Public Policy Forum
SUMMARY OF TEXAS LEGISLATURE, 2011
PRIORITY 1
MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT
Funding
The NorthSTAR region (Collin, Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties) saw an increase of funding from $199,099,627 in the 2010-2011 biennium to $225,224,965 for the 2012-2013 biennium. In mid-session, advocates from this region successfully defeated an ill-advised rider to totally delete all funding for the NorthSTAR region, which would have left 72,000 individuals without mental health or substance abuse treatment. Both victories are a great tribute to the advocacy efforts put forth from this region. Many thanks to all of you who wrote postcards, sent e-mails, made telephone calls and visited your elected officials in support of mental health and substance abuse funding.
We must remember, however, that at the opening of the legislative session, Texas ranked at or near the bottom of all 50 states in per capita spending for public mental health and substance abuse treatment. With the cuts in other parts of the mental health and substance abuse treatment budgets statewide, Texas has not made significant progress and may have in fact slipped even lower in the state rankings.
For example, funding for substance abuse treatment slipped from $312,479,673 in the 2010-2011 biennium to $283,285,699 for the upcoming biennium. To put this in context, substance abuse disorders affect approximately 1 in 10 Americans over the age of 12, and that the Texas Department of State Health Services estimates that 1,855,364 Texans have a chemical dependency.
There were also losses in the Adult Community-based Mental Health Services. The Criminal Justice budget saw cuts as well in critical mental health and substance abuse treatment to ex-offenders and those still incarcerated. These funds are pennies per day compared with the scores of taxpayer dollars per day if the individual re-offends and is re-incarcerated after revocation of probation or parole.
Statutes--Wins
HB 1386--Coleman and Ellis—requires the Department of Health and Human Services, in coordination with the Texas Education Agency, to provide and annually update a list of best practice-based early mental health intervention and suicide prevention programs for implementation in public junior, middle, and high schools. Programs on the list must include components that provide training for counselors, teachers, nurses, administrators, and other staff, as well as law enforcement officers and social workers who regularly interact with students.
HB 1908-Madden, Whitmire—Allows student loan repayment assistance for mental health professionals who provide services in correctional institutions. Another great idea from the Dynamic Duo!
HB 3145—Naishtat and Zaffirini—updates licensing fees and eligibility requirements for licensed chemical dependency counselors
HB 3146-Naishtat—Expands the list of mental health professionals who can take an informed consent to include Licensed Chemical Dependency Counselors.
SB 219—Nelson, Gonzalez, Naomi—Directs Texas Department of Family and Protective Services (DFPS) to help Court Appointed Special Advocates (CASA), Child Advocacy Center staff, local community mental health center staff and domestic violence shelters to locate resources and develop trauma-informed care training, and directs the Texas Health and Human Services Commission (HHSC) to offer trauma-informed training to the State of Texas Access Reform (STAR) health providers and to encourage STAR Health Managed Care Organizations (MCOs) to offer Post Traumatic Stress Disorder (PTSD) and Attention Deficit Hyperactivity Disorder training to network physicians and to ensure that network providers include a mental health screening in the child’s Texas Health Steps checkup.
SB 293—Watson and Davis—Allows telehealth and home telemonitoring services to be reimbursed under Medicaid.
SB 331-Shapiro—Designates synthetic cannabinoids (often marketed to adolescents) as controlled substances.
SB 501-West, Marquez—Establishes the Interagency Council for Addressing Disproportionality to examine the disproportionate involvement of children who are members of a racial or ethnic minority group at each stage in the juvenile justice, child welfare and mental health systems, examine disproportionate delivery of various educational service and assist the HHSC in eliminating health access disparities.
SB 1449-Zaffirini—Allows the State of Texas to recognize accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO or The Joint Commission) to satisfy the requirement for State licensure inspection.
Losses
HB 758-Eiland—Would have Repealed the current law that require insurance companies to exclude coverage for medical services when injuries are sustained when the insured person is intoxicated or under the influence of a narcotic. HB 758 does not require insurers to cover the injuries, it simply no longer requires them to exclude coverage. Left pending in House Insurance Comm.
HB 1192-Castro—Authorizes a study of the issue of insurance coverage for children with Serious Emotional Disturbance (SED). Reported favorably from House Insurance Committee, but died in House Calendars. Getting out of committee represents some progress for this particular issue.
