2021 Oklahoma Legislature: Mental health opportunities

January 29, 2021

As Oklahoma enters the 2021 Legislative Session, it does so amid an exhausting global pandemic that has elevated depression, anxiety, addiction and childhood trauma to unprecedented levels in our state – including sharply-increasing opioid deaths.  Fortunately, the current crisis has not radically changed the solutions needed for a better path forward. It has merely changed the urgency.

The Legislature took positive steps early in the pandemic to pass landmark mental health parity legislation ensuring fairness for Oklahomans seeking behavioral health care, and by protecting valuable mental health funding amid an emerging budget shortfall.

A year later, the Oklahoma Legislature in 2021 can continue to outsmart this crisis by building toward a more strategic, cohesive health care system that effectively engages more Oklahomans earlier in their mental health and addiction needs, and produces better health, economic and education outcomes.

2021 legislative opportunities

Telehealth expansion and reimbursement: SB 674 by Sen. McCortney expands access to telehealth services by ensuring medically-appropriate health and mental health care delivered by telehealth is reimbursed and treated equally. The bill covers key recommendations made by Healthy Minds as critical next steps for cementing Oklahoma’s status as a telehealth leader in the COVID-19 era and beyond.

Spending and Strategy: SB 295 by Sens. Simpson and Haste calls for an analysis of mental health spending across state agencies and requires inter-agency strategic collaboration on mental health services across state government making more efficient of use of funding already allocated to mental health services across the state.

School-based data collection: HB 1103 by Rep. Mark Vancuren expands use of the evidence-based Oklahoma Prevention and Needs Assessment (OPNA), providing a critically-needed glimpse of children’s trauma, mental health and social-emotional learning needs in the wake of COVID-19. A voluntary survey administered to a sample-size of students with parental consent and no cost to schools, the OPNA will support long-term strategies to better integrate community mental health services with school-level needs. It also allows districts to work immediately with the Oklahoma Department of Mental Health on specific interventions informed by their data.

Harm reduction: SB 511 by Sen. Montgomery and Rep. Bush will improve access to evidence-based services that reduce the proliferation of used syringes in Oklahoma communities while connecting individuals with addiction to appropriate care. The bill, intended to support first-responders and empower medical professionals, includes data-collection and accountability requirements ensuring programs achieve the desired results.

Reinvesting ODMHSAS savings: Amid a difficult year for Oklahoma’s budget but a time of critical need for mental health services, the State has a unique opportunity to reinvest in mental health services with no new funding. Savings generated by the pending increase in the federal government’s share of Medicaid expansion have created the potential to reinvest up to $29 million in mental health by holding ODMHSAS’ budget level with previous-year appropriations. This reinvestment could go toward improving crisis services and criminal justice diversion efforts just at the right time, as Oklahoma grapples with a rise in pandemic-related mental health and addiction issues. This would ultimately save costs by preventing crises from escalating to costlier, poor-outcome alternatives such as inpatient hospitalization or criminal justice involvement.

Other key issues in 2021

Medicaid and managed care: Oklahoma voters in 2020 elected to expand Medicaid, bringing health care coverage to an additional 200,000 Oklahomans with a 9-to-1 federal match. The Legislature will need to appropriate $164 million this fiscal year to cover the 10% state match. In addition, the Oklahoma Health Care Authority is moving forward with privatizing the state’s Medicaid program by hiring commercial Managed Care Organizations (MCOs) to operate the program, and legislators will debate funding for this proposal.

Children’s mental health: Recognizing the elevated childhood mental health needs caused by COVID-19, legislators have filed numerous pieces of legislation addressing children’s mental health in schools. Key bills include data collection through HB 1103; teacher training through HB 1773; school-based trainings and education through SB 21, SB 89, HB 1027, HB 1686, and HB 1568; and other proposals that focus on mental health personnel in schools.

Police and first responders: Supporting first responders is an important goal in 2021, with positive implications for mental health. One proposal likely to appear in multiple bills would shift responsibility for mental health transports from police to a contractor, alleviating strain on systems (SB 3). Public safety districts, HB 1970 and SB 838, could boost local resources for police and mental health diversion, while SB 87 highlights police-led diversion programs. Several bills also address officer training.

Breaking barriers: Numerous bills seek to improve access to mental health or addiction treatment via telehealth or other methods. SB 674, for example, extends temporary COVID-19 telehealth innovations, while HB 1005 and SB 511 increase access to addiction treatment. HB 1740 would allow more access to substance use disorder treatment information in hospital emergency rooms, and SB 902 would help ensure health coverage for people re-entering society from prison.