Texas Mental Health and Substance Use Funding

*Note: If you find the text on some of the images blurry or hard to read, right-clicking the image and then selecting “open image in new tab” may improve the issue.

Acronyms 

  • CMS – Center for Medicaid/Medicare Services 
  • CPAN – Child Psychiatry Access Network 
  • DSRIP – Delivery System Reform Incentive Payment Program 
  • ESC – Education service centers 
  • FTE – Full-time equivalent 
  • GR – General revenue 
  • HHSC – Health and Human Services Commission 
  • IDEA – Individuals with Disabilities Education Act 
  • LBB – Legislative Budget Board 
  • LIDDA – Local intellectual/developmental disability authority 
  • LMHA – Local mental health authority 
  • MCO – Managed care organization 
  • MDCP – Medically Dependent Children’s Program 
  • SAMHSA – Substance Abuse/Mental Health Services Administration 
  • SBHCC – Statewide Behavioral Health Coordinating Council 
  • SPF-RX – Strategic Prevention Framework for Prescription Drugs 
  • SOR – State Opioid Response 
  • SSLC – State supported living center 
  • STR – State Targeted Response 
  • TCHATT – Texas Child Health Access Through Telemedicine 
  • TDCJ – Texas Department of Criminal Justice 
  • TDHCA – Texas Department of Housing and Community Affairs 
  • TEA – Texas Education Agency 
  • TJJD – Texas Juvenile Justice Department 
  • TTOR – Texas Targeted Opioid Response 
  • YES – Youth Empowerment Services Waiver 

Texas Mental Health and Substance Use Funding 

Funding mental health and substance use services in Texas is complex and includes a multitude of state agencies, institutions of higher education, community mental health centers, community health clinics, as well as a myriad of programs, providers, non-profits, private entities, and projects funded by federal, state, and local dollars. The Health and Human Services Commission (HHSC) has made great strides in identifying and coordinating behavioral health services funding through the initial development and annual updating of the Coordinated Statewide Behavioral Health Expenditure Proposal. The report identifies state funding for mental health and substance use services spread across 23 state agencies and institutions of higher education that are members of the Statewide Behavioral Health Coordinating Council. The coordinated expenditure proposal links funding to the strategies included in the Statewide Behavioral Health Strategic Plan. 

The funding sources for mental health and substance use are diverse and often co-mingled with other strategic purposes, making it difficult to accurately pinpoint behavioral health funding. Some of the legislative funding directives allow enhanced spending for existing or new programs, while other directives appropriate existing funding to specific projects. In this section of the guide, we will highlight the major sources of behavioral health funding and how that funding has been allocated in recent years. 

The increased demand for mental health and substance use services in Texas directly impacted the overall cost of services. One obvious reason for increased demand is the fast-growing Texas population. According to the Texas Demographic Center, the population of Texas is projected to reach 29,677,772 in 2020. This is an increase of approximately 4,532,211 over the 2010 U.S. Census. 

Figure 12 for MH GUIDE

Source: U.S. Census Bureau. 2019. https://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_ y=population&idim=state:48:06&hl=en&dl=en#!ctype=l&strail=false&bcs=d&nselm=h&met_ y=population&scale_y=lin&ind_y=false&rdim=country&idim=state:48&ifdim=country&hl=en_ US&dl=en&ind=false 

In this section of the guide, general information on the funding of mental health and substance use services will be provided as an overview. Additional funding information such as funding trends for agencies and costs for services are provided in the agency sections of the guide. 

Sources of Mental Health and Substance Use Funding 

Mental health and substance use services are funded through both the federal and state governments. Federal funding comes to Texas through a multitude of agencies and programs with Medicaid and the mental health/substance use block grants being the largest federal appropriation. The Centers for Medicare and Medicaid Services (CMS) funds Medicaid services in addition to state funding while the Substance Abuse and Mental Health Services Administration (SAMHSA) under the US Department of Health and Human Services funds the mental health/substance use block grants. Federal funding for mental health and substance use services is also funneled to Texas through other agencies such as the Department of Education, Department of Justice, Department of Veterans Affairs, Department of Housing, Social Security Administration, and more. 

