About Annalee Gulley via Rebecca Fowler

Coordinator of Advocacy and Veterans Behavioral Health at Mental Health America of Greater Houston.

Written Comments on Draft Policy for House Bill 2466 Postpartum Depression Screening

On Monday, December 18, 2017, Annalee Gulley, Director of Government Affairs and Public Policy at Mental Health America of Greater Houston, provided the Texas Health and Human Services Commission feedback on the proposed draft policy language for Texas Health Steps (THSteps) Preventive Care Medical Checkups:
Postpartum Depression Screening and Referral Services.


December 18, 2017

 

Texas Health and Human Services Commission
Attn: Medicaid/CHIP Office of Policy
Brown-Heatly Building
4900 North Lamar Blvd
Austin, Texas 78751

Submitted via email to MCDMedicalBenefitsPolicyComment@hhsc.state.tx.us; Joanna.Seyller@hhsc.state.tx.us

Re: Written Comments on Draft Policy for House Bill 2466 Postpartum Depression Screening

To Whom It May Concern,

 Mental Health America of Greater Houston thanks you for the opportunity to submit comments on the draft policy for House Bill 2466 regarding the ability of an infant’s provider to conduct and bill for postpartum depression (PPD) screening for the infant’s mother in Medicaid and CHIP. We believe the following recommendations will assist in the successful implementation of this Medicaid benefit.

In early 2017, the American Academy of Pediatrics (AAP) recommended PPD screening at one, two, four and six months postpartum.[i] Line 1 of the draft policy states the Academy’s recommendation of screenings at the infant’s pediatric well-child visits but does not include the suggested intervals. We recommend adding language to line 1 about the appropriate integration of screenings at the 1-, 2-, 4- and 6-month visits.

HHSC’s draft policy (line 22) limits screening to once per provider in the year postpartum. We understand the need to implement this benefit within existing funds. That said, we recommend the agency consider the feasibility of screening according to national recommendations, as indicated by the American Academy of Pediatrics. This will result in multiple screens reimbursed per provider, and the language should be changed appropriately.

Mental Health America of Greater Houston participates in the Regional Maternal Mortality Task Force, where we examine the leading causes of maternal deaths in Houston. This task force is acutely aware of “white coat” syndrome, in which individuals are likely to lessen the severity of a condition when speaking to a doctor to disclose physical and behavioral health issues. Significantly more positive screens result in studies in which the screen was performed by a licensed clinical social worker, rather than a medical doctor.  Line 7 states that screening tools may include the Edinburgh Postnatal Depression Scale (7.2), Postpartum Depression Screening Scale (7.3) and the Patient Health Questionnaire 9 (7.4). To ensure the successful roll-out of this new benefit and accurate screenings, it is important all THStep providers including physician assistants, nurses and licensed social workers are trained on the screening tools and the risk factors for postpartum depression.

The three tools listed above are all validated and routinely used for postpartum depression and identify a range of severity or level of need, which help guide clinician-patient decision making regarding necessary supports. The Edinburgh is most routinely used and available in more than 20 languages. While these screening tools are effective, they may not capture positive screens for women facing other maternal mental health disorders, including anxiety and obsessive-compulsive disorder present during the postpartum period. We recommend adding to the list of validated tools (line 7) so THSteps providers may screen moms using validated tools identifying a range of postpartum mood and anxiety disorders, such as the Generalized Anxiety Disorder-7 (GAD-7) tool, among others. No-cost screening tools should be prioritized to increase access to THSteps providers.

We appreciate HHSC recognizing that screening alone does not improve clinical outcomes for moms and infants, but more guidance is needed to ensure successful referrals and improved outcomes. Specifically, pediatric providers need to know the appropriate and available supports for mothers. While some pediatric providers may already screen mothers, most are not familiar with the mental health providers serving parents. We recommend HHSC should provide a menu of resources with which provider can refer when a mother screens positive for postpartum depression or other perinatal mood disorder. At a minimum, HHSC should provide THStep providers a menu of referral options in each region that serve women enrolled in or eligible for Medicaid, Healthy Texas Women or the Family Planning Program, as well as city or county indigent care programs. Also, at a minimum, this should include clear guidance to THSteps providers on how to refer women, in consultation with any existing primary care physician to the Local Mental Health Authority (LMHA). The Office of Mental Health Coordination offers a list of mental health and substance use professionals, including LMHAs and other mental health clinicians across the state. Including a list of postpartum depression treatment providers on this list would be a good resource for pediatric providers screening for perinatal mood disorders. Some moms may need more intensive therapy or medication; others may need a lower level of supports or services. It’s important that a menu of referral options is available so THStep providers, in consultation with existing primary care providers, can help refer women to services that meet her needs.

