About Annalee Gulley via Rebecca Fowler

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

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.

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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.

What’s Our Agenda? Center for School Behavioral Health

In April 2012, Mental Health America of Greater Houston (MHA) launched the Harris County School Behavioral Health Initiative, a community-wide collaboration aimed at ensuring students with behavioral health needs are identified early and able to receive needed services. The initiative convened school district personnel, behavioral health providers, child-serving and education-related agencies, and parents to develop recommendations to improve the prevention, identification, and treatment of behavioral health issues among students. The initiative was born out of a 2003 report on school-based mental health care sites in Abilene, Austin, El Paso, Houston, Lubbock, Tarrant/Denton Counties, and Tyler. According to the report, counselors across the state faced challenges in providing appropriate levels of mental health services to students; teachers lacked both experience in recognizing early signs of mental health issues and an awareness of available community treatment resources; and schools burdened by financial constraints were unable to adequately meet the needs of students with mental health problems who were ineligible for services under federal law.

What began as a stakeholder meeting comprised of 40 organizations has grown into The Center for School Behavioral Health,  thanks in large part to the ongoing commitment and engagement of collaborative members and generous philanthropic support. A major gift from the Houston Endowment enabled the creation of the Center, which serves as a “living laboratory” for incubating innovative, cost-effective and replicable best practices to improve the behavioral health of students by facilitating collective action; providing highly specialized professional development opportunities, technical assistance and community education; and conducting research, advocacy, and policy analysis. The long-term vision of the Center is to transform school behavioral health to support the healthy psychological and cognitive development of children in the Greater Houston region through services and programs promoting behavioral health, as well as the prevention, early identification, and treatment of behavioral health disorders.

School Behavioral Health Initiative: 37 Recommendations

Harris County School Behavioral Health Initiative (SBHI) meetings included personnel from ten school districts, county level educational organizations, behavioral health providers, child-serving agencies and advocacy organizations, and during the course of a year, workgroups prioritized the following activities:

  • Review of state and federal laws that govern the identification and treatment of students with behavioral health issues, including the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act, as well as relevant state regulations;
  • Creation of a system “maps” of four school districts to determine their policies related to prevention, identification and treatment of mental health and/or substance use issues;
  • Examination of national evidence-based and promising school behavioral health programs. These included best practices related to prevention, identification, and intervention;
  • Completion of 32 individual interviews with key community members to obtain their views of how school behavioral health processes currently are working and ways in which they can be improved;
  • Execution of site visits to locations that have been recognized statewide or nationally for innovative and best practice-based school mental health initiatives.
  • Collection of data from the 20 Harris County school districts related to special education categorization, racial patterns, and disciplinary placements.

By February 2013, the SBHI developed and shared 37 recommendations based on their activities, including 7 recommendations for the Texas legislature:

  • Restore the $5.4 billion in education funding cuts made during the 82nd Legislature
  • Restore the almost $13 million in funding cuts made to Communities in Schools during the 82nd Legislature.
  • Increase funding for substance use prevention, intervention and treatment for children and adolescents.
  • Increase funding for children’s mental health treatment services.
  • Designate at least 5% of current funding for children’s mental health treatment services to prevention programs, such as mental health literacy, personal safety, and suicide prevention.
  • Appropriate General Revenue funds to increase grants for school-based health clinics.
  • Require, in educator preparation programs, that teachers receive training in the detection of students with behavioral health issues.

Between 2013 and 2016, the School Behavioral Health Initiative worked toward system or district-wide implementation of the 37 recommendations. All seven of the legislative recommendations were fully or partially implemented, and 20 of the 21 school district recommendations were being implemented district-wide by at least one area school or charter school district.  In total, 34 of the 37 recommendations have been realized.

