MHA Houston To Bring Focus on Veterans Mental Health at 2014 Texas Tribune Festival

Over three days on the University of Texas at Austin campus, more than 200 speakers will dive into the state’s and nation’s most pressing issues: public and higher ed, immigration, health care, transportation, energy, the environment, criminal justice and – new this year – government transparency.

On Saturday, September 20th, Tony Solomon, Director of the Veterans Behavioral Health Initiative at Mental Health America of Greater Houston is slated to participate in the panel, “Health Care: What’s Next for Mental Health?” moderated by Alana Rocha,  Reporter for The Texas Tribune.  He is a panelist along side Harris County Sheriff, Adrian Garcia, State Senator; Vice Chairwoman of the Senate Criminal Justice Committee, Joan Huffman; Commissioner of the Texas Department of State Health Services, and David Lakey; President and CEO of the Meadows Mental Health Policy Institute, Tom Luce.  For more information or to attend the 2014 Texas Tribune Festival, September 19-21, visit:  http://www.texastribune.org/festival/2014/home/

Legislative Update and Local News

Hello, everybody!  I hope that all of you volunteer and professional advocates alike have had ample time to recuperate after the busy session!  Wish I could say the same for our state legislators and their staff, who have now entered their 3rd Special Session. Sheesh! I just want to share two quick updates in this post.

83rd Regular Legislative Session Wrap-Up

For those who are interested, I wanted to give you the opportunity to check out MHA Houston’s 83rd Legislative Wrap-Up.  This is a pretty comprehensive look at the legislative and budget initiatives that passed during the regular session that affect mental health and substance abuse services.  Please download a copy here and feel free to distribute.  If you’d like a hard copy, please let me know.

Finally!  Boarding Homes Regulations Come to Houston

Last Wednesday, July 24th, the Houston City Council unanimously passed an ordinance that will regulate boarding homes in the city of Houston for the first time.  Boarding homes serve an important role in the continuum of care for people with mental illness and other disabilities, and the majority of them provide safe and affordable
living quarters for their residents.  However, some boarding homes have
been found to engage in abusive behavior, including the withholding of their
residents’ social security checks, failing to provide food and other basic
necessities and treating residents as commodities rather than clients.

The Houston ordinance will require all boarding homes to register with the
City; conduct criminal background checks on employees; maintain appropriate records; develop a fire safety plan and submit to annual fire safety inspections; and publicly post information regarding resident rights, as well as the toll-free Department of Family
and Protective Services hotline to report abuse, neglect and
exploitation.  There are over 400 known boarding homes in the city of
Houston, while potentially dozens more are flying under the radar.

MHA Houston has been working on this issue for over 4 years and thanks all the individuals and organizations who partnered with us to make this a reality.  Special thanks go to Mayor Pro Tem Ed Gonzalez and the Houston Police Department Mental Health Division for their invaluable efforts!

That’s all I’ve got for now.  Until next time (whenever that may be)!

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!

Budget and Bills

On this 129th day of the 83rd Legislature, find out some news on the conference committee budget decisions, as well as more bill updates.

Budget

On Monday, the budget conference committee met to adopt its Article II decisions, and it simply confirmed that this was a GREAT session for mental health and substance abuse services! While I was able to obtain information on the final items approved for these services, because the documents have not yet been publicly posted, I won’t be able to post the full list on this blog. However, I will share a few key items, particularly where there were differences in the House and Senate version:

• Funding was approved for each of the previously explained items from DSHS’ mental health expansion plan. This includes funding for both school-based prevention and early identification services and a public awareness campaign, though the public awareness campaign was funded at a lower level than the Senate version proposed.
• Funding to eliminate the children and adults mental health waiting list was reduced by $9 million to account for a revised estimate of the number of folks who currently are waiting for services.
• Funding for each of the substance abuse items was approved, though the provider rate increase was lower than the Senate version proposed.
• Funding for psychiatric residency positions was approved.
• Funding for the Harris County Psychiatric Center was approved.
• Funding for the Harris County Jail Diversion Project was approved (consistent with SB 1185).
• Funding for a Jail-Based Competency Restoration program was approved (contingent on passage of SB 1475).

