Friday, May 28, 2021
In the midst of Covid-19, state legislators worked to reduce the mental health impacts of the pandemic while also supporting children’s mental health efforts and expanding telemedicine coverage. This recap highlights the bills that will have a significant impact on mental health in Oklahoma.
In addition, 2021 was the first year of the new Oklahoma Legislative Mental Health caucus, created to enhance discussions and find solutions for Oklahoma’s mental health and addiction challenges in the Legislature. Read the session recap by the caucus chairs, Rep. Josh West and Sen. Julia Kirt, here.
2021 State Legislative Budget
The Legislature appropriated about $335 million dollars to the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS). Although this is about $13 million less than last year’s appropriation, the Legislature is actually re-investing a portion of $30 million in mental health savings that will be generated by Medicaid expansion. In the end, ODMHSAS received an effective increase of $17 million dollars to support the State’s mental health crisis response services. The funding will help build new crisis centers and provide additional help to law enforcement who are often tasked with de-escalating mental health crises and transporting individuals to treatment.
About $7.5 million dollars will add mental health urgent care centers across the state. Another $3 million dollars will fund mobile crisis response teams, $2 million dollars will alleviate some of law enforcement role in mental health transports, and $2 million dollars will add technology to law enforcement vehicles so that those is crisis can be connected to treatment in the field. All of this funding supports a more complete crisis continuum of care which ensures that Oklahomans in crisis will have their needs met regardless of where they reside in the state.
In addition, children’s mental health was both a policy and a budget focus in 2021. Through an appropriation to University of Oklahoma Health Physicians, additional children’s behavioral beds will be added to the system.
Expanding access to care
SB 674, authored by Senator Greg McCortney (R-Ada) and Marcus McEntire (R-Duncan), renews Oklahoma’s leadership in the telehealth sphere and was a key legislative opportunity identified this year by Healthy Minds. SB 674 ensures that health care practitioners are reimbursed at the same rate for similar services delivered via telehealth as an in-person visit. Additionally, SB 674 ensures that co-pays will not be higher than they would be for an in-person visit and that there not be any additional utilization review or requirement to use a particular telehealth platform. This bill moves Oklahoma toward equitable health care access for those in rural areas or for others who are aging or experiencing chronic conditions.
SB 511, authored by Sen. John Michael Montgomery (R- Lawton) and Rep. Carol Bush (R- Tulsa), allows medical practitioners, law enforcement, tribes and registered social service entities to administer harm reduction syringe exchange programs with careful oversight by the State Department of Health. This bill was a key legislative opportunity identified this year by Healthy Minds. Other states have seen benefits from such programs including improved treatment admissions and substance abuse rates, fewer law enforcement officers with needle stick injuries from used syringes, and lower transmission rates of infectious disease.
HB 1071, authored by Representative Jeff Boatman (R-Tulsa) and Senator Brenda Stanley (R-Midwest City), adds health centers to the current list of people and organizations exempt from the requirement of receiving additional certification from ODMH in order to provide substance use disorder treatment and recovery services for patients. Removing this barrier will make it easier for health center patients to receive access to integrated, comprehensive primary care that includes substance use disorder treatment. This will lead to an increased number of individuals receiving support for substance use disorders and improved outcomes for those patients’ physical and behavioral needs.
Criminal justice – mental health
SB 3, authored by Senator David Bullard (R-Duncan) and Representative Justin Humphrey (R-Lane), is collection of amendments to law enforcement transportation responsibilities. SB0003 permits sheriffs and peace officers to (at their discretion) utilize telemedicine to have an individual assessed by a licensed mental health professional. If the individual in question is determined to require further assessment, emergency detention, or protective custody, the law enforcement agency will then be responsible for transportation to the appropriate facilities (within a 30-mile radius of their operational headquarters). Law enforcement agencies may contract these responsibilities out to a third party—provided that this third party meets minimum standards. SB0003 is another piece of legislature meant to improve interactions between agents of the criminal justice system and individuals in need of mental health services—with ultimate hopes to reduce the number of justice-involved persons living with mental illness.
HB 2877, authored by Rep. Kevin Wallace (R- Wellston) and Sen. Zack Taylor (R- Seminole) allows officers to utilize telemedicine when a person is experiencing to a mental health crisis in order to be assessed by a licensed mental health professional. It also requires police to transport individuals who need to be assessed by mental health professionals to a facility within 30 miles.
