In June of this year, the Centers for Medicaid and Medicare Services (CMS) approved a change for Georgia’s Medicaid program that shifts how school nurses can bill for their services. Before June, Medicaid would only pay for school health services, including nursing services, if the student had a special education plan called an Individualized Education Program (IEP). IEPs are maps that lay out a program of tailored education instruction, supports, and services. These plans are required for all students receiving special education services like students with ADHD, autism, or a speech impairment. The approved change allows Medicaid to pay for more school health services provided to any student with Medicaid coverage.

Legislative Update: Week 7

The GHF team prides itself on being able deliver timely and accurate updates on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!

In this week’s update:

• The General Assembly approves the calendar for the rest of session
• Action alerts: prior authorization, Medicaid expansion, & mental health & substance use updates!
• Legislation: telehealth, changes to nursing rules, & protecting the ACA 
• Advocacy events this week: transgender rights!
• Federal COVID-19 relief – including extra Medicaid expansion funding – passed by U.S. House
• GHF’s got you covered this session!

The ongoing COVID-19 crisis has damaged the mental health of many Georgians and exacerbated the use of alcohol and drugs. Financial stressors, the difficulties of parenting, and almost universal uncertainty brought about by COVID-19 have dramatically increased depression, anxiety, stress, and substance use among Georgians. Some will seek supports and services to manage their health, which may be provided in part by certified peer specialists.

Certified peer specialists (CPS) provide support and education to individuals and families while they navigate mental health and/or substance use recovery supports and services. CPS have played a vital role in Georgia’s mental health and substance use recovery systems for over 20 years.

A recent poll from the Kaiser Family Foundation found that 45% of Americans reported that the COVID-19 crisis has harmed their mental health. Anxiety and fear are common with people concerned about contracting the virus, a loved one getting sick, and the economic impact of the crisis, including job loss, lost income, and loss of health care coverage.

Georgia non-profits and state agencies have come together to ensure resources and supports are available for Georgians who need help with their mental health. The following list provides information and links to resources to help get all of us through these difficult times.

If you need to talk to someone:

• National Suicide Prevention Lifeline
  Call 1-800-273-8255 or use the chat option on their webpage
  en Espanol: 888-628-9454
  Deaf and hard-of-hearing: 1-800-799-4889
  Open 24/7. We can all help prevent suicide. The Lifeline provides free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.

• Georgia Mental Health Consumer Network’s Peer2Peer Warm Line
  Call 888-945-1414
  Open 24/7/365 providing peer support over the phone. Support is available to all Georgians experiencing anxiety or stress, or who need support through the pandemic. Please call any time.

• Georgia Council on Substance Abuse’s CARES Warm Line
  Call or text 844-326-5400
  Open every day, 8:30 am to 11 pm. FREE, confidential, and available to anyone who has questions about addiction and recovery, needs someone to listen to them or wants to talk with someone who is also in recovery from substance use disorders.

• Georgia COVID-19 Emotional support line
  Call 866-399-8938
  Open 24/7. This confidential line offers assistance for those needing emotional support or resource information as a result of the COVID-19 pandemic. The support line is staffed by volunteers, including mental health professionals and others who have been trained in crisis counseling. This is part of a partnership between the Georgia Department of Behavioral Health & Developmental Disabilities, Beacon Health Options, and Behavioral Health Link.

If you need a support group:

• The Georgia Council on Substance Abuse is offering a FREE and confidential series of virtual All Recovery Meetings for those who want to stay connected during COVID-19. To learn more about GCSA and find the most up-to-date meeting times, visit their FaceBook page.
• NAMI Georgia and their local chapters around the state offer virtual support meetings for people with mental illness and family members. To get more information about the meetings, call (770) 408-0625 or email programs@namiga.org.

If you want to learn skills or information about mental health:

COVID-19 and your mental health:

• Learn self-care strategies and get the care you need to help you cope with resources and tips from the Mayo Clinic.
• Mental Health and COVID-19 information and resources, Mental Health America
• Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life

If you have health coverage:

• Medicaid – If you need mental health or substance use recovery services during this time, check with your Medicaid insurance company and doctor to see if you can schedule a safe, socially distanced in-person appointment or a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person. The contact information for your Medicaid insurance company is on the back of your insurance card.
• Private insurance – If you need mental health or substance use recovery services during this time, call your insurance company using the number on the back of your insurance card or visit their website to search for an in-network health care provider near you who offers the services that you need.
• Uninsured – If you need mental health care services during this time, call the Georgia Crisis & Access Line at 800-715-4225, visit the GCAL website, or download the MyGCAL app to find free or low-cost, local mental health & substance abuse services. Georgians should not let their insurance status get in the way of getting needed support or treatment.
• You can find more insurance information and resources (including how your insurance will cover COVID-19 testing & treatment) on our COVID-19: Your health coverage, health care, & well-being blog.

