History of LWVTX Action on Behavioral Health Services

History of LWVTX Action on Behavioral Health Services

1989: League efforts focused primarily on increasing the Texas Department of Mental Health and Mental Retardation (TDMH/MR) budget in order to initiate programs for youths and to expand services to rural areas. Although the final budget was an expansion over previous levels, it primarily reflected the increased cost of providing current service levels and some court-- mandated reforms for hospitalized clients. A small amount of funding was designated for programs for children and youth. The League also opposed several discriminatory bills, which ultimately died. These bills would have significantly reduced access to housing, within residential areas, for disabled persons including the mentally ill.

1990-1993: During the 1990 interim, LWV-TX testified before a hearing of the Senate Health and Human Services Committee to reiterate our support for private board and care homes operated in a responsible fashion. The 1991 legislative session produced successful legislation clarifying the regulatory and licensing procedures for board and care homes and outlining a "bill of rights" for residents and providers. Although not active on this specific issue in the 73rd Legislature, the League worked to maintain funding levels for human services programs, including those for the mentally ill.

1994-1995: During the legislative interim, LWV-TX presented testimony to an advisory task force of the TDMH/MR charged with delineating authority/provider roles. The League objected to the proposed separation of local authority from local providers, noting the need for the authority and provider to be one entity at the local level to ensure accessibility, continuity, and flexibility of assistance to those in need of services.

2005: The Legislative Priority for the 2005 session was to work to influence the Legislature to maintain or increase the current funding level for services for the seriously mentally ill, when appropriate, combining efforts in coalition with other organizations. We appreciate being able to work with the Mental Health Association of Texas, and in particular, the Mental Health Association of Greater Dallas.

The final budget bill included the following mental health items: $20 million added statewide for adult community mental health, $3 million added statewide for children's community mental health, $15 million added statewide to increase state psychiatric hospital bed capacity, $3.3 million added for full restoration of CHIP mental health benefit, $44 million added for restoration of Medicaid adult psychological counseling benefit, $195 million for the NorthSTAR program.

The following mental health related bills were signed by the Governor: HB 224 (Corte) preventing a minor from discharging him or herself or refusing psychoactive medication under specified conditions, and SB 1473 (Lindsay)/ HB 2524 (Coleman) requiring that all law enforcement officers, veterans as well as cadets, receive training on de-escalation and crisis intervention techniques for dealing with persons with mental impairments. HB 2572 (Truitt) authorizing a local mental health and mental retardation authority to determine whether to provide services directly or to contract with another organization to provide service, was vetoed.

2007: The LWV-TX worked to influence the Legislature to maintain or increase the current funding level for services for the seriously mentally ill. A request by the Department of State Health Services for $82 million in new dollars for mental health crisis services was full funded. The additional funding will allow the state to pen six new psychiatric emergency observation sites, provide children's outpatient and crisis stabilization for 87,000 people and to train and certify 340 community center staff to respond to crisis calls. In addition funding provided for state mental health facilities totaled $634 million, a $14.6 million increase to maintain the 2007 caseloads. Legislation for "parity" to require health insurance plans to cover treatment for serious mental health disorders advocated by LWV-TX did not make it through the process. However SB 568 (Ellis), which mirrored pending federal legislation, and HB 510 (Fabree) made it through respective chambers. The features of both pieces of parity legislation were attached to HB 1919 relating to health insurance coverage for individuals with brain injury, however at the last minute these were stripped from the bill in conference committee.

2011:The League monitored legislation affecting mental health and substance abuse services throughout the legislative session and encouraged members through the Legislative Newsletter to contact their congressional representatives serving on the relevant committees and when budget considerations came to the floor of both houses in support of League positions. In light of current language being used to describe mental health and substance abuse issues, it was recommended and adopted that the issue title be changed to "Services for People with Behavioral Health Disorders."

Although the State Legislature generally maintained 2010-2011 levels of funding for mental health in the Department of State Health Services budget, this must be understood in the context that Texas is at the bottom of all 50 states in per capita spending for public mental health services. While Community-based Services for Children were increased by almost $21 million, Community-based Services for Adults were decreased by over $11 million, and Substance Abuse Treatment Services were decreased by over $29 million. Substance Abuse Treatment Services are critical because of the large number of people with mental illnesses who have co-occurring substance abuse disorders. 2013: While Texas continued to be at the bottom of all 50 states in per capita spending for public mental health and substance abuse services, the Legislature did provide an additional $350 million for the biennium. This significant increase was in large measure motivated by several tragic mass shootings of people attending a political event, people at a movie, and children and teachers in an elementary school; the three shootings were conducted by young people with histories of mental illness.

