1. 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 Harris County Office of Legislative Relations 2 Appropriations  Mental Health;  Substance Abuse;  Intellectual & Developmental Disabilities; &  Juvenile Justice. Sunset

3. Appropriations Harris County Office of Legislative Relations 3 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 Harris County Office of Legislative Relations 4 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 Harris County Office of Legislative Relations 5 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 Harris County Office of Legislative Relations 6 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 Harris County Office of Legislative Relations 7 Veterans mental health services received $5 million in DSHS’ bill pattern.

8. Home and Community-based Services Harris County Office of Legislative Relations 8 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 Office of Legislative Relations 9 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 Harris County Office of Legislative Relations 10 HB 1 assumes the discontinuation of the NorthSTAR behavioral health program in January 2017!!!

11. Substance Abuse Treatment Harris County Office of Legislative Relations 11 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 Harris County Office of Legislative Relations 12 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 Harris County Office of Legislative Relations 13

14. Autism Harris County Office of Legislative Relations 14 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 Harris County Office of Legislative Relations 15 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 Harris County Office of Legislative Relations 16 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 Harris County Office of Legislative Relations 17

18. Sunset: Health & Human Services Agencies Harris County Office of Legislative Relations 18

19. DSHS Sunset Harris County Office of Legislative Relations 19 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) Harris County Office of Legislative Relations 20 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 Harris County Office of Legislative Relations 21 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.