Legislative Report 79th Legislative Session

The 2005 Legislative Session has ended. The following NAMI Texas Legislative update contains significant Riders and Appropriations to the Health & Human Services Commission and Department of State Health Services as well as Legislation passed during the 79th Legislative Session that impacts persons with serious mental illnesses.

To view the Riders and Appropriations Bill, go to the Legislative Budget Board website and click on the Conference Committee Report on Senate Bill 1 at http://www.lbb.state.tx.us/The_LBB/Access/AppBills_LBEs.htm

To view Legislation go to Texas Legislature Online at http://www.capitol.state.tx.us/ and type in the SB or HB number. You will be directed to the legislation, click on Text. Click next on Enrolled version which is the final version of the bill.

Significant Riders to the Appropriations Bill:

• Rider 7 to DSHS - authorizes up to 17.5% of funds to be transferred from Mental Health State Hospitals to funding for Community Mental Health Services for Adults or Children and/or Community Mental Health Hospitals;
• Rider 80 to DSHS - requires local MHAs to conduct CARE system database checks within 72 hours of referrals for local and county jails to determine if offenders have a history of a mental illness and report such information to the requesting jail. Quarterly reports will be filed with TCOOMMI as a part of the community of care mandate;
• Sec. 29 Rider (to all Health & Human Services) - requires DSHS and DARS to implement an “equity” plan among local MHMR authorities from FY 2006 - 2013. Funding reductions to a local authority to achieve equity may not exceed 5%;
• Sec. 44 Rider (to all Health & Human Services) - authorizes local MHA to expend up to 15% of New Generation Medication (NGM) funding on related services and, if local MHA exceeds NGM to the extent that patient assistance programs have been maximized, this amount may be expended on direct services to clients;
• Rider 8 to HHSC - HHSC will develop a plan to prevent custody relinquishment of youth with serious emotional disturbances and request any necessary waivers from the federal government to do so;
• Rider 69 to HHSC - $75,000 per year to provide a grant to a non-profit organization to develop a pilot project directed at enhancing the well being and care of citizens who are dually diagnosed with mental retardation and mental illness;
• Rider 83 to TDCJ - $160,000 per year for Permian Basin Mental Health Deputy Pilot Program for Ector & Midland Counties;
• Rider 2 to Commission on Jail Standards - Commission will amends its rules and procedures to require county and local jails to:
  1. check each offender upon intake into jail against the DSHS’ CARE system to determine if the offender has previously received state mental healthcare;
  2. record whether the CARE system was checked on the initial intake screening form; and
  3. include any relevant mental health information on the mental health screening instrument and, if sentenced to the DCR, on the Uniform Health Status Update form.

Significant Legislation.

The full text of each bill can be found by going to the Texas Legislature Online and typing in the bill number in the section Bill History and Vote History.
• HB 2572 - Changes the provider of last resort language from the 78th Session. Allows a local mental health authority to be a qualified service provider if the authority makes every reasonable effort to solicit the development of an available and appropriate provider base that is sufficient to meet the needs of the consumers in its service area. The bill also stalls the implementation of “fee-for-service” requiring a study on the impact of various forms of payment for services and a report to the legislature. The bill also authorizes a joint interim legislative committee to study the local mental health and mental retardation delivery system and to develop recommendations for improving the provision of services and increasing the accountability for funds management in the system.
• HB 291 - Requires notification of a victim upon the discharge or release into community outpatient care of certain defendants found not guilty by reason of insanity.
• HB 2518 - Conditions for a person’s participation in a mental health court program - requires appointment of an attorney; requires a court-ordered individualized treatment plan.
• SB 826 - HHSC shall conduct a study to determine the feasibility of providing 12 months of health services under the Medicaid program to women who are diagnosed with postpartum depression.
• SB 566 - Requires HHSC to implement a Medicaid buy-in program for persons with disabilities authorized by the Ticket to Work and Work Incentives Act no later than 12/1/2005. Will require eligibility requirements and cost sharing.
• HB 224 - Requires an inpatient mental health facility to consult with the parent or guardian of a person younger than 18 who has filed a written request for discharge from an inpatient mental health facility. If the parent or guardian objects in writing to the patient’s discharge, the facility shall continue treatment of the patient as a voluntary patient.
• SB 1473 - Requires 16 hours de-escalation and crisis intervention techniques training to facilitate interaction with persons with mental impairments for all peace officers as a part of their continuing education and certification.
• SB 465 - Relating to the administration of psychoactive medication (forced medication) of patients in custody awaiting trial or those sent to a state hospital for competency restoration. This bill brings Texas law into compliance with a U.S. Supreme Court decision that set forth standards regarding forced medication in these cases.
• SB 679 - General provisions improving the Incompetency to Stand Trial Procedure including providing for videoconferencing of competency hearings. If the hearing on competency restoration is not held at the state hospital or via videoconferencing, then transfer of the defendant to the jail will not occur earlier than 72 hours before the hearing.
• SB 837 - Insanity Defense. Does not change the substantive law in Texas, which still requires a Defendant to prove that as a result of a severe mental disease or defect he/she did not know that the conduct was wrong. It does outline requirements for experts who testify on the issue of insanity. The bill goes on to outline what happens to a Defendant who is found Not Guilty by Reason of Insanity (NGRI). Under certain findings (serious threats or bodily injury to another) the trial court will retain continuing jurisdiction over the Defendant and there is one path. If the individual is not found to be a danger there is another. The significant change in the bill relate to release of a Defendant found NGRI to court-ordered outpatient or community-based treatment and supervision after inpatient commitment to Vernon State Hospital. The Trial Court must receive and approve an individualized treatment plan; must find that the services are available; may mandate participation in treatment and order supervision by TCOOMMI. The bill also requires HHSC to collect and report to the Legislature annually a report of all person’s found NGRI; ordered to inpatient services; or ordered to community supervision and the outcomes.
• SB 410 - Although this bill reauthorizes the State Board of Pharmacy, it contains provisions that sets up a state sponsored Internet site listing Canadian pharmacies that meet Texas licensing standards and that sell drugs approved by the U.S. Food and Drug Administration. Texans could buy direct from the Canadian pharmacies despite rarely enforced federal restrictions. Purchases must be limited to renewal prescriptions, drugs for long-term use and 90-day supplies.

Appropriations

1. Health & Human Services Commission - Administers Medicaid and CHIP - 93% of funds received by HHSC was for Medicaid and CHIP ($13.4 Billion of GR). 98% of Exceptional Items ($2.9 Billion GR) funded were for those 2 programs. Medicaid and CHIP were funded for 6 months eligibility.
   
   Medicaid Counseling was restored, along with other optional benefits cut in 2003. However, 75% of funding restoration contingent upon the Comptroller certifying an additional $34.6 million above the Biennial Revenue Estimate.
   
   CHIP mental health benefits were fully restored.
2. Department of State Health Services

   	FY 2005	FY 2006
   MH Services/Adult	$281 M	$293 M
   MH Services/Children	$62 M	$64 M
   NorthSTAR	$97 M	$97 M
   State Hospitals	$266 M	$277 M
   Community Hospitals	$20 M	$20 M