When the document becomes public, I will post the funding levels in full.  But if you can’t wait and want more specifics, just give me a call and I’ll share!  All in all, HOORAY for lots more mental health and substance abuse funding!

Stayin’ Alive

Last week was the deadline for house bills to be passed out of the House (and to some extent, for senate bills to be passed out of the Senate) in order to remain alive. Lots of bills died, but lots of bills are still alive. However, we have another round of deaths coming soon. This Saturday is the deadline for senate bills to be voted out of house committees (and to some extent, house bills out of senate committees), and Sunday is the last day the House Calendars Committee can meet to set bills for the Daily House Calendar. As I mentioned in my last post, next Tuesday and Wednesday present the final opportunity for ANY bill to be voted out of the House or Senate on second reading. So, while many bills are still alive, we’ll unfortunately have more deaths to report in a week.

Anyhoo, several good behavioral health bills are steadily making their way through the process, and some of them already are on their way to the Governor. Just a note about the categories I used below–the bills under the headline of “Passed Out of Opposite Chamber” are bills that have passed both chambers but were amended in the second chamber, so will have to go through a longer process (concurrence with the amendments added or appointment of a conference committee) before they are sent to the Governor. The bills that are “Headed to the Governor” remained unchanged in the second chamber and thus, barring a veto, are on their way to becoming law of the land!

Passed Out of Opposite Chamber Committee

HB 424
Relating to the sex offender status of a person who becomes a resident of certain group home facilities.

HB 646
Relating to the requirements for members appointed to the Texas State Board of Examiners of Psychologists.

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

HB 808
Relating to the authority of a psychologist to delegate the provision of certain care to a person under the psychologist’s supervision, including a person training to become a psychologist.

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

HB 978
Relating to the transportation of certain patients to a mental health facility.

HB 1191
Relating to certain information about housing for persons with mental illness provided through the Texas Information and Referral Network Internet site.

HB 1396
Relating to a study on alcohol and controlled substance statistics prepared by the Department of Family and Protective Services and the Department of State Health Services.

HB 2392
Relating to the mental health program for veterans.

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

SB 44
Relating to maintaining and reporting certain information regarding certain child abuse or neglect cases and the provision of mental health services for children in those cases.

SB 58
Relating to the integration of behavioral health and physical health services into the Medicaid managed care program.

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

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

SB 263
Relating to the designation for criminal prosecution and other purposes of certain chemicals commonly referred to as synthetic cannabinoids as controlled substances and controlled substance analogues under the Texas Controlled Substances Act.

SB 264
Relating to the addition of certain substances to Penalty Groups 1-A and 2 of the Texas Controlled Substances Act for criminal prosecution and other purposes.

SB 421
Relating to the Texas System of Care and the development of local mental health systems of care for certain children.

SB 646
Relating to court-ordered outpatient mental health services.

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

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

SB 1003
Relating to a review of and report regarding the use of adult and juvenile administrative segregation in facilities in this state.

SB 1185
Relating to the creation of a mental health jail diversion pilot program.

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

Passed Out of Chamber of Origination

HB 705
Relating to the definition of emergency services personnel for purposes of the enhanced penalty prescribed for an assault committed against a person providing services in that capacity.

HB 868
Relating to exceptions to mental health information disclosure prohibitions.

HB 1143
Relating to certain assessments for children in the conservatorship of the state.

HB 1396
Relating to a study on alcohol and controlled substance statistics prepared by the Department of Family and Protective Services and the Department of State Health Services.

HB 1856
Relating to the authority of a mental health facility to require a peace officer to transport a person apprehended for emergency detention to a medical facility to receive a medical evaluation before being transported to the mental health facility.

HB 2038
Relating to addressing disproportionality and disparities in the education, juvenile justice, child welfare, health, and mental health systems, the continuation and operation of the Interagency Council for Addressing Disproportionality, and the duties of the Center for Elimination of Disproportionality and Disparities.

HB 2240
Relating to a study on homeless youth.

HB 2625
Relating to disease management practices of local mental health authorities.

HB 3227
Relating to coverage of certain eating disorders as serious mental illnesses under certain group health benefit plans.

HB 3731
Relating to the date of a hearing on an application for an order to authorize psychoactive medication for a person receiving inpatient mental health services.

