86th Legislative Session Report OVERVIEW The Texas Coalition for Healthy Minds (TCHM) worked throughout the 86th Texas Legislative Session, serving as a resource for member organizations, policymakers, and other stakeholders on policy issues related to mental health and substance use disorder. This session, the coalition strategically aligned with other colleagues and pertinent groups to expand our platform, creating a larger forum to share information and expertise, collaborate on advocacy efforts, facilitate constructive dialogue around opposing viewpoints, and coordinate action. Collectively, member organizations and partners educated advocates and lawmakers, helping to advance TCHM’s public policy priority areas. COALITION ENGAGEMENT TCHM advanced legislation by facilitating information sharing and collaboration among coalition members working in support of our shared priorities. The coalition’s frequent and ongoing activities improved communication and understanding among member organizations, enabled stronger policy proposals, and increased engagement of a broad range of stakeholders that otherwise may not have worked on TCHM priority issues. Progress was made on nearly all of the policy priorities identified in the TCHM’s 2019-2020 Legislative Priority Agenda. Several bills became law. Many others made significant advancement through the legislative process, helping to increase legislative offices’ awareness and understanding of key behavioral health issues and policy solutions, to refine legislative language, and to lay the groundwork for continued efforts during the interim and next legislative session. The following pages highlight key bills organized by TCHM priority area that were impacted by TCHM engagement, including facilitated discussions, collaboration, and coordination among partners. While members of the coalition dropped cards in support or opposition of many bills, and participated in or led various methods of advocacy on a more extensive range of bills (See Appendix), the selected bills represent the most extensive and sustained legislative efforts. Although a number of factors contributed to their advancement, each of the bills summarized on the following pages were impacted by TCHM’s members through written or delivered testimony; facilitated discussions and dialogue during (and outside of) Friday meetings which allowed member organizations and/or partners to make better informed decisions and perhaps weigh in on issues they may not have otherwise; and joined together for collaborative office visits. These bills received the most engagement from the coalition, and are the most important pieces of mental health legislation considered this session as well as the issues that will be kept in focus through the interim and the next session. BUDGET The Legislature passed a $251 billion budget that includes $4,359,301,473 in funding for behavioral health. In addition, $6.5 billion was dedicated for school finance reform and $5 billion for property tax reform. $343.5 million in all funds were allocated for school safety, with the funds aimed at both school hardening as well as mental health supports. Through the Texas Child Mental Health Care Consortium, $100 million will support research and loan repayment programs for psychiatrists. Texas Council of Community Center staff created detailed summaries of state budget decisions that can be viewed here: • Hospitals and State Supported Living Centers • Mental Health/Substance Use Disorder Services • Intellectual and Developmental Disability, Early Childhood Intervention • Select Riders Fiscal Year 2020 Fiscal Year 2021 Article I Trusteed Programs, Office of the Governor $31,701,616 $121,083,087 Veterans Commission $5,789,000 $5,789,000 Article II Department of Family and Protective Services $38,642,408 $38,778,899 Department of State Health Services $2,661,560 $2,661,558 Health and Human Services Commission $1,706,890,657 $1,551,760,104 Texas Civil Commitment Office $154,611 $154,611 Article III University of Texas - Health Science Center Houston $8,000,000 $8,000,000 University of Texas - Health Science Center Tyler $6,730,000 $6,730,000 $6,730,000 $6,730,000 Texas Tech University Health Sciences Center $2,500,000 $2,500,000 Texas Higher Education Coordinating Board $50,000,000 $50,000,000 Texas Coalition for Healthy Minds Page 2 Article IV Supreme Court of Texas $1,000,000 $1,000,000 Court of Criminal Appeals $318,500 $318,500 Office of Court Administration $2,500,000 $2,500,000 Article V Commission on Jail Standards $185,856 $185,856 Department of Criminal Justice $262,806,849 $262,756,856 Juvenile Justice Department $89,552,219 $89,527,600 Military Department $966,700 $944,900 Article VIII State Board of Dental Examiners $132,240 $132,240 Board of