Mental Health Needs Council

Council meeting recap by Amanda Jones, J.D., on recent legislative changes impacting behavioral health and intellectual and developmental disabilities in Harris County.

• Legislative
• Health
• Disabilities
• Harris County

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1. Mental Health Needs Council September 2, 2015 A LEGISLATIVE UPDATE ON BEHAVIORAL HEALTH AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES by Amanda Jones, J.D. Legislative Coordinator Harris County Office of Legislative Relations

2. Overview 2 Appropriations Mental Health; Substance Abuse; Intellectual & Developmental Disabilities; & Juvenile Justice. Sunset Harris County Office of Legislative Relations

3. Appropriations 3 Total appropriations for FY 2016-17 Biennium was $209.4 billion. This was an increase of $7.4 billion over the last biennium or 3.6 percent. Harris County Office of Legislative Relations

4. Mental Health Funding 4 HB 1 provided $150 million increase in mental health funding to expand outpatient, inpatient, & crisis services. Harris County Mental Health Jail Diversion pilot program was fully funded at $5 million per year. Harris County Office of Legislative Relations

5. Outpatient Mental Health Funding 5 Funding for outpatient mental health services increased by $46.5 million. $37 million of this amount must be allocated using a formula that considers historical billing patterns, population, & income. $9.4 million was earmarked to service 960 persons on waiting lists. Harris County Office of Legislative Relations

6. Crisis Services 6 The Legislature appropriated $31.3 million for crisis services alternatives. HB 1 funded 100 new inpatients in FY 2016 & 150 new beds in FY 2017. The new beds will be purchased locally. Harris County Office of Legislative Relations

7. Veterans Mental Health Services 7 Veterans mental health services received $5 million in DSHS bill pattern. Harris County Office of Legislative Relations

8. Home and Community-based Services 8 Funding for Home & Community-based Services for individuals with serious mental illness (HCBS-MI) was increased from $7.8 million to $32 million (310 percent increase). HB 1 also mandated that the Department of State Health Services (DSHS) to expand access to new populations with serious mental illness, including frequent users of jails & emergency systems. Harris County Office of Legislative Relations

9. Harris County Psychiatric Center 9 Harris County Psychiatric Center received a $1.2 million rate increase. HB 1 also provided funding ($1.2 million) for 6 longer-term beds. Harris County Office of Legislative Relations

10. NorthSTAR 10 HB 1 assumes the discontinuation of the NorthSTAR program in January 2017!!! behavioral health Harris County Office of Legislative Relations

11. Substance Abuse Treatment 11 There was an increase of $9.5 million in substance abuse treatment funding. The bill also increased funding for substance abuse purchased services for parents involved in the CPS system by $6.5 million (61.8 percent increase). Harris County Office of Legislative Relations

12. Intellectual & Developmental Disabilities 12 HB 1 appropriated $122.2 million for 3,040 slots to reduce various waiting lists. Local authorities & community providers will receive $47.2 million to help prevent institutionalization for approximately 1,000 persons with complex needs & to provide intensive service coordination for residents of institutions transitioning to the community. HB 1 also provided $18 million to expand crisis intervention teams to provide supports to people with IDD who live in the community. Harris County Office of Legislative Relations

13. HCS Slots 13 Summary of New Slots for Home & Community-based Services (HCS) for Persons with IDD under HB 1 Target Population with IDD Number of New Slots Persons with IDD Currently on Waiting List 2,134 Persons Moving from Nursing Facilities 700 Persons Diverted from Nursing Facilities 600 Persons Moving Out of Large & Medium Intermediate Care Facilities 500 Youth Aging Out of Foster Care 216 Persons At-Risk of Institutionalization/Crisis 400 Persons Moving Out of State Mental Hospitals Children Moving Out of DFPS General Residential Operations 120 25 Total 4,695 Harris County Office of Legislative Relations

14. Autism 14 Funding for Autism increased by $5 million. HB 1 assumes the phase out of the Comprehensive Applied Behavioral Analysis (ABA) program. The program will continue to provide focused ABA treatment services. This change will allow the program to serve more children with the less comprehensive services. Harris County Office of Legislative Relations