85th Legislative Session Platform: Education

Guided by the 37 recommendations at the core of the Center’s advocacy efforts, MHA prioritized the development and implementation of school behavioral health services in our 85th Legislative Session Platform. Some may ask why it is necessary or, even, appropriate to address mental and behavioral health issues in a classroom environment instead of a home or doctor’s office. The answer to that question is simple, but not easy: One out of every five children has a mental illness or addictive disorder that causes some type of functional impairment. Youth with behavioral health issues may experience challenges such as academic underachievement, criminal justice involvement, and even suicide, and more than one-quarter of the total costs for mental health treatment services among adolescents were incurred in the education and juvenile justice systems. Lastly, children and adolescents spend much of their waking hours at school, making classrooms the ideal setting to recognize and initiate services to address the social, emotional and behavioral needs of our kids. Based on these facts, we support legislation focusing on school-based initiatives to improve prevention, identification and treatment of behavioral health issues among students. Specifically, we are looking at legislation related to behavioral health campus professionals, general reporting and trauma training, and transition services planning.

We spoke with Center for School Behavioral Health Director, Janet Pozmantier, and Professional Development Manager, Betsy Blanks, to get a comprehensive understanding of the legislative needs of the Center.

Janet: The Center came about because our schools were being overwhelmed with the number of children who were experiencing severe emotional difficulties and because of the severity of the difficulties our students were experiencing. We had long-time educators who were at a loss of what to do and how to handle so many children. We had a big win during the legislative session with Senate Bill 460, which mandates that all educators receive training in identifying the signs and symptoms of mental health problems among students and how to assist the child to get the appropriate help.  We are grateful for that legislation being passed. It was very unusual because normally legislation does not pass right out the gate. Usually, it takes at least three sessions to pass.

What we have found four years later is that most of our educators are not aware of the fact that this mental health training is required, and the districts that are implementing the training do not have the time or resources to reach all of their teachers in an effective manner.

There are some wonderful evidence-based trainings out there. A free online training is Kognito At-Risk, a phenomenal interactive avatar based training. Unfortunately, free access to that may end and then I don’t know what’s going to happen. A lot of us offer the Youth Mental Health First Aid training.  These trainings are free to districts through the Harris Center for Mental Health and IDD, our local mental health authority. However, there is a limit to how many the Harris Center can serve in any given year so organizations like Mental Health America of Greater Houston and NAMI are certified trainers. The challenge we have encountered is that our training is eight hours and costs money, limiting the number of school personnel who can take the training. The legislature did provide some money during the 83rd legislative session for these trainings but it is not enough to take care of the majority of teachers in the Greater Houston region because the money is to fund trainings statewide. That is a big problem.

The Center’s priority is getting these trainings out to people. Making sure people know about it. Currently, there are no “teeth” in the training legislation and that is why we have the proposed amendments to SB 460 that we are looking at today. There is no reporting requirement and so the schools are not going to do it. So, we want to make sure we have that reporting component inserted into the language of the updated bill. We also want to have trauma training included because of the things we have learned– especially from our conference this past fall — is there is an overwhelming desire from schools and districts to learn more about trauma and how it shows up in the classroom, and how to handle it. So many of the behavioral health problems we are seeing are not necessarily due to someone having a serious mental illness, but because it is a response to unresolved trauma and grief.

Betsy: Students who experience trauma are two and a half times more likely to be retained and are suspended and expelled more often. A student’s academic achievement can also be harmed because of trauma with reports of lower scores on standardized achievement tests and substantial impacts on IQ, reading achievement and language. Over the last ten years, teachers have really started to realize that this is an issue.  Many of their students are not necessarily suffering from a mental illness but they are impacted by trauma. Teachers are recognizing it but they do not know what to do about it.

Annalee: Betsy, as a former teacher coming into this, what can you say about seeing both sides of this issue?

