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79R7028 CME-D
By: Villarreal H.C.R. No. 103
CONCURRENT RESOLUTION
WHEREAS, The State of Texas ranks last in percentage of its
citizens with health insurance; in 2003, nearly 1.4 million Texas
children did not have health insurance, the highest rate of
uninsured children in the nation; and
WHEREAS, Concurrent with this deficiency in health coverage,
many Texas children face substantial risks to their mental health;
in 2002, the United States Department of Health and Human Services
identified 1.2 million Texas children who suffered from some form
of diagnosable mental health disorder; in that same year, more than
400,000 Texas children were reported as suffering mental illness
serious enough to impair their ability to function; and
WHEREAS, Without insurance, however, many families must
resort to public hospital emergency departments for their most
basic health care needs, including treatment of mental health
illnesses; this brings to bear significant economic consequences to
local governing authorities through which public hospitals receive
funding; the Texas Department of State Health Services estimates
that of the 30,489 emergency room visits reported in 2002 that
resulted in a stay of less than 24 hours, 26.5 percent of the
patients admitted received care for which the hospital was not
compensated; and
WHEREAS, Uninsured children who do not receive adequate
mental health care likewise affect the fiscal well-being of state
government by being forced into the costly juvenile justice system;
in 2002, 50 percent of the juveniles in the Texas Youth Commission
and nearly half of the youth referred to the Juvenile Probation
Commission had a mental illness; and
WHEREAS, The Children's Health Insurance Program (CHIP) was
created to mitigate these concerns by providing insurance coverage
to children in low-income families for whom employer-sponsored
insurance was either unavailable or unaffordable; the program was
designed specifically to cover preventive care, such as annual
doctor visits and inpatient and outpatient mental health services,
to avoid more costly interventions later in life; and
WHEREAS, Regrettably, the substantial changes to the CHIP
enrollment process, eligibility standards, and benefits enacted by
the 78th Texas Legislature have decreased the program's rate of
participation and, thereby, its effectiveness; enrollment has
dropped by more than 175,000 children since September 2003, when
these changes became effective, and during the second half of 2003
Texas alone accounted for more than 50 percent of the nation's CHIP
enrollment decline; and
WHEREAS, The drop in CHIP enrollment has meant the immediate
loss of federal matching dollars allotted for Texas' program that
will instead be diverted to finance children's health insurance
programs in other states; the Texas Health and Human Services
Commission estimates the state has forfeited approximately $229
million in federal funds for the 2004-2005 biennium that it could
have spent had there been no change in CHIP enrollment beyond state
fiscal year 2003; although those federal funds would have required
an additional $76.6 million in state funds, each state dollar would
have drawn down three federal dollars for a substantial return on
the investment; and
WHEREAS, The Texas Workforce Commission's child care and
development fund offers an innovative, successful model that could
be adapted to address the statewide need for CHIP mental health
services by increasing the state's contribution to maximize federal
matching funds; through local match agreements, the commission's
workforce boards pursue community funds that are then transferred
and certified with other eligible public funds to attract more
federal support for the child care and development fund; and
WHEREAS, This same strategy, were it employed by the Texas
Health and Human Services Commission through local mental health
authorities, could minimize the impact of the budget cuts sustained
by the Children's Health Insurance Program and provide additional
funding for the program's much-needed mental health services; now,
therefore, be it
RESOLVED, That the 79th Legislature of the State of Texas
hereby direct the Texas Health and Human Services Commission to
conduct a study to determine the feasibility of adopting match
agreements between the commission and local mental health
authorities, similar to those implemented by the Texas Workforce
Commission's child care and development fund, to augment the
state's financial support for the Children's Health Insurance
Program mental health services by maximizing local funds to be
certified for federal matching funds; and, be it further
RESOLVED, That the commission include in its study the
possibility of sponsoring a pilot project for adopting local match
agreements limited to certain areas of the state to ascertain their
effectiveness; and, be it further
RESOLVED, That the commission report its findings, including
an impact analysis, to the governor and Texas Legislature by
January 15, 2007; and, be it further
RESOLVED, That the secretary of state forward an official
copy of this resolution to the executive commissioner of the Texas
Health and Human Services Commission.