Some 70 bills related to mental health were filed and LWV-TX monitored and advocated for those related to our positions. In addition to our highest priority for increased funding, the most significant bills passed include the following: authorization of a study of the mental health workforce shortage; facilitation of best practices in hospital emergency rooms for Screening, Brief Intervention and Referral to Treatment (SBIRT) in cases of injuries from substance use/abuse; authorization of a study of the need statewide for forensic and civil hospital beds; expansion of the number of mental illnesses eligible for treatment (previous law limited coverage to major depression, bipolar disorder and schizophrenia) and funding for Mental Health First Aid training statewide; integration of mental health with the rest of the health care system in the Medicaid program; provision of improved mental health awareness and suicide prevention training for public school educators and staff; and clarification of judicial authority to court-order outpatient treatment for people with mental illness.

2017 Congratulations to the 85th Texas Legislature! There were many, many good bills supporting behavioral health introduced this session, 41 of which the League actively supported. Of these, 22 were finally passed.

Of the $1 billion appropriate from the Rainy Day Fund, $300 million will be dedicated to state-run mental hospitals for new construction, significant repairs, and increased capacity. Also appropriated were $62.7 million to eliminate projected waiting lists for community mental health services for adults and children, $37.5 million for a new mental health jail diversion program, and $160 million for deferred maintenance at state schools and hospitals.

Under the leadership of Chairman Four Price, the House Select Committee on Mental Health passed four significant bills: HB 10, HB 13, HB 1486, and HB 3083. Their provisions include: (a) an ombudsman position for behavioral health access to care, (b) a mental health and substance use disorder parity work group to coordinate state and federal rules and statutes about benefits for these disorders, (c) requirement for the Health and Human Services Commission to establish a matching grant program for the purpose of supporting community mental health programs and provide services and treatment to individuals experiencing illness, (d) a provision in Tex. Gov. Code requiring the Health and Human Services Commission to adopt rules on the training and certification of peer specialists for mental health, and (e) a chemical dependency counselor for those who are eligible to receive repayment assistance on college loans.

House bills supported by the LWVTX that passed.

  • HB 1600 (Thompson): Amends the Human Resources Code to provide an annual mental health screening under Texas health Steps program for children aged 12-18 years.
  • HB 1794 (Bell): Requires the Health and Human Services Commission to establish a work group on mental health access for first responders that will make recommendations for improving access to mental health care services for these workers.
  • HB 1983 (Wray): Provides that firefighters and peace officers who have post traumatic stress disorder (PTSD) as a result of on-the-job events are eligible for workers compensation benefits.
  • HB 2466 (S. Davis): Defines coverage for maternal depression screening of mothers and requires it under the child health plan.
  • HB 2619 (Giddings): Requires the criminal justice divisions of the governor's office to establish a peace officer mental health grant program for applicants from law enforcement agencies.
  • HB 2904 (White): Further specifies the memorandum of understanding of agencies (adds Texas Education Agency and others) to promote local level interagency staffing to coordinate services in least restrictive setting for persons needing multiagency services.

 Senate bills supported by the LWVTX that passed.

  • SB 27 (Campbell): Gives authority to establish a National Center for Warrior Resiliency at the University of Texas Health Science Center-San Antonio to conduct research and provide clinical care to enhance psychological resiliency for veterans, defines peer service coordinator for mental health program for veterans, and requires the mental health intervention program for veterans to include training for licensed mental health professionals.
  • SB 74 (Nelson): A provider in a managed care organization that contracts with the Health and Human Services Commission to provide behavioral health services may contract with the organization to provide targeted management and psychiatric rehabilitation services to children and their families.
  • SB 344 (West): Provides authority of licensed paramedics to transport a person taken under custody of a peace officer to a mental health facility.
  • SB 578 (Lucio): Requires the Texas Veterans Commission to create a veterans suicide prevention plan.
  • SB 613 (Whitmire): Requires the Health and Human Services Commission to provide in-house mental health services to an inmate sexual offender whose mental illness will not allow the offender to participate in the sex offender treatment program.
  • SB 674 (Schwertner): Requires that an expedited licensing process be implemented for certain physicians that are specializing in psychiatry.
  • SB 790 (Miles): Continues the Women's Health Advisory Committee.
  • SB 1264 (Huffman): Amends the Code of Criminal Procedure to allow commissioners courts to approve post investigation psychological counseling for a grand juror in a grand jury investigation.
  • SB 1326 (Zaffirini): Relating to procedures regarding criminal defendants who are or may be persons with mental illness or and intellectual disability.
  • SB 1533 (Rodriguez): Allows university employees, as ell as school district employees and resource officers, to be eligible for grants for training in mental health first aid.
  • SB 2001 (Watson): Clarifies the definition of psychology and therefore prevents those who are not licensed by the Medical Board from claiming to be psychologists.
  • SB 2027 (Rodriguez & Moody): Requires the Health and Human Services Commission and the Texas Workforce Commission to study and evaluate occupational training and employment opportunities for individuals with intellectual disabilities.

