Gov. Kemp’s budget proposal for the 2021 fiscal year cuts state general funds for the Department of Behavioral Health and Developmental Disabilities by $24.3 million from FY 2020. These cuts required the agency to prioritize the growing need for psychiatric crisis services while having to reduce funding for general behavioral health services and the implementation of newer mental health programs. Georgia has invested $256 million in the state’s behavioral health system since 2011, as part of the state’s efforts to meet the terms of a legal settlement with the United States Department of Justice. The Department of Justice settlement required the state to move more individuals with developmental disabilities out of state hospitals and provide them with additional supports in their communities. The settlement was set to end in June 2018, but the independent reviewer’s latest report in August 2019 said the state still needs federal oversight to meet its obligations. State lawmakers will need to consider how the department can meet the terms of the legal settlement while facing cuts to their budget.
Funding for the State’s Behavioral Health Safety Net System
The department consists of the Division of Behavioral Health and 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.
Amended FY 2020 Budget
The amended 2020 budget cuts state general funds to the agency by $33.3 million. Some of these changes include:
- $4.9 million cut to funding that was added in last year’s budget to add 144 new residential treatment beds for people with addictive diseases. The department currently has 309 beds at twelve providers across the state for short-term treatment that typically lasts 90 days. People enter the residential treatment programs either after being discharged from crisis services or without coming from a crisis facility
- $3.5 million reduction in funding for adult mental health services, including a $1.1 million cut to provider support and training and a $2 million cut to supported employment services based on fewer people using those services. Supported employment includes services like job coaching and ongoing aid to help people with mental illnesses find and maintain employment or enroll in education programs.
- A $12.8 million reduction in funding for child and adolescent mental health services, including a reduction of $5.9 million for four crisis respite homes that were not created and a $3 million cut to supported employment and education services.
Fiscal Year 2021 Budget
Overall, state general funds for the agency are set to be cut by $24.3 million, a 2 percent decrease from last year. Some of these changes are similar to those in the 2020 amended budget. Highlights include:
- $6.6 million added for a 40-bed forensic unit in Columbus beginning October 2020. The department is responsible for providing psychological evaluation of defendants and inpatient mental health treatment for people who the courts deem meet the criteria for those services.
- $2.7 million added to pay for the cost of 125 NOW and COMP waiver slots added last year but no funding to add new slots. More new slots are needed because as of August 2019, there were about 6,000 people on the waiting list for these services.
- A $4.9 million cut to funding residential treatment beds for people with addictive diseases.
- A $7.4 million reduction in funding for adult mental health services, including $8.3 million from core behavioral health services, $2.4 million from supported employment services and a $1.2 million from provider support and training. Some of these cuts were offset by an increase of $5.1 million for a $1,000 pay raise for full-time employees in adult mental health with salaries at or below $40,000 a year.
- A $14.1 million reduction in funding for child and adolescent mental health services, including a reduction of $5.9 million for four crisis respite homes that were not yet implemented and a$3 million cut to supported employment and education services.
In addition to these changes in the budget, the department will need to redirect funds to preserve capacity for psychiatric crisis services. These services are delivered through the purchase of private hospital beds that allow short-term stays for people facing a mental health crisis. The state is funded for 35 beds, but they require about 95 beds to keep up with the increased demand for these services.
The department needs an additional $13 million to increase the number of beds, and these funds would be redirected from newly added funds for core outpatient services and housing. Some of the funds being redirected were added last year to increase the number and quality of core behavioral health services. This would have funded services for about 9,400 more people. These core services are provided by the community service boards and include a range of supports such as assessments, outpatient therapy services, case management and community assistance.