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« Legislative News Mental Health Updates: Budget Woes and Medical Clearance
By Laura Nicholes
TAC Legislative Staff
The state’s budget hurdle has been raised and, once again, mental health funding is at issue because it is one of the largest budget items in the Department of State Health Services’ (DSHS) budget. The Legislative Budget Board (LBB) and the Governor’s Office of Budget, Planning and Policy have directed each state agency to submit proposals detailing how they would reduce their general revenue by an additional 10 percent for the 2012-2013 biennium (in two 5 percent increments).
The DSHS presented its options for 10 percent reductions and included in those reductions are: - $80 million from Community Mental Health Services ($33M and $47M)
- $10 million from MH Crisis Services and Transitional Services ($5M and $5M)
- $4 million from Substance Abuse Intervention ($4M and $0)
- $44 million from State Mental Health Hospital Services ($30M and $14M)
With $138 million in proposed cuts to the public mental health system, DSHS has estimated that more than 20,000 people — 11,000 adults, 2,600 children and 6,500 persons in need of crisis services — would be cut from the service system. The $44 million reduction to state hospitals would result in 1,128 fewer patients being seen.
In testimony provided to DSHS at a July 6 hearing, Joe Lovelace, associate director for Behavioral Health at the Texas Council of Community MHMR Centers, cited statistics from a 2010 Texas A&M University report on the Evaluation of Crisis Services Redesign (CSR).
“According to the TAMU Evaluation, the percentage of crises involving hospitalization has fallen from 17 to 11 percent. More people than ever before are receiving intervention locally and at a lower cost per crisis episode than before CSR,” he said. “In the last two legislative sessions, smart investments were made in the mental health system… and the investments are demonstrating reduced reliance on more expensive systems such as state hospitals, emergency rooms and local law enforcement. We know it is a fact that cuts to our system of care will cost tax payers in other more expensive areas of government.”
Each of the 39 local MHMR centers has undertaken a grassroots effort to gather support from local county officials. County officials should expect a representative of the local MHMR center to ask the commissioners court to adopt a resolution recognizing the value of MHMR centers and asking the Legislature to continue existing funding.
AG rules on medical transport clearance
On Dec. 28, 2009, Attorney General Gregg Abbott released Opinion No. GA-0753 regarding whether a peace officer who has taken a person into custody is required to transport that person to a medical facility for evaluation prior to taking that person to a mental health facility (RQ-0809-GA).
The summary of the response from the AG states “An inpatient mental health facility or a mental health facility is not statutorily authorized to require a peace officer to transport a person in custody under chapter 573, Health and Safety Code, to a medical facility for a medical evaluation prior to taking that person to the mental facility.”
In an effort to alleviate medical clearance issues around the state, a Medical Clearance Workgroup was formed by mental health stakeholders, such as community MHMR centers, county and city law enforcement, state mental hospitals and local medical hospitals.
“We give great regard to the enormous public safety responsibility law enforcement has in our community,” Lovelace said. “To address this issue, the Texas Council is working with a broad group of statewide stakeholders to improve local practices and alleviate the time required for medical clearance wherever possible, which will complement the investments made by the Legislature to improve crisis services in communities across our state.”
A suggested guideline for medical clearance issues has been approved by mental health stakeholders represented on the workgroup; training on the use of the new Psychiatric Emergency Flowchart as a reference tool will soon be made available to law enforcement officers, medical hospitals, mental health agencies and facilities charged with transporting, evaluating and serving persons experiencing mental health issues.
The 2010 TAMU Evaluation of Crisis Services Redesign is available online. For additional information on this article, please contact TAC Legislative Staffer Laura Nicholes at (800) 456-5974 or lauran@county.org.
23 July 2010
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