Federal Funding 

MENTAL HEALTH AND SUBSTANCE USE BLOCK GRANTS

Mental health and substance use block grant funding is distributed in a noncompetitive manner to states based on congressionally mandated formulas. States must submit applications to SAMHSA annually in order to be eligible for the funds. Block grant funding is used for prevention services and programs, treatment, and to support mental wellness and recovery. Texas block grant funding allotments for FY 2019 are shown below.

Table 8 for MH GUIDE

Source: SAMHSA. 2019. Texas Summaries FY 2019. Retrieved from https://www.samhsa.gov/grants-awards-by-state/TX/2019 

DELIVERY SYSTEM REFORMINCENTIVE PAYMENT PROGRAM (DSRIP) 

Delivery System Reform Incentive Payment Program (DSRIP) provides a pool of federal funds to be used in locally driven projects aimed at improving the healthcare delivery system through the Quality Improvement Program Medicaid 1115 Demonstration Waiver. The 1115 Waiver also allows for statewide expansion of Medicaid managed care and provides uncompensated care funding for hospitals. Uncompensated care funding is used when a patient is uninsured and unable to pay for their treatment. From 2012-2019, over $15 billion was used to serve approximately 11.7 million Texans. The primary areas of focus for DSRIP projects in Texas includes:

  • Behavioral health 
  • Primary care 
  • Patient navigation, care coordination, and care transitions, especially for complex populations 
  • Chronic care management 
  • Health promotion and disease prevention 

DSRIP projects are intended to provide opportunities for innovation while demonstrating cost neutrality. The most recent extension of the waiver provided approval through September 30, 2022. 

In 2020, the state was required to submit a final DSRIP transition plan to CMS. The plan describes how Texas will continue to develop and improve service delivery without the aid of federal DSRIP funding after Demonstration Year 10. Key focus areas of the transition plan include: 

  • Sustain access to critical health care services; 
  • Behavioral health; 
  • Primary care; 
  • Patient navigation, care coordination, and care transitions, especially for patients with complex conditions that have high costs and high utilization; 
  • Chronic care management; 
  • Health promotion and disease prevention; 
  • Maternal health and birth outcomes, including in rural areas of the state; 
  • Pediatric care; 
  • Rural health care; 
  • Integration of public health with Medicaid; 
  • Telemedicine and telehealth; 
  • Social drivers of health.

DSRIP projects have had a direct impact on both access to behavioral health services and the quality of services provided. Many of the state’s DSRIP projects addressed mental health and substance use through integrated healthcare, expansion of peer support services, expanded telehealth and telemedicine, increase in outpatient locations, improvement in residential options, expansion of innovative services offered, and much more. 

The figure below depicts the general timeline of the original waiver and subsequent extensions. 

Figure 13 for MH GUIDE

Source: HHSC Presentation to Senate Health and Human Services Committee. December 3, 2019. Retrieved from https://hhs.texas. gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/leg-presentations/senate-health-human-services-dec-3-2019.pdf 

The amount of funding provided to Texas for innovative healthcare projects has been significant. The table below provides estimates of funding for Demonstration Years 7-11. 

Figure 14 for MH GUIDE

Source: Health and Human Services Commission. (August 27, 2020). Delivery System Reform Incentive Payment (DSRIP) Transition Plan. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/ Waivers/medicaid-1115-waiver/dsrip-transition-plan.pdf 

The local mental health authorities (LMHAs) have contributed general revenue (GR) funds to draw down the federal funding since the beginning of the program. The figure below depicts the GR funds contributed through FY 2018. 