Betsy:  The first time I attended the Mental Health First Aid course, it was after I started here at the Center, throughout the training, all day long, it just hit me over and over and over again how many kids I failed because I did not have this mental health training; the context. I worked at an inner-city school where kids were coming in with a lot of trauma and my school never talked about mental health, never talked about trauma. Teachers did not receive any information about that side of a child. It was all academic focus, and they did great things academically at my school, but you lose a lot of kids if you are not addressing that side.  It was really hard as someone who cared deeply about being a good teacher and about my students. It was really difficult to later receive this training and get this information and look back and think about the specific children I let down because I was not prepared to handle their traumas. That’s not acceptable. We do such a disservice to our children in schools when our teachers are not prepared to address the whole child. They want to. No one goes into teaching with bad intentions. They want to do the best for their students and it’s not fair to the child to not equip our teachers with those tools. We send them to a lot of professional development and it’s not acceptable that at least a certain portion of that training is not dedicated to mental health training.

Janet: Our public schools are de facto providers of mental health services, and who is on the front lines at schools? The teachers. They don’t have the necessary training so we want to give them the tools to be trauma informed and understand mental health issues in order to understand how to refer out. We don’t want teachers to be therapists. That’s not their role. But who are they going to refer to?  In many of our schools, there is no one there. Even if there is someone there, for example, school counselors are busying working on graduation plans and writing letters of recommendation or doing lunch line duties or testing. So, that is why we are advocating for one licensed behavioral health professional on every school. To help our teachers have more time to teach. If they identify a student who is in need of some type of service, then they can make sure that student gets those services. In other school districts around the country, schools have three, four, five counselors per grade because they realize a child cannot learn if they are experiencing homelessness, poverty, hunger, or trauma of any kind.

Trauma is everywhere, in all strata of society, and that is why we want a licensed behavioral health professional on every campus. I don’t buy the argument that we don’t have the money. We have the rainy-day fund, and you can get very creative with Medicaid reimbursement. We have great models here in Houston. Legacy Community Health has partnered with schools and figured out how to host integrated health care clinics on every campus so we can do this. You cannot live in a city like Houston and use the arguments that we cannot afford it. It’s not okay. Or in a state like Texas.

Behavioral Health Campus Professional

No conversation about improved prevention, identification and treatment of behavioral health issues among students would be complete without addressing the shortage of school counselors in Texas schools. National prevalence estimates indicate that one in five children have a mental illness or addictive disorder, meaning that approximately one million Texas public school students are dealing with these issues on a daily basis.  These illnesses can cause mild to significant impairment in home and school activities and can lead to school failure, disciplinary placements,  juvenile justice involvement, and, in extreme cases, suicide.

Despite the high prevalence of mental health and substance use disorders among children and adolescents, most schools do not have a designated staff person available to provide counseling or other needed services. In addition, school counselors, who historically were responsible for providing some of these services, are increasingly loaded down with administrative duties unrelated to mental or behavioral health counseling. They also are expected to handle increasingly large student caseloads.

Although the counselor shortage can be attributed to a mix of overburdened caseloads, funding cuts, and hiring shortages, the result is a student-to-counselor ratio well above the American School Counselor Association recommendation of 250-to-1. Following the 2011 cuts to public education, the Ray Marshall Center for the Study of Human Resources at the LBJ School of Public Affairs released Texas School Counselor Study: Exploring the Supply, Demand, and Evolving Roles of School Counselors. The study found “[b]eginning in 2012 and through 2014 the student-to-counselor ratio also remained relatively constant … between 460:1 and 470:1.”  These numbers do not take into consideration the counselors’ ability to identify and address the behavioral health needs of students.


Credit: MARSHALL CENTER FOR THE STUDY OF HUMAN RESOURCES /UT AUSTIN


Credit: MARSHALL CENTER FOR THE STUDY OF HUMAN RESOURCES /UT AUSTIN

To address the shortage of counselors and other student support staff, MHA of Greater Houston supports legislation requiring at least one licensed behavioral health professional on each campus, as funding allows. While the long-term goal would be requiring one behavioral health professional per campus, the cost of associated with this type of legislation would be prohibitive in the current legislative climate. We have seen great success in meeting the behavioral health needs of students in public-private partnerships between school districts and community-based organizations like Communities in Schools and believe this is an incredibly positive starting point that would greatly benefit students.

