2007 Legislative Compendium: Mental Health

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

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