Table 9 for MH GUIDE

Sources: Texas Health and Human Services. (December 2018). Report on Mental Health Appropriations and the 1115 Texas Medicaid Transformation Waiver. Retrieved from https://hhs.texas.gov/sites/default/files/documents/ laws-regulations/reports-presentations/2018/rider-72-mental-health-approp-1115-waiver-fy-2018.pdf 

Texas Health and Human Services. (November 2017). Report on Mental Health Appropriations and the 1115 Texas Medicaid Transformation Waiver. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2017/sb1-fy2017-mental-health-appr-1115-transformation-waiver-nov-2017.pdf 

Texas Health and Human Services. (February 2017). Report on Mental Health Appropriations and the 1115 Texas Medicaid Transformation Waiver. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2017/mental-health-appropriations-1115-waiver.pdf 

Texas Department State and Health Services. (January 2016). Report on Mental Health Appropriations and the 1115 Texas Medicaid Transformation Waiver. Retrieved from https://www.dshs.texas.gov/legislative/2016- Reports/Mental-Health-Appropriations-and-the-1115-Texas-Medicaid-Transformation-Waiver.doc 

Transitioning to a post-DSRIP period presents many challenges for Texas due to the substantial funding decreases. The final, DSRIP Transition Plan released on August 27, 2020 can be viewed at https://hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/Waivers/medicaid-1115-waiver/dsrip-transition-plan.pdf. Sustaining the many successful programs and services developed during the DSRIP years is essential to the quality of mental health and substance use services available to Texans. HHSC and a myriad of stakeholders have invested enormous amounts of time in developing a plan and working with CMS on how to move forward. Transition plan milestones are included in the figure below. 

Figure 15 for MH GUIDE

Source: HHSC Presentation to Senate Health and Human Services Committee. 1115 Demonstration Waiver Timeline, December 3, 2019. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/leg-presentations/senate-health-human-services-dec-3-2019.pdf 

The outstanding question remains. How will the successful projects be sustained without the federal DSRIP pool? As of the writing of this guide, many questions were unanswered. 

TEXAS TARGETED OPIOID RESPONSE PROGRAM (TTOR)

Through various grants, the federal government is partnering with states to address the opioid crisis caused by decades of misuse and over-prescribing of opioid drugs with addictive qualities. The opioid crisis has a devastating impact on individuals and families in addition to an incredible adverse impact on the Texas economy. Texas has been granted four federal grants focused on addressing opioid misuse from four federal grants from SAMHSA: 

  • State Targeted Response Grant (STR) 
  • State Opioid Response Grant (SOR) 
  • Strategic Prevention Framework for Prescription Drugs (SPF-Rx) – a five-year discretionary grant in the amount of $1,858,080 aimed at raising awareness about the risks of overprescribing to young adults and bringing prescription misuse prevention activities and education to schools, communities, and parents. 
  • Texas First Responders – Comprehensive Addiction and Recovery Act Grant (FR-CARA) – a four-year discretionary grant in the amount of $3.2 million. The goal of this collaborative project is to reduce opioid overdose related mortality rates, strengthen the successfulness of first response to overdose, and coordinate care for overdose survivors in Bexar County. 

TTOR was originally created when Texas was awarded the State Targeted Response (STR) grant in 2017, and has continued as Texas continues to receive opioid-focused federal grant funding. HHSC applied for and received a no-cost extension (NCE) of the STR funds allowing HHSC to extend federally approved projects beyond the grant term.

TTOR strategies address prevention, treatment, and recovery, including medically assisted treatment which includes a combination of medication, counseling, and behavioral therapies, and integrated care shown in Figure 16. While the attention to opioid abuse is important, much of the conversation, funding, and services have historically been limited to only opioids. This restricted focus prevents attention, and potential services and supports for individuals with other substance use concerns. Fortunately, SAMHSA has begun to recognize the critical demand to recognize a wider array of needs. SAMHSA’s FY 2020 SOR application allows funds to “support evidence-based prevention, treatment and recovery support services to address stimulant misuse and use disorders.” 

The SOR formula is based on two equally weighted elements: the state’s proportion of people who meet criteria for dependence or abuse of heroin or pain relievers who have not received any treatment and the state’s proportion of drug-poisoning deaths. This funding formula highlights the critical importance of data collection in Texas. Accurate and adequate data not only highlights needs and gaps within the state, but also provides an opportunity for Texas to receive appropriate funding for needed services and support. While the grant is planned for 2 years, it is dependent on Congressional appropriations. 

