Texas Big City Mayors Release State Mental Health Funding Priorities
As Mayors of the largest cities in Texas, we take this opportunity to call upon the Texas Legislature to make transformational investments in the state’s mental health system. Despite progress over several sessions, Texas still ranks dangerously low on access to mental health services.
As the elected leadership for local governments, we know firsthand how this leaves our local police departments as a primary safety net mental health provider for too many Texans.
People living with mental health conditions need access to mental health services, and our police need to be able to better focus on public safety.
Given the record surplus in funding for state government and with the base budgets of both the House and Senate released, we would offer the following remarks about key priority areas:
Community Based Care
On January 24, 2023, the Health & Human Services Commission announced $148 million for salary increases for employees of the state hospitals and state supported living centers. We support this action. However, this leaves out the community-based settings – including the mental health authorities that we often partner with and who are active in our cities.
The Legislature should significantly invest in this workforce or the system as a whole will not function. The Texas Council of Community Centers has identified $155,805,409 for 5 funding strategies that are critically needed to address inflationary cost increases. We strongly support this needed investment in our community-based teams.
Coordinated Specialty Care
Currently, there are 37 Coordinated Specialty Care Teams in Texas that provide services to Texans experiencing their first episode of psychosis. The outcomes produced by these services have shown strong results that improve overall quality of life, reduce recurring episodes, and, accordingly, create long-term savings of taxpayer dollars.
We applaud the $4 million increase that would add 4 additional teams. However, we believe Texas should go farther by funding 10 Coordinated Specialty Care Teams to offer intervention services across the state. The cost of each team is approximately $475,000 annually, meaning this expansion would cost $5.7 million more than in the base budget.
Crisis Calls and Response
With the rollout of “9-8-8” this past July, Texas is expected to have a three-fold increase of calls coming into call centers.
In the first month only 57% of calls were answered in state, while the other 43% went out of state. Through community mental health crisis services, Texas funds call centers, mobile crisis outreach teams (MCOTs), crisis stabilization, crisis respite and other follow-up services an individual may need. The foundation of community mental health crisis services is in diverting people from emergency rooms and criminal justice involvement. It is critical that as a state we fund these vital services for those experiencing a crisis.
We are very pleased to see the $84 million increase over the biennium in crisis services, increasing the annual allocation for strategy D.2.3 from $115 million to over $157 million. This shows an understanding that with increased access will come increased usage. Inclusion of this increase in the final budget is vital to providing needed crisis services.
Loan Forgiveness
In 2015, Texas created the Loan Repayment Program for Mental Health Professionals, a financial incentive program for a broad spectrum of mental health providers. The program was funded with $2 million and requires graduates to work in a mental health professional shortage area (MHPSA) for five years. Despite the state’s dire workforce needs, there have been no new applicants to the program since 2019 because of a lack of funding.
Both base budgets provide $24.8 million to create more capacity for the mental health workforce as well as consider removing the MHPSA requirement to include all of Texas. We applaud this wise investment by the House and Senate and strongly recommend that members keep this measure in the final budget.
New Mothers Medicaid Coverage
In 2021, the Texas Legislature took the first step in expanding Medicaid coverage to new mothers from 60 days to 6 months. According to the Maternal Mortality and Morbidity Task Force top recommendation, these services should be expanded to 1 year. Patient advocacy organizations note this policy would be the single most effective step the State of Texas can take to combat Post-Partum Depression.
The Legislature should continue its commitment to Texas families by extending the existing maternal Medicaid benefit to one year to reduce healthcare costs, uncompensated emergency room visits, and preventable deaths.
Many of these initiatives have received repeated, strong bipartisan support in both chambers of the Texas Legislature. Whether we are Republicans or Democrats, local government is impacted by the State’s underfunded mental health system.
Costs estimate showed the difference between expanding from 6 months to 12 months was $41 million annually, $82 million over the biennium.
Children, students, and adults - especially our own frontline workers – are facing unprecedented mental health challenges that were only heightened by the pandemic. We call on Legislators to make mental health access a top priority by providing transformative funding to these key areas.
Community Based Care Workforce - $155 million
Coordinated Specialty Care - $5.7 million
Crisis Call and Response - $84 million*
Loan Forgiveness - $25 million*
Mothers’ Medicaid - $82 million
Total above base budgets - $242.7 million
*Already in both base budget proposals
Based on the figures in the base budgets, it is clear that Legislators are taking the issue of access to mental healthcare seriously. We thank Finance Chair Senator Joan Huffman as well as Houston Appropriations Chair Greg Bonnen for their continued work on the budgeting process. We believe the recommendations listed here align with the overall state plan to increase access and fund needed interventions as well as expanding existing programs with proven track records of success.
We look forward to working with you throughout this Legislative Session to make sure every Texan has access to the mental healthcare they need.
Sincerely,