Reporting and Trauma Training

MHA is incredibly proud of our work on Senate Bill (SB) 460, passed by the 83rd Texas Legislature in 2013. SB 460 requires school districts to provide teachers, administrators and staff with training in mental health intervention and suicide prevention to help them identify red flags in a child’s behavior and respond effectively.  House Bill (HB) 2186, passed by the 84th Texas Legislature in 2015, requires suicide prevention training for all new school district and open-enrollment charter school educators annually and for existing school district and open-enrollment charter school educators on a schedule adopted by the Texas Education Agency (TEA) by rule.


Source: Understanding Child Trauma, National Child Traumatic Stress Initiative

Currently, Section 161.325 (Early Mental Health Intervention and Suicide Prevention), Health and Safety Code requires teachers, counselors, principals, and all other appropriate personnel to be trained in how to recognize and appropriately respond to signs of mental health and substance use disorders, as well as suicide. However, the trainings are not required to cover students who have experienced physical and emotional trauma. Additionally, there are not any reporting requirements to ensure that school districts are conducting the trainings.

The goal of MHA’s proposed general reporting and trauma training legislation is two-fold: 1) to provide accountability measures to reinforce the training mandate through reporting to the  Texas Education Agency; 2) to require all school personnel to receive training in how to recognize and appropriately respond to signs of trauma.

As proposed, this legislation would amend SB 460 to require school districts to train educators in how to recognize and appropriately respond to physical and emotional trauma, as well as to report all training information to the Texas Education Agency. This accountability measure does not serve as a new mandate. SB 460 already requires school district employees to receive training. The school district is also required to keep records of all training participation. This amendment would strengthen the already existing requirements in the bill by ensuring the records kept by the district on the required training would then be reported to the TEA and be accessible to parents and community members.

To better understand the need for trauma training and the impact of trauma on students, Annalee Gulley sat down with Julie B. Kaplow, Ph.D., A.B.P.P., Director of the Trauma and Grief Center for Youth at The University of Texas Health Science Center at Houston. The Trauma and Grief Center for Youth opened in December 2014  and treats youth ages seven to 17 who have experienced trauma and loss.

Annalee:  If you were a teacher and were in your classroom, what are some of the signs you might recognize in a child who has experienced some type of trauma?

Julie:  What makes this difficult is that posttraumatic stress symptoms can look a lot like ADHD symptoms. We will often hear from teachers, “This child won’t sit still. They are distracted. They seem like they are in another world. You say one thing that sets them off and you cannot seem to calm them down.” These may be signs of ADHD, but they can also be signs of posttraumatic stress. It is important to help teachers understand how kids may react in the aftermath of trauma and put these behaviors into context. Many traumatized kids may be triggered without knowing why inside the classroom. It is often helpful to inform teachers about potential trauma reminders – people, places, situations, or things that remind kids of the frightening thing that happened to them. Trauma reminders can be as subtle as kids screaming on the playground (if the traumatic event involved the sound of screams) or the teacher giving that child a certain look or scolding them. These kids often get mislabeled or are misunderstood as “behavior problems” when in fact they are simply reacting to their environment and are being reminded of whatever traumatic experience they had.

A trauma training would help to educate teachers about the many ways in which various forms of trauma and adverse life events, such as the death of a loved one, as well as accompanying posttraumatic stress or maladaptive grief can impact learning and how this may manifest in the classroom. When teachers really do understand how trauma impacts children, they are able to have more empathy in the classroom, they are better able to see why certain children may be behaving the way they are and are then able to help them to modify those behaviors in a much more effective way. What we also know is that teachers can use all of the behavioral strategies and positive reinforcement they want with a traumatized child, but if they are not able to identify what it is that is triggering them, that’s not going to help them in the classroom. A trauma training for teachers would help to explicate the ways in which posttraumatic stress and/or grief reactions can manifest in the classroom and what teachers can do to help these youth to de-escalate and stay on track.