Figure 16 for MH GUIDE

Source: Texas Health and Human Services. (August 2019). Texas Targeted Opioid Response. Retrieved from https://hhs.texas. gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/tx-targeted-opioid-response.pdf 

Table 10 for MH GUIDE

Source: Texas Health and Human Services. (August 2019). Texas Targeted Opioid Response. Retrieved from https:// hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/ tx-targeted-opioid-response.pdf 

The figure below provides an overview of the timeframe for TTOR Projects. 

Figure 17 for mH GUIDE

Source: Texas Health and Human Services Commission. Texas Targeted Opioid Response. https://hhs.texas.gov/doing-business-hhs/provider-portals/behavioral-health-services-providers/texas-targeted-opioid-response-providers 

Anytime funds are appropriated to specific issue areas, it is vital to track the outcomes and be able to determine with confidence whether the dollars invested have been beneficial and to what extent. Indications to date show that TTOR grant funds have had significant impact on the lives of many Texans. In Texas, opioid-involved deaths totaled 1,104 in 2018. Also in 2018, Texas had the lowest prescription opioid prescribing rate since 2006 when the data become available at 47.2 opioid prescriptions per 100 people. The U.S. average was 51.4 for the same year. The subsequent question should be whether or not the narrow focus on opioid overuse has had unintended consequences on our ability to combat other addictive substances and has the reduction in access to opioids increased the demand for other substances. 

Below are some indicators of the outcomes associated with the TTOR funding. 

Table 11 for MH GUIDE

Source: https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/tx-targeted-opioid-response.pdf 

Texas State Appropriations for Mental Health and Substance Use 

Note to readers: due to the COVID-19 pandemic, delays were experienced in the release of agency Legislative Appropriations Requests. The information provided in this section is what was available at the time of writing. 

Over the past decade, the Texas Legislature has continued to increase overall funding for behavioral health although there have been ebbs and flows in specific budget strategies. Below is a historical view of the mental health and substance use funding in the health and human services system. 

COORDINATED STATEWIDE BEHAVIORAL HEALTH EXPENDITURE PROPOSAL

There are 23 members of the Statewide Behavioral Health Coordinating Council (SBHCC). Each of these agencies and institutions of higher education provide some level of mental health/substance use services or mental health/substance use education and training. This may be provided directly by the funded entity or through contracted services. The legislature has charged the SBHCC with developing a consolidated behavioral health expenditure proposal to promote cross-agency collaboration and prevent duplication of effort. The SBHCC is required to analyze all of the member agencies’ exceptional items requests related to behavioral health to ensure that they are coordinated and non-duplicative. The coordinated expenditure proposal for FY 2020 is shown below and can be found at https://hhs.texas.gov/ sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1- behavioral-health-expenditure-proposal-fy20.pdf

Figure 18 for MH GUIDE

i. Office of the Governor (OOG) – OOG’s behavioral health funding included in this proposal differ from amounts included in Section 10.04 for several reasons. 1) The Edward Byrne Memorial Justice Assistance Grant Program, Crime Victim Assistance Program, Violence Against Women Program, and the Juvenile Justice & Delinquency Prevention Program are federal formula grant programs. The annual award amounts provided to OOG are based on congressional appropriations and federal formulas that are subject to change year-to-year. 2) These fund sources are also competitive grant programs that support a wide array of initiatives including behavioral health and non-behavioral health services. Actual expenditures related to behavioral health will vary every year based on the grant applications submitted, state and local priorities, and whether or not those projects intend to support behavioral health-related activities. 

ii. Texas Veterans Commission (TVC) – TVC’s behavioral health funding amounts included in this proposal differ from amounts included in Section 10.04 because amounts listed in Section 10.04 were based on estimates included in TVC’s Legislative Appropriations Request (LAR). The amounts included in this proposal are actual amounts. 

iii. Department of Family and Protective Services (DFPS) – DFPS’ behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 due to exclusion of substance abuse testing expenditures from previously reported amounts. 

iv. Department of State Health Services (DSHS) – DSHS’ behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because amounts listed in Section 10.04 were based on estimates included in DSHS’s Legislative Appropriations Request (LAR). The amounts included in this proposal are actual amounts. 

v. Health and Human Services Commission (HHSC) – HHSC’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 due to certain differences in the following programs: 