Pharmacy $243,004 $243,005 Board of Veterinary Medical Examiners $45,000 $45,000 Optometry Board $36,000 $36,000 Board of Nursing $1,005,458 $1,005,458 Medical Board $643,561 $643,560 Total $2,212,505,239 $2,146,796,234 Texas Coalition for Healthy Minds Page 3 PRIORITY ONE: This priority was advanced through the passage of legislation that will: • Target the underlying issues through criminal justice diversion and reintegration programs, improving long-term public safety and reducing recidivism. • Promote the growth of telehealth and telemedicine programs. • Increase funding for inpatient, outpatient and crisis services. • Provide funding necessary to implement plans for state hospital redesign, including construction of state-of-the-art facilities and ensuring capacity necessary to implement the full continuum of psychiatric services. Several policy recommendations TCHM identified in its policy agenda did not become law, but made significant progress. This includes bills addressing supportive housing programs; criminal justice diversion and reintegration programs; improving long-term public safety and reducing recidivism; behavioral health workforce needs; and closing gaps in behavioral health care coverage. TCHM and its members were able to educate legislative offices, refine policy proposals, and lay important groundwork that will help increase access to a continuum of care during the interim and the 87th Legislative Session. BILLS THAT PASSED HB 2813 (Rep. Price) - Relating to the statewide behavioral health coordinating council. • Establishes a statewide behavioral health coordinating council to create a strategic approach to behavioral health services. • Council will meet at least 4 times per year and monitor the implementation of a five-year plan, which will include developing an inventory of state-funded behavioral health programs and services. HB 3285 (Rep. Sheffield/Sen. Huffman) - Relating to programs and initiatives to prevent and respond to opioid addiction, misuse, abuse, and overdose and identify and treat co-occurring substance use disorders and mental illness. • Creates a telehealth Substance Use Disorder (SUD) treatment program and requires Behavioral Health strategic plan to include strategies for SUD issues. • Requires the state to conduct an opioid misuse public awareness campaign; requires an opioid antagonist program; requires Continuing Medical Education for prescribers and dispensers, under the direction of the Texas Medical Board. Texas Coalition for Healthy Minds Page 4 • Requires data collection and analysis for opioid overdose deaths and co-occurrence of SUD and mental illness, including analysis of the treatment capacity for people with co- occurring SUD and mental illness. • Requires the Health and Human Services Commission (HHSC) to reimburse for Medication-Assisted Treatment (MAT) without prior authorization or precertification for the treatment; allows HHSC to pay for MAT only if the treatment is prescribed by a licensed health care provider who is authorized to prescribe methadone, buprenorphine, or naltrexone. HB 3980 (Rep. Hunter) - Relating to a requirement that the Statewide Behavioral Health Coordinating Council prepare a report regarding suicide rates in this state and state efforts to prevent suicides. • Requires the Statewide Behavioral Health Coordinating Council to study and report on the landscape of suicide in Texas, including prevalence, laws, statewide and agency efforts to address suicide. BILLS THAT DID NOT PASS HB 10 (Rep. S. Thompson) - Relating to the creation of the Texas Mental and Behavioral Health Research Institute. • Would have established the Texas Mental and Behavioral Health Research Institute, which would have expanded funding for and coordinated research across state universities and other research stakeholders on treating mental health and substance use disorders. HB 1465 (Rep. Moody) - Relating to a study on expanding recovery housing in this state. • Would have required HHSC to conduct a study to evaluate the current status of and opportunities, challenges, and needs to expand recovery housing in Texas. HB 1669 (Rep. Lucio) - Relating to increasing and improving the mental health and substance use disorder workforce in this state and increasing the capacity of local mental health authorities (LMHAs) to provide access to mental health services in certain counties. • Would have required the Statewide Behavioral Health Coordinating Council to develop a comprehensive plan to increase and improve the mental health workforce. HB 2368 (Rep. Miller) - Relating to access to and the provision of behavioral and mental health care services and trauma-informed care in the Medicaid managed care program. • Would have required all Medicaid STAR Health behavioral