Annalee: How would you respond to the argument that this is not a teacher’s job? That we are turning teachers into counselors or behavioral health professionals when we ask them to identify a child who has been traumatized or ask them to de-escalate a situation or determine whether a child has been abused or is suffering PTSD?

Julie: I would say that, first, we are obviously not asking teachers to treat a child’s posttraumatic stress because that would require a higher level of training and intervention. What we are suggesting though is that teachers can play a critical role in identifying those youth who may need to be referred for an evaluation. It is important to remember that, for many traumatized youth, their teachers may be the only adults in their lives who are actually seeing their posttraumatic reactions and/or behaviors. So the school can actually serve as a critical point of entry. In addition, we know that trauma and PTSD can directly impede the child’s ability to learn, and a primary goal of most teachers is to create an environment in which all kids in the classroom are able to learn in the most effective way possible. When youth are struggling with PTSD, this may directly interfere with the primary goal for teachers. By empowering teachers with the knowledge and information needed to identify trauma and PTSD in youth, they will begin to feel like they have more control over their classroom. We see many teachers, particularly in underserved communities, who are faced with a lack of resources and high levels of trauma in the neighborhoods in which they work. Many teachers feel overwhelmed and think “I’ve just got to get through this day” as opposed to ” I am starting to notice a pattern with this child and this might be a sign that they have a history or trauma.” This new knowledge allows teachers to feel more in control of their classroom, less overwhelmed, and better equipped to refer those kids who may need a thorough trauma-informed evaluation and/or intervention.

 Transition Services Plan

To ensure students with prolonged placements in out-of-school facilities, including disciplinary programs and residential treatment facilities to address disciplinary or behavioral health needs, have a continuum of services, MHA of Greater Houston seeks to require the creation of a transition plan for the returning student. Annalee Gulley spoke to Latashia Crenshaw, Director of Educational Support and Advocacy Services at the Harris County Juvenile Probation Department. The Education Support and Advocacy Services is tasked with “advocate[ing] for improved educational services for probation-involved youth in community settings.”

Annalee: When you are able to get them back to the home campus, do you encounter many schools that have the ability or systems in place to integrate that child successfully back into school?

Latashia: Some districts, as with everything, are better than others when it comes to transitioning our youth back into their home school. It also depends on how long the youth has been out of their system and involved in our system. For youth who have not been out of their home school for very long, I can say that they have much easier chances transitioning back into the school from an out-of-school facility. Those who have been out of their school for quite a while, or not attending their home school prior to coming to us, those are the youth who concern us the most. We are trying to focus on making sure we have the correct records, the correct grade level for that student or making sure that the special education services are in place. Transitioning the services we have in place while the youth are in a placement because they may look completely different than what needs to happen when the youth returns to the home school. We have found there are gaps when making sure there is a continuum of support and services between placements.

Annalee: If you were to help facilitate the process of creating a standardized transition plan, what do you think some of the core elements of the plan would need to include?

Latashia: In an ideal world, we would have transition specialists or people designated in the district who would track youth who have been withdrawn from their district and in our facility because once the youth is enrolled in our system for a designated number of days, they are withdrawn from their home district and placed in our school system.

For transition plans, if the youth is in our facility — for say 60 days or longer– if we could have a transition specialist work with us when we know that youth is going to be released, to have the home school become involved with the youth transition plan so that we can ensure that everything is in place when they go back to the home school. This would include setting up Admission, Review, and Dismissal (ARD) meetings, as well as 504 meetings because most of our students have some sort of disability. A  transition plan would definitely include looking at the courses the youth is enrolled in with us versus what they need to be enrolled in when they return to their home school. Again, what types of transition services this youth would need just to really get reintegrated back into their home school system versus the education system we were involved in. To me, a transition plan would include reintegration meetings prior to the youth being released, including staff from probation, the home school and any other services they are going to be involved with in the community. Some sort of meeting that includes all the people who are going to be working with the student and family.