SB 925
Relating to a license requirement for licensed professional counselors employed by school districts.

SB 1304
Relating to school district reports concerning corporal punishment and the issuance of citations by a peace officer.

Passed Out of Opposite Chamber (Almost Headed to Governor)

HB 243
Relating to the authority of a community center that provides mental health or mental retardation services to sell certain real property of the center.

HB 617
Relating to transition and employment services for public school students enrolled in special education programs.

HB 1738
Relating to the emergency detention by a peace officer of a person who may have mental illness, including information provided to the person subject to detention and a standard form of notification of detention to be provided to a facility by a peace officer.

SB 715
Relating to use of consistent terminology to refer to school counselors in the Education Code.

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

HB 915
Relating to the administration and monitoring of health care provided to foster children.

Headed to the Governor

HB 144
Relating to a mental examination of a child subject to the juvenile justice system.

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

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

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

For a more in-depth look at these bills, check MHA’s bill tracker here.

‘Til next week!

Tick, Tock…The Session Clock is Ticking

In this post, learn about the budget, looming legislative deadlines and the status of behavioral health legislation.

A Little on the Budget

The conference committee on CSSB 1 has been meeting for a couple of weeks and initially hoped to have decisions finalized by the end of this week. However, they are still working in earnest, with the expectation that the decisions will be finalized by next week.

In related news, Governor Perry has threatened to not “sign the budget until he signs significant tax relief”. Last month, the Governor called for $1.6 billion in business tax relief. While CSSB 1 currently does not include tax relief, legislation is making its way through the House that would provide businesses with tax breaks under the much-maligned franchise tax. If that legislation doesn’t make it through the Senate, the Governor may make good on his promise and keep legislators in Austin until they deliver on one of his top priorities.

Session Deadlines Are Looming

Well, on this 121st day of the 140-day legislative session, the smoke has started to clear, and we can now see where all of the dead bills lie–and there are LOTS of them.  The deadline for house bills to be voted out of the House on second reading is tomorrow, meaning that bills that still are in the Calendars Committee are, for all sense and purposes, dead.

Possibly the most noteworthy among dead bills is HB 3791, Rep. Zerwas’ “Texas Solution” healthcare coverage expansion bill. While the bill was voted out of the House Appropriations Committee 15-9, the Calendars Committee failed to set it for a vote before the full House. This obviously represents a major missed opportunity to expand health coverage options for the uninsured, but there still remains a remote possibility that the budget conference committee will include language in the budget setting forth the parameters for Medicaid expansion negotiations.  Although the House passed a non-binding resolution instructing the House budget conferees not to vote to expand Medicaid, it is worth noting that all five of the House conferees voted in favor of HB 3791.  So while the prospects for expansion still look bleak, it aint over til it’s over.

Behavioral Health Legislation

The MHA bill tracker has been updated to reflect bills that currently are dead–over half of them! The dead bills are denoted with a blacked-out box next to the bill number.  However, remember that just because a specific bill is dead, it does not mean the issue is dead.  Several of the dead bills have Senate companions that are still moving along in the process, and others may be tacked on as amendments to other legislation.  Note that the House must hear all senate bills on second reading by May 21st (for the daily or supplemental calendar) or May 22nd (local calendar).

On the other hand, just because a bill on the tracker is not dead today doesn’t mean it won’t be dead as early as tomorrow.  The current House calendar is about 2 days behind, meaning that the House is just starting to debate some bills today that were originally set to be considered on Monday.  Because of this backlog, a house bill that has been set for the daily House calendar tomorrow (the deadline) may not even come up for a vote.  A sad, but true commentary on a process designed to kill bills!

However, there is some good news.  Several good behavioral health bills (and a couple so-so bills) are moving along and still alive…for now.  They include:

Passed Out of Committee

HB 2401 (Set for House calendar tomorrow)
Relating to the provision of community-based services to individuals who have or may have mental illness.

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

SB 1057 (Out of House Committee)
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 1189 (Out of House Committee)
Relating to the disposition of certain firearms seized by a law enforcement agency.

Passed Out Of Chamber

HB 124
Relating to the addition of Salvia divinorum and its derivatives and extracts to Penalty Group 3 of the Texas Controlled Substances Act.

