BILL ANALYSIS

C.S.H.B. 1119

By: Gámez

Public Health

Committee Report (Substituted)

BACKGROUND AND PURPOSE

While the Department of State Health Services, the Health and Human Services Commission, and the advisory panel on the allocation of outpatient mental health services and beds in state hospitals are currently required to submit a report on the regional allocation of mental health beds, the bill author has informed the committee that including additional factors under the report would help provide more accuracy on the allocation of mental health beds. For example, providing for more transparency on the bed day allocation methodology could hopefully increase equity in mental health resources, especially in medically-underserved regions. C.S.H.B. 1119 seeks to address this issue by revising the required contents of the report to add factors to evaluate when distributing mental health beds and an explanation of the bed day allocation methodology.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 1119 amends the Health and Safety Code to remove the Department of State Health Services (DSHS) as one of the entities involved in the required biennial preparation and submission of a report on the regional allocation of mental health beds to the governor, lieutenant governor, speaker of the house of representatives, senate finance committee, house appropriations committee, and standing legislative committees having jurisdiction over mental health and human services and to accordingly remove DSHS activities and recommendations from inclusion in the report. The bill further revises the report requirements by doing the following:

· including an explanation of the bed day allocation methodology and factors influencing the applicability of that methodology among the information required to be included in the report;

· changing from DSHS to the Health and Human Services Commission (HHSC) the agency that calculates, for planning purposes and for each region, the actual value of a bed day for the two years preceding the date of the report and the projected value of a bed day for the five years following the date of the report;

· removing the specification that the evaluation of the factors impacting the use of state-funded beds in state hospitals and other inpatient mental health facilities by certain patients with a mental illness or an intellectual disability is required for each region and the specification that the factors include the availability of resources in the region;

· specifying that those factors include the following:

o the total amount of state money allocated to mental health services in Texas, categorized by service type;

o a breakdown by region of existing state-funded mental health facilities and programs, including the capacity, demand, and waitlist for those facilities and programs;

o the targeted number and actual number of patients served by state-funded mental health facilities and programs for each region;

o an assessment of the outcomes for patients who occupied a state-funded bed;

o a comprehensive analysis of state-funded mental health facilities and programs, including funding allocations, service gaps, and capacity constraints; and

o the total number of entities that applied for and were denied state-funded mental health grants due to funding limitations, including, for each entity, the type of grant requested and the amount actually provided; and

· specifying that the outcomes of the implementation of a bed day utilization review protocol includes the peer review process required under current law to be included in the bed day utilization review protocol developed by the advisory panel that assists in the development of a plan for allocation of outpatient or community health based services and state hospital beds.

EFFECTIVE DATE

September 1, 2025.

COMPARISON OF INTRODUCED AND SUBSTITUTE

While C.S.H.B. 1119 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

While both the substitute and the introduced revise the required contents of the report on the regional allocation of mental health beds with respect to the evaluation of the factors impacting the use of state-funded beds in state hospitals and other inpatient mental health facilities, the versions differ as follows:

· the substitute removes the specification that the evaluation is required for each region, whereas the introduced did not;

· the substitute removes the specification that the factors to be evaluated include the availability of resources in the region, whereas the introduced retained this inclusion;

· whereas the introduced required the factors to include the funding amounts and methodologies for the resources identified for an applicable region, the substitute requires the inclusion of the total amount of state money allocated to mental health services in Texas, categorized by service type;

· while both the introduced and the substitute require the factors to include the target number and actual number of patients served, the substitute further specifies that the patients are those served by state-funded mental health facilities and programs for each region;

· whereas the introduced required the factors to include the outcomes of the use of state-funded beds, the substitute requires the inclusion of an assessment of the outcomes for patients who occupied a state-funded bed; and

· the substitute requires the factors to include the following, which were not required to be included in the factors by the introduced:

o a breakdown by region of existing state-funded mental health facilities and programs, including the capacity, demand, and waitlist for those facilities and programs;

o a comprehensive analysis of state-funded mental health facilities and programs, including funding allocations, service gaps, and capacity constraints; and

o the total number of entities that applied for and were denied state-funded mental health grants due to funding limitations, including, for each entity, the type of grant requested and the amount actually provided.