a legislative update on behavioral health and intellectual and developmental disabilities mental...

A LEGISLATIVE UPDATE ON BEHAVIORAL HEALTH AND

INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

Mental Health Needs Council

by

Amanda Jones, J.D.Legislative Coordinator

Harris County Office of Legislative Relations

September 2, 2015


2

Overview

Appropriations Mental Health; Substance Abuse; Intellectual & Developmental Disabilities; & Juvenile Justice.

Sunset


3

Appropriations

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.


4

Mental Health Funding

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.


5

Outpatient Mental Health Funding

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.


6

Crisis Services

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.


7

Veterans Mental Health Services

Veterans mental health services received $5 million in DSHS’ bill pattern.


8

Home and Community-based Services

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.


9

Harris County Psychiatric Center

Harris County Psychiatric Center received a $1.2 million rate increase.

HB 1 also provided funding ($1.2 million) for 6 longer-term beds.


10

NorthSTAR

HB 1 assumes the discontinuation of the NorthSTAR behavioral health program in January 2017!!!


11

Substance Abuse Treatment

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).


12

Intellectual & Developmental Disabilities

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.


13

HCS Slots

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

120

Children Moving Out of DFPS General Residential Operations

25

Total 4,695

Summary of New Slots for Home & Community-based Services (HCS) for Persons with IDD under HB 1


14

Autism

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.


15

Early Childhood Intervention

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.


16

Juvenile Justice Funding

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.


17

Sunset

Agency Bill No. Final ActionState Offi ce of Administrative Hearings HB 2154 Continued for 12 years

Department of Aging & Disability Services SB 204Failed to Pass, but abolished with functions consolidated at HHSC

Assistive and Rehabilitative Services HB 2463Abolished with functions consolidated at HHSC

Texas Council for Developmental Disabilities HB 1679 Continued for 12 years

Texas Education Agency SB 214Failed to Pass, but continued for 10 years in HB 3123

Texas Education Agency, Driver Education Program

HB 1786 Transferred to TDLR

Texas Facil ities Commission HB 3123 Continued for 6 years

Department of Family & Protective Services SB 206 Continued for 8 years

Health & Human Services Commission (HHSC) SB 200Continued for 12 years with a l imited scope review in 2023

Department of State Health Services SB 202 Continued for 8 years

Texas Health Services Authority SB 203 Removed from state statute in 6 years

Offi ce of Inspector General, HHSC SB 207 Special review in 6 yearsGovernor's Committee on People with Disabilities

HB 1678 Continued for 12 years

Texas Council on Purchasing from People with Disabilities

SB 212Abolished with state use program transferred to TWC

Self-Directed Semi-Independent Agencies SB 217 Failed to Pass

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

Summary of Sunset Bills in the 84th Legislative Session


18

Sunset: 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

Timeline of SB 200's Consolidation of Health & Human Services Agencies


19

DSHS Sunset

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.


20

DSHS Sunset (continued)

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.


21

State Supported Living Centers

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.

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