15. Early Childhood Intervention 15 Early Childhood Intervention services (ECI) was cut by $35.2 million (11 percent reduction) over last biennium. HHSC has proposed a Medicaid rate cut to certain physical, occupational, and speech therapy providers of services to disabled children. This cut is estimated to save the state $150 million in General Revenue; the state will lose $200 million in federal funds. Harris County Office of Legislative Relations

16. Juvenile Justice Funding 16 HB 1 removed agency s wide discretion & restored legislative direction regarding use of funds. Restored $1 million in funding for the Harris County Leadership Academy. Increased the rate for the Juvenile Justice Alternative Education Program from $86 per student per day to $96 per student per day. Commitment Diversion funding included rate increase from $19.42 to $35.51 per juvenile per day. $9.5 million in new funding for regional diversion alternatives to place youth closer to home. Harris County Office of Legislative Relations

17. Sunset 17 Summary of Sunset Bills in the 84th Legislative Session Agency Bill No. HB 2154 Final Action State Office of Administrative Hearings Continued for 12 years Failed to Pass, but abolished with functions consolidated at HHSC Abolished with functions consolidated at HHSC Continued for 12 years Failed to Pass, but continued for 10 years in HB 3123 Department of Aging & Disability Services SB 204 Assistive and Rehabilitative Services HB 2463 Texas Council for Developmental Disabilities HB 1679 Texas Education Agency SB 214 Texas Education Agency, Driver Education Program Texas Facilities Commission HB 1786 Transferred to TDLR HB 3123 Continued for 6 years Department of Family & Protective Services SB 206 Continued for 8 years Continued for 12 years with a limited scope review in 2023 Continued for 8 years Health & Human Services Commission (HHSC) SB 200 Department of State Health Services SB 202 Texas Health Services Authority SB 203 Removed from state statute in 6 years Office of Inspector General, HHSC Governor's Committee on People with Disabilities Texas Council on Purchasing from People with Disabilities Self-Directed Semi-Independent Agencies SB 207 Special review in 6 years HB 1678 Continued for 12 years Abolished with state use program transferred to TWC Failed to Pass SB 212 SB 217 University Interscholastic League SB 213 Failed to Pass Texas Workforce Commission (TWC) SB 208 Continued for 12 years Texas Workforce Investment Council HB 1606 Continued for 12 years Harris County Office of Legislative Relations

18. Sunset: Health & Human Services Agencies 18 Timeline of SB 200's Consolidation of Health & Human Services Agencies Description Date HHSC must develop transition plan March 1, 2016 Client Services Consolidated September 1, 2016 Dept of Assistive & Rehabilitative Services Abolished September 1, 2016 Institutional & Regulatory Functions Consolidated September 1, 2017 Dept of Assistive & Aging & Disabilities Services Abolished September 1, 2017 Administrative Services (Legal, Budget, IT, HR, Contracts, Internal Audit, Rate Analysis, etc) Consolidated September 1, 2017 HHSC conducts separate consolidation of study of Dept of State Health Services & Dept of Family & Protective Services September 1, 2018 Dept of State Health Services & Dept of Family & Protective Services sunset September 1, 2023 Harris County Office of Legislative Relations

19. DSHS Sunset 19 The Sunset Advisory Commission found DSHS to be one of the most complex agencies in Texas government. SB 200 transfers many of DSHS functions to HHSC, but DSHS will continue as an independent, but pared down, agency. SB 202 by Nelson narrows the mission of DSHS by reducing its role in regulating occupations. 8 professions deregulated; 17 programs transferred to Texas Department of Licensing & Regulation (including dyslexia therapists and speech-language pathologists) & Texas Medical Board. Harris County Office of Legislative Relations

20. DSHS Sunset (continued) 20 SB 1507 by Garcia requires a locally driven process for allocating & reviewing use of state hospital beds among regions, with input from key stakeholders. SB 1507 also requires the integration of mental health & substance abuse hotlines, screening, assessment, & referral functions. The bill also allows the continued participation by existing substance abuse treatment providers. HB 1 requires DSHS & HHSC to conduct a review to identify improvements in performance measures & contracting. Harris County Office of Legislative Relations

21. State Supported Living Centers 21 The Department of Aging and Disabilities Services (DADS) sunset bill (SB 204 by Nelson) did not pass because the members could not agree on the future of the state supported living centers. SB 200 requires a separate study on transferring the Austin State School from its current location by September 1, 2016. Harris County Office of Legislative Relations