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

HB 2407
Relating to restoration of a person’s right to purchase a firearm on termination of a guardianship.

HB 2887
Relating to the establishment and expansion of community collaboratives by entities to provide services to and coordinate the care of persons who are homeless, persons with mental illness, and persons with substance abuse problems.

HB 3327

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

SB 44
Relating to maintaining and reporting certain information regarding certain child abuse or neglect cases and the provision of mental health services for children in those cases.

SB 338
Relating to the liability of certain social workers who provide volunteer health care services to charitable organizations.

SB 460
Relating to inclusion of instruction in the detection and education of students with mental or emotional disorders in the requirements for educator training programs.

Again, you can check the status of these bills (and all the dead ones) on MHA’s bill tracker by clicking here.

That’s all for now!

Back After a Hiatus

Lots has been going on over the past couple of weeks, so we won’t cover EVERYTHING in this post, but will share a budget update, more on the Mental Health Improvement and Awareness Act, and as always, bill updates.

Budget Moving Forward

Both the House and Senate have appointed members to the conference committee to iron out differences in the budget bill. The conferees are:

Senate: Tommy Williams, Juan Hinojosa, Robert Duncan, Jane Nelson, John Whitmire
House: Jim Pitts, Myra Crownover, John Otto, Sylvester Turner, John Zerwas

Sen. Nelson and Rep. Zerwas are the two members responsible for Article 2, which covers health and human services. All conference committee decisions are expected to be completed by the end of next week.

As we’ve covered extensively in this blog, the total behavioral health funding differences between the House and Senate are not very significant.  However, a few of the key differences include:

• The Senate adds $2 million for psychiatric residency positions in state hospitals while the House does not
• The Senate increases funding for crisis services by $30 million while the House increases it by $25 million
• The Senate funds prevention and early intervention and public awareness at a combined level of $6 million while the House does not include funding for either
• The Senate adds $30.4 million for a substance abuse provider rate increase, expanding the Oxford House model, setting aside DFPS slots and addressing the waiting list while the House adds just $15.9 million
• The House increases funding for collaborative, Haven for Hope-like projects by $25 million, while the Senate increases it by $15 million
• The House adds $2.4 million for the Harris County Psychiatric Center while the Senate does not

For more behavioral health side-by-side comparisons across all articles, check out the Legislative Budget Board Issue Docket here.

Mental Health Improvement and Awareness Act Has Overwhelming Support, But…

On April 18th, amid the many failed amendments to the background check/school violence bill, an amendment that included the language of the Mental Health Improvement and Awareness Act (MHIAA) actually was adopted by a vote of 95-2.  However, because the bill subsequently was pulled down, the future of MHIAA is unknown.  Several senators have expressed a desire to see the bill move forward separate from the gun control debate (Amen to that!), so we’ll see what the leadership decides to do in the coming weeks.  At the very least, it’s good to know that the bill has overwhelming support in the upper chamber.

Behavioral Health Legislation

Well, since it’s been 2 weeks since I’ve last posted, legislation is really piling up!  Dozens of mental health and substance abuse bills are steadily moving through the process, including the following:

VOTED OUT OF CHAMBER

HB 517
Relating to the eligibility of inmates convicted of certain intoxication offenses for release on parole or mandatory supervision. 

HB 617
Relating to transition and employment services for public school students enrolled in special education programs. 

HB 646
Relating to the requirements for members appointed to the Texas State Board of Examiners of Psychologists.

HB 705
Relating to enhanced penalties for assault of emergency room personnel.

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

HB 915
Relating to the administration and monitoring of health care provided to foster children.

HB 978
Relating to the transportation of certain patients to a mental health facility.

HB 1023
Relating to the creation of a task force to investigate and make recommendations regarding mental health workforce shortages.

HB 1191
Relating to certain information about housing for persons with mental illness provided through the Texas Information and Referral Network Internet site.

HB 1739
Relating to the administration of psychoactive medications to persons receiving services in certain facilities.

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.

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

SB 263
Relating to the designation for criminal prosecution and other purposes of certain chemicals commonly referred to as synthetic cannabinoids as controlled substances and controlled substance analogues under the Texas Controlled Substances Act.

