State and Federal Updates

In this post, surprisingly NO budget updates, but a little on Medicaid and federal and state behavioral health legislation.

Medicaid Expansion Being Debated Today

This morning, the House Appropriations Subcommittee on Budget Transparency and Reform heard testimony on HB 3376 by Rep. Sylvester Turner, which would expand Medicaid to all individuals eligible under the ACA.  As previously mentioned, it is estimated that 90% of individuals currently receiving public mental health and substance abuse services would be eligible for Medicaid under such an expansion.

Dozens of advocates were out in full force to express their support for this important legislation.  NAMI Policy Director Greg Hansch and Hogg Foundation for Mental Health Fellow Peter McGraw gave testimony about the positive impact Medicaid expansion would have on people with mental illness.  The hearing recessed for House proceedings but will resume after the House adjourns for the day.

Other legislation the subcommittee will consider include HB 3791, Rep. Zerwas’ “Texas solution” Medicaid expansion bill, and HB 3339 by Rep. Martinez-Fisher, which would allow the use of Rainy Day Funds to restore the $5.4 billion cut from public schools last session.

Comprehensive Federal Behavioral Health Legislation Moving Forward

Last week I shared a little about S. 689, the Mental Health Awareness and Improvement Act, which is being sponsored by Health, Education, Labor and Pensions (HELP) Committee Chairman Tom Harkins. The bipartisan bill was introduced after the HELP Committee’s January hearing to assess the state of the country’s mental health system. The bill was voted unanimously out of the HELP Committee last Wednesday and is now awaiting action by the full Senate.

The bill takes a number of positive steps to promote prevention and early intervention and improve the delivery of mental health and substance abuse services. From the Section-by-Section analysis (with a few minor revisions), key provisions of the bill include:

• Encouraging the development of school-wide prevention programs, such as positive behavioral interventions and supports.

• Encouraging states to provide technical assistance to school districts and school personnel on the implementation of school-based mental health programs.

• Reauthorizing the Youth Suicide Early Intervention and Prevention Strategies grants to states and tribes.

• Reauthorizing the Mental Health and Substance Use Disorder Services on Campuses grant program and updates the use of funds to allow for the education of students, families, faculty, and staff to increase awareness and training to respond effectively to students with mental health and substance use disorders, to provide outreach to administer voluntary screenings and assessments to students, and to enhance networks with health care providers who treat mental health and substance use disorders. Incorporates consideration of the needs of veterans enrolled as students on campus.

• Reauthorizing grants to states, political subdivisions of states, Indian tribes, tribal organizations, and nonprofit private entities to train teachers, appropriate school personnel, emergency services personnel, and others, as appropriate, to recognize the signs and symptoms of mental illness, to become familiar with resources in the community for individuals with mental illnesses, and for the purpose of the safe de-escalation of crisis situations involving individuals with mental illness.

• Reauthorizing the National Child Traumatic Stress Initiative.

• Requiring a Government Accountability Office (GAO) report on the federal requirements affecting access to mental health and substance use disorder treatment related to integration with primary care, administrative and regulatory issues, quality measurement and accountability, and data sharing.

• Directing the Substance Abuse and Mental Health Services Administration to advance the education and awareness of providers, patients, and other stakeholders regarding FDA-approved products to treat opioid use disorders; calls for a report on such activities, including the role of adherence in the treatment of opioid use disorders, and recommendations on priorities and strategies to address co-occurring substance use disorders and mental illness.

• Requiring a GAO report on the utilization of mental health services for children, including information about how children access care and referrals; the tools and assessments available for children; and the usage of psychotropic medications.

• Encouraging the Secretary of HHS to disseminate information and provide technical assistance on evidence-based practices for mental health and substance use disorders in older adults.

• Requiring a GAO study on the status of implementation of recommendations developed after the Virginia Tech tragedy, as well as identification of any barriers to implementation and identification of additional actions the Federal government can take to support states and local communities to ensure the Federal government and laws are not obstacles at the community level.

We will continue to monitor and share updates on this bill as it makes its way through the legislative process.

Behavioral Health Legislation

Many pieces of legislation MHA is tracking continue to be on the move. In the last week, the following bills have passed out of committee or their respective chambers:


HB 592
Relating to the definition of serious mental illness for purposes of certain group health benefit plans. 

HB 1947
Relating to the criteria for commitment of a person with mental illness.

HB 1952
Relating to professional development training for certain public school personnel regarding student disciplinary procedures.

HB 2392
Relating to the mental health program for veterans.

HB 2812
Relating to an annual report by the reentry and integration division and the parole division of the Texas Department of Criminal Justice.

SB 34
Relating to the administration of psychoactive medications to persons receiving services in certain facilities.

SB 861
Relating to requiring certain notices to be posted on the premises of certain alcoholic beverage retailers. 

SB 913
Relating to the reexamination of an applicant for a professional counselor license. 

SB 914
Relating to a behavior improvement plan adopted for certain students with an individualized education program.

SB 1356
Relating to requiring trauma-informed care training for certain staff of county and state juvenile facilities.


HB 232
Relating to allowing certain minors convicted of certain alcohol offenses to perform community service instead of attending an alcohol awareness program.

HB 807
Relating to the practice of psychology; authorizing a fee.

HB 1738
Relating to a standard form of notification for the detention of a person with mental illness.

SB 718
Relating to voluntary and involuntary mental health services.

SB 831
Relating to a list of mental health, substance abuse, and suicide prevention programs that may be selected for implementation by public schools.

SB 898
Relating to the mental health program for veterans.

SB 1057
Relating to information about private health care insurance coverage and the health insurance exchange for individuals applying for certain Department of State Health Services health or mental health benefits, services, and assistance.

SB 1114
Relating to the prosecution of certain misdemeanor offenses committed by children and to school district law enforcement.

SB 1178
Relating to training for public school educators in identifying mental health and suicide risks among students.

SB 1352
Relating to inclusion of mental health concerns in existing state and local coordinated school health efforts.

For a more in-depth view of behavioral health legislation and MHA’s position on these bills, check out our bill tracker here.

More next week!


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