Interim Report to the 85th Texas Legislature House Select Committee on Mental Health December 2016 HOUSE SELECT COMMITTEE ON MENTAL HEALTH TEXAS HOUSE OF REPRESENTATIVES INTERIM REPORT 2016 A REPORT TO THE HOUSE OF REPRESENTATIVES 85TH TEXAS LEGISLATURE FOUR PRICE CHAIRMAN COMMITTEE DIRECTOR SANDRA TALTON Select Committee On Mental Health DecemberJanuary 3,29, 2017 2016 Four Price P.O. Box 2910 Chairman Austin, Texas 78768-2910 The Honorable Joe Straus Speaker, Texas House of Representatives Members of the Texas House of Representatives Texas State Capitol, Rm. 2W.13 Austin, Texas 78701 Dear Mr. Speaker and Fellow Members: The Select Committee on Mental Health of the Eighty-fourth Legislature hereby submits its interim report including recommendations for consideration by the Eighty-fifth Legislature. Respectfully submitted, _______________________ Four Price, Chair ___________________________ ______________________________ Joe Moody, Vice Chair Representative Greg Bonnen ___________________________ ______________________________ Representative Garnet Coleman Representative Sarah Davis ___________________________ ______________________________ Representative Rick Galindo Representative Sergio Munoz ___________________________ ______________________________ Representative Andy Murr Representative Toni Rose ___________________________ ______________________________ Representative Kenneth Sheets Representative Senfronia Thompson ___________________________ ______________________________ Representative Chris Turner Representative James White ACKNOWLEDGEMENTS The Chairman, the Vice-Chairman and the Members of the House Select Committee on Mental Health would like to acknowledge and thank Ms. Sandra Talton, Committee Director, for her consummate professionalism and consistent and stellar dedication throughout the entire committee process and for making this report possible through her efforts as initial drafter and editor of this report. The Chairman, the Vice-Chairman and the Members of the House Select Committee on Mental Health also express gratitude to Ms. Elizabeth Kerpon, Assistant Committee Clerk, and to each Member’s respective office staff for their efforts on the success of the House Select Committee on Mental Health. TABLE OF CONTENTS THE SELECT COMMITTEE ON MENTAL HEALTH............................................................... 1 EXECUTIVE SUMMARY ............................................................................................................ 1 INTRODUCTION .......................................................................................................................... 5 INTERIM STUDY CHARGES...................................................................................................... 7 PUBLIC HEARING #1: MENTAL HEALTH OVERVIEW ........................................................ 9 Introduction............................................................................................................................. 9 Background............................................................................................................................. 9 Statistics ................................................................................................................................ 10 Overview of the current landscape of mental health services and funding mechanisms...... 11 Recent legislative actions and funding measures.................................................................. 12 Programs and Services.......................................................................................................... 15 Detailed Funding Breakdown ............................................................................................... 15 Detail of Programs and Services Through the Department of State Health Services........... 17 Community Services Through Local Mental Health Authorities (LMHAs)........................ 17 Services Accessible Statewide.............................................................................................. 20 Community Services Directly Through Department of State Health Services..................... 20 Services Through State Hospitals ......................................................................................... 21 Additional State Agencies Providing Services ..................................................................... 21 Statewide Behavioral Health Coordinating Council in the Health and Human Services Commission (HHSC)............................................................................................................ 22 0HQWDO+HDOWK$GYRFDWHVޤ5HFRJQLWLRQRILPSURYHPHQWVDQG,GHQWLILFDWLRQRI*DSV........ 23 Best Practices Identified .......................................................................................................24 Challenges............................................................................................................................. 25 Recommendations.................................................................................................................26 PUBLIC HEARING #2: Mental and Behavioral Health Services and Treatments For Children 28 Introduction........................................................................................................................... 28 Background........................................................................................................................... 28 Statistics ................................................................................................................................ 29 Services and Providers..........................................................................................................30 Physicians ............................................................................................................................. 30 A Center for Children ...........................................................................................................30 Services through Department of State Health Services (DSHS) and Health and Human Services Commission (HHSC) ............................................................................................. 31 School Settings...................................................................................................................... 32 Examples of Best Practices................................................................................................... 33 Urban Schools....................................................................................................................... 33 Suburban Schools.................................................................................................................. 34 Rural Schools........................................................................................................................ 36 Juvenile Justice Services.......................................................................................................37 Best Practice Example in Juvenile Justice............................................................................ 38 Challenges............................................................................................................................. 40 Recommendations.................................................................................................................41 PUBLIC HEARING #3: Mental and Behavioral Health Services and Treatment Access, Continuity of Care, Coordination, and Workforce ....................................................................... 44 Introduction........................................................................................................................... 44 Background........................................................................................................................... 44 Statistics ................................................................................................................................ 45 Providers ............................................................................................................................... 46 Physicians in Private Practice or in a Hospital ..................................................................... 46 Examples of Innovative DSRIP Projects by Hospitals......................................................... 48 Workforce and Provision of Care ......................................................................................... 48 Addressing Workforce and Research of Mental Health ....................................................... 48 UTHealth Northeast..............................................................................................................49 UTHealth Houston................................................................................................................50 Challenges............................................................................................................................. 51 Recommendations.................................................................................................................52 PUBLIC HEARING #4: Mental and Behavioral Health Services and Treatment Access, Continuity of Care, Coordination, and Workforce ....................................................................... 53 Introduction........................................................................................................................... 53 Providers and Services..........................................................................................................53