All About the Budget…and a Little More

In this issue, get more detailed information on the mental health and substance abuse services funded by the House and Senate budget bills, information on how sequestration will affect behavioral health, and as always, a bill update.

Senate Budget On Its Way to the Floor

Last Wednesday, the Senate Finance Committee voted out its budget bill, CSSB 1, which includes over $200 million more for behavioral health services.  Since I’ve previously outlined the approved Senate mental health and substance abuse initiatives, I won’t repeat all of that information. However, there are a few budget riders–“footnotes” that designate funding for certain purposes–worth mentioning:

  • Requirement that DSHS withhold 10% of appropriated funds to each Local Mental Health Authority (LMHA) for ongoing community and crisis mental health services and distribute the funds based upon a performance-based incentive plan
  • Requirement that DSHS develop a 10-year plan for the provision of psychiatric services at state hospitals (with the inclusion of public input)
  • Designation of children’s mental health prevention and early intervention funds for  evidence-based curricula that train school personnel and community members about the signs and risks of mental health issues
  • $8 million of appropriated funds designated for the veterans mental health program
  • $8 million of appropriated crisis funds designated for outpatient competency restoration programs

House Makes Amends

As I mentioned in my last post, also on Wednesday, the House Appropriations Committee approved over $200 million more for mental health and substance abuse services as well. This was a reversal from earlier Article II Subcommittee decisions that amounted to just $33 million more for behavioral health. The House budget bill, which will be substituted in place of the Senate bill when it makes its way over to the House, funds the following services:

Mental Health

  • $54.2 million to eliminate the ~6,500 person waiting list for mental health services
  • $24.8 million to expand housing support options for people with mental illness
  • $32.5 million to expand the YES waiver
  • $25 million for Haven for Hope-like community parterships
  • $25 million to expand crisis services
  • $20 million to expand community mental health services for children and adults
  • $17 million to increase service package offerings for underserved children and adults
  • $6 million to expand NorthSTAR services
  • $4 million for veterans mental health
  • $2.4 million for 6 long-term treatment beds (up to 90 days) at the Harris County Psychiatric Center

Substance Abuse

  • $6 million to increase substance abuse provider rates by 3.9%
  • $5 million for substance abuse services for individuals referred by DFPS
  • $4.9 million to eliminate the 946-person substance abuse service waiting list
  • $1.1 million to expand the Oxford House model across Texas

Additionally, Representatives Sylvester Turner and Ruth Jones McClendon submitted a rider to the budget that would ensure that increased mental health funding would address inequities among LMHAs. If maintained in the final version of the bill, this would mean that Harris County MHMRA, which has one of the lowest per capita funding rates among the LMHAs, would receive a disproportionate amount of the additional monies. The House Appropriations Committee also adopted the performance-based incentive plan rider adopted by Senate Finance.

Regarding funding for behavioral health services, so far, so good! If you didn’t get a chance to respond to the MHA alert sent out yesterday, how about take a moment to call your favorite members of House Appropriations and Senate Finance to thank them for their good work?

Federal Behavioral Health Funding Cut

While the budget is looking good at the state level, things are shaky at the federal level. As a result of sequestration–the automatic federal budget cuts that are kicking in due to lack of Congressional action on deficit reduction–the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) is set to lose $168 million, or about 5%, of its total funding by September 30th of this year. This will include across-the-board cuts to all programs, including the mental health block grant (funded at a level of $460 million) and the substance abuse block grant (funded at a level of $1.8 billion). As a result, funding will be reduced accordingly at the state level.

According to DSHS, funding for substance abuse services will need to be reduced by $6.7 million and funding for mental health services by $1.7 million. DSHS has asked stakeholders to complete a survey to give input on how DSHS should implement these cuts.

Obviously, substance abuse programs will take a bigger hit, so it’s important to try and minimize the impact to the most important programs. For whatever my 2 cents is worth, I probably would recommend that funding for children’s substance abuse prevention, intervention and treatment services remain unharmed. If the adults take cuts, it may be better to target those to prevention and intervention, rather than treatment, since we still have a substance abuse treatment waiting list (at least in the current fiscal year). Again, that’s just what I think.  If the substance abuse community has any thoughts, please share!

That being said, please take a moment to complete this survey. It is due this Friday, March 22nd.

Behavioral Health Legislation

As you know, MHA is tracking over 200 mental health- and substance abuse-related bills. You can view them all here. Many of the bills have been progressing quickly through the process.The following legislation has been voted out of committee:

HB 908
Relating to the assessment of an elderly or disabled person’s psychological status for purposes of an emergency order authorizing protective services.

SB 36
Relating to the detention and transportation of a person with a mental illness.

SB 58
Relating to integrating behavioral health and physical health services provided under the Medicaid program using managed care organizations.

SB 152
Relating to the protection and care of persons who are elderly or disabled or who are children.

SB 256
Relating to tracking career information for graduates of Texas medical schools.

SB 401
Relating to a notification requirement if a school counselor is not assigned to a public school campus.

SB 462
Relating to specialty court programs in this state.

SB 944
Relating to criminal history record checks for certain employees of facilities licensed by the Department of State Health Services.

In addition, the Senate already has voted a few bills out of its chamber, which are now awaiting action in the House. These include:

SB 50
Relating to the Children’s Policy Council, including the composition of the council.

SB 109
Relating to a housing plan developed and certain housing information collected and reported by the Texas Department of Housing and Community Affairs.

SB 126
Relating to the creation of a mental health and substance abuse public reporting system.

SB 426
Relating to a home visiting program for at-risk families.

Again, check out summaries of these bills, MHA’s positions, and more by viewing our bill tracker.

Catcha next week!

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