Mental health highlights of the 2022 legislative session

For the second regular session of the 58th Oklahoma Legislature, mental health remained a unifying, bipartisan issue. Lawmakers recognized the challenges facing our state — increased emergency room admissions for teens in crisis, record levels of overdose deaths, and demand for behavioral health services straining the capacity of providers — and advanced evidence-based policy interventions to improve the health outcomes of vulnerable Oklahomans.

Highlights of the session include:

• Passage of several bills to address the epidemic of youth suicides
• A 5.8% increase in funding for the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), including new mental health beds at the Oklahoma Forensic Center
• Large-scale privatization of Oklahoma’s Medicaid system, with key protections for mental health coverage
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Key mental health wins

With an unprecedented increase in mental health need, Healthy Minds proposed two bills that advance a transformation of Oklahoma’s approach to behavioral health treatment and prevention. Lawmakers approved these bills with broad bipartisan support, laying the groundwork for establishing national best practices in all Oklahoma schools and achieving true parity between the mental and physical health care systems.

HB 4106 by Rep. Mark Vancuren (R-Owasso) and Sen. Dewayne Pemberton (R-Muskogee) establishes partnerships between public schools and community mental health providers for responding to students in a suicidal crisis. Every school district in Oklahoma must establish protocols that define what constitutes a crisis, document how a crisis can be identified, maintain the involvement of a student’s family, and protect student privacy and anonymity.

SB 1413 by Sen. John Michael Montgomery (R-Lawton) and Rep. Chris Sneed (R-Fort Gibson) strengthens Oklahoma’s ability to enforce parity in insurance coverage between mental and physical health care. The bill aligns state parity reporting requirements for insurance companies with federal requirements, making compliance easier for insurers and encouraging more transparent and useful reporting.

Additionally, Healthy Minds provided counsel and analysis to dozens of lawmakers, advocates, and treatment providers during negotiations about the transition of Oklahoma’s Medicaid system to managed care model. The passage of SB 1337 by Sen. Greg McCortney (R-Ada) and Rep. Marcus McEntire (R-Duncan) requires the Oklahoma Health Care Authority to establish a new managed care system no later than Oct. 1, 2023.  Healthy Minds helped ensure that managed care – which pays health care providers a flat fee per individual served rather than reimbursing for services performed – includes adequate coverage for behavioral health.

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Mental health bills signed into law

SB 626 by Sen. David Bullard (R-Durant) and Rep. Randy Randleman (R-Eufaula) mandates that inpatient mental health facilities communicate the importance of disclosing a minor’s mental health needs to their school district when the minor is discharged. If parents choose to disclose this information to the school and the student has received inpatient or emergency outpatient mental health services in the past two years, an employee from the student’s school must meet with the parent or guardian of the student and a representative from the mental health facility to determine if the student needs special accommodations.

SB 888 by Sen. Rob Standridge (R-Norman) and Rep. T.J. Marti (R-Broken Arrow) allows the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control (OSBNDDC) to, in the event opioids caused or contributed to someone’s death, determine if such drugs were prescribed in the year prior. The bill allows the bureau to report the name of the prescribing practitioner to their licensing board. The bill also requires pain management clinics and their owners to register with the OSBNDDC and report to the bureau quarterly.

SB 1307 by Sen. Bill Coleman (R-Ponca City) and Rep. Mark Vancuren (R-Owasso) requires that schools provide the National Suicide Prevention Lifeline and the Crisis Text Line numbers on student identification cards for students in grades 7th through 12th.  

SB 1370 by Sen. Kevin Matthews (D-Tulsa) and Rep. Jason Lowe (D-Oklahoma City) requires the Council on Law Enforcement Education and Training to establish minimum requirements for training for security guards, armed security guards, and private investigators that include recognizing and managing a person appearing to require mental health treatment or services, crisis intervention, and techniques to assist with de-escalating interactions.  

SB 1516 by Sen. Darrell Weaver (R-Moore) and Rep. Jeff Boatman (R-Tulsa) establishes May 11 as Oklahoma Overdose Awareness Day.

SB 1548 by Sen. Roger Thompson (R-Okemah) and Rep. Kyle Hilbert (R-Depew) directs drug courts to develop objective criteria for participant eligibility and allows individuals with violent offenses (except domestic violence) to be considered for participation.

SB 1613 by Sen. Kimberly David (R-Porter) and Rep. John Echols (R-Oklahoma City) establishes a Mental Wellness Division under the Department of Public Safety that will provide services and programs to public safety personnel.

SB 1738 by Sen. James Leewright (R-Bristow) and Rep. Kyle Hilbert (R-Depew) sets a process for determining if an individual with a death sentence is mentally competent to be executed through an evaluation by the Department of Mental Health and Substance Abuse Services.

HB 3053 by Rep. Brad Boles (R-Marlow) and Sen. Lonnie Paxton (R-Tuttle) provides the option for someone who has successfully completed drug court to receive a deferred sentence, not to exceed two years, as opposed to a dismissal.  

HB 4227 by Rep. Jeff Boatman (R-Tulsa) and Sen. Lonnie Paxton (R-Tuttle) creates a new class of urgent recovery clinics that offer voluntary assessment and stabilization services for acute symptoms of mental illness, substance use disorders, and emotional distress. The bill allows these clinics to treat a medically unstable patient if capable, or direct them to a more appropriate facility if not. Clinics are only able to provide emergency detention until the individual is medically stabilized.  

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Appropriations and funding

The Legislature appropriated $340 million to ODMHSAS, a 5.8% ($18.6 million) increase from the previous fiscal year.

SB 1048 establishes limits for ODMHSAS spending:

• $7 million to increase provider reimbursement rates for peer recovery support specialists, Program of Assertive Community Treatment (PACT), individual and family therapy services, and psychosocial rehabilitation
• $3.5 million to add 80 beds at the Oklahoma Forensic Center
• $2.6 million for program growth to account for increased behavioral health costs for SoonerCare participants
• $2 million for increasing services for children with acute behavioral health issues
• $1 million to expand the family treatment court program to 14 jurisdictions
• $700,000 for services for veterans and their families, providing matching funds for a new Cohen Veterans Network facility
• $500,000 for pilot programs to treat incarcerated individuals in county jails with medication-assisted treatment for opioid and alcohol dependence
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Other mental health appropriations include:

• HB 4466 directs the Department of Human Services to spend $32.5 million to provide additional services and programs for persons with developmental disabilities in order to eliminate the waiting list for the Developmental Disabilities Services Division. The bill also implements a 25% increase in rates for all services within the Home and Community-Based Services Waiver program to ensure access to services for people with developmental disabilities and those served through the ADvantage waiver.
• HB 4470 designates $150,000 for the creation and maintenance of the Mental Wellness Division within the Department of Public Safety.
• Oklahoma’s share of American Rescue Plan Act (ARPA) funding remains largely unappropriated. Legislators convened a special session to reformat the allocation of ARPA funds, requests for which include several mental health initiatives.