The Department of Behavioral Health and Developmental Disabilities plays a crucial role in the state of Georgia, managing a variety of responsibilities aimed at supporting individuals with mental health conditions, substance use disorders, and developmental disabilities. Among its many duties, the Department operates five state psychiatric hospitals and provides evaluation and treatment for individuals within the court system to assess their competency to stand trial. Additionally, the Department offers vital community-based services for Georgians in need, ensuring that they receive appropriate support in their daily lives.
Governor Kemp’s 2025 Fiscal Year budget proposal allocates $1.6 billion in state funds to the Department. This proposal reflects a significant increase of $139 million, or 9%, compared to the original fiscal year 2024 budget. A substantial portion of this increase focuses on enhancing home- and community-based services for individuals with intellectual and developmental disabilities, as well as raising compensation for their dedicated providers. By prioritizing these areas, the Department aims to improve service delivery and workforce conditions, which are essential for meeting the needs of the population it serves.
Among the proposed enhancements is a one-time $1,000 bonus for employees, accompanied by a cost-of-living adjustment designed to help retain staff and fill vacancies. Commissioner Tanner highlighted the pressing need for these measures, referring to the current situation as “a state of emergency when it comes to our state workforce.” Such statements underscore the critical nature of the challenges faced by the Department as it strives to maintain a robust workforce committed to supporting those in need.
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
- $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 an average of 40%. Paying providers a living wage has long been a significant barrier to filling additional waiver slots.
- $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, addressing the fact that approximately 13,000 individuals currently benefit from these services, while over 7,300 remain on the planning list.
- $27 million increase for a 4% cost-of-living adjustment for full-time staff (capped at $3,000 each) at the Department and its associated agencies.
- $22 million increase to implement a 30% average increase in provider rates for community-based behavioral health providers, which was part of the Community Behavioral Health Rehabilitation Services rate study for uninsured Georgians.
- An additional $4 million increase in state funds to support the implementation of this rate study as outlined in the Department of Community Health’s proposed budget.
- $16 million increase for behavioral health crisis centers (BHCC), which provide essential assessment, intervention, and counseling for individuals facing mental health or substance abuse crises. Notably, $9.5 million of this funding is allocated for BHCC in North Georgia, where a bed capacity study revealed a significant need for adult behavioral health beds concentrated in Northwest Georgia.
- $6.6 million increase to annualize the operations of BHCCs located in Fulton County, Dublin, and Augusta.
A $11 million decrease for core mental health services reflects workforce shortages at community service boards and a reduction in the utilization of private psychiatric beds due to increased capacity at state hospitals.
The Impact of Medicaid Expansion
The Department’s budget is poised to benefit significantly if the state fully expands Medicaid. Under the ‘Adult Mental Health Services’ line item, the Department funds evaluation, treatment, crisis stabilization, and residential treatment for adults living with mental health conditions. Over the past decade, adult mental health services have accounted for approximately 37% of the Department’s state general funds. Most of these services are provided to individuals without access to healthcare coverage, placing a considerable financial burden on the state.
For example, the Department supports 22 community service boards across Georgia that deliver community-based mental health and addiction services to roughly 120,000 adults—many of whom are uninsured or have limited financial means. If Medicaid expansion occurs, a greater number of uninsured Georgians would gain access to essential healthcare coverage, with the federal government absorbing 90% of the associated costs. This development could enable the state to recover some of its expenditures, allowing for potential reallocations to address other pressing needs.
More than 1 in 4 Georgians currently in the coverage gap are believed to have a behavioral health condition. States that have already 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, reduced psychological distress among low-income individuals, lowered suicide rates, and enhanced participation of behavioral health providers in Medicaid.
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