#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Senate Districts The candidates were asked the following open-ended questions:

1. Texas is experiencing a shortage of mental health and addiction care providers, especially in rural and underserved areas. How will you make sure more people have access to mental health treatment and services? 2. State and federal law requires mental health parity, or the NAMI Texas staff and NAMI volunteers sent out a mental health equal treatment of mental health conditions and substance policy six-question questionnaire on Google Forms to every use disorders, compared to physical health conditions, in individual running for a state legislative seat in a contested race. insurance plans. However, individuals in Texas still often Candidates were also provided information on NAMI Texas’ receive unequal coverage for mental health treatment and public policy platform. For now, we are only sharing the results for services. What will you do to improve coverage for candidates who are in a contested primary race. If we have not mental health care? received a completed questionnaire from a candidate, we will 3. At least 30% of individuals in local Texas jails have a indicate that we have not received a response yet. severe mental illness, and more than half of justice- involved individuals nationwide have at least one mental NAMI Texas is a non-partisan 501(c)(3) non-profit organization. health condition. What will you do to divert people with We DO NOT endorse any candidates, or rank or alter their answers mental illness from the criminal justice system? in any way. We provide this information to educate you on where 4. Almost a quarter of individuals experiencing candidates in your district stand on key mental health issues and let homelessness have a severe mental illness, and mental you use this information to inform your vote on March 3rd. A illness has been identified as the third leading cause of candidate’s inclusion of answers here does not indicate a homelessness nationwide. How will you help people with preference or endorsement by NAMI Texas. We encourage NAMI mental illness who are struggling with housing? members and mental health advocates to continue asking important 5. Half of mental health conditions begin by the age of 14 questions of legislative and local candidates and and 75% begin by the age of 24, but these issues often go #Vote4MentalHealth! undetected and untreated until they reach a crisis point. How will you promote earlier intervention for people experiencing mental illness? 6. Texas has the highest uninsured rate in the country, and has faced serious challenges in ensuring individuals in underserved areas have access to health care. What will you do to improve access to health care and reduce our high uninsured rate?

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Districts

Senate District 1 Susan Criss (D)

Bryan Hughes (R, Incumbent) 1. How will you make sure more people have access to Bryan Hughes is running unopposed in the Republican primary. mental health treatment and services? When I was a district court judge I was Chair of the Gulf Coast Audrey Spanko (D) MHMR Task Force for Jail Diversion for the Mentally Ill. I Audrey Spanko is running unopposed in the Democratic primary. lobbied for treatment dollars. This is a budget priority.

2. What will you do to improve coverage for mental Senate District 4 health care? (R, Incumbent) I spoke on the Capitol steps for parity for the mentally ill at a rally Brandon Creighton is running unopposed in the Republican many years ago. I will fight for parity. primary. 3. What will you do to divert people with mental illness Jay Stittleburg (D) from the criminal justice system? Jay Stittleburg is running unopposed in the Democratic primary. As a district judge and Chair of the Gulf Coast Task Force on Jail Diversion for the Mentally Ill I worked on a multi-disciplinary task Senate District 6 force to find ways to improve the criminal justice system in Galveston County for the mentally ill. Mental Health courts and (D, Incumbent) treatment dollars as well as process changes are critical. Carol Alvarado is running unopposed in the Democratic primary and in the general election. 4. How will you help people with mental illness who are struggling with housing? Senate District 11 Housing is a major component of diversion and yet the least dealt with. Miami has a great program with this component. I would Larry Taylor (R, Incumbent) explore ways to set up programs like theirs. Larry Taylor is running unopposed in the Republican primary. 5. How will you promote earlier intervention for people experiencing mental illness?