SB 264
Relating to the addition of certain substances to Penalty Groups 1-A and 2 of the Texas Controlled Substances Act for criminal prosecution and other purposes.

SB 418
Relating to a notification requirement if a public school campus or open-enrollment charter school does not have a nurse assigned to the campus during all instructional hours.

SB 646
Relating to court-ordered outpatient mental health services.

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 937
Relating to the authority of a peace officer to apprehend a person for emergency detention and the authority of certain facilities to temporarily detain a person with mental illness.

SB 955
Relating to the training of employees of local mental health authorities and certain educators in mental health first aid and the establishment of the mental health first aid fund.

SB 1003
Relating to the creation of the Adult and Juvenile Administrative Segregation Task Force.

SB 1189
Relating to the disposition of certain firearms seized by a law enforcement agency. 

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

SB 1475
Relating to the development and use of a jail-based restoration of competency pilot program.

VOTED OUT OF COMMITTEE 

HB 205
Relating to the allocation of beds in and the commitment of certain persons to certain mental health facilities.

HB 1012
Relating to the elements of and punishment for the offense of providing an alcoholic beverage to a minor.

HB 1013
Relating to civil liability for the provision of an alcoholic beverage to a minor.

HB 1070
Relating to the expunction of certain alcohol- and drug-related offenses following successful treatment and rehabilitation.

HB 1143
Relating to certain mental health and medical services for children in foster care and the conservatorship of the state, including the administration of psychotropic drugs.

HB 1396
Relating to alcohol and controlled substance statistics compiled and reported by the Department of Family and Protective Services.

HB 1743
Relating to the prosecution of certain offenses involving controlled substances and other prohibited drugs, substances, or paraphernalia.

HB 1853
Relating to a behavior improvement plan adopted for certain students with an individualized education program.

HB 1856
Relating to a peace officer’s determination whether medical services are needed for persons apprehended for emergency detention. 

HB 2038
Relating to addressing disproportionality and disparities in the education, juvenile justice, child welfare, health, and mental health systems, the continuation and operation of the Interagency Council for Addressing Disproportionality, and the duties of the Center for Elimination of Disproportionality and Disparities.

HB 2349
Relating to alternate methods for providing mental health and related services to certain defendants found incompetent to stand trial or acquitted by reason of insanity in a criminal case. 

HB 2407
Relating to restoration of a person’s right to purchase a firearm on termination of a guardianship.

HB 2418
Relating to the penalties for the production or delivery of marihuana plants.

HB 2572
Relating to the qualifications of certain experts authorized to examine a defendant and testify as to the issue of the defendant’s sanity or insanity in a criminal case.

HB 2652
Relating to providing inmates of the Texas Department of Criminal Justice with information regarding reentry and reintegration resources.

HB 2887
Relating to the establishment of community collaboratives by local entities to provide services to and coordinate the care of persons who are homeless, persons with mental illness, and persons with substance abuse problems.

HB 2914
Relating to the penalty for possession of certain small amounts of controlled substances in Penalty Group 1.

HB 3227
Relating to coverage of certain eating disorders as serious mental illnesses under certain group health benefit plans.

HB 3327

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

HB 3632
Relating to a mandatory drug, alcohol, and substance abuse education program for certain minors convicted of, or placed on deferred disposition or community supervision for, certain drug or alcohol related offenses; authorizing a fee.

HB 3731
Relating to the date of a hearing on an application for an order to authorize psychoactive medication for a person receiving inpatient mental health services.

HB 3791
Relating to the creation of a “Texas” solution to issues related to Medicaid, including flexibility in the administration of the Medicaid program, tailored to the needs of the state.

HB 3809
Relating to use of consistent terminology to refer to school counselors in the Education Code. 

SB 44
Relating to maintaining and reporting certain information regarding certain child abuse or neglect cases.

SB 50 (Out of House Committee)
Relating to the Children’s Policy Council, including the composition of the council.

SB 338
Relating to the liability of certain social workers who provide volunteer health care services to charitable organizations.

SB 426 (Out of House Committee)
Relating to a home visiting program for at-risk families.

SB 460
Relating to inclusion of instruction in the detection and education of students with mental or emotional disorders in the requirements for educator training programs.

