Allow Adolescent Mental Health Screens During Each Annual Exam

Testimony by Pritesh Gandhi, MD, MPH

House Public Health Committee
In Support of House Bill 1600 by Rep. Four Price

March 14, 2017

Submitted on behalf of:

  • Texas Pediatric Society
  • Texas Medical Association
  • Texas Academy of Family Physicians  

Chairman Price and Committee Members,

My name is Pritesh Gandhi, and I am a pediatrician and associate chief medical officer at People’s Community Clinic here in Austin. I am testifying on behalf of the Texas Pediatric Society, Texas Medical Association, and the Texas Academy of Family Physicians. Our organizations are registered in support of House Bill 1600 and its goal to increase access to mental health screenings for adolescents enrolled in Medicaid

Approximately half of all mental health conditions begin by age 14. The American Academy of Pediatrics recommends annual mental health screening for adolescents beginning at age 12. 

According to the Centers for Disease Control and Prevention, one in five children experience a mental disorder, and an estimated $257 billion is spent on childhood mental disorders in a given year. The same report found suicide to be the second leading cause of death in the adolescent population. Children with mental health disorders are at higher risk for poor educational achievement and increased involvement in the child-welfare and juvenile justice systems. 

Additionally, children with mental health disorders more often have chronic health conditions such as asthma and obesity and are at increased risk for mental illness in adulthood.  Long-term, the lifespan of people with severe mental illness is actually shorter compared with that of the general population. When children are diagnosed and treated early, we reduce the chance of these detrimental outcomes.

At People’s Community Clinic, we conduct mental health screenings at each well-child visit because we know that physical and behavioral health go hand in hand and that truly comprehensive medical care considers both. 

HB 1600 addresses limited access to mental health screenings for adolescents enrolled in Texas Medicaid, allowing payment for, but not requiring, physicians to conduct a mental health screening at each annual well-child exam. 

Currently in Texas Medicaid policy, physicians are required to conduct at least one mental health screening for adolescents aged 12 through 18 enrolled in Medicaid, using one of four standardized, validated screening tools recognized by Texas Health Steps. However, the designated Medicaid procedure codes for this screening may be used only once per lifetime. 

HB 1600 mirrors current Medicaid policy stating that the physician must conduct a mental health screening using a standardized, validated screening tool only once for every child between the ages of 12 and 18. Additionally, HB 1600 would allow payment for, but not require, physicians to conduct this screening and be paid up to once per annual well-child exam, aligning Texas with the national standard of care.  

In its interim report to the 85th legislature, the House Select Committee on Mental Health listed increased access to children’s mental health screenings as its first recommendation for addressing children’s mental health in Texas. 

Anu Partap, MD, pediatrician and Texas Pediatric Society Mental Health Committee cochair, testified at an interim Mental Health Select Committee hearing in support of increased access to adolescent mental health screenings. “It is imperative that children and families receive expert care the moment they present,” she stated. “A better designed health system will mean more immediate access to timely, evidence-based mental health treatments.” As the report concluded, Texas is well-positioned to be a national leader for mental and behavioral health care.   By increasing access to early detection of mental health disorders in children, the proposed legislation takes Texas a step closer to this goal, giving Texas children a better chance at health and success.

Thank you for providing me the opportunity to speak today in support of HB 1600. With the help of the legislature, we truly can make Texas a leader in mental health care. 

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Last Updated On

March 14, 2017