Mental Health America of Greater Houston also asks you to consider the efficacy of the existing referral process for postpartum mental health treatment. New mothers who are not eligible for Medicaid are automatically enrolled in Healthy Texas Women sixty days following delivery when their CHIP perinatal benefits expire. Healthy Texas Women’s coverage of postpartum depression treatment is minimal at best. Many women with the most complicated postpartum mood disorders cannot receive adequate treatment within the confines of the Healthy Texas Women reimbursement model. Should mothers require more intensive medication or hospitalization, they are typically referred out to another facility, frequently an emergency room, where they do not have coverage for services. We need to ensure that doctors have a safe place with the appropriate supports to send mothers who screen positively for postpartum mood disorders; otherwise, doctors will not feel comfortable making referrals and women won’t get the treatment they need. We recommend HHSC shall communicate clearly to state health programs and community mental health providers, including LMHAs, that women with postpartum depression fall under priority diagnosis of major depressive disorder and assist them to prepare for increased referrals of women with postpartum depression.

Lastly, the results of the screenings used are not digital – leaving a paper form to record the results of a postpartum screen. Mothers are sent from the pediatrician’s office with the paper medical record and information can be lost in the process. With digital records, a “warm handoff” can be more secure knowing that all information is transmitted to the next provider. We recommend the agency consider the feasibility of digital records to ensure successful referrals and improved clinical outcomes.

Again, we sincerely thank you for the opportunity to provide input on the draft policy for HB 2466. We look forward to continued partnership with the Texas Health and Human Services Commission to ensure families have access to needed mental health supports. For any questions or concerns, please contact Annalee Gulley at agulley@mhahouston.org or (210) 823-5818.

Sincerely,

Annalee Gulley
Director of Public Policy and Government Affairs
Mental Health America of Greater Houston

[i] American Academy of Pediatrics (Bright Futures). (2017). Recommendations for Preventive Pediatric Health Care. Retrieved from: https://www.aap.org/enus/Documents/periodicity_schedule.pdf

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Tracking Women’s Mental Health Policy in Texas: Implementation of House Bill 2466 (85 R)

On June 15, 2017, Governor Greg Abbott signed into law Texas’ first post-partum depression screening legislation. HB 2466, authored by Representative Sarah Davis (R-Houston), allows for Texas Health Steps provider reimbursement for post-partum depression during the twelve-month period following delivery. Reimbursement will be funded through an infant’s Medicaid or perinatal CHIP.

Parents with postpartum depression experience a range of physical, emotional, and behavioral changes including sadness, anxiety and exhaustion that interfere with day-to-day life and routines. Postpartum depression is the most common complication of childbirth, with approximately one-in-nine women experiencing depression or anxiety during pregnancy and/or the first year after childbirth. Postpartum depression, and other perinatal mood disorders, can result in adverse maternal, infant and child outcomes, including lower rates of breastfeeding initiation and shorter duration, poor maternal and infant bonding and infant developmental disorders.

Symptoms of postpartum depression include:

  • Feeling sad, hopeless, empty or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable or restless
  • Oversleeping, or being unable to sleep even when her baby is asleep
  • Having trouble concentrating, remembering details and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment to her baby
  • Persistently doubting her ability to care for her baby
  • Thinking of harming herself or her baby.

Under current state law, women who receive prenatal care through Medicaid for Pregnant Women remain eligible for Medicaid benefits for 60 days following delivery. During this time, Medicaid will cover the postpartum visits as well as medication and follow-up necessary for women who are diagnosed with postpartum depression. However, postpartum depression and other perinatal mood disorders can present anytime within the first four-to-six weeks up to 12 months following childbirth. When coverage under Medicaid for Pregnant Women ends, a woman will transition to the Healthy Texas Women Program, if she meets eligibility requirements.

For more information on postpartum depression, click here.

To review HB 2466’s draft policy language or provide public comment, click here before Tuesday, December 19.

Testimony on Hurricane Harvey presented to the House Public Education Committee

On Tuesday, November 14, 2017, Annalee Gulley, Director of Government Affairs and Public Policy at Mental Health America of Greater Houston, was invited to provide testimony before the House Committee on Public Education.

The Committee considered the following interim charges:

– Recommend any measures needed at the state level to prevent unintended punitive consequences to both students and districts in the state accountability system as a result of Hurricane Harvey and its aftermath.

– Examine the educational opportunities offered to students displaced by Hurricane Harvey throughout the state and the process by which districts enroll and serve those students. Recommend any changes that could improve the process for students or help districts serving a disproportionate number of displaced students.

Ms. Gulley was on one of five panels of invited testimony and shared the importance of trauma training for classroom teachers and the impact transition plans could have on displaced students. Other panelists included Superintendents from Aldine, Alief,  Aransas County, Flour Bluff, Katy, Orange Field, Port Arthur, and Sheldon Independent School Districts. Josette Saxton, Director of Public Policy for Texans Care For Children, also provided testimony. This was the last House Public Education Committee meeting of 2017.