SB 87, authored by Senator John Haste (R-Tulsa) and Representative Carol Bush (R-Tulsa), authorizes peace officers to divert publicly intoxicated persons to (1) their own home, (2) a drug treatment facility, or (3) a substance abuse evaluation center—without creating records indicative of arrest. Individuals found to be in possession of controlled dangerous substances or drug paraphernalia may also be diverted. SB0087 proposes valid alternatives to arrest—including opting into treatment. SB0087 hopes to promote treatment and reduce the punitive impact of living with substance abuse issues for those that opt into treatment.
SB 50, authored by Sen. Brent Howard (R- Altus) and Rep. Rande Worthen (R- Lawton), modifies the confidentiality requirements of mental health court program records and clarifies language related to mental health courts. The bill also requires any criminal case be cross-referenced to a mental health court case file by the court clerk if the case is assigned to a mental health court program in the future.
SB0848, authored by Senator Kim David (R-Porter) and Representative Kevin Wallace (R-Wellston) requires funds for new crisis intervention training for law enforcement, firefighters, and emergency medical personnel. This training is meant to promote wellness among civil servants, and will address the potential impacts of traumatic job duties–including strategies for mitigation and peer support. SB00848 not only promotes greater mental health within law enforcement, firefighter, and emergency medical personnel communities—but by receiving training on the impact of trauma, these organizations may also establish better relations with other trauma-affected communities.
SB 89, authored by Senator John Haste (R-Broken Arrow) and Representative Rhonda Baker (R-Yukon), requires health education, including physical, mental, social and emotional, and intellectual health, to be taught in public schools. This bill has the potential to significantly impact Oklahomans’ health long-term. If students learn healthy mental and physical habits at an early age, it has the potential to affect their health far into their futures, leading ultimately to better overall health outcomes across the state. This includes mental health. The development of an awareness of mental health and substance abuse, good stress management techniques, coping skills for understanding and managing trauma, building positive relationships, and learning responsible decision making can go a long way toward managing mental health throughout one’s life.
HB 1568, otherwise known as Maria’s Law, authored by Jeff Boatman (R-Tulsa) and Senator John Haste (R-Tulsa), requires that Oklahoma public schools include instruction on mental health wellbeing as part of their health education curriculum. Previous language regarding mental health education in schools was permissive; Maria’s Law makes it so that mental health education is mandatory. Maria’s Law also establishes basic curriculum standards—namely that materials emphasize the interrelation of physical and mental well-being.
HB 1103, authored by Rep. Mark Vancuren (R- Owasso) and Sen. Haste (R- Broken Arrow) greatly expands the use of the Oklahoma Prevention Needs Assessment (OPNA) in Oklahoma schools and was a key legislative opportunity identified this year by Healthy Minds. Already used by about half of schools at the 6th, 8th, 10th, and 12th grade levels, the OPNA increases that to 100 percent, helping schools and families better understand school climate and how to anticipate and respond to the needs of students. It is a critical best practice for informing prevention programs.
HB 1773, authored by Representative Sherrie Conley (R-Newcastle) and Senator Jessica Garvin (R-Duncan), requires Oklahoma teacher candidates to study multi-tiered systems of support (MTSS) during their preservice teacher preparation program. Multi-tiered systems of support provide levels of progressively increasing support and resources as the needs of students increase. Teacher candidates will be trained in evidence-based assessment, intervention, and data-based decision-making procedures, in order to better identify and support students at risk for negative academic or nonacademic outcomes. This legislation and MTSS training support students’ mental health by equipping teachers with the tools and skills to manage students’ problematic behaviors and reinforce appropriate behaviors in supportive, evidence-based ways. It will also enhance support for and success of students with a history of trauma, as the training includes the “identification and impact of trauma on student learning” and equips teachers with tools for trauma-informed responsive instruction.
HB 2006, authored by Representative Tammy Townley (R-Ardmore) and Senator Brenda Stanley (R-Midwest City), directs ODMH to promulgate rules and standards for certification of problem gambling treatment counselors. These rules will include criteria for certification and renewal, necessary education and examination, and professional conduct. The creation of rules surrounding certification of problem gambling treatment counselors will lend legitimacy to the profession, standardize training, and ensure appropriate treatments are used.
SB 21, authored by Senator Kay Floyd (D-Oklahoma City) and Representative Marcus McEntire (R-Duncan), requires the board of education of each school district to provide district-wide evidence-based training to all staff on suicide awareness and prevention. The bill also includes permissive language allowing school districts to provide suicide awareness and prevention training to students in grades seven through twelve starting with the 2022-2023 school year. Uptake of this training should be relatively straightforward, as ODMH already has a suicide awareness and prevention program called “At Risk” that schools can use. This bill has substantial positive potential mental health impacts for our students. Staff members will be better able to identify suicidal ideation in students, engage in preventive discussions, and connect students with appropriate services.