SB 462 (Out of House Committee)
Relating to specialty court programs in this state.

SB 898 (Out of House Committee)
Relating to the mental health program for veterans.

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

SB 925
Relating to a license requirement for licensed professional counselors employed by school districts.

SB 1114 (Out of House Committee)
Relating to the prosecution of certain misdemeanor offenses committed by children and to school district law enforcement.

For more in-depth information on filed behavioral health legislation, check out MHA’s bill tracker here.

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:

VOTED OUT OF COMMITTEE

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.

VOTED OUT OF CHAMBER

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!

More on the Budget and Bill Updates

In this post, get an update on the state budget, some federal mental health news, and more bills!

State Budget

Last Thursday, the Texas House had a marathon debate on CSSB 1. The $193.8 billion bill passed the House 135 to 12. House members adopted dozens of amendments, including the following mental-health related amendments:

Amendment 41 by Zerwas, which would require DSHS and other state agencies to review and revise contracts with LMHAs to ensure compliance with federal requirements and to coordinate with private hospitals to improve access to services and funding under the 1115 Waiver;

Amendment 44 by Naishtat, which would provide $5 million over the biennium for technical assistance and grants to school districts that implement best practice-based positive youth development, mental health promotion, and substance abuse prevention and intervention programs;

Amendment 48 by Menendez, which would designate $37 million of mental health funds to expand or improve community mental health services and ensure funding equity among LMHAs;

Amendment 49 by Menendez, which would designate $57.2 million of mental health funds to eliminating the children and adult waiting lists and allocate any unused funds to LMHAs that are below per capita funding levels;

Amendment 57 by Naishtat, which would require HHSC to hire one FTE to maintain an interagency consortium to oversee the Texas Integrated Funding Initiative; and

Amendment 66 by Naishtat, which would allocate $150,000 to HHSC to facilitate cross-agency services to improve service delivery to, and outcomes for, children and their families.

In addition, an amendment by Rep. Lon Burnam and Rep. John Zerwas that would have set the parameters for Medicaid expansion in Texas initially passed by a vote of 86 to 57. A few hours later, however, Rep. Geannie Morrison made a motion to reconsider the vote, which passed by a margin of 93 to 54. Rep. Burnam subsequently withdrew the amendment.

Of course, this doesn’t mean the end of expansion discussions. The Senate already included a similar rider in its version of the budget, and there is buzz around the Capitol that the House Appropriations Committee will be considering Rep. Zerwas’ “Texas solution” Medicaid expansion bill next week. So it aint over til it’s over…

Mental Health Moving Forward at the Federal Level

There are also some positive mental health developments going on at the federal level. President Obama is set to release his budget today, and reports indicate that he is asking for at least $235 million more for mental health services, including many of the projects he recommended in the aftermath of the Newtown tragedy. These include funding to train educators and other individuals on how to recognize the signs of mental illness, as well as funding to expand the mental health workforce.

Meanwhile, the Senate Health, Education, Labor, and Pensions Committee currently is marking up the Mental Health Awareness and Improvement Act, a bill to reauthorize and improve programs related to mental health and substance use
disorders. While the text of the legislation is not yet available online, it likely is a combination of already filed legislation, including some of the President’s mental health recommendations. It is being sponsored by Chairman Tom Harkin, and is co-sponsored by 5 Republicans, including Ranking Sen. Lamar Alexander, and 4 Democrats on the committee. I’ll share more on this next week as additional information becomes available.

Behavioral Health Legislation

Many pieces of mental health and substance abuse legislation have been on the move. The following bills have been voted out of committee or their respective chamber:

VOTED OUT OF COMMITTEE

HB 459
Relating to the creation of a navigator program as described by the Patient Protection and Affordable Care Act.

HB 517
Relating to the eligibility of inmates convicted of certain intoxication offenses for release on parole or mandatory supervision.

HB 1191
Relating to certain information about housing for persons with mental illness provided through the Texas Information and Referral Network Internet site.

HB 1561
Relating to access to a deceased person’s mental health information.

HB 1739
Relating to the administration of psychoactive medications to persons receiving services in certain facilities.

HB 2240
Relating to a study on homeless youth.