If you want to help:

• If you have completed Mental Health First Aid training and are interested in volunteering to provide support via the Georgia COVID-19 Emotional Support Line please email your name and contact info to MHFAvolunteer@dbhdd.ga.gov

Legislative Update: Week 4

Legislative session paused amid budget disagreements

The Georgia legislature voted to pause the official legislative calendar last week due to the difficult and sometimes contentious discussions over the state budget. Governor Kemp’s proposed budget cuts for the current and subsequent state budgets have left the legislature to the difficult tasks of finding savings where possible, making cuts to some services and programs, and debating how to bring in sufficient revenue. Speaker of the House David Ralston has instructed the House to hold only budget-related hearings this week. 

The legislature plans to officially reconvene next Tuesday, February 18th for day 13 of this year’s legislative session. According to the legislature’s new calendar, Crossover Day (the day by which a bill has to be approved by at least one chamber in order to remain “alive” for this year) is scheduled for March 12th.

Strong surprise billing legislation introduced

Surprise billing legislation would protect consumers in emergency & non-emergency situations

Last week companion legislation were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. If passed, these bills would protect 2.6 million Georgians from surprise medical bills.

SB 359 has been read and reffered to the Senate Health and Human Services committee. HB 888 is in House first readers and in the House Special Committee on Access to Quality Health Care.

Call one or more of these committee leaders to ask for their support of SB 359 and HB 888: 

• Sen. Ben Watson, Chairman of Senate HHS committee,
  404-656-7880
• Sen. Dean Burke, Vice Chairman of Senate HHS committee, 404-656-0040
• Rep. Mark Newton, Chairman of the House Special Committee, 404-656-0254
• Rep. Sharon Cooper, Vice Chairman of the House Special Committee, 404-656-5069

If your state Senator or Representative is on either committee, please call them as well!

House examines mental health and organ transplant issues

Involuntary commitment emerges as theme in mental health legisation

Two pieces of mental health legislation garnered attention from mental health advocates and legislators last week.

HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances. This bill sits in the House Judiciary committee but the discussions of this issue may instead be moved to a subcommittee of the Behavioral Health Innovation and Reform Commission.

HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances. This legislation is not supported by mental health advocacy groups because it could lead to involuntary committal for people with mental health issues. The bill now sits in the House Public Safety and Homeland Security committee.

Gracie’s Law would protect organ transplant discrimination for Georgians with disabilities

Rep. Rick Williams has introduced HB 842, titled “Gracie’s Law.” According to the Georgia Council on Developmental Disabilities (GCDD), Gracie’s Law would protect patients with disabilities from being removed from the organ donor waiting list because of their disability. According to an article in GCDD’s Making a Difference magazine, “While the Americans with Disabilities Act (ADA) denies discrimination based on any disability, there is still a lack of federal enforcement,” prompting the need for state action on this issue. This bill has been referred to the House Insurance committee. You can read more about Gracie’s Law here (pg. 12-13).

Thank you!

Health care heroes like you submitted 1,710 comments!

Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with plans to change Medicaid and private insurance in Georgia. When health officials needed your input on the Medicaid plan, more than 1700 Georgians like you stepped up! 
 

We are incredibly grateful for your advocacy on behalf of Georgians and communities who would benefit from Medicaid expansion in Georgia. Thank you for speaking up for your friends, neighbors, and all Georgians! Now your comments become part of a powerful legal record that health officials must take into acocunt as they decide whether or not to approve Governor Kemp’s Medicaid plan.

Stay tuned! Health officials are still reviewing Governor Kemp’s planned changes for private insurance. When the time comes, we will ask you to speak up again by submitting a comment again! Here and at coverga.org, we will let you know what those changes mean for you and your loved ones and when you can comment.

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• GHF’s 2019-2020 legislative priorities

Georgia consistently ranks poorly among states in children’s mental health services, this year ranking 51st in a report from the Commonwealth Fund.  However, state leadership has been adamant about improving Georgia’s system of care through the infusion of additional dollars for children’s mental health services in the state budget and through innovative programs like Project Advancing Wellness and Resilience Education (AWARE).

Georgia Project AWARE is a youth mental health initiative focused on improving the experiences of school-aged youth in Georgia, and is funded by a grant from the Substance Abuse and Mental Health Services Agency (SAMHSA) to the Georgia Department of Education (GaDOE).

The purpose of Georgia’s Project AWARE is “to increase awareness of mental health issues among school-aged youth; provide training in Youth Mental Health First Aid; and connect children, youth, and families who may have behavioral health issues with appropriate services.”

The four main goals of Georgia Project AWARE are:

1. Increase participation of families, youth, and communities and mental health providers in efforts to identify the mental health resources available to meet the needs of students and families;
2. Increase awareness and identification of mental health and behavior concerns, and student and family access to mental health providers through the PBIS framework in Georgia Project AWARE (GPA) schools; 
3. Increase the percentage of Georgia youth and families receiving needed mental health services through collaboration between school systems and community mental health providers; and
4. Train educators, first responders, parents and youth group leaders to respond to mental health needs of youth by providing free training in Youth Mental Health First Aid (YMHFA).

Georgia’s Project AWARE grant supports the participation of three Georgia school systems: Griffin-Spalding County School System, Muscogee County School District, and Newton County Schools. The GaDOE has partnered with these school districts to provide training in Youth Mental Health First Aid and to develop innovative ways to connect youth and families to community-based mental health services.

