Georgia, like most states, is facing a growing need for social and emotional health support for young children and families. During the past year, in response to concerns about prevention and early identification of mental health problems in children and adolescents in Georgia, a study committee comprised of five members of the state’s House of Representatives has been studying infant and toddler social and emotional health needs and recently issued recommendations for how Georgia can move forward.

Over the course of five meetings, members of the study committee learned from pediatricians, child care providers, and infant and early childhood mental health specialists who testified to the social-emotional issues they witness in young children and called on the members for state support. For example, they noted, though the first three years of a child’s life represent the most critical time for brain development, preschool students are expelled at more than three times the rate of K-12 students.

The members heard from a national expert from ZERO TO THREE about how caretaker relationships and early experiences during the first three years of life can shape a child’s brain architecture, contributing to their ability to succeed in school, career, and future relationships.

State agency representatives testified about how current programs impact infants, toddlers, and their families. A representative from Medicaid indicated that behavioral health services for children age 0-4 were not covered under the state’s Fee for Service Medicaid.

This was echoed in additional testimony from a representative for the state’s Care Management Organizations, also known as Medicaid managed care plans, though the representative also noted that a service would be reimbursed if deemed medically necessary. Committee members asked questions about Medicaid coverage throughout the meetings, and often, they were left unanswered by the state.

Finally, state officials from neighboring Alabama offered guidance from their experience taking major steps to implement a statewide system that cares for the social-emotional needs of young children and their families.

In January 2020, the Study Committee delivered a report and recommendations to the Speaker of the House and the public. The recommendations include:

1. Creating a coordinator position to be housed at the Department of Early Care and Learning focused on infant and toddler social and emotional health. This coordinator will be instrumental in creating a cross-agency leadership team focused on infant and toddler social-emotional health. This leadership team would then be tasked with creating a plan to promote a mental health workforce that supports young children.
2. Charging the Department of Community Health, which administers Medicaid and the Department of Behavioral Health and Developmental Disabilities, which administers the state’s behavioral health safety net, with creating and submitting a plan no later than June 2020 with information on how Medicaid might clarify existing service codes for children ages 0-4. The report pointed to Arkansas as an example of how other states have done this.
3. Extending Medicaid for women up to twelve months postpartum. Several of the presenters noted the stress that untreated postpartum depression can have on a mother and baby, and the committee recognized the importance of extended Medicaid coverage to accessing treatment for depression and any other health needs new mothers face. The Maternal Mortality Study Committee, led by House Health & Human Services Committee Chair Rep. Sharon Cooper (R-Marietta), also recommended extending Medicaid coverage for 12 months in their final report.

Currently, pregnancy Medicaid in Georgia only lasts 60 days post-partum. Georgia is one of the states that did not expand Medicaid under the Affordable Care Act and continues to struggle with high uninsured rates for adults and children.

In 2019, Georgia proposed an 1115 waiver that would provide a limited Medicaid expansion (up to 100% FPL) for working adults. This recommended Pregnancy Medicaid extension would be a separate legislative endeavor.

These recommendations are promising. While Georgia has lagged behind our neighbors in addressing the social and emotional needs of infants, toddlers, and their families, GEEARS is hopeful that the recommendations from this study committee will help to make Georgia a better place to raise a family.

About GEEARS: Georgia Early Education Alliance for Ready Students

Callan Wells is Health Policy Manager at GEEARS. GEEARS is a nonprofit organization operating to inspire and provide leadership for a statewide movement on quality early learning and healthy development for all children ages birth through five. GEEARS was established in 2010 to help business, civic and government leaders maximize the economic return on the state’s investments in early care and learning.