SB 291-Watson—Would have added an alcohol awareness component to public school science classes. Passed Senate, left pending in House Education
PRIORITY 2
HOUSING
In a session in which resources were so limited, sometimes we even look at major losses and say, “Well, it could have been worse!” This is definitely the case with funding for the Homeless Housing Services Program. The funding was in serious jeopardy all regular session long and into the special session. Seasoned advocates will remember that in 2009, the mayors of the seven largest cities in Texas banded together to ask Legislators to appropriate $50 million for transitional and supportive housing, job training and behavioral health services for people moving from homelessness to recovery. $20 million was appropriated for 2010-2011 with 75% of the funding going to urban areas and 25% to people who are homeless in rural areas.
This session, the funding went on a roller-coaster ride from zero to $20 million and landed at $10 million earmarked as legislative intent for HHSP. Unfortunately, the permanent supportive housing was a casualty of the process, so we must redouble our advocacy efforts next session not only for the HHSP, but for cost-effective solutions like permanent supportive housing.
PRIORITY 3
PROMOTE RECOVERY, PREVENT RECIDIVSM
Statutes
Wins
HCR 4—Naishtat, Huffman—Designates the week of September 10 each year as Texas Suicide Prevention Week.
HB 35—Menendez and Uresti—Pilot project in Bexar County (San Antonio) to facilitate collaboration among parents, educators, state juvenile justice and health and human services agencies, healthcare and mental healthcare providers for the exchange of certain information relating to a child in the program among participating agencies, with proper parental consent, in order to better coordinate and reduce duplication of effort. Initial program will serve over 150 children. Advocates around the state should monitor the results of this pilot.
HB 359—Allen—Requires that restraints used by school resource officers must be tracked and reported the same as are those by school police officers, and eliminates giving children (6th grade and younger) tickets from law enforcement officers for infractions of school rules and other minor misbehaviors at school or on school buses.
HB 748—Menendez, Van de Putte—Provides defendants an opportunity to earn time credit for time spent in a competency restoration program.
HB 968—Strama and Watson—Eliminates “persistent misbehavior” as grounds for school expulsion, changes the definition of “serious misbehavior” to include acts specified by the penal code in an effort to prevent schools from referring students to the juvenile justice system for infractions of school rules. See HB 1386 for related reforms.
HB 1481—Truitt—requires the state to use respectful language when referring to people with disabilities.
HB 1942—Patrick—Anti-bullying legislation.
HB 2725-Hartnett—Clarifies the Texas requirements to determine if an individual is incompetent to stand trial.
SB 118-Uresti, Menendez—Currently, an individual may be considered by a judge for involuntary extended outpatient mental health services only if he or she has experienced 60 consecutive days or more of court ordered in-patient services in the last 12 months. Because of financial constraints and reductions in available state hospital beds, fewer people with mental illness remain hospitalized for 60 consecutive days. This bill allows a judge to consider an individual for involuntary outpatient treatment if he or she has been hospitalized for a total of 60 days or more in the last 12 months. This restores the original intent of the involuntary treatment statute—to allow a judge to assign individuals who frequently cycle through emergency and in-patient hospitalization to lower-cost community based treatment when appropriate.
SB 471—West—Provides for public school and child care facilities policies on sexual abuse and other abuse or maltreatment of children. Child abuse and neglect are risk factors in the later development of serious emotional disturbance in children, of depression and other mental illnesses in adults.
SB 653-Whitmire, Madden
Merges Texas Youth Commission and Texas Juvenile Probation Commission into the Texas Juvenile Justice Department. Includes creation of a full continuum of services that give priority to community- and family-based services, making incarceration a last resort; requires an initial assessment to include mental health and substance abuse.
SB 1106—Harris, Madden—Requires juvenile justice service providers to share certain health records about specific juveniles with other juvenile service providers including Local Mental Health and Intellectual Disability Authorities.
SB 1796—Van de Putte, Miller—Creates Texas Coordinating Council for Veterans Services.