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts This has to be something that school officials are taught and encouraged to look for. The juvenile justice system has begun this now with their intake procedure. I am a family doctor who has provided addiction care, although in the past that was mostly alcohol and nicotine. But I am now DEA- 6. What will you do to improve access to health care and waived to provide opioid MAT care myself, and plan to do so as reduce our high uninsured rate? soon as my clinic sets up a comprehensive program that includes the important integrated behavioral health component. This will all We must accept the federal Medicaid dollars. be done via FQHC clinics, which provide affordable care to uninsured and underinsured Texans all over the state. I will also Margarita Ruiz Johnson (D) endorse legislation to ensure much improved availability of such Margarita Ruiz Johnson has not responded to the questionnaire care to all Texans via other mechanisms. I also think Texas drug yet. policy needs to more evidence based, which means a harm reduction approach. Senate District 12

Jane Nelson (R, Incumbent) 2. What will you do to improve coverage for mental is running unopposed in the Republican primary. health care?

Randy Deniels (D) Randy Deniels has not responded to the questionnaire yet. I strongly support parity, not simply in words but in actions. All private and public insurance should be mandated to cover both Shadi Zitoon (D) mental and medical conditions. And where necessary the state Shadi Zitoon has not responded to the questionnaire yet. should provide subsidies for getting providers into underserved rural and urban parts of Texas, for example loan payback programs. Senate District 13 3. What will you do to divert people with mental illness (Incumbent) from the criminal justice system? Borris Miles has not responded to the questionnaire yet.

Richard Andrews (D) As my full page ad in the Chronicle (2/23/2020) noted I 1. How will you make sure more people have access to think people with addictions and other mental health conditions are at greater risk for contact with law enforcement. By removing mental health treatment and services? felony penalties from simple drug use/possession (as Oklahoma

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts showed) we can keep these Texans out of prison and jail. Similarly affordability issue -- recognizing health and mental health care as a for providing alternative responses to people who have been right is the first step. arrested, and proper evaluation-treatment for those who meet criteria for mental health. Melissa Morris (D) Melissa Morris has not responded to the questionnaire yet.

4. How will you help people with mental illness who are William Booher (R) struggling with housing? William Booher has not responded to the questionnaire yet.

Milinda Morris (R) Texas should systematically review national municipal and state Milinda Morris has not responded to the questionnaire yet. models for addressing homelessness. Certainly, marked increase in availability of affordable housing is high on the list -- affordable housing is a right, not a luxury, and our policies should reflect that Senate District 18 priority. (R, Incumbent) 5. How will you promote earlier intervention for people Lois Kolkhorst is running unopposed in the Republican primary. experiencing mental illness? Michael Antalan (D) Michael Antalan is running unopposed in the Democratic primary. Expanding Medicaid and improving support for low-cost clinics will be key. My own FQHC has had NO state support for the last Senate District 19 five year, for example. That is unconscionable. I would also ensure that stakeholders such as patients, patient advocates, and mental Pete Flores (R, Incumbent) health professionals are engaged in terms of suggested evidence Pete Flores is running unopposed in the Republican primary. based interventions, and "models that work". Roland Gutierrez (D) Roland Gutierrez has not responded to the questionnaire yet. 6. What will you do to improve access to health care and reduce our high uninsured rate? Freddy Ramirez (D) Freddy Ramirez has not responded to the questionnaire yet. See my answers above. As a family doctor who has worked my whole career in FQHCs I know there are available solutions to the Xochil Pena Rodriguez (D) Xochil Pena Rodriguez has not responded to the questionnaire yet.

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts

Senate District 20 Senate District 27

Juan "Chuy" Hinojosa (D, Incumbent) Eddie Lucio Jr. (D, Incumbent) Juan "Chuy" Hinojosa is running unopposed in the Democratic primary. 1. How will you make sure more people have access to mental health treatment and services? Judith Cutright (R) Judith Cutright is running unopposed in the Republican primary. Addressing the mental health needs of Texans in need has been a passion of mine. That is why during the 2017 Session, I worked with my colleagues in the Legislature to begin to address the health Senate District 21 care shortage in Texas.