2019. Here is a breakdown of major behavioral health bills that passed and have been signed by
the governor:
School Behavioral Health/School Climate

1. HB 18 (Price) - Relating to consideration of the mental health of public school students in
training requirements for certain school employees, curriculum requirements, counseling
programs, educational programs, state and regional programs and services, and health care
services for students and to mental health first aid program training and reporting regarding
local mental health authority and school district personnel.
2. HB 19 (Price) - Relating to mental health and substance use resources for certain school
3. SB 11 (Bonnen) - Relating to policies, procedures, and measures for school safety and
mental health promotion in public schools; making an appropriation.
4. SB 504 (Seliger) - Relating to the inclusion of certain information in postsecondary
education and career counseling academies developed for certain school counselors and
other postsecondary advisors employed by a school district.

Foster Care, Trauma, and Behavioral Health
1. HB 53 (Minjarez) - Relating to the transitional living services program for certain youth in
foster care.
2. HB 72 (White) - Relating to the continuation of Medicaid benefits provided to certain children adopted from the conservatorship of the Department of Family and Protective Services.
3. HB 475 (Howard) - Relating to information for foster children who are pregnant or minor parents.
4. SB 355 (West) - Relating to developing a strategic plan to ensure the provision of prevention and early intervention services complies with federal law.

Maternal Behavioral Health
1. HB 253 (Farrar) - Relating to a strategic plan to address postpartum depression.
2. SB 750 (Kolkhorst) - Relating to maternal and newborn health care and the quality of
services provided to women in this state under certain health care programs.

Criminal Justice and Behavioral Health
1. HB 601 (Price) - Relating to procedures and reporting requirements regarding criminal
defendants who are or may be persons with a mental illness or an intellectual disability.
2. HB 1342 (Leach) - Relating to the consequences of a criminal conviction on a person's
eligibility for an occupational license.
3. SB 652 (Zaffirini) - Relating to the delivery of certain mental health information regarding a
defendant transferred from a county to the custody of the Texas Department of Criminal
Justice, the commitment of certain defendants for competency restoration, and the use of
telepsychiatry in determining whether a defendant is manifestly dangerous before

Substance Abuse
1. HB 4298 (Murr) - Relating to the licensing of satellite offices of outpatient chemical
dependency care facilities.
2. SB 340 (Huffman) - Relating to the creation of a grant program to assist law enforcement
agencies with the purchase of opioid antagonists.
3. SB 436 (Nelson) - Relating to state-wide initiatives to improve maternal and newborn health
for women with opioid use disorder.
4. SB 1564 (West) - Relating to access to medication-assisted treatment for opioid use disorder
under Medicaid.

Telehealth Services
1. HB 3345 (Price) - Relating to health benefit coverage provided by certain health benefit plans
for telemedicine medical services and telehealth services.
2. HB 4455 (Miller) - Relating to the provision of mental health services through a telemedicine
medical service or telehealth service.
3. SB 71 (Nelson) - Relating to the establishment of a statewide telehealth center for sexual
assault forensic medical examination.

Other bills to address behavioral health
1. HB 1590 (Howard) - Relating to the establishment of the Office for Sexual Assault Survivor
Assistance within the criminal justice division of the governor's office.
2. HB 1735 (Howard) - Relating to sexual harassment, sexual assault, dating violence, and
stalking at public and private postsecondary educational institutions; providing an
administrative penalty.
3. HB 2813 (Price) - Relating to the state-wide behavioral health coordinating council.
4. SB 37 (Zaffirini) - Relating to the abolition of student loan default or breach of a student loan
repayment or scholarship contract as a ground for nonrenewal or other disciplinary action in
relation to a professional or occupational license.