’ line, the Department provides evaluation, treatment, crisis stabilization and residential treatment for adults living with mental health conditions. Over the past decade, adult mental health services have, on average, accounted for about 37% of the Department’s state general funds. Most of those services are provided to individuals who lack access to healthcare coverage, and the state largely assumes that cost. For example, the Department funds 22 community service boards across the state that provide community-based health mental and addiction services to about 120,000 adults—many of whom lack health insurance or have limited means to pay.[5] Under full Medicaid expansion, as a greater number of uninsured Georgians gain access to healthcare coverage and the federal government shoulders 90% of the financial burden, the state stands to recover some of these funds, allowing for potential reallocation to other areas of need.
More than 1 in 4 Georgians in the coverage gap are believed to have a behavioral health condition. States that have expanded Medicaid coverage to adults earning up to 138% of the federal poverty level have documented a range of benefits, including increased access to mental health services; reductions in psychological distress for people with low incomes; lowered rates of suicide; and increases in behavioral health providers’ participation in Medicaid.[6]
Endnotes
*This is not an exhaustive list; it represents notable budget changes. Budget amounts are rounded to the nearest whole number.
[1] Tanner, K. (2024). Department of Behavioral Health and Developmental Disabilities budget overview [Testimony for Joint Appropriations Committee starting at 1 hour and 17 minutes]. https://vimeo.com/showcase/8988927?video=905727322
[2] Tanner, K. (2024). Department of Behavioral Health and Developmental Disabilities budget overview [PowerPoint slides]. https://www.legis.ga.gov/api/document/docs/default-source/house-budget-and-research-office-document-library/2024-joint-budget-hearings/wednesday-presentations/dbhdd_2024_joint_budget_presentationf1776c4b230148b8b872066849b188bc.pdf?sfvrsn=d476244f_2
[3] Ibid.
[4] Ibid.
[5] Georgia Association of Community Service Boards (2023). Service quality report for Georgia’s community service boards, FY 2022 – 2023. https://www.gacsb.org/annual-benchmark-reports
[6] Chan, L. (2023). Georgia Health Budget Primer for State Fiscal Year 2023. Georgia Budget and Policy Institute. Georgia Health Budget Primer for State Fiscal Year 2024 – Georgia Budget and Policy Institute (gbpi.org)