  • State Hospitals 
  • Substance Use Disorder programs 
  • Child Advocacy Programs 
  • Children with Special Needs 
  • Regional Medical, Behavioral, and Psychiatric Technical Support Team 
  • Enhanced Community Coordination 
  • Promoting Integration of Primary and Behavioral Health Care 
  • Advancing Wellness and Resilience in Education 

vi. Texas Higher Education Coordinating Board (THECB) – THECB’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because this proposal includes the amounts included in THECB’s funding appropriated in Article III of the 2020-21 General Appropriations Act (GAA), 86th Legislature, Regular Session, 2019. 

vii. Supreme Court of Texas – The Supreme Court’s behavioral health funding amounts in this proposal differ from the amounts included in Section 10.04 due to the Supreme Court’s plan to hire an additional employee to support the Judicial Commission on Mental Health. 

viii. Texas Military Department (TMD) – TMD’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 due to additional appropriation for the Sexual Assault Response Coordinator program. 

xi. Texas Medical Board (TMB) – TMB’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because the amounts referenced above are included in TMB’s GAA strategy B.1.2. 

Source: Texas Health and Human Services Commission. (2019). Coordinated Statewide Behavioral Health Expenditure Proposal, Fiscal Year 2020. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1- behavioral-health-expenditure-proposal-fy20.pdf 

The table below provides a breakdown of the consolidated expenditures by Service Type. 

Table 12 for MH GUIDE

Source: Health and Human Services Commission (2019). Coordinated Statewide Behavioral Health Expenditure Proposal for FY 2020. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1-behavioral-health-expenditure-proposal-fy20.pdf 

TEXAS GENERAL APPROPRIATIONS FOR MENTAL HEALTH/SUBSTANCEUSE SERVICES

The general appropriations bill is the only piece of legislation that the legislature is required to pass each biennium. It must be approved by both the Texas House of Representatives and the Texas Senate, certified by the Comptroller, and signed by the Governor. The majority of state mental health and substance use funding is appropriated through Article II, Texas Health and Human Services Commission. The general appropriations bill includes funds from a variety of sources, both state and federal.

Table 13 for MH GUIDE

Source: Hogg Foundation Legislative Summaries, 2019. Retrieved from https://hogg.utexas.edu/wp-content/ uploads/2019/09/86th-Legislative-Summary.pdf. Note: Blank cells in the table above reflect that the data was not available at the time of this writing. 

TEXAS MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) 

Texas Medicaid and the Children’s Health Insurance Program (CHIP), both of which are managed care and fee-for-service programs, provide significant funding for behavioral health services. In 2018 the Texas Legislative Budget Board (LBB) estimated: 

Medicaid expenditures for behavioral health services total $3.5 billion in All Funds for the 2018–19 biennium, and estimated Children’s Health Insurance Program (CHIP) expenditures total $48.7 million in All Funds. These amounts include cost growth that is not funded for both programs and Medicaid caseload growth for fiscal year 2019, which also is not funded. Total behavioral health funding, including estimated Medicaid and CHIP expenditures, is estimated to be $7.6 billion in All Funds for the biennium. 

Figure 19 for Mh guide

Source: Texas Health and Human Services Commission. (2019). Coordinated Statewide Behavioral Health Expenditure Proposal, Fiscal Year 2020. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1- behavioral-health-expenditure-proposal-fy20.pdf 

Figure 20 for MH GUIDE

Source: Texas Health and Human Services Commission. (2019). Coordinated Statewide Behavioral Health Expenditure Proposal, Fiscal Year 2020. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/hb1- behavioral-health-expenditure-proposal-fy20.pdf 

HB 1, 86TH LEGISLATURE – GENERAL APPROPRIATIONS (ZERWAS/NELSON) 

As with several previous legislatures, the 86th Texas Legislature made efforts to improve mental health funding in Texas by increasing resources to expand access to services. As discussed above, mental health programs, services, and education span many state agencies. The following tables depict the primary funding strategies. 

Article II, Health and Human Services Commission (HHSC) Mental Health and Substance Use Funding 

Table 14 for MH GUIDE

Source Hogg Foundation Legislative Summaries, 2019. Retrieved from https://hogg.utexas.edu/wp-content/ uploads/2019/09/86th-Legislative-Summary.pdf. Note: Blank cells in the table above reflect that the data was not available at the time of this writing. 