Latashia:  I cannot stress how significant it would be, especially for those youths who have significant mental health concerns and disability, to collaborate on transition meetings while the youth is in placement. This would include having home school personnel come to ARD meetings or hold these meetings in conjunction with our staff so that we can ensure that when this youth leaves placement they are actually successful with transitioning back to their home school and don’t return to us simply because records are not there or they are sitting at home waiting to be in enrolled in a school, which may or may not happen.

What’s Next?

As we build support for this legislation in Austin, we will report on important milestones like bill filings, committee assignments, and committee hearings. Your voices need to be heard by legislators to ensure they understand the importance of these issues for students in Houston and beyond. Stay tuned!

One Month In: A Look at the 85th Legislature

On Tuesday, January 10, the 85th Texas Legislature was officially gaveled into session. As we mark the close of the first month of this biennial 140-day period, our team at Mental Health America of Greater Houston took a quick look back at what has happened thus far inside Austin’s Pink Dome.

Biennial Revenue Estimate
Comptroller Glenn Hegar released the 2018-2019 Biennial Revenue Estimate (BRE) on Monday, January 9, kicking off the 85th Legislative Session with a bleak fiscal report that left lawmakers with roughly $104.9 billion in general revenue funding for the state’s two-year budget. The 2018-2019 BRE is approximately $7 billion less than the 2015 allocation, largely because of low oil prices coupled with the required reallocation of billions of tax revenue dedicated to the State Highway Fund following the passage of Proposition 7* in 2015.

Estimates suggest that it would require $109 billion in general revenue monies to fund state programs at currently established levels. In July, anticipating the budget shortfall to come, Governor Greg Abbott, Lt. Governor Dan Patrick and House Speaker Joe Straus requested all state agencies to scale back their budget requests by 4 percent in an effort to curb government spending. Mental and behavioral health services were deemed priority funding areas, along with funds for public schools, border security, and Child Protective Services, and were excluded from the required 4 percent scale back scenarios. However, the 2.7 percent decrease in overall funding for state provided services established by the Comptroller’s BRE in January leaves less money available for schools, child welfare, and health care, among many others, than originally expected – leading some advocates to call for legislators to dip into the Economic Stabilization Fund, commonly known as the “Rainy Day Fund,” which is currently valued at nearly $12 billion. Legislators have been reticent to draw funds from this emergency fund in the past, which points to difficult – and contentious – decisions to come.

*Proposition 7, passed by taxpayers in November 2015, requires the state to dedicate up to $5 billion in sales tax revenue to the State Highway Fund.

Base Budget Breakdown: SB 1/HB 1
On Tuesday, January 17, State Senator Jane Nelson, Finance Chairman, filed SB 1 – the  Texas General Appropriations Act, which serves as the Senate’s base budget and establishes state funding priorities for the next two years. SB 1 includes $103.6 billion of general state funding with overall spending — including federal and other funds — of $213.4 billion.

Like many of her colleagues, Senator Nelson shared concerns regarding “difficult decisions to make this session,” which makes the inclusion of key funding items for mental and behavioral health significant as they signal the Senate’s commitment to prioritizing these issues this session. Included in the budget is funding for workforce development, with an additional $44.1 million for Graduate Medical Education to ensure residency slots are available for Texas medical school graduates; and $260 million for Child Protective Services. To address current needs, SB 1 committed $1 billion for the state hospital system and facilities and $63 million for community mental health services to eliminate waitlists. Women’s health and veterans’ services programs maintained existing funding levels, including funding for Texas Veterans + Family Alliance, a $20 million grant program to assist veterans with post-traumatic stress and other mental health issues.

Shortly after SB 1 was filed, Texas House Speaker Joe Straus filed HB 1, the House’s initial 2018-2019 budget. HB 1 includes $108.9 billion in general fund allocations, approximately $4 billion more than the Comptroller’s estimated available revenue, and a total budget of $221.3 billion.

The House’s base budget touts a significant investment in public education, child protection, and mental health services, while only increasing the state budget by less than one percent. “We keep overall spending low while making investments in children and our future … This is the first step toward producing a balanced budget that reflects the priorities of the Texas House and does not raise taxes,” said Speaker Joe Straus.

