In recent years, a growing number of business leaders, law
enforcement officials, and civic groups have joined with medicine
and mental health advocates to push for better coverage of and
funding for mental health services. Local business and law
enforcement officials have been particularly influential in helping
lawmakers recognize the importance of mental health services in
reducing overcrowded emergency rooms, decreasing the number of
people incarcerated for minor offenses, and improving the overall
health of their communities.
Mental Health Funding
Legislators approved $82 million in new funding - the full amount
requested by the Department of State Health Services to support
community-based mental health crisis services. Monies will be
distributed to communities across the state. Funds will be
allocated based on a per-capita basis, to improve equity-funding
for mental health authorities, and on a competitive basis. The goal
of the funding is to prevent unnecessary hospitalizations and to
improve jail diversion programs by supporting initiatives such as
mobile crisis units and in-home crisis services.
Health Plan Coverage for Autism Spectrum Disorder
House Bill 1919 by Rep. Todd Smith (R-Euless) and Sen. Leticia Van
de Putte (D-San Antonio) relates to coverage of post-acute care
treatment for acquired brain injuries. (See
EMS and Trauma Care Section
for details.) The bill was amended in the Senate by Sen. Eddie
Lucio (D-Brownsville) to add coverage for "autism spectrum
disorder" for children who are diagnosed with the disorder between
ages 2 and 6. The provision does not preclude coverage if the child
needs treatment beyond the age of 6. Health benefit plans must
provide enrollees all "generally recognized services" prescribed by
the primary care physician. The provision defines "generally
recognized services" as evaluation and assessment services; applied
behavior analysis; speech, occupational, and physical therapies;
and medications or nutritional supplements used in the treatment of
the disorder. The provision does not apply to Consumer Choice
benefit plans, which are exempt from mandates. TMA and the Texas
Pediatric Society generally supported the provision, though
concerns were raised that the bill did not specify that "generally
recognized services" must be evidence-based.
Mental Health Services and Mental Retardation Authorities
House Bill 2439 by Rep. Vicki Truitt (R-Southlake) and
Sen. Kyle Janek, MD (R-Houston), moves the administration and
rulemaking functions of the local mental health and mental
retardation authorities under the Texas Health and Human Services
Commission (HHSC). Before the Texas Department of State Health
Services (DSHS) institutes a change in payment methodology for
mental health services, it must evaluate various forms of payment;
evaluate the effect of the proposed payment methodologies on local
providers; determine operation costs associated with each type of
payment; develop an implementation plan; and prepare a report to
HHSC and the Texas Legislature no later than Jan. 1, 2009. The bill
restricts local mental retardation authorities from serving as a
provider of ICF-MR and related waiver programs in cases where a
service provider is not available. It also changes the name of the
"Local Authority Technical Advisory Committee" to "Local Authority
Network Advisory Committee" and adds additional members. The
members of the committee must have some knowledge, familiarity, or
understanding of the operations of a local mental health authority.
It also requires a local mental health authority to develop a local
network development plan on provider networks and establishes an
online clearinghouse of information for best practices in the
provision of mental health services.
Family Violence Training
Senator Bill 44 by Sen. Jane Nelson (R-Lewisville) and Rep.
Yvonne Gonzalez-Toureilles (D-Alice) provides for the training of
professionals and accreditation of family violence programs. Courts
are allowed to require persons convicted of a family violence
offense to attend such programs
Mental Health Near Miss
Mental Health Parity
While legislators invested significant new dollars in mental health
funding in 2007, efforts to pass a mental health parity bill fell
short in the final days of session. Senate Bill 568 by Sen. Rodney
Ellis (D-Houston) and Rep. Garnet Coleman (D-Houston) would have
required group health plans that currently offer coverage for
mental disorders to ensure that the coverage is equal to that
provided for other medical and surgical conditions. The bill
had strong bipartisan support, including Senator Duncan, Senate
State Affairs chair, and Representative Smithee, chair of the House
Committee on Insurance. The bill included protections for small
employers: It specified that if a group health plan's costs
increased by more than two percent during the first year or one
percent in subsequent years, it would not have to comply with the
provisions.
The bill passed the Senate 27-3 and cleared the House Insurance
Committee only to die in Calendars in the last few days of session.
In an attempt to revive the bill, it was amended to House Bill 1919
(described above), but was stripped off in conference committee due
to concerns that the governor might veto the entire bill under
pressure from the Texas Association of Business.
Mental Health TMA Staff Team:
Legislative: Greg Herzog
Policy: Helen Kent Davis, Susan Griffin, and Nancy Bieri
Legal: Kelly Walla
Overview
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Managed Care/Insurance Reform
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Scope of Practice
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Retail Health Clinics
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Responsible Ownership
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Corporate Practice of Medicine
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Health Care Funding
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Medicaid, CHIP, and the
Uninsured
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Public Health
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Border Health
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Mental Health
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Emergency Medical Services and
Trauma Care
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Rural Health
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Medical Science and Quality
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Physician Workforce, Licensure,
and Discipline
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Health Information Technology
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Prescription Drugs
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Long-Term Care
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Workers' Compensation
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Abortion
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Franchise Tax Reform