Through Project AWARE, elementary and middle school teachers conduct universal screenings of their students and the screening results are used in two ways. School-, grade-, and classroom-level data is used to guide decisions about what universal supports or programs may be needed to better support the social and emotional needs of students. For example, if the results of the screening show high rates of anxiety for an entire grade of students, school leaders and teachers may make changes to school practices that may contribute to student anxiety or implement a program to help reduce or address the anxiety students are feeling.

Individual level screening results are used to identify those students who could benefit from extra social and emotional supports. These students are then connected to the appropriate behavioral services through partnerships the schools have developed with community-based providers.

Georgia Project AWARE has already screened a total of 18,713 students in 29 schools. Georgia State University’s Center for Leadership in Disability and the Center for Research on School Safety, School Climate and Classroom Management provide support for the program through analysis of the screening results and trainings for school leadership and staff.

In Getting to know Project AWARE: Part II, we’ll learn more about Youth Mental Health First Aid and how it helps educators meet the social and emotional needs of their students.

To learn more about Georgia Project AWARE:

• Visit the Georgia Department of Education (GaDOE)
• Read more from the Substance Abuse and Mental Health Services Agency (SAMHSA)
• Read the latest issue of the Georgia Project AWARE Digest

Georgians for a Healthy Future hosted an educational forum titled Strong Foundations: Building a System of Care to Address the Behavioral Health Needs of Georgia Children on Tuesday, May 15. The forum explored the behavioral health needs of Georgia children and youth, Georgia’s publicly-supported behavioral health landscape, and successes and opportunities in the current system of care. The event also raised awareness about Georgia’s system of care in an effort to improve access to behavioral health services for children and youth.

The event began with Respect Institute speaker Tammie Harrison, who shared her experiences navigating the behavioral health care system and getting to a place of recovery.

Because many of the event attendees were new to the topic of children’s behavioral health (BH), GHF’s Executive Director Laura Colbert provided some foundational information about the prevalence of children’s BH conditions, contributors to poor BH, and the pathways to BH care and supports for young Georgians. You can find Laura’s PowerPoint slides here. She also debuted GHF’s new behavioral health fact sheet.

Dante McKay, Director of the Office of Children, Young Adults, & Families at the Georgia Department of Behavioral Health & Developmental Disabilities (DBHDD) provided attendees with an overview of DBHDD’s work, the 2017 System of Care state plan, and how the recently signed FY19 budget would impact the department’s ability to serve Georgia children and youth.

Dr. Erica Fener-Sitkoff, Executive Director of Voices for Georgia’s Children moderated a panel discussion of BH service providers, which included Wendy Farmer of Behavioral Health Link, Laura Lucas of Project LAUNCH (DBHDD), and Monica McGannon of CHRIS 180. The panelists discussed barriers to accessing BH services, which they said include continued stigma, lack of trained workforce, and transportation. The panel also identified innovative efforts, like Project LAUNCH and mobile crisis services, to bring BH services closer to consumers when and where they need it. When asked how Georgia’s next Governor could continue to make progress in the area of children’s behavioral health, panelists suggested a focus on workforce development, increasing access to community-based substance use treatment for teens, and prevention and early intervention.

If you missed the event, a recording of the webcast is available here.

To see photos, review materials, and read more about our Strong Foundations event, please visit the event page.

Despite several missed opportunities to address consumer health concerns during this year’s state legislative session, the FY2019 budget includes several impactful investments. Last week, Governor Nathan Deal traveled through Georgia and held budget signing ceremonies in Atlanta, Acworth, Blue Ridge, Statesboro, and Tifton for the $26 billion spending plan which will begin on July 1 of this year through June 30, 2019. The infusion of dollars into children’s mental health is especially noteworthy and exciting because of the impact it is expected to have across the state.

Governor Deal has recently made children’s behavioral health one of his top health care priorities and this year included in his proposed budget $20.6 million to fund recommendations from the Governor’s Commission on Children’s Mental Health. During its consideration of the state budget, he legislature ultimately increased the funding dedicated to these recommendations to $21.4 million.

These funded recommendations include behavioral health crisis services, supported employment and education for young adults with behavioral health needs, provider training and telehealth, and opioid abuse prevention for youth. Funding for suicide prevention will in part go towards expanding the capacity of GCAL, the Georgia Crisis and Access Line, which provides 24/7 online and telephone support for people who are seeking services for developmental disabilities, mental health, or substance use issues. Some of the additional funding is also dedicated to the Georgia Apex Program, a school-based mental health program that improves early identification, access to and coordination of needed behavioral health (BH) services for children with BH needs..

In the coming months, we will break down the Commission’s funded priorities and their impact on young Georgians. Look for our Healthy Minds, Healthy Bodies blog mini-series.

Looking for more information on this topic? Georgians for a Healthy Future will be hosting an educational forum later this month during which we will explore the behavioral health needs of Georgia children and youth, Georgia’s publicly-supported behavioral health landscape, and successes and opportunities in the current system of care. Join us in person or via webcast for this exciting and important event!