SB 11
Relating to the drug testing of certain persons seeking financial assistance benefits.

SB 263
Relating to the designation of certain synthetic cannabinoids as controlled substances and controlled substance analogues under the Texas Controlled Substances Act.

SB 264
Relating to the addition of a synthetic hallucinogenic substance to Penalty Group 2 of the Texas Controlled Substances Act.

SB 418
Relating to a notification requirement if a public school campus or open-enrollment charter school does not have a nurse assigned to the campus during all instructional hours.

SB 646
Relating to court-ordered outpatient mental health services.

SB 898
Relating to the mental health program for veterans.

VOTED OUT OF CHAMBER

HB 243
Relating to the authority of a community center that provides mental health or mental retardation services to sell certain real property of the center.

HB 808
Relating to the authority of a psychologist to delegate the provision of certain care to a person under the psychologist’s supervision, including a person training to become a psychologist.

HB 838
Relating to the monitoring of certain medications provided to foster children.

SB 1115
Relating to reporting, standards, restrictions, and requirements regarding public school disciplinary actions.

You can find out more about these bills using MHA’s bill tracker here.

Hasta next week!

The Budget, Parity and Bills

In this post, more about the budget, a little news on parity, and bill updates, including exciting news about school behavioral health legislation.

Budget Amendments

As I mentioned last week, the full House is scheduled to take up and consider CSSB 1, the budget bill, this Thursday. House members pre-filed a total of 267 budget amendments, which will make for a loooong day for members. Several behavioral-health related amendments have been pre-filed, including:

An amendment by Alonzo, which would require the collection of behavioral health outcomes data for indigent & Medicaid-eligible LGBT youth;

An amendment by Bohac, which would designate 5% of children’s mental health funding to mental health promotion, literacy and personal safety activities. This is a recommendation from the School Behavioral Health Initiative;

An amendment by Burnam to require expansion of Medicaid to all populations eligible under the Affordable Care Act;

An amendment by Sarah Davis to fund best practice-based school behavioral health programming; and

An amendment by Naishtat to fund an institution of higher education to provide technical assistance to communities across the state in implementing evidence-based and promising practices to serve children with Serious Emotional Disturbance.

All 267 amendments can be found here.

Getting Serious on Parity

As many of you know, the Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act (MHPAEA) passed in 2008. However, to this date, the Obama Administration has not issued final rules for the law, which leaves in limbo some of the treatment and coverage requirements of the law. There has been speculation that some insurance companies have been skirting provisions of the law, and now, finally, the first class-action lawsuit citing MHPAEA violations has been filed. The lawsuit, which was filed in New York, accuses United-Health, UHC Insurance, United Healthcare of New York, and United Behavioral Health of violating the law by, among other things, limiting psychotherapy visits and denying long-term treatment. In the absence of final rules, there may be more lawsuits filed that seek to clarify these provisions.

If you are someone you know feels your insurance company is denying you needed mental health or substance abuse services in violation of MHPAE, please visit the national Mental Health America Parity Center to share your story. The Obama Administration needs to hurry up and issue those almost 5 year-late rules, or they may end up writing themselves through lawsuits!

Bill Updates

We’ve had some major movement on a number of mental health and substance abuse bills, but before I cover the full list, I want to hone in on specific school behavioral health legislation that passed Senate Education last week.

For those who recall, I mentioned in an earlier post that Sen. Dan Patrick, Chair of the Senate Education Committee, has previously expressed support for behavioral health initiatives and that I hoped we would see that reflected in the legislation that passes his committee. Well, last Thursday that hope came true!

The Senate Education Committee heard 3 pieces of school behavioral health legislation that MHA is supporting:

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

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

Particularly on SB 1178, the committee heard very moving testimony from a number of family members who have lost loved ones to suicide, including Linda de Sosa, a School Behavioral Health Initiative participant. After the testimony, two witnesses who initially were opposed to the bill withdrew their opposition.

All three bills sailed out of the committee unanimously, and the bills were referred to the Local and Uncontested Calendar. If they remain on that calendar, they will pass the Senate without debate.

Thanks to everyone who testified in favor of, or registered support for, these important bills.  We’ve got to start investing in prevention and early intervention if we are truly going to improve outcomes for children and adults down the line!