Article II – HHSC Mental Health and Substance Use Related Budget Riders 

Budget riders are legislative directives that instruct agencies on how to spend certain appropriated funds. Riders do not typically provide additional or new funding. 

HHSC Rider 1 for MH GUIDE HHSC Rider 1.5 FOR MH GUIDE HHSC Rider 2 FOR MH GUIDE HHSC Rider 2.5 FOR MH GUIDE

Major Behavioral Health Grant Programs Included in Article II Riders 

Rider 56 – Healthy Community Collaboratives – directs HHSC to allocate up to $25 million of amounts appropriated over the biennium to fund grants to Healthy Community Collaboratives. Also allows for up to $10 million of these funds to be allocated to collaboratives in rural areas contingent on the availability of the required matching funds. Requires a legislative report by December 1, 2020. 

Rider 61 – Mental Health for Veterans Grant Program – allocates $20 million in GR in FY 2020 to operate a grant program to support community mental health programs providing services and treatment to veterans and their families. Requires a legislative report by December 1, 2020. 

Rider 62 – Mental Health Grant Program for Justice-Involved Individuals – allocates $25 million in GR each year of the biennium for administering the grant program to reduce recidivism, arrests, and incarceration among individuals with mental illness and to reduce wait times for forensic commitment. Also directs that $5 million in GR each year be allocated to the Harris County jail diversion program. Requires each grantee to report twice annually to the SBHCC. 

Rider 68 – Unexpended Balance Authority within the Biennium for the Community Mental Health Grant Program – allocates $20 million in GR each fiscal year for the Community Mental Health Grant Program and allows unexpended funds from FY 2020 to be used in FY 2021 for the same purposes. 

Article II – Special Provisions Relating to all HHS Agencies 

Special Provisions are instructions included in the appropriations bill that apply to multiple agencies within one or multiple articles. Typically, these provisions are used to restrict the amount and conditions under which appropriations may be expended. 

Special Provisions for mH GUIDE

Article III (86th) – Texas Education Agency (TEA) School Climate/Safety Funding 

Following the shooting at Santa Fe High School, Governor Greg Abbott announced school safety as an emergency item and prioritized mental health as a component of securing schools’ safety. While no funding was specifically allocated for student mental health by the 86th legislature, funds for programs and services located within these strategies directly affect school climate and can be used toward efforts that improve student and teacher well-being and safety.

HB 1 for mH GUIDE

It is important to note that the largest of the above funding, the School Safety Allotment, is based on average daily attendance and is spent at a school district’s discretion. The funds can be used to support student and staff mental health, including: prevention and treatment related to adverse childhood experiences (ACEs), providing mental health personnel and support, or programs related to suicide prevention, intervention, and post-intervention. However, schools may prioritize the funds towards other allowable uses, such as physicality of buildings, employing security, or establishing threat reporting systems. 

Article III, TEA School Climate/Safety Related Riders 

TEA Rider for MH GUIDE

Article III (86th) – Higher Education School Climate/Safety Funding 

TEA 1.5 for MH GUIDE

The Texas Child Mental Health Care Consortium, created by SB 11 (86th, Taylor/ Bonnen), is intended to enhance access to mental health services for children and adolescents through collaboration with health-related institutions of higher education. The primary components of this legislation include: 

  • Child Psychiatry Access Network (CSPAN) 
  • Texas Child Health Access Through Telemedicine (TCHATT) 
  • Community Psychiatry Workforce Expansion 
  • Funding for child and adolescent psychiatry fellowships 

More information can be found at https://hhs.texas.gov/sites/default/files/ documents/about-hhs/communications-events/meetings-events/vbpqi/sept-2019- vbpqiac-agenda-item-3.pdf. 

