HB 10 as engrossed, Relating to the creation of the Texas Mental and Behavioral Health Research Institute
LBB Fiscal Note Summary. Depending on the amount of funding distributed by the Texas Mental and Behavioral Health Research Institute, there would be some fiscal impact to the state.
Bill Summary and Analysis. The bill would establish the Texas Mental and Behavioral Health Research Institute at the Higher Education Coordinating Board (THECB). The institute would create best practices, leadership, and vision for addressing child and adolescent behavioral health needs and provide funding for researching behavioral health issues. The institute would be administratively attached to THECB, which could use up to 3 percent of the institute’s funds for providing administrative support to the institute and would assist the institute in creating a website. The institute would be funded solely by money appropriated to THECB for the purpose of the institute. The institute would be required to solicit federal funding for mental and behavioral research and other of its functions. It would also be authorized to solicit and accept gifts, grants, and donations from any source.
The institute would consist of thirteen health-related institutions of higher education (HRIs), three representatives of nonprofit organizations that focus on mental health care, and representatives from the Health and Human Services Commission and THECB. The institute would provide funding to HRIs for research efforts; disseminating best-practice guidelines; recruiting researchers and clinicians; training students, residents, and fellows in connection to a research effort under the bill; and clinical trials, studies, or other patient programs approved by an institutional review board.
The bill would also require the institute to establish a mental health, behavioral health, and substance use disorder research program to provide funding to member HRIs for a range of activities related to researching, preventing, and treating conditions related to mental and behavioral health and substance use. The institute would be allowed to prioritize funding awards to an IHE that applies in partnership with a state agency or other institution. The institute would be required to evaluate research projects on their alignment with the statewide behavioral health strategic plan or whether they address key issues identified by the institute.
The cost, timing, and institutional recipients of the funding authorized by the bill are not known. Costs of the funding may vary depending on the size, infrastructure, and existing resources of the member institutions.
For illustrative purposes, the University of North Texas Health Science Center at Fort Worth
estimated they would need approximately $2.9 million over the next biennium to implement the provisions of the bill. Their estimate includes costs related to hiring providers (including behavioral health specialists and a pharmacist), faculty, and staff members; telemedicine units for each provider; and ongoing administrative costs related to running an educational program and community monitoring program. Costs at other HRIs would vary depending on the staff and infrastructure currently available to implement provisions of the bill.
The institute would be required to implement a provision of the bill only if the legislature appropriates money specifically for that purpose. If the legislature does not appropriate money specifically for that purpose, the institute may, but is not required to, implement the provision using other money available to the institute for that purpose.
The institute would be eligible to receive funding through the proceeds of bonds issued under the authority of Section 68, Article III, Texas Constitution if a constitutional amendment providing for the dedication of certain sales and use tax revenue to fund research, treatment, and substance use and addiction issues is approved by the voters.
The Texas Board of Pharmacy, Health and Human Services Commission, and Department of State Health Services indicate no significant costs to their agencies.
Senator Kolkhorst explained the bill. H.B. 10 seeks to address the growing issue of mental and behavioral health in the state through the creation of the Texas Mental and Behavioral Health Research Institute. The Institute will be administratively attached to the Texas Higher Education Coordinating Board, and will lead the charge on addressing child and adolescent behavioral health needs by funding extensive research and fostering statewide collaboration among Texas’s health-related higher education institutions and other state entities. This model will enable Texas to be at the forefront of mental and behavioral health research.
H.B. 10 amends current law relating to the creation of the Texas Mental and Behavioral Health Research Institute.
There will be a committee substitute. This bill works in conjunction with SB10 by Nelson. They are working with stakeholders on the substitute to harmonize the bill with SB10.
TESTIMONY.
Dr. Walss-Bass, UT Medical School, Houston stated that we are behind other fields of medicine and as a result, are treating the symptoms instead of the causes. These are genetic disorders and there is a strong environmental component. Changes in the brain can lead to changes in behavior later in life. We want to treat our children early. This bill will allow all parties to be engaged on the issue. Like CPRIT, Texas can become a leader in mental health through the Institute.
The Chair followed up on the speaker’s comment about leading in mental health research. She asked if this effort might spur interest at the federal level for more funding. The speaker answered in the affirmative. The Chair stated that she is not only interested in drugs but in psychology. The speaker stated that psychologists and psychiatrists work together, for instance, in cognitive behavioral therapy. This will allow families to be empowered.
Kristin McGarrity, Self, testified against HB10. She stated that the CDC just issued a warning that does not allow doctors to bypass best practices when their judgment would indicate other treatment. However, sometimes, relying on best practices can result in the patient being prescribed a dose that is significantly higher than their condition warrants. Best practices for prescribing should involve the medical board.
Julia Heath, Physician Assistant, Don’t Punish Pain, stated that she supports Kristin’s testimony concerning best practices and good judgment. She stated that she needs pain medication for her care. Opioids are necessary for pain management and we do not want our rights to be pain-free mixed in with other efforts related to curbing addiction.
Sheila Hemphill, Texas Right to Know, testified against the bill. She stated that it does not include physical considerations in the determination of addiction, polypharmacy considerations are not addressed, and upon admission to a mental health facility, families should be given the patient’s bill of rights.
On May 10th, the Chair laid out the Committee Substitute as pending business providing clarifying language so it specifies that children will not be named. Reporting requirements were added as were other amendments important to stakeholders.
The committee substitute was reported favorably on May 10th.
Find the full report on the meeting of the Senate Committee on Health and Human Services here.
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