Judith Zaffirini (D, Incumbent) In fact, I co-authored Senate Bill 1107 to provide more access to is running unopposed in the Democratic primary. doctors via telemedicine and to create a clear and accountable regulatory structure regarding the establishment of a valid Frank Pomeroy (R) practitioner-patient relationship via telemedicine. We also updated Frank Pomeroy is running unopposed in the Republican primary. the guidelines governing telemedicine to allow the creation of greater valid practitioner-patient relationship in a telemedicine encounter. Senate District 22 We also took some positives steps forward to address the shortage (R, Incumbent) of psychiatrists. As you are aware, by some reports, there are less Brian Birdwell is running unopposed in the Republican primary. than 2,000 psychiatrists actively licensed and offering direct care in Texas. As of January 2015, over two-thirds of the state’s Robert Vick (D) counties were designated as Mental Health Professional Shortage Robert Vick is running unopposed in the Democratic primary. Areas.

Senate District 26 Because we have geographic areas in our state with a ratio of (D, Incumbent) 30,000 people to one psychiatrist, I co-authored Senate Bill 674 in Jose Menendez is running unopposed in the Democratic primary 2017 to create an expedited licensing process for out of-state and in the general election. psychiatrists. With this bill, we directed the Texas Medical Board will create an expedited licensing process for applicants who hold an unrestricted license to practice medicine issued in another state,

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts are board certified in psychiatry, and meet other general eligibility requirements. This is a very good question and something I have been working on over the years. That is why I supported voted in favor of Senate Additionally, I authored SB 578 and also co-authored SB 27 in Bill 292 which became law in 2017. With this bill, HHSC is 2017. Both of these bills address access to mental health providers directed to establish a grant program to reduce recidivism, arrest, for our veterans and their families. Through SB 27’s and incarceration among individuals with mental illness and to implementation, the Texas Health and Human Services reduce wait time for forensic commitment to a state hospital. With Commission (HHSC) opened up six sites in different areas of the this bill, our state will be providing a grant to a county-based state to increase access to clinical mental health treatment for community collaborative in the most populous counties in the state veterans, members of our armed forces, and their families. for the same purpose. As supporters of the Legislator’s efforts have stated, this will help the state by reducing the number of people I want to build on that effort and similarly increase access to with mental illness in county jails and thereby reducing the waiting mental health treatment and services to everyone in the state. This time for a forensic commitment to a state hospital can be done by having increased collaboratives with our hospitals, treatment centers, mental health professions. Regrettably individuals with Mental Illness do find themselves in the Criminal Justice System. That I why I supported Senate Bill 2. What will you do to improve coverage for mental 1849 in 2017 that directs local jails to increase mental health health care? supervision and training to prevent suicides of prisoners. With this bill we require law enforcement to complete training in de- First we need to have increased access and make more mental escalating confrontations, in order to better handle inmates with health services available. We also need to work with our Managed mental health issues, and jails to provide prisoners with access to Care Organizations to ensure that those who need mental health mental health professionals. Because of the bill, law enforcement treatment and services are not denied care by implementing the officers must make a “good faith effort” to divert those arrested for right reforms, initiatives, and oversight to achieve that goal. nonviolent misdemeanors to needed treatment for mental health or substance abuse. Additionally, I plan to provide a Task Force of Mental Health Patient Advocates to the HHSC so that the overseeing state agency Additionally, two interims ago, my office worked with gets just-in-time feedback of how those needing mental health representatives of the Big Urban Counties and HHSC Medicaid services are being treated to ensure that we truly have improved overseeing staff to see what steps Texas can undertake to ensure coverage for mental health care. that individuals who need mental health services are not in our state jail system. 3. What will you do to divert people with mental illness from the criminal justice system? Additionally, I just hosted a hearing in my district of the Senate