 

 

AEG 11147 Testimony

Annalee Gulley testifying in front of the House Public Education Committee (Left to Right: Rep. Linda Koop, Rep. VanDeaver, Rep. Ken King, Rep. Bernal (Vice Chair), Rep. Huberty (Chair), Rep. Allen). Ms. Gulley was on a panel with Mr. Loius Malfar, President of Texas AFT, Dr. Bruce Marchand, Director of Charter School Growth and Development with Texas Charter School Association, and Ms. Josette Saxton, Director of Mental Health Policy at Texans Care for Children.

 

 


Annalee Gulley
Director of Government Affairs and Public Policy
Mental Health America of Greater Houston

Chairman Dan Huberty
Texas House Committee on Public Education
Austin, Texas

November 14, 2017

Chairman Huberty and Public Education Committee Members:

Thank you for the opportunity to testify today, Chairman Huberty.

Last week, Governor Greg Abbott said, “[T]he invisible wounds left behind after this storm are often the most difficult to recover from. It is crucial that the State of Texas provides our educators and students with all available resources to address mental health needs as quickly as possible.”

Since Harvey hit Houston, Mental Health America of Greater Houston has prioritized the mental health needs of Houston’s approximately 800,000 youths aged 6-17 with supports and interventions that are more important now than ever. Our primary focus has been to provide trauma-informed training to teachers within 27 schools across 10 independent school districts in the Greater Houston Area. We are also advocating for the implementation of transition plans within school districts with a disproportionate number of displaced students to aid in the successful reintegration into the public-school system.

Before the storm, national prevalence data estimated that 10 percent of Texas’ youth will experience an average of three adverse child experiences – or traumas – before the age of 17. With 2 in 5 youths affected by mental health or substance use issues, we know that approximately 250,000 Houston-area students went into the storm with a predisposition to trauma, as trauma affects individuals with mental health issues more severely. Even if you excluded youth predisposed to adverse childhood experiences from the conversation, we are no longer just talking about kids with mental health issues, or “bad kids” or “problem kids.” We are talking about every kid throughout the region.

The psychological reaction to disaster lasts approximately one to three years, with signs and symptoms presenting most frequently three months after the traumatic event. Unlike some affected groups, we know how to access this population and the necessary supports for trauma-affected youth. Teachers are our entry point. They work in classrooms eight hours a day, five days a week. With trauma-informed training, they can properly identify and respond to signs and symptoms of trauma such as inattentiveness, poor academic achievement and difficulty following rules of the classroom. Trauma-trained teachers also will better know how to prepare for triggering events such as heavy storms, the holidays and the first anniversary of a disaster.

State funding will be required for comprehensive, trauma-informed training within public schools. Mental Health America of Greater Houston has been fortunate to partner with private sponsors to provide trauma-informed training, but the funds allocated were not enough to meet the existing need in Harris County – and Harris County is not the only affected county by Hurricane Harvey.

Again, we appreciate the Committee’s time today and the opportunity to bring trauma-informed training and transition service plans into the conversation surrounding Hurricane Harvey recovery efforts. The Governor was right when he said that our hardest to heal wounds would be invisible. That does not mean they should be forgotten. With trauma-informed training and transition service plans, we can provide impacted youth with the necessary supports begin anew.

Sincerely,

Annalee Gulley
Director of Public Policy and Government Affairs,
Mental Health America of Greater Houston

The Texas House and Senate release interim charges: A look ahead for Behavioral Health in the 86th Legislative Session

On Monday, October 23, Speaker of the House Joe Straus and Lt. Governor Dan Patrick released a full list of interim charges for Texas’ State House and State Senate committees to study before the 86th Legislative Session begins in January 2019. Many of the interim charges examine Hurricane Harvey and the state’s response, including the storm’s impact on public health, the juvenile justice system, agriculture and the state’s tax structure. In addition to these charges, Speaker Straus called for the creation of a Select Committee on Opioid and Substance Abuse which will study the prevalence and impact of substance abuse and substance use disorders in the state. This committee, chaired by Representative Four Price, is an extension of the work of the Select Committee on Mental Health, convened following the 84th Legislative Session.

Mental Health America of Greater Houston will be following many of the charges issued, with special attention to the following charges pertaining to mental and behavioral health:

House Committee on Appropriations:

  • Examine the Early Childhood Intervention Program (ECI) in Texas, including a review of historical funding levels, programmatic changes, challenges providers face within the program and utilization trends. Evaluate ECI’s impact on reducing the long-term costs of public education and health care. Identify solutions to strengthen the program.
  • Monitor Congressional action on federal healthcare reform and CHIP reauthorization. Identify potential impacts of any proposed federal changes. Identify short- and long-term benefits and challenges related to converting Texas Medicaid funding to a block grant or per capita cap methodology. Determine how Texas should best prepare for federal changes, including statutory and regulatory revisions, as well as any new administrative functions that may be needed. Explore opportunities to increase the state’s flexibility in administering its Medicaid program, including but not limited to the use of 1115 and 1332 waivers.

