Bill Caption

Relating to the creation of the Texas Mental Health Care Consortium.

Fiscal Notes

Depending on the amount of funding distributed by the Consortium's executive committee to health-related institutions of higher education for mental health research projects and for workforce expansion, there would be some fiscal impact to the state. SB 1 as introduced includes $50 million in General Revenue for each year of the 2020-21 biennium for this purpose. 

Bill Analysis

SB 10 would establish the Texas Mental Health Care Consortium to coordinate the delivery of mental health care services. The consortium would consist of health-related institutions of higher education (HRIs), the Health and Human Services Commission, and nonprofit organizations. 

The consortium would establish a network of child psychiatry access centers at the member HRIs. A center would collaborate with community health providers by providing consultation services and training opportunities for pediatricians and primary care providers operating in the center's area. The consortium would also establish or expand telemedicine or tele-health programs at the member HRIs for identifying and assessing behavioral health needs.

The consortium would leverage the resources of a hospital system if the hospital system provides consultations and training opportunities for pediatricians and PCPs, and if the hospital system has an existing telemedicine or tele-health program for the behavioral and mental health needs of children and adolescents.

The executive committee may provide funding to the academic department of psychiatry at an HRI for the purpose of funding one full-time psychiatrist and two resident positions. The psychiatrist would coordinate with community mental health providers to expand the availability of mental health state resources by developing training opportunities for residents and medical students as well as promoting the use of telemedicine.

Mental health care services may be provided to a child younger than 18 years of age through a program established by the consortium only if the person obtains the written consent of the parent, legal guardian, or caretaker of the child. Additionally, data on or personally identifying information of a person obtained may not be used for research purposes.

Finally, the consortium will coordinate mental health research and strengthen judicial training on juvenile mental health.

Vote Recommendation Notes

Texas Action recommends opposing SB 10 because it infringes on the principle of limited government by creating a new $100 million program that is outside of the core functions of state government.

In addition to creating an expensive new program, much of what this legislation proposes may already be done, and in fact is currently being done, under existing authority.

The TWITR Project of the Texas Tech University Health Sciences Center is an example of a successful program currently in operation. The TWITR Project has used mental health screenings through telemedicine to provide psychiatric help to hundreds of children throughout the ten school districts it serves. It is notable that this program was implemented with a grant of only $565,000.

Additionally, several medical schools across the state already participate in a mental health consortium which meets quarterly. A new consortium is not necessary to enable further collaboration and coordination of higher education institutions for the purpose of improving access to mental health care. For these reasons, we view the consortium proposed by SB 10 as largely duplicative and unnecessary to achieve the goals of the legislation. Instead of appropriating $100 million for a new program, the state could re-prioritize some of the $7.6 billion currently spent on mental health to improve and expand existing efforts.

While we oppose the bill for the reasons stated above, there are some elements we support.

Telemedicine and telehealth services offer a convenient, affordable way to access health care services, and could increase access to health care in more than 90% of Texas counties that are designated health professional shortage areas or medically underserved areas. Increasing access to mental health experts via telemedicine could help combat the shortage of mental health professionals in the state. Expanding access to telemedicine and telehealth services is good public policy.

We also recognize that investing in preventative measures may lead to lower government spending in the future, including the cost of health care, special education, juvenile justice services, and decreased productivity. However, these potential savings remain speculative. Only time will tell whether the speculative savings materialize to offset the cost of the program.

Several amendments could be adopted to improve this legislation. Should amendments along these lines be offered, we would support them.

1. Explicitly require that all meeting and materials are subject to open meetings/open records.
2. Protect the information collected in any research and/or counseling to ensure it is confidential and not subject to disclosure to anyone other than the treating physician and the patient or guardian of the patient.
3. Require that any information gathered through research or treatment may not be included in a student's permanent file. The information cannot be shared in a database, released without express informed consent of the patient or guardian of the patient, and all files are delivered to the parent and destroyed after the student leaves the school or graduates.
4. Prohibit the sale or sharing of any information collected in the research or counseling for any commercial purposes.