HB 1738-Walle, SB 1259-Ellis—Allows the State of Texas to immediately restore eligibility for Medicaid and mental health care following a period of confinement or incarceration, so that they have no lapse in treatment. Left pending in House Public Health
HB 2159—Coleman—Would have amended the “Not Guilty by Reason of Insanity” portion of the Texas Penal Code and Code of Criminal Procedure to provide that:
- ” an affirmative defense to prosecution exists if, at the time of the commission of the acts constituting the offense, the defendant, as a result of severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his or her acts”
- It also says that the individual, if committed to in-patient or outpatient treatment after the verdict of Not Guilty by Reason of Insanity, can remain in court custody for as long as the maximum sentence for the offense.
- Presently, many jurors believe that if they find the person ‘Not Guilty by Reason of Insanity, that it means the person will simply return to society in their untreated, dangerous state. HB 2159 mandates explicit instructions to the jury regarding the treatment options available to the judge after the verdict of Not Guilty by Reason of Insanity. HB 2159 represented a compromise among prosecutors, criminal defense attorneys and all of the mental health advocacy organizations but was left pending in House Criminal Jurisprudence.
HB 3692—Gallego—Would have amended the Texas Code of Criminal Procedure to insure that law enforcement officers have the fullest range of options and alternatives to taking an individual to jail when responding to emergency calls involving a person with a mental illness. It also would have made it easier to get competency assessments in criminal cases. HB3692 had the support of law enforcement and mental health advocates. Was favorably reported from House Criminal Jurisprudence Committee but died in House Calendars.
BAD BILLS DEFEATED!
Sometimes it is as important to defeat bad legislation as it is to pass good laws. Unfortunately, there were some bills that, though perhaps well intentioned, would have had disastrous effects on people with mental illness and the community. We had to fight both of these issues in the 2009 session as well, so clearly more education of legislators and staff is required. We must continue to advocate and ask our local legislators to refuse to co-sponsor similar legislation in the future.
HB 3609—Gallego, SB 295-Watson, HB 703--Gutierez
These similar bills would have enhanced the penalty for assaulting an emergency services personnel to a felony. Although perhaps well-meaning, this bill would have a disproportionately negative effect on people with mental illness in crisis, and would result in their increased incarceration. Mental Health America of Greater Dallas suggests that a better option would be to require that emergency workers be required to take specialized training on mental health crisis intervention, which has proven to significantly reduce injuries to law enforcement officers and people with mental illness. We believe that mental health crisis intervention training would reduce injuries to health care workers too, and would assist them in establishing a therapeutic rapport with the individual in crisis. In a state that ranks at the bottom of all the states in funding for mental health and substance abuse treatment, the further criminalization of mental illness is simply unconscionable.
HB 86-Simpson, HB 750-Driver, SB 354-Wentworth
These bills may have been intended to prevent a Virginia Tech tragedy from occurring in Texas by allowing college students to carry concealed weapons on campus. The problem is that this legislation would likely result in the very kind of tragedy it seeks to prevent. Mental illness frequently first manifests itself in the college years. Thus, the individual may pass the required criminal and mental illness background checks, but may be suffering from delusions or hallucinations. Increasing access to guns at a time in life when young people typically experience depression, sleep deprivation and other emotional highs and lows is a recipe for disaster. Furthermore, given the stigma related to mental illness, Mental Health America of Greater Dallas is concerned that people with mental illness may be shot simply because they may be exhibiting symptoms of the illness, even though they are of no danger to anyone else. People who do not have mental illness, but who exhibit similar symptoms due to substance abuse will also be endangered should this law take effect.
If an armed student becomes impaired by drugs or alcohol the student who intended to be a protector may become an assailant. In addition, the armed students would not have the experience and training given to law enforcement officers to recognize mental illness and employ proper de-escalation techniques, nor the authority to escort the individual to appropriate mental health care, not to mention the exhaustive training on shooting in crowds that law enforcement officers have.
When you add on top of all those factors that Texans unfortunately have the lowest or near the lowest access to mental health care and substance abuse treatment, this legislation is unconscionable and unwise.
MANY THANKS TO ALL WHO ADVOCATE
ON BEHALF OF MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT
Mental Health Monday
is our weekly e-mail advocacy alert mental health policy issues at the national, state, and local levels. If you would like to be on our distribution list, please send an e-mail to
Janie Metzinger, Public Policy Director, Mental Health America of Greater Dallas at
JMetzinger@mhadallas.org or call (214) 871-2420, Ext. 114