 

House Committee on Corrections:

  • Examine the use of social workers and peer support specialists in the Texas criminal justice system to assist individuals on probation, on parole or who have been discharged, in order to reduce recidivism and improve outcomes. Identify best practices and make recommendations for legislative action.

 

House Committee on County Affairs:

  • Study how counties identify defendants’ and inmates’ behavioral health needs and deferral opportunities to appropriate rehabilitative and transition services. Consider models for ensuring defendants and inmates with mental illness receive appropriate services upon release from the criminal justice system.

 

House Committee on Criminal Jurisprudence:

  • Assess developments in medical science and legal standards related to the imposition of the death penalty on defendants with serious mental illness or intellectual and developmental disabilities. Review statutorily prescribed jury instructions used during capital sentencing.

 

House Committee on Defense & Veterans’ Affairs:

  • Examine the needs of homeless veterans in Texas. Examine obstacles veterans may face finding housing across the state. Recommend measures to bolster the state’s efforts to address veteran homelessness in Texas.
  • Monitor the agencies and programs under the Committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 85th Legislature. In conducting this oversight, review the implementation of S.B. 27 (85R) and the related Veterans Mental Health Program, as well as S.B. 578 (85R) and the development of the Veterans Suicide Prevention Action Plan.

 

House Committee on Human Services:

  • Review the history and any future roll-out of Medicaid Managed Care in Texas. Determine the impact managed care has had on the quality and cost of care. In the review, determine: initiatives that managed care organizations (MCOs) have implemented to improve quality of care; whether access to care and network adequacy contractual requirements are sufficient; and whether MCOs have improved the coordination of care. Also determine provider and Medicaid participants’ satisfaction within STAR, STAR Health, Star Kids, and STAR+Plus managed care programs. In addition, review the Health and Human Services Commission’s (HHSC) oversight of managed care organizations, and make recommendations for any needed improvement.
  • Review the availability of prevention and early intervention programs and determine their effectiveness in reducing maltreatment of children. In addition, review services available to children emancipating out of foster care, as well as services available to families post-adoption. Determine if current services are adequately providing for children’s needs and meeting the objectives of the programs. While reviewing possible system improvements for children, follow the work of the Supreme Court of Texas Children’s Commissions’ Statewide Collaborative of Trauma-Informed Care to determine how trauma-informed care impacts outcomes for children.
  • Analyze the prevalence of children involved with Child Protective Services (CPS) who have a mental illness and/or a substance use disorder. In addition, analyze the prevalence of children involved with CPS due to their guardian’s substance abuse or because of an untreated mental illness. Identify methods to strengthen CPS processes and services, including efforts for family preservation; increasing the number of appropriate placements designed for children with high needs; and ensuring Texas Medicaid is providing access to appropriate and effective behavioral health services. (Joint charge with the House Committee on Public Health)

 

House Committee on Judiciary & Civil Jurisprudence:

  • Study the increased use of specialty courts across the state. Examine the role these courts play in the judicial system and recommend improvements to ensure they continue to be appropriately and successfully utilized.

 

House Committee on Juvenile Justice & Family Issues:

  • Evaluate the use of telemedicine to improve behavioral health services in the juvenile justice system.

 

House Committee on Public Health:

  • Review state programs that provide women’s health services and recommend solutions to increase access to effective and timely care. During the review, identify services provided in each program, the number of providers and clients participating in the programs, and the enrollment and transition process between programs. Monitor the work of the Maternal Mortality and Morbidity Task Force and recommend solutions to reduce maternal deaths and morbidity. In addition, review the correlation between pre-term and low birth weight births and the use of alcohol and tobacco. Consider options to increase treatment options and deter usage of these substances.
  • Study and make recommendations to improve services available for identifying and treating children with mental illness, including the application of trauma- and grief-informed practices. Identify strategies to assist in understanding the impact and recognizing the signs of trauma in children and providing school-based or community-based mental health services to children who need them. Analyze the role of the Texas Education Agency and of the regional Education Service Centers regarding mental health. In addition, review programs that treat early psychosis among youth and young adults.
  • Study the overlays among housing instability, homelessness, and mental illness. Review the availability of supportive housing opportunities for individuals with mental illness. Consider options to address housing stability and homelessness among people with mental illness. (Joint charge with the House Committee on Urban Affairs)
  • Review opportunities to improve population health and health care delivery in rural and urban medically underserved areas. Identify potential opportunities to improve access to care, including the role of telemedicine. In the review, identify the challenges facing rural hospitals and the impact of rural hospital closures.
  • Analyze the prevalence of children involved with Child Protective Services (CPS) who have a mental illness and/or a substance use disorder. In addition, analyze the prevalence of children involved with CPS due to their guardian’s substance abuse or because of an untreated mental illness. Identify methods to strengthen CPS processes and services, including efforts for family preservation; increasing the number of appropriate placements designed for children with high needs; and ensuring Texas Medicaid is providing access to appropriate and effective behavioral health services. (Joint charge with the House Committee on Human Services)