Other behavioral health legislation on the move include the following bills that have been voted out of committee:

HB 915
Relating to the administration and monitoring of certain medications provided to foster children.

HB 978
Relating to the transportation of certain patients to a mental health facility.

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

SB 11
Relating to the administration and operation of the Temporary Assistance for Needy Families (TANF) program.

SB 1115
Relating to reporting, standards, and restrictions regarding public school disciplinary actions.

In addition, the following bills have been voted out of their respective chambers:

HB 144
Relating to a mental examination of a child subject to the juvenile justice system.

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

SB 58
Relating to the integration of behavioral health and physical health services into the Medicaid managed care program.

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

SB 250
Relating to the requirements of using certain technology to conduct certain mental health hearings or proceedings.

SB 256
Relating to tracking career information for graduates of Texas medical schools and persons completing medical residency programs in Texas.

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 715
Relating to use of consistent terminology to refer to school counselors in the Education Code.

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

SB 1185
Relating to the creation of a mental health jail diversion pilot program.

To see MHA’s full bill tracker for summaries and positions, click here.

That’s all I’ve got for now!  Toodles!

A Little News Here and There

In this post, an update on the budget, a look at how Harris County squares up health-wise, and the status of a few bills.

On the Budget

Last Wednesday, the Texas Senate passed CSSB 1, the budget bill, on a vote of 29-2. The only “no” votes were newly elected Senator Sylvia Garcia and Senator Wendy Davis, largely due to the fact that the Senate version restored only $1.4 billion of the $5.4 billion cut from public schools last session. On Thursday, the House Appropriations Committee substituted the bill with its own version and voted it out unanimously.

There are not significant funding differences for mental health and substance abuse services between the two bills, but one issue of note is that the House version added $2.5 billion for public education–over $1 billion more than did the Senate.

The full House is scheduled to take up CSSB 1 next Thursday, April 4th. A great thing about the House (at least to an advocate like me) is that all 150 members have an equal opportunity to put their imprint on the budget by offering amendments on the Floor. Expect anywhere from 200-300 amendments to be filed by this Thursday’s deadline, including a couple recommended by MHA. 🙂

State of Health in Harris County

In the recently released 2013 County Health Rankings and Road Map, a joint project of the Robert Woods Johnson Foundation and University of Wisconsin Population Health Institute, Harris County ranked 70th among 232 counties. This is down from a rank of 53 last year. Williamson County was ranked first, and Polk County was ranked last. The rankings take a variety of health factors into consideration, including poor health and mental health days, excessive drinking, physical activity, and the rate of uninsured. For a complete look at the rankings, click here.

Bills on the Move

Many pieces of legislation that MHA is tracking are on the move.  You can view an update on them all by checking MHA’s bill chart.  Bills that recently have been voted out of committee include:

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

HB 591
Relating to the health professions resource center.

HB 1872
Relating to federal firearm reporting for a person who voluntarily identifies as a person with mental illness.

SB 1185
Relating to the creation of a mental health jail diversion pilot program.

In particular, I want to call attention to HB 1872, which would require the Department of Public Safety (DPS) to include in the information it reports to the Federal Background Check System a person who voluntarily identifies himself or herself to DPS or local law enforcement as a person with mental illness who should be precluded from purchasing a gun.

MHA and several other advocacy organizations oppose this legislation because it unfairly and discriminatorily singles out people with mental illness.  While there may indeed be people with mental illness who would voluntarily place themselves on this list, there are likely just as many people without mental illness who would do the same.  In my view, this legislation unnecessarily stigmatizes an entire group of people. Thankfully, the good folks at MHA Texas are working on a floor amendment that would strike the reference to mental illness in the bill.  If it comes up for a vote on the Floor, look for an advocacy alert on that amendment, and please be sure to contact your representative and show them your support!

“A pen rather than a lance has been my weapon of offence and defence; with its point I should prick the civic conscience and bring into a neglected field men and women who should act as champions for those afflicted thousands least able to fight for themselves.”

–Clifford Beers: mental health consumer,Yale graduate, and founder of the National Committee for Mental Hygiene, predecessor of Mental Health America

Write ya next week!