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DSHS Commissioner's Report to the DSHS Council
April 2006
Demonstration to Maintain Independence and Employment
The Texas Health and Human Services Commission received a four year $18.6 million
federal grant from the Centers for Medicare and Medicaid Services (CMS). This grant is
part of a national demonstration project with the objective of determining whether access
to health insurance benefits (including behavioral health benefits) will enable working
adults with behavioral health conditions who do not yet meet federal disability criteria to
continue to work and to avoid future dependence on publicly funded programs. DSHS is
administering the grant project under an interagency agreement with HHSC and is
partnering with the Harris County Hospital District (HCHD). HCHD is certifying $7.5
million in local match and will operate the project at the local level. In addition, DSHS is
contracting with an independent evaluator to assess the project's performance. The project
is currently in the planning phase working with the independent evaluator and HCHD to
develop operational and evaluation protocols. Operations are scheduled to begin in the
fall.
For more information, contact Dena Stoner, Mental Health and Substance AbuseServices Division, at 512/206-4851, or e-mail
dena.stoner@....Legislative