 

House Committee on Urban Affairs:

  • Study the overlays among housing instability, homelessness and mental illness. Review the availability of supportive housing opportunities for individuals with mental illness. Consider options to address housing stability and homelessness among people with mental illness. (Joint charge with the House Committee on Public Health)

 

House Select Committee on Opioids and Substance Abuse:

  • Study the prevalence and impact of substance use and substance use disorders in Texas, including co-occurring mental illness. Study the prevalence and impact of opioids and synthetic drugs in Texas. Review the history of overdoses and deaths due to overdoses. Also review other health-related impacts due to substance abuse. Identify substances that are contributing to overdoses, related deaths and health impacts, and compare the data to other states. During the review, identify effective and efficient prevention and treatment responses by health care systems, including hospital districts and coordination across state and local governments. Recommend solutions to prevent overdoses and related health impacts and deaths in Texas.
  • Review the prevalence of substance abuse and substance use disorders in pregnant women, veterans, homeless individuals and people with co-occurring mental illness. In the review, study the impact of opioids and identify available programs specifically targeted to these populations and the number of people served. Consider whether the programs have the capacity to meet the needs of Texans. In addition, research innovative programs from other states that have reduced substance abuse and substance use disorders, and determine if these programs would meet the needs of Texans. Recommend strategies to increase the capacity to provide effective services.
  • Examine the impact of substance abuse and substance use disorders on Texans who are involved in the adult or juvenile criminal justice system and/or the Child Protective Services system. Identify barriers to treatment and the availability of treatment in various areas of the state. Recommend solutions to improve state and local policy, including alternatives to justice system involvement, and ways to increase access to effective treatment and recovery options.
  • Identify the specialty courts in Texas that specialize in substance use disorders. Determine the effectiveness of these courts and consider solutions to increase the number of courts in Texas.

 

For a full list of the Texas State House of Representatives’ Interim Charges, click here.

 

Senate Finance Committee:

  • Adult and Juvenile Corrections Funding: Examine the funding patterns used to fund the juvenile justice system and adult probation departments. Develop recommendations to ensure the Texas Juvenile Justice Department budget does not dis-incentivize the use of cost-effective best practices such as diverting youth from the juvenile justice system, providing services to youth in their community and keeping youth closer to home. In addition, review funding to adult probation departments and ensure it provides for an equitable distribution to all Texas Probation Departments.
  • Monitor the state’s progress in coordinating behavioral health services and expenditures across state government, pursuant to Article IX section 10.04, including the impact of new local grant funding provided by the 85th Legislature.

 

Senate Health and Human Services Committee:

  • Substance Abuse/Opioids: Review substance use prevention, intervention and recovery programs operated or funded by the state and make recommendations to enhance services, outreach and agency coordination. Examine the adequacy of substance use, services for pregnant and postpartum women enrolled in Medicaid or the Healthy Texas Women Program and recommend ways to improve substance use related health outcomes for these women and their newborns. Examine the impact of recent legislative efforts to curb overprescribing and doctor shopping via the prescription monitoring program and recommend ways to expand on current efforts.
  • Medicaid Managed Care Quality and Compliance: Review the Health and Human Services Commission’s efforts to improve quality and efficiency in the Medicaid program, including pay-for-quality initiatives in Medicaid managed care. Compare alternative payment models and value-based payment arrangements with providers in Medicaid managed care, the Employees Retirement System and the Teachers Retirement System, and identify areas for cross-collaboration and coordination among these entities.
  • Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 85th Legislature and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:
    • Initiatives to increase capacity and reduce waitlists in the mental health system, including the construction of state hospitals and new community grant programs;
    • Initiatives to better understand the causes of maternal mortality and morbidity, including the impact of legislation passed during the first special session of the 85th Legislature. Recommend ways to improve health outcomes for pregnant women and methods to better collect data related to maternal mortality and morbidity;
    • Initiatives intended to improve child safety, Child Protective Services workforce retention, and development of additional capacity in the foster care system. Make additional recommendations to ensure children with elevated levels of medical or mental health needs receive timely access to services in the least restrictive setting.

 

Senate Veterans’ Affairs and Border Security Committee:

  • Veterans’ Health: Study the effectiveness of veterans’ health and mental health initiatives in Texas and recommend ways to improve access and delivery. Explore the state of the federal VA Choice Program, including potential expiration, continuation or expansion of the program. Consider the impact of the VA Choice Program on improving the delivery of health care, and determine ways to raise awareness and increase participation among Texas veterans. Consider the potential connection between chronic pain and mental health and identify strategies to improve the prevention of veteran suicide.
  • Monitor the implementation and impact of legislation passed by the Texas Legislature, including SB 27 by Campbell 85(R), relating to the mental health program for veterans.

 

For a full list of the Texas State Senate’s Interim Charges, click here.

Lessons Learned: The 85th Texas Legislature

While Texas’ 85th Legislative Session has been touted as one of the most contentious sessions in recent memory, mental and behavioral health funding and programming received important time and attention – largely due to the formation of the Interim Select Committee on Mental Health. Below is a brief summary of both the regular session and the special session and the status of MHA of Greater Houston’s legislative agenda.
MH Photo

MHA Houston 85th Legislative Briefing [Regular and Special]

As always, The Texas Tribune is an incredible resource in Austin. Please listen to recordings of their recent TribFest, which covered important topics including mental health, maternal mortality and the future of Medicaid.

URGENT ACTION ALERT

Friends,

At 9:00 a.m. on Thursday, House Bill 2623 (Allen, Alma | Thompson, Senfronia) and House Bill 3887 (Coleman) will be heard before the Senate Education Committee – because of you.

Your calls, your emails to friends, your commitment to advancing legislation for youth mental health. You made this happen. And you can’t stop now. We’ve come too far. Together.

Each member of the Senate Education Committee needs to know how important these bills are to Texas students and that, when I stand before them to testify tomorrow, I have all of you standing beside me.

We have eight days left to pass these bills.

Please take five minutes to call your State Senator and the Senate Education Committee to let them know you support our Senate sponsor, Senator Zaffirini, and House Bill 2623 (Transition Services) and House Bill 3887 (Trauma Training). Ask them to vote yes on both bills and send them to the Senate floor for a vote.

With gratitude,

Annalee Gulley
Director of Public Policy and Government Affairs
Mental Health America of Greater Houston

Please call your Houston Senator – and members of the Senate Education Committee – and ask that they support HB 2623 (Allen | Thompson, Senfronia) and HB 3887 (Coleman).  The more support they hear, the better our chance of getting the bills voted out of the Education Committee as soon as possible.

State Senator Larry Taylor, Chair (Houston): (512) 463-0111
State Senator Eddie Lucio, Jr., Vice Chair: (512) 463-0127
State Senator Paul Bettencourt (Houston): (512) 463-0107
State Senator Donna Campbell: (512) 463-0125
State Senator Bob Hall: (512) 463-0102
State Senator Don Huffines: (512) 463-0116
State Senator Bryan Hughes: (512) 463-0101
State Senator Kel Seliger: (512) 463-0131
State Senator Van Taylor: (512) 463-0108
State Senator Carlos Uresti: (512) 463-0119
State Senator Royce West: (512) 463-0123
Senate Education Committee: (512) 463-0355

Here is a sample script to use for your calls to Senate Education Members:

Hello, my name is ________. I am calling Senator _______ because I want to make sure they support HB 2623 (Allen | Thompson, Senfronia) and HB 3887 (Coleman). Both bills are scheduled for a hearing in the EDUCATION COMMITTEE this Thursday, May 18. I support these bills and the positive impact they will have on mental health in education in the state of Texas and encourage Senator ______ to do so as well. Thank you very much!

Sample script for Senate Education Committee:

Hello, my name is ________. I am calling Senate Education Committee to show my support of HB 2623 (Allen | Thompson, Senfronia) and HB 3887 (Coleman). Both bills are scheduled for a hearing in the EDUCATION COMMITTEE this Thursday, May 18. I support these bills and the positive impact they will have on mental health in education in the state of Texas. Thank you very much!

When the Dust Settles: Bill Filing Deadline

Great news from Austin!

Friday, March 10 marked the deadline to file legislation for Texas’ 85th legislative session. Mental Health America of Greater Houston is excited to report on the progress of our priorities.

MHA of Greater Houston successfully filed four bills, supporting both our Center for School Behavioral Health and Women’s Mental Health programs. We have also worked closely with Chairman Four Price and Representative Sarah Davis to ensure specific language reflecting our priorities was inserted into their existing bills concerning these legislative issues. We are proud both of the final bills resulting from these ongoing conversations and of the influence MHA of Greater Houston demonstrated during a critical moment when competing political priorities can too often sink impactful legislation.

After meeting with many members of the Houston delegation, we believe that our legislative agenda is strong; however, the current fiscal outlook and political climate in Austin make the passage of any bill a very difficult task. We have our work cut out for us during the next 67 days.

MHA OF GREATER HOUSTON’S LEGISLATIVE AGENDA

Bill Number  Author  Caption Status Focus Area
HB 2623 Allen  Relating to requiring school districts to assist students in making the transition back to school after certain prolonged placements outside of school.  03/21/2017 H Referred to Public Education Center for School Behavioral Health
HB 3853 Coleman  Relating to the availability of certain behavioral health professionals at certain public schools. 03/10/2017 H Filed Center for School Behavioral Health
HB 3887 Coleman  Relating to trauma training for public school personnel.  03/10/2017 H Filed Center for School Behavioral Health
HB 2135 Coleman | Farrar Relating to coverage for certain services and the provision of certain information relating to postpartum depression under the medical assistance and CHIP perinatal programs. 03/13/2017 H Referred to Public Health Women’s Mental Health

MHA OF GREATER HOUSTON’S PRIORITY PARTNERSHIP BILLS

Bill Number  Author  Caption Status Focus Area
HB 11 Price Relating to consideration of the mental health of public school students in school planning, educator training requirements, curriculum requirements, educational programs, state and regional programs and services, and health care services for students. 03/09/2017 H Referred to Public Health Center for School Behavioral Health
HB 2466 Davis Relating to coverage for certain services related to maternal depression under the Medicaid and child health plan programs. 03/21/2017 H Referred to Public Health Women’s Mental Health

First Comes Filing Then Comes Referrals …

Now that our bills have been filed, the next step is getting them through their respective committees. HB 2135, our Post-Partum Depression bill, and HB 11, Chairman Four Price’s children’s mental health bill, were referred to the House Public Health Committee in the beginning of March. Earlier this week, HB 2135, Representative Davis’s Post-Partum Depression bill, was referred to the House Committee on Public Health and HB 2623, our transition services bill, was referred to the House Committee on Public Education.

In a session in which 6,657 bills were filed and money is tight, now is the time to connect with your legislators and bring our bills to the front of their priority list.

We Need Your Help!

Center for School Behavioral Health
We are thrilled House Bill 2623 (Allen), relating to requiring school districts to assist students in making the transition back to school after certain prolonged placements outside of school, has been referred to the House Public Education Committee! For a refresher on the importance of this bill, check out our recent Center for School Behavioral Health post in which local expert Latashia Crenshaw, Director of Educational Support and Advocacy Services at the Harris County Juvenile Probation Department, talks to MHA of Greater Houston about transition services.

Here is a brief summary of House Bill 2623:

Bill Snapshot:
House Bill 2623 (Allen): Back to School: Transition Support for Students Returning to School

What does House Bill 2623 (Allen) do?
This bill requires that school districts provide assistance to students transitioning back to school after 30 or more days in a disciplinary alternative education program, a juvenile justice alternative education program, a residential program or facility operated by or under contract with the Texas Juvenile Justice Department, a juvenile board, or any other governmental entity, a residential treatment center, or a public or private hospital.

Under this legislation, schools will be required to create individualized transition service plans for returning students. The plan, to the extent possible, must be developed in conjunction with the student’s parent/guardian. As appropriate, the plan must include: consideration of the best educational placement for the student; provision of counseling, behavioral management assistance, or academic assistance; and access to community mental health or substance abuse services.

What problem does the bill solve?
Education is the key to a successful life, reducing juvenile recidivism, and ending the school-to-prison-pipeline. For a child returning to school following a prolonged absence, particularly for a disciplinary placement in the judicial system, succeeding once there is not easy. There are a variety of individual, school, and systemic factors that must be addressed if young people are to successfully return to schools. Individual factors include poor academic and social–emotional skills, credit deficits, special education needs, and the failure to develop an identity as a learner. Systemic factors include the failure of agencies and institutions to share records quickly, the absence of alignment and articulation between sending and receiving schools at both ends of the transition process, the dearth of accountability for mobile student outcomes, and inadequate systemic capacity to collaborate with families.

Through collaboration and planning, administrators that serve transitioning youth can prepare youth, from entry through discharge, for their return to their home-based school, enabling them to resume educational services successfully.

While HB 2623 was referred to the House Public Education Committee, there is no guarantee it will be heard before the committee. The House Public Education Committee is chaired by Houston State Representative Dan Huberty and includes Houston-area Representatives Alma Allen, Harold Dutton, Jr., and Representative Dwyane Bohac.

Please call your Houston Representatives on the Public Education Committee – and the Public Education Committee itself – and ask that they set a hearing date for this bill. The more support they hear, the better our chance of getting a hearing scheduled as soon as possible.

State Representative Dan Huberty: (512) 463-0520
State Representative Alma Allen: (512) 463-0744
State Representative Harold Dutton, Jr.: (512) 463-0510
State Representative Dwayne Bohac: (512) 463-0727
House Public Education Committee: (512) 463-0804

Here is a sample script to use for your calls:

Hello, my name is ________. I am calling Representative _______ because I want to make sure that House Bill 2623 (Allen) gets a hearing scheduled in the PUBLIC EDUCATION COMMITTEE. I support this bill and the positive impact it will have on mental health in education in the state of Texas and encourage Representative ______ to do so as well. Thank you very much!