Under the House budget, mental and behavioral health services receive $162 million of additional funding. These funds would eliminate wait lists for mental health services and allow for the implementation of many of the House Select Committee on Mental Health’s recommendations, including efforts to increase the implementation of early identification and jail diversion programs across the state. As in SB 1, HB 1 also earmarks monies for the treatment of post-traumatic stress disorder among veterans.

Nearly $8 billion separates the Senate and House base budgets [difference between the Senate and House base budgets ] and we have until May 29th to see how negotiations between the two chambers unfold.

House Select Committee on Mental Health – Interim Report to the 85th Texas Legislature
In early January, the House released an interim report from the Select Committee on Mental Health. Speaker Joe Straus formed the Select Committee in November 2015 to better understand the existing behavioral health system for adults and children in Texas. Chaired by Representative Four Price, the Select Committee on Mental Health held eight hearings throughout 2015-2016. Representatives Garnet Coleman, Sarah Davis, and Senfronia Thompson served as Houston’s representatives on the committee.

When he announced the formation of the committee, Speaker Straus identified the need for “[a] smarter approach to mental health” and expressed his hope that this approach would result in “improve[d] treatment and care while saving taxpayers money.” The interim report is intended to “give the House valuable guidance,” on how to make positive advancements in behavioral health during this legislative session.

The interim report highlights opportunities to solve existing service gaps and key takeaways include:

  • Prioritizing early intervention and prevention measures – especially among school age children;
  • Expanding innovative public school-based programs;
  • Sustainability of the 1115 Transformation Waiver / DSRIP funded programs;
  • Expanding bed capacity by expanding step-down beds to provide a continuum of care, including expanding jail diversion programs for nonviolent offenders;
  • Continuing to address mental health workforce shortages through educational incentives and by expanding the availability and utilization of technology, such as telemedicine;
  • Integrating healthcare to treat the whole person, physically and mentally, although questions remain among the committee surrounding the implementation.

Committee Assignments: Senate and House Committees Announced
On January 18, Lt. Governor Dan Patrick announced Senate committee assignments for the 85th Legislative Session. The Houston delegation includes Chair and Vice Chair assignments to the Criminal Justice, Education, and State Affairs, Intergovernmental Relations, and Business & Commerce Committees, and is represented on committees relevant to behavioral health work.

houston-senate-delegation

Traditionally, behavioral health bills pass through the Senate Health and Human Services Committee, but to monitor the Center for School Behavioral Health’s bills and issues relevant to Veterans Behavioral Health Initiative, MHA of Greater Houston will also watch the Senate Education Committee and Senate Veteran Affairs & Border Security. Houston Senator Borris Miles is a member of the Health and Human Services Committee. The Education Committee had two members of the Greater Houston delegation: Senator Larry Taylor, Chair, and Senator Paul Bettencourt.

Health and Human Services Committee

Role Senator City
Chair Charles Schwertner Georgetown
Vice Chair Carlos Uresti San Antonio
Member Dawn Buckingham Lakeway
Member Konni Burton Colleyville
Member Lois W. Kolkhorst Brenham
Member Borris L. Miles Houston
Member Charles Perry Lubbock
Member Van Taylor Plano
Member Kirk Watson Austin

Education Committee

Role Senator City
Chair Larry Taylor Friendswood
Vice Chair Eddie Lucio, Jr. Brownsville
Member Paul Bettencourt Houston
Member Donna Campbell New Braunfels
Member Bob Hall Edgewood
Member Don Huffines Dallas
Member Bryan Hughes Mineola
Member Kel Seliger Amarillo
Member Van Taylor Plano
Member Carlos Uresti San Antonio
Member Royce West Dallas

Senate Veteran Affairs & Border Security

Role Senator City
Chair Donna Campbell New Braunfels
Vice Chair Don Huffines Dallas
Member Dawn Buckingham Lakeway
Member Bob Hall Edgewood
Member Eddie Lucio, Jr. Brownsville
Member José Rodríguez El Paso
Member Carlos Uresti San Antonio