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts Veteran Affairs Committee to see how we can increase the use of Veteran Treatment Courts to provide needed care and services to Our research indicated that according to the U.S. Interagency veterans so that they do not end up in the criminal justice system. Council on Homelessness, the most successful model for housing My office is developing an initiative to not only increase access to these individuals is Permanent Supportive Housing. As you may be mental health providers, but to also encourage more of our local aware, this provides housing as well as services designed to build district attorneys to use diversion treat programs like Veteran independent living and tenancy skills, assistance with integrating Treatment Courts to provide individuals the needed services that into the community, and connections to community-based health they need and to lower the possibilities of them ending up in the care, treatment, and employment services. criminal justice system. Because there is a significant gap between the permanent 4. How will you help people with mental illness who are supportive housing units being created and the need for these units, struggling with housing? I want to create more permanent supportive housing units by having a mechanism to allow for more private investment in these Mental health is indeed one of the biggest cause of people ending developments. That is exactly what my SB 1116 from last session up in homelessness. This issue is a complex one that requires a would have done. comprehensive solution. Last session, I began working on addressing homelessness in our most vulnerable population, our The Committee that I chair is currently working with TSAHC to 111,000 youth in Texas facing homelessness. By sponsoring House strengthen my SB 1116 from last session and to be able to provide Bill 2564, I helped direct the Texas Department of Housing and a state tax credit system that would be administered by TSAHC Community Affairs to update their Texas Housing Plan to include and the comptroller of public accounts of the State of Texas. the unique needs of youth facing homelessness. TSAHC would certify developments as permanent supportive housing eligible and award credits that could be assigned to an As Chairman of the Senate Committee which has standing entity with an insurance premium tax liability under Chapter 222 jurisdiction over all housing matters, I am currently conducting the of the Insurance Code. In this way, we can incentivize the necessary interim research to increase the availability of affordable construction of these facilities to ensure that everyone needing housing in our state. One issue we are studying from last session is supportive housing, especial those with mental health illness, can Senate Bill 1116 that I authored in 2019. Last session, I worked be appropriately served with specialized housing. with interested parties who help people experiencing homelessness and other vulnerable populations dealing with housing instability. 5. How will you promote earlier intervention for people By working with the Texas State Affordable Housing Corporation experiencing mental illness? (TSAHC) and the Texas Homeless Network we want to be able to address the struggle special populations have in finding long-term, I created several programs to help children with special needs, affordable housing. including providing children with autism disorder early screening,

#Vote4MentalHealth Senate Primary Candidates Questionnaire For all Texas Senate Districts intervention, and made their treatment accessible. As evidenced by diagnosed until they turned 10 years of age by sponsoring House my youth homeless law that I passed last session (HB 2564), the Bill 451. I further strengthened the coverage of children with needs of our youth are very important to me. autism by removing the age restriction to ensure continuum of services and coverage by co-authoring Senate Bill 1484 in 2013. As Sunset Commissioner, I am currently preparing for next session Also, in 2013, I co-sponsored House Bill 3276 to require health by review the Early Childhood Health and Nutrition Interagency insurance companies cover screening of Autism Spectrum Council, a council that I created in 2009 with the passage of my Disorder. Senate Bill 395. Health officials in my district have asked me to consider expanding this council the teenage years for the similar Ruben Cortez Jr. (D) reasons as your question poses. I will use my Sunset Ruben Cortez Jr. has not responded to the questionnaire yet. Commissioner position to ensure that mental health concerns are appropriately addressed by a stronger, more comprehensive Sara Stapleton Barrera (D) council during the 2021 Legislative Session. Sara Stapleton Barrera has not responded to the questionnaire yet.

6. What will you do to improve access to health care and Vanessa Tijerina (R) reduce our high uninsured rate? Vanessa Tijerina is running unopposed in the Republican primary.

I have always been for Medicaid expansion and have done everything to increase services. Regrettably, as Democrats we are Senate District 28 part of a minority party and currently the decision for Texas to expand Medicaid and increase coverage lands in the hands of the Charles Perry (R, Incumbent) majority party and the Office of the Governor. Charles Perry is running unopposed in the Republican primary and in the general election. Since coverage is so critical, especially for vulnerable populations, over the years I have worked hard to expand coverage for our most needed, children with special needs. Senate District 29

In 2007, I added my Senate Bill 419 to House Bill 1919 as a (D) Senate Floor amendment to provide critical health coverage to Cesar Blanco has not responded to the questionnaire yet. children with Autism. I required health benefit plans in Texas to provide early intervention coverage to 3- to 5-year-old children Bethany Hatch (D) diagnosed with Autism Spectrum Disorder (ASD). In 2009, I Bethany Hatch has not responded to the questionnaire yet. required treatment of children with autism from the time they were