The bill would make changes to examinations and other procedures related to the emergency detention of a person.
The bill would require counties with a population of more than 1.2 million to establish a crisis service center to provide comprehensive crisis and mental health services no later than September 1, 2028. The bill would allow an impacted county to coordinate with the Texas Facilities Commission (TFC) concerning land or facilities available for establishing a crisis service center. The bill would require the Health and Human Services Commission (HHSC) to provide assistance to an impacted county to establish and operate a crisis service center. HHSC may solicit and accept gifts, grants, and donations to support counties establishing and operating a crisis service center. The bill would require impacted counties to prepare and submit quarterly reports on the crisis service center services to HHSC and the Texas Department of Housing and Community Affairs (TDHCA) no later than January 1, 2029.
The fiscal implications of the bill cannot be determined due to the unknown number of counties that would have a population of more than 1.2 million no later than September 1, 2028, and would be required to establish a crisis service center pursuant to the bill. However, it is assumed that the bill would have a significant negative fiscal impact to HHSC to provide financial assistance to counties to establish and operate the crisis service centers. For illustrative purposes, the possible cost based on information from the United States Census Bureau and another similar center financed by HHSC is provided below.
Based on Annual Estimates of the Resident Population for Counties in Texas: April 1, 2020, to July 1, 2024, from the United States Census Bureau, Population Division, there are six counties that were estimated to have population of more than 1.2 million as of July 1, 2024, and would require a crisis service center. Those counties include Harris County, Dallas County, Tarrant County, Bexar County, Travis County, and Collin County.
HHSC estimates that the cost of services per center could total $19.0 million in General Revenue per center, or $114.0 million in General Revenue for six centers, and would include: $15.0 million for crisis intervention and stabilization services; $3.0 million for housing-related services; and $1.0 million for medical detoxification. According to information provided by HHSC, the Uvalde Behavioral Health Campus is the closest model of care related to crisis services that HHSC currently supports and was used to develop a potential estimate of cost related to comprehensive crisis and mental health services. However, some of the estimated costs per crisis service center may change because the Uvalde Behavioral Health Campus does not provide the full array of crisis and mental health services required by the bill and further analysis is needed to determine a more representative cost per center. In addition, there may be a cost to HHSC to provide funding for construction for a new facility or to repair and rehabilitate an existing facility. For illustrative purposes, HHSC received $33.6 million in General Revenue for construction of the Uvalde Behavioral Health Campus. The actual amount of construction per facility may differ due to other factors like the size and location of the facility, date of construction, and cost of materials and supplies.
Based on information provided by HHSC, this analysis assumes HHSC would require an additional 5.5 full-time-equivalents (FTEs) to implement the provisions of the bill, including: 1.0 Program Specialist V to provide quality management; 1.0 Program Specialist VI to provide technical assistance to the crisis centers; 1.0 Program Specialist VII to provide financial analysis; 1.0 Contract Specialist V and 1.0 Contract Administration Manager I to oversee the crisis center contracts; and 0.5 Program Specialist VI to assist with direct administration. Total personnel-related costs, including salaries and travel, are estimated to total $944,403 in All Funds in fiscal year 2026 and $892,339 in All Funds in fiscal year 2027.
It is assumed that HHSC can absorb all other costs related to implementing the bill within current resources.
According to TFC, the bill would have an indeterminate, but significant, fiscal impact because of the requirement to coordinate with county governments concerning land and facility acquisition for establishing crisis service centers.
It is assumed that the Texas Medical Board and TDHCA could absorb the costs related to implementing the bill within current resources.