On February 9, Speaker Straus shared House assignments to the 38 standing committees, as well as the creation of two new select committees: the Select Committee on State and Federal Power and Responsibility and the Select Committee on Texas Ports, Innovation & Infrastructure.

houston-house-delegation

The Houston delegation includes Chair assignments to Appropriations, County Affairs, General Investigating & Ethics, Government Transparency & Operation Juvenile Justice & Family Issues Local Consent & Calendars, Public Education, Special Purpose Districts, and Urban Affairs. Vice Chairs committee assignments from the Greater Houston area include Corrections, Environmental Regulations, Economic & Small Business Development, International Trade & Intergovernmental Affairs, Judiciary & Civil Jurisprudence, Special Purpose Districts, and Texas Port, Innovation, & Infrastructure.

House Committees of particular interest to MHA of Greater Houston are Public Education, Human Services, Public Health, and Defense & Veterans’ Affairs. Representative Dan Huberty chairs Public Education and members include Representative Alma Allen, Harold Dutton, Jr. and Dwayne Bohac. Public Health membership includes Representatives Garnet Coleman and Tom Oliverson. Houston-area legislators make up half of the membership of the Human Services Committee with Representatives Mark Keough, Rick Miller, Valoree Swanson, and Gene Wu.

Public Education

Role Representative City
Chair Dan Huberty Houston
Vice Chair Diego Bernal San Antonio
Member Alma Allen Houston
Member Joe Deshotel Beaumont
Member Harold Dutton, Jr. Houston
Member Lance Gooden Terrell
Member Dwayne Bohac Houston
Member Ken King Canadian
Member Linda Koop Dallas
Member Morgan Meyer Dallas
Member Gary VanDeaver New Boston

Human Services

Role Representative City
Chair Richard Peña Raymond Laredo
Vice Chair James Frank Wichita Fall
Member Mark Keough The Woodlands
Member Stephanie Klick   Fort Worth
Member  Toni Rose  Dallas
Member Rick Miller Sugar Land
Member Ina Minjarez San Antonio
Member Valoree Swanson Houston
Member Gene Wu Houston


Public Health

Role Representative City
Chair Four Price Amarillo
Vice Chair J.D. Sheffield Gatesville
Member Garnet Coleman Houston
Member R.D. “Bobby” Guerra Mission
Member William “Bill” Zedler Arlington
Member Diana Arévalo San Antonio
Member Nicole Collier Fort Worth
Member Phillip Cortez San Antonio
Member Stephanie Klick Fort Worth
Member Tom Oliverson Cypress

Defense & Veterans’ Affairs

Role Representative City
Chair Roland Gutierrez San An
Vice Chair César José Blanco El Paso
Member Diana Arévalo San Antonio
Member Stan Lambert Abilene
Member Briscoe Cain Deer Park
Member Dan Flynn Canton
Member Terry Wilson Marble Falls

Stay Engaged: Know Your Reps, Advocacy Taskforce, and Social Media 

The procedural nature of the Texas Legislature requires a somewhat paradoxical mix of steadied patience and swift action. In this space, we’ll discuss effective advocacy strategies in the weeks ahead. One simple step to begin to make your voice heard in Austin is to become familiar with the offices of your State Senator and State Representative. Find their district and capitol offices, save their phone numbers, and research the issues they care about the most.

Here within Mental Health America of Greater Houston, the Center for School Behavioral Health and the Women’s Mental Health Initiative joined forces and launched an Advocacy Task Force for the 85th Texas Legislature. The Task Force will be instrumental in advancing legislation around children and women’s mental health in the coming months. We welcome anyone interested in helping our cause to join the Task Force and our Rapid Response Team. For more information, visit our Advocacy Task Force page or email Lauren at lpursley@mhahouston.org.

To keep up with our advocacy work, check back in with Minding Houston every other Thursday starting February 23, like us on Facebook and follow us on Twitter.