Texas Lt. Gov. Dan Patrick and House Speaker Dade Phelan (R-Beaumont) called on state leaders to spend nearly $180 million on mental health and school safety programs in a series of proposals following the mass shooting at Robb Elementary School in Uvalde last month.
State lawmakers are examining the proposals during hearings that began Tuesday, and organized medicine has taken the opportunity to weigh in.
On behalf of the Texas Medical Association and seven other state medical organizations, TMA submitted written testimony to the Senate’s Special Committee to Protect All Texans, which was convened in response to the Uvalde shooting. TMA and the other groups called for a multipronged approach to strengthen the state’s health and social services. Some of their recommendations align with those proposed by state leadership, including proposals to expand the Texas Child Health Access Through Telemedicine (TCHATT) initiative and to increase pediatric mental health bed capacity.
TMA’s recommendations follow its creation of a multistakeholder Mental Health Rapid Response Team to respond to the Uvalde crisis and prevent such tragedies from occurring again.
The Special Committee to Protect All Texans began a two-day hearing on June 21, and a House committee hearing on the Robb Elementary shooting was scheduled for the same day.
State leaders’ proposals
In a June 3 statement, Lieutenant Governor Patrick initially proposed reallocating $50 million of the state’s biennial budget to provide bulletproof shields for local law enforcement.
“We have used transfer authority this year to spend billions on the border,” he wrote. “We can surely find this amount of money to better protect our kids.”
Speaker Phelan endorsed this proposal and asked for nearly $125 million in additional funding for a spate of mental health and school safety programs ahead of the 2022-23 school year.
“Like you, I believe our respective chambers have the obligation to take immediate, concrete action with the goal of making our schools as safe as possible before the start of the upcoming school year,” he wrote.
On the mental health front, Speaker Phelan proposed:
- Expanding the TCHATT program – which provides telemedicine services to schools to identify, assess, and treat students with behavioral and mental health needs – at an estimated cost of $37.5 million per year;
- Increasing inpatient bed capacity for children in need of mental health treatment, at an estimated cost of $30 million per year;
- Implementing Pediatric Crisis Stabilization and Response Teams (PCSRTs), which respond to mental health crises and help connect those in distress to care, at an estimated cost of $13.5 million for the first year;
- Increasing the number of Multisystemic Therapy teams, which have been proven to reduce the risk of violence, at an estimated cost of between $10.1 million and $14.2 million for the first year; and
- Expanding Coordinated Specialty Care teams, which treat youth experiencing a first episode of psychosis, at an estimated cost of $950,000 for the first year.
Speaker Phelan also asked Lieutenant Governor Patrick to consider three school safety initiatives, including funding for:
- The purchase of silent panic alert technology by school districts, at an estimated cost of $18.7 million;
- Advanced Law Enforcement Rapid Response Training for all law enforcement cadets and active-duty licensed peace offices, including school resources officers, at an estimated cost of $7 million; and
- The Texas School Safety Center to provide training, assessments, and support to school districts as they review their emergency operations plans and address campus security needs, at an estimated cost of $7 million.
In response, Lieutenant Governor Patrick expressed support for Speaker Phelan’s proposals. He also wrote that lawmakers would address the remaining proposals – including increasing the number of pediatric mental health beds and implementing PCSRTs – during the interim period.
Lieutenant Governor Patrick also expressed interest in two additional priorities:
- Allocating $5 million to expand fusion centers, which could help facilitate data-sharing among local, state, and federal law enforcement agencies to identify threats to school districts; and
- Funding the purchase of automatic door-locking and alarm systems for schools.
Lieutenant Governor Patrick wrote that state lawmakers may address these proposals during the hearings this week, as committees work through their interim charges, and throughout the upcoming legislative session, which begins in January 2023.
Organized medicine’s proposals
TMA, the Texas Pediatric Society, the Texas Academy of Family Physicians, and five other organizations developed a series of recommendations to improve mental health care. Together, they asked state leaders to:
- Expand the Perinatal Psychiatric Access Network and TCHATT initiatives statewide;
- Establish Medicaid and Children’s Health Insurance Program payment for physicians and health care providers who screen patients for adverse childhood experiences, or ACEs;
- Establish a Medicaid policy framework to better integrate clinical and community services designed to address social drivers of health;
- Expand crisis intervention and trauma-informed training among health professionals, school and community leaders, and families;
- Expand outpatient and inpatient mental health bed capacity for children and adolescents; and
- Expand Texas’ statewide Safe Gun Storage Campaign.
TMA and the other groups also included a caveat.
“[M]ost people diagnosed with a mental health condition, even severe ones, rarely commit these types of crimes,” medicine wrote. “It’s important to reiterate this message so that people in need of mental health services feel safe seeking care without stigma, including the children, parents, and community members of Uvalde – and their fellow Texans – suffering after the horrific trauma experienced.”