2023 Legislation: Mental Health Services

HB 400 (Author: Klick | Sponsor: Kolkhorst), Relating to innovation grant programs to support residency training programs in psychiatric specialty fields and recruitment, training, and retention programs in behavioral health fields. To address a shortage of licensed mental health providers in Texas, HB 400 establishes the Psychiatric Specialty Innovation Grant Program to award incentive payments – subject to available funds – to medical schools with innovative residency programs designed to increase the number of physicians specializing in adult or pediatric psychiatric care. This bill similarly establishes the Behavioral Health Innovation Grant Program to award incentive payments – again subject to available funds – to institutions of higher education that administer innovative recruitment, training, and retention programs designed to increase the number of mental health professionals or professionals in related fields. The Texas Higher Education Coordinating Board must draft rules regarding eligibility criteria, including demonstrating regional and state workforce needs and guidelines for grant procedures and amounts. Effective on 9/1/23 

HB 2100 (Author: Price | Sponsor: Schwertner), Relating to eligibility requirements for student loan repayment assistance for certain mental health professionals. To incentivize more people to enter Texas’ behavioral health workforce, HB 2100 expands eligibility for the state’s Loan Repayment for Mental Health Professionals Program to include mental health professionals providing services to: people in state psychiatric hospitals, or people receiving community-based mental health services from Local Mental Health Authorities, regardless of location. To be eligible to receive repayment assistance, mental health professionals must apply to the Texas Higher Education Coordinating Board and must have completed between one and five consecutive years of practice in Texas. Effective on 9/1/23 

SB 26 (Authors: Kolkhorst; Alvarado; Bettencourt; Blanco; Campbell; et al. | Sponsor: Jetton), Relating to local mental health authority and local behavioral health authority audits and mental and behavioral health reporting, services, and programs. Among other provisions related to audits of and transparency around behavioral health services, SB 26 requires the Health and Human Services Commission (HHSC) – provided money is appropriated – to establish a matching grant program for mental health early intervention and treatment. This program provides support to eligible entities for community-based initiatives that promote identification of mental health issues and improve access to early intervention and treatment for children and families. Eligible entities include certain nonprofit organizations, mental health hospitals and other hospitals, Local Mental Health Authorities, child-care facilities, and counties or municipalities. 

The community-based initiatives may be evidence-based or otherwise demonstrate positive outcomes, including reduced involvement in the juvenile justice system, avoidance of emergency room use, and improved relationship skills and self-esteem. The initiatives may also include training, as well as services and supports for children in or at risk of placement in foster care or the juvenile justice system, agencies that provide services to children and families, community-based initiatives, and individuals who work with children or caregivers of children showing atypical social or emotional development or other challenging behaviors. 

The HHSC must prioritize entities that work with children and family members of children with a high risk of experiencing a crisis or developing a mental health condition, in specific efforts to reduce: the number of children at risk of placement in foster care or the juvenile justice system; the need for future intensive mental health services; or the demand for placement in state hospitals, inpatient mental health facilities, and residential behavioral health facilities. A grant recipient may only use grant money to develop innovative strategies that provide resiliency, coping and social skills, healthy social and familial relationships, and parenting skills and behaviors. Effective on 9/1/23 

SB 532 (Author: West | Sponsors: Kuempel; Mary González; Anchía), Relating to providing mental health services information to certain higher education students and to the repayment of certain higher education loans. To help the state meet its need for more mental health professionals, SB 532 extends eligibility for participation in the state’s Mental Health Professional Loan Repayment Program to those providing services to: people in state psychiatric hospitals, or people receiving community-based mental health services from a Local Mental Health Authority. Additionally, mental health professionals will be required to participate in loan repayment for only three (versus five) years. 

Separately, SB 532 requires institutions of higher education to provide any incoming students with information about available mental health and suicide prevention services, as well as information regarding early warning signs that are often present if someone is considering suicide. Additionally, incoming students must receive a campus map identifying where mental health services are provided, and each tour for entering students must include at least one location where students can receive mental health services. Effective on 9/1/23 

SB 1677 (Author: Perry | Sponsor: Price), Relating to the establishment and administration of Health and Human Services Commission programs providing mental health services to certain individuals in this state. Among other things, SB 1677 requires Texas’ Health and Human Services Commission (HHSC) – in cooperation with Local Mental Health Authorities located primarily in rural areas, and provided sufficient money is appropriated – to contract with nonprofit organizations or governmental entities to establish or expand behavioral health centers and jail diversion centers to provide: services to reduce recidivism and the frequency of arrest, incarceration, and emergency detentions among people with mental illness; inpatient and outpatient mental health services to children and adults; and additional forensic hospital beds and competency restoration services. HHSC’s Executive Commissioner must develop criteria for the evaluation of applications and proposals submitted by nonprofits or governmental entities seeking a contract.

Separately, the State Auditor’s Office must conduct an audit of incarcerated people in county jails waiting for a forensic hospital bed for competency restoration services. The audit must identify any issues and inefficiencies in the commitment process. By December 2024, the State Auditor must prepare a report of the audit and publish it on its website. The report must include: a review of the history and status of the waitlist beginning September 2018 through the most current year for which information is available; as well as any disparities in treatment in the forensic commitment process based on race, gender, ethnicity, or age. Effective on 9/1/23 

During the 2023 session of the Texas Legislature, the Texas Center for Justice and Equity tracked around 40 youth and adult justice bills that made it to the Governor's desk. You can find links to all of our analyses in our 2023 Bill Analysis Guide.