Article III (86th), Higher Education School Climate/Safety Contingency Riders 

Art III Rider for MH GUIDE

Article III (86th) – Special Provisions Relating Only to Higher Education 

Special Provision #24 FOR MH GUIDE

Article IV (86th) – The Judiciary 

Supreme court TX FOR MH GUIDE

Article V (86th) – Public Safety and Criminal Justice 

TDCJ FOR MH GUIDE

TDCJ 2 FOR MH GUIDE

TDCJ 3 FOR MH GUIDE

Article VII (86th) – Business and Economic Development 

TDCJ 4 FOR MH GUIDE

Article IX (86), Contingencies and Other Special Provisions 

Contingency riders are legislative directives that instruct agencies on how to spend certain appropriated funds if/when legislation passes. Contingency riders typically do not provide additional or new funding. Special Provisions are instructions included in the appropriations bill that apply to multiple agencies within one or multiple articles. Typically, these provisions are used to restrict the amount and conditions under which appropriations may be expended. 

Special provisions 2 FOR MH GUIDE

SB 500 (86TH, NELSON/ZERWAS) – SUPPLEMENTAL APPROPRIATIONS BILL 

Funding for important mental health and substance use services was included in the supplemental appropriations bill, including essential funding to continue state psychiatric hospital redesign projects. Also included were funds to support school safety. 

sb 500 FOR MH GUIDE

Sources for General Appropriations: 

Texas Health and Human Services Commission. (November 2018). Statewide Behavioral Health Coordinating Council: Consolidated Behavioral Health Schedule and Exceptional Item Review. FY 20-21. Retrieved from https://hhs.texas.gov/sites/default/ files/documents/laws-regulations/reports-presentations/2018/consolidated-bh-schedule-ei-review-nov-2018.pdf 

Legislative Budget Board. (July 2017). Informational Program Listing of the Conference Committee Report for Senate Bill 1, 85th Texas Legislature. Retrieved from http://www.lbb.state.tx.us/documents/appropriations_bills/85/conference_bills/infolisting_program.pdf 

Legislative Budget Board. (December 2019). Informational Program Listing of the General Appropriations Act for the 2020-21 Biennium, 86th Texas Legislature. Retrieved from http://www.lbb.state.tx.us/documents/appropriations_bills/85/ conference_bills/infolisting_program.pdf 

Legislative Budget Board. (2019). General Appropriations Act for the 2020-21 Biennium, 86th Texas Legislature. Retrieved from https://www.lbb.state.tx.us/Documents/GAA/General_Appropriations_Act_2020_2021.pdf 

Legislative Budget Board. (2017). General Appropriations Act for the 2018-19 Biennium, 85th Texas Legislature. Retrieved from http://www.lbb.state.tx.us/Documents/GAA/General_Appropriations_Act_2018-2019.pdf 

Texas Legislature Online. (2019). Senate Bill 500, 86th Texas Legislature. Retrieved from https://capitol.texas.gov/ tlodocs/86R/billtext/pdf/SB00500F.pdf#navpanes=0 

State Hospital Redesign 

The physical condition of the state psychiatric hospitals and the state supported living centers (SSLCs) continues to be a priority for policymakers. Much of the inpatient infrastructure is old, outdated, and in need of immediate repair or renovation. HHSC was directed to develop a three-phase plan to address the immediate infrastructure needs of the state hospital system. Planning and renovation was the priority for Phase I, and new construction was approved in Phase II. Currently, two new state hospitals are under construction (Austin State Hospital and San Antonio State Hospital) as well as a new maximum-security unit at Rusk State Hospital. While construction has started, only approximately half of the needed funding for the new Austin State Hospital and the San Antonio State Hospital has been appropriated. 

Figure 21 for MH GUIDE

Source: http://www.lbb.state.tx.us/documents/publications/fiscal_sizeup/fiscal_sizeup.pdf 

According to a presentation made by HHSC to the Transition Legislative Oversight Committee in August 2019, the figure below depicts the additional funding needed to complete the redesign/construction of ASH and SASH. 

Figure 22 for MH GUIDE

Source: Health and Human Services Commission, Presentation to the Transition Legislative Oversight Committee, August 26, 2019. Retrieved from https://hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2019/leg-presentations/ presentation-transition-legislative-oversight-committee-aug-26-2019.pdf 

 

PREVIOUS SECTION / NEXT SECTION