While we still need support for HB 3853 and HB 3887, we will focus our attention on scheduling a hearing for HB 2623 until they are referred to a committee.

Women’s Mental Health

We urge you to connect with members of the House Public Health Committee to let them know that you support MHA of Greater Houston and hope the Representatives will fight to make sure our bills are heard before their committee as quickly as possible!

Luckily, the House Public Health Committee includes Houston-area Representative Garnet Coleman and Representative Tom Oliverson.

State Representative Garnet Coleman: (512) 463-0524
State Representative Tom Oliverson: (512) 463-0661

Please call these State Representatives and ask for these bills to be heard in front of the Public Health committee. The more support they hear, the better our chance of getting a hearing on this important women’s health issue.

Sample script for your calls:

Hello, my name is ________. I am calling Representative _______ because I want to make sure that House Bill [ ] gets a hearing scheduled in the PUBLIC HEALTH COMMITTEE. I support this bill and the positive impact it will have on women’s mental health in Texas and encourage Representative ______ to do so as well. Thank you very much!

Call Your Local Representative
While you’re making calls, call your local State Representative to express support for House Bill 2623 (Allen), as well! While your local Representative may not be a member of House Public Education, his or her support for House Bill 2623 is important! As a constituent, your opinion matters! Ask them to use their influence with their colleagues on the Public Education Committee to make sure House Bill 2623 (Allen) gets a hearing! Better yet, ask them to “Joint Author” the bill!

To find your Representative, click here: http://www.house.state.tx.us/members/find-your-representative/

A sample script is below:

Hello, my name is ________, I’m a constituent from Houston, zip code ___. I am calling Representative _______ to urge [him/her] to consider becoming a joint author of House Bill [2623| 3853| 3887]. This bill is incredibly important for the future of the kids in our local schools and a great step toward ending the school-to-prison-pipeline. If you won’t consider joint authoring the bill, please reach out to your colleagues on the PUBLIC EDUCATION COMMITTEE and tell them your constituents want this bill to be heard in front of this committee. Thank you very much!

Mental Health America of Greater Houston Bill Tracker
In addition to our priority partner bills, we are also following these bills for their impact on mental and behavioral health in Texas.

Bill Number  Author  Caption Status Focus Area Position
HB 2897 Price Relating to the mental health first aid program training and reporting. 03/06/2017 H Filed EDUCATION Support
 HB 322 Canales  Relating to the automatic expunction of arrest records and files for certain veterans and the waiver of fees and costs charged for the expunction.  03/21/2017 H Committee report sent to Calendars VETERANS  Support
 SB 74 Nelson  Relating to the provision of certain behavioral health services to children, adolescents, and their families under a contract with a managed care organization. 03/22/2017 S Committee report printed and distributed MENTAL HEALTH–CHILDREN  Support
 HB 1486 Price Relating to peer specialists, peer services, and the provision of those services under the medical assistance program.  03/21/2017 H Scheduled for public hearing MENTAL HEALTH–GENERAL  Support
SB 1 Nelson General   Appropriations 03/22/2017 S Ordered not printed MENTAL HEALTH–GENERAL  Support
HB 2094 Price Relating to coverage for serious mental illness, other disorders, and chemical dependency under certain health benefit plans. 03/16/2017 H Referred to Public Health MENTAL HEALTH–GENERAL  Support
SB 861 Zaffirini Relating to coverage for serious mental illness, other disorders, and chemical dependency under certain health benefit plans. 02/27/2017 S Referred to Business & Commerce MENTAL HEALTH–GENERAL  Support
 HB 10 Price | Bonnen, Greg | Rose | Muñoz, Jr. | Coleman  Relating to access to and benefits for mental health conditions and substance use disorders. 03/22/2017 H Committee report sent to Calendars MENTAL HEALTH–GENERAL  Support
SB 1107 Schwertner|Perry Relating to telemedicine and telehealth services. 03/22/2017 S Committee report printed and distributed MENTAL HEALTH–GENERAL  Support
HB 2697 Price Relating to telemedicine and telehealth services. 03/02/2017 H Filed MENTAL HEALTH–GENERAL  Support
HB 2096 Price Relating to access to and benefits for mental health conditions and substance use disorders. 03/16/2017 H Referred to Public Health SUBSTANCE ABUSE–GENERAL  Support
SB 674 Schwertner Relating to an expedited licensing process for certain physicians specializing in psychiatry; authorizing a fee.  03/21/2017 H Received from the Senate WORKFORCE  Support
HB 1488 Price Relating to eligibility requirements for repayment assistance for certain mental health professional education loans. 03/09/2017 H Referred to Public Health WORKFORCE  Support


Countdown to Sine Die

In the meantime, take heart in knowing we still have time to get some great work done.