TGSO–Thank God Session’s Over–Post

Monday, May 27th, marked the 140th and final day of the 83rd Regular Session of the Texas Legislature–Hallelujah! Though the Governor immediately called a special session to deal with redistricting, I think I can say that we’ve seen all we’re going to see regarding behavioral health. Lots of bills have passed, lots of bills have died, and lots of money has been appropriated to improve the statewide mental health and substance abuse service system. Read on for more…

Budget Wrap-Up

The conference committee report for SB 1 passed both the House and Senate over the weekend and will soon be on its way to the Governor. In the end, the Legislature appropriated an additional $312.5 million over and above the base budget to mental health and substance abuse services. Key (though not all) initiatives that were funded include:

Mental Health

Children and Adult Mental Health Waiting List Elimination: $48.2 million
1915i Home and Community Based Services and Rental Assistance: $24.8 million
YES Waiver: $58.6 million
Crisis Services: $25 million
Haven for Hope-like Projects: $25 million
Underserved at LMHAs: $17 million
School-based Training on Prevention/Early Identification: $5 million
Public Awareness: $1.4 million
Harris County Diversion Program: $10 million
Harris County Psychiatric Center: $2.4 million
Veterans Mental Health Services: $4 million
NorthSTAR Increase: $6 million

Substance Abuse

Substance Abuse Capacity Expansion: $4.9 million
Substance Abuse Provider Rate Increase: $10.7 million
Oxford House Expansion: $1.1 million
Substance Abuse Slots for DFPS: $10.1 million

In addition, the Legislature designated $43 million to address the per capita inequities between Local Mental Health Authorities (LMHAs) across the state. This means that Harris County MHMRA will receive additional funding to bring it closer to the statewide per capita average.

Finally, I should mention that the Legislature restored about $3.9 billion in funding to public schools, though with inflation and enrollment growth, it still leaves schools far short of where they were before last session. This funding includes an increase of just over $11 million for Communities in Schools, which will allow the program to serve approximately 30,000 more students per year.

To look more closely at mental health and other items in the budget, check out LBB’s budget documents here.

Behavioral Health Legislation

There were many great pieces of behavioral health legislation that passed during the 83rd Legislature. A couple questionable ones passed as well, but the good far outweighed the bad. Instead of posting all of the legislation that passed, I’m going to refer you to our trusty bill chart here. Just about everything is updated, except for some of the summaries that don’t reflect amendments that were made to the bills after they were introduced. To read the text of the bill, simply click on the bill number. Bills that have a black box next to them died, with the exception of a few that were successfully amended onto other legislation. I will discuss some of those bills, and a few other key ones below.

The first bill I want to boast about is SB 460, which will require mental health trainings in educator preparation programs. The bill was successfully amended to include SB 1178/HB 3225, which will require mental health trainings for current teachers and administrators and SB 1352/HB2477, which will require local school health advisory committees to make recommendations on strategies to prevent mental health concerns among students. This bill, which originated from the Harris County School Behavioral Health Initiative, was one of MHA Houston’s top priorities for the session. Additional legislation that quite nicely dovetails with this bill is HB 3793. Included in HB 3793 is language from SB 955, which will set up a fund for LMHAs to train individuals to deliver Mental Health First Aid (MHFA). The fund will allow MHFA to be delivered to educators free of charge. With the passage of these important bills, expect a significant and positive shift in the way students with behavioral health issues are handled in our schools!

Another big win was passage of HB 3105. This bill puts Texas in line with national insurance law standards by striking the provision in current statute that allows an insurer to refuse a claim of loss or injury due to the insured being intoxicated or under the influence of controlled substances. This was a top priority for the Association of Substance Abuse Programs and the Texas Association of Addiction Professionals and represents a major step in removing the stigma associated with substance use disorders.

Some great legislation affecting children also passed. SB 44 will require the Department of Family and Protective Services to report the number of children whose parents relinquished custody of them to the state solely for the purpose of obtaining mental health services and to study and make recommendations to prevent this practice. SB 421 will convert the Texas Integrated Funding Initiative to the Texas System of Care consortium to oversee and implement strategies to expand a state system of care for minors receiving residential or inpatient mental health services, who are at risk of being placed in a more restrictive environment to receive mental health services, and other at-risk populations. Both of these bills should help provide additional supports to children with SED and their families.

With the passage of SB 7 and HB 3793, the so-called “big three” of schizophrenia, bipolar disorder and major depression will be no more…that is, as a required diagnosis for treatment through LMHAs. Both of these bills included language from HB 2625, which expanded the list of diagnoses to include post-traumatic stress disorder, obsessive compulsive disorder, anxiety disorder, eating disorders, and “any other diagnosed mental health disorder”. As a result, indigent individuals with these “other” diagnoses can receive needed ongoing treatment through LMHAs rather than being managed from crisis to crisis, which all too often is the case.

Lots of other great bills passed, so be sure to check MHA Houston’s bill tracker for more detailed information.

A Little on Medicaid Expansion

Of course, one of the biggest missed opportunities this session was making headway on the expansion of coverage for individuals up to 133% of the Federal Poverty Level as set forth by the ACA. The expansion rider that the Senate initially included in the budget ultimately was removed due to concerns that the House would kill the entire budget as a result. So where does this leave us? Some speculate that during the interim the Governor will allow HHSC Commissioner Kyle Janek to negotiate some type of “Texas solution” with CMS after all. This blogger, who’s been observing the Governor since 1999 when he was a younger and far more flexible Lt. Governor, is somewhat doubtful of that. But would Gov. Perry really allow Texas to leave billions of federal dollars on the table and leave hundreds of thousands of Texans uninsured? I think the answer lies in his plans for 2014 and 2016, which are still unknown.  I’m sure we’ll hear far more on this issue in the coming months.

Has This Blog Been Helpful?

Well, if you’ve read this far (or at least skipped to the bottom), I consider you a Texas Legislative Blog Stalwart! This will be my last post for a while as I work on session wrap-up and oh, all the other stuff I’m supposed to be doing in my job besides legislative stuff! But if this blog added a little knowledge, a little joy, a little humor, a little something, ANYTHING to your life, why not post a comment and let me know? Your feedback is much appreciated! 🙂

That’s all for…a long time. Stay tuned for MHA Houston’s biennial Legislative Wrap-up.  Otherwise, enjoy your interim!