Austin, Texas
February 25, 2019

Honorable Senfronia Thompson, Chair, House Committee on Public Health
John McGeady, Assistant Director     Sarah Keyton, Assistant Director
Legislative Budget Board
HB10 by Thompson, Senfronia (Relating to grants and programs for researching and treating behavioral health and psychiatric issues.), As Introduced

Depending on the amount and number of grants distributed by the Child and Adolescent Psychiatric Nursing Grant Program and the Texas Behavioral Health Research Institute, there would be some fiscal impact to the state.

The bill would establish the Child and Adolescent Psychiatric Nursing Grant Program at the Higher Education Coordinating Board. The program would award grants to advanced practice registered nursing (APRN) programs at public or private institutions of higher education to support the salaries of a program's faculty and staff; increase the number of enrollments and graduations of students who seek to become APRNs specializing in child and adolescent psychiatric nursing; recruit child-adolescent psychiatrists to help provide clinical instruction; or establish or expand the number of postgraduate residency and fellowship training positions for APRNs to receive specialized training in child and adolescent psychiatry.

The bill would also establish the Texas Behavioral Health Research Institute to address child and adolescent behavioral health needs. The institute would consist of thirteen health-related institutions of higher education (HRIs), the Health and Human Services Commission, a member of the public representing pediatricians, and a member of the public representing nonprofit organizations in the state with a focus on mental health care. The institute would provide grants or other funding to member HRIs and community mental health providers to provide direct mental health care and treatment; establish child psychiatry access lines for peer-to-peer consultation support for direct care providers who use tele-psychiatry; establish partnerships between behavorial health professionals from the member HRIs and direct care providers to encourage use of the child psychiatry access lines; educate direct care providers about services and supports that child-adolescent psychiatrists provide; create a program to provide students access to tele-psychiatry through the access lines to support public school personnel who are assisting students with behavioral health concerns; and establish and provide grants to member HRIs through the Behavioral Health Research and Treatment Grant Program and Addiction Crisis Grant Program established by the bill. The institute would only be required to implement a provision of the bill if the legislature appropriates money for that purpose.
The bill would also amend the existing graduate medical education expansion program.

The cost, timing, and institutional recipients of the grants authorized by the bill are not known. Costs of the grants 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 Higher Education Coordinating Board has indicated they would require an increase of a partial FTE program director and administrative assistant to develop and administer the Child and Adolescent Psychiatric Nursing Grant Program. 

The Texas Board of Nursing, Health and Human Services Commission, and Department of State Health Services indicate no significant costs to their agencies.

Local Government Impact

The fiscal implications of the bill cannot be determined at this time. There could be some impact to local units of government from receiving a grant from the Behavioral Health Research Institute

Source Agencies:
507 Texas Board of Nursing, 529 Health and Human Services Commission, 537 State Health Services, Department of, 710 Texas A&M University System Administrative and General Offices, 758 Texas State University System, 768 Texas Tech University System Administration, 769 University of North Texas System Administration, 781 Higher Education Coordinating Board, 783 University of Houston System Administration, 212 Office of Court Administration, Texas Judicial Council, 720 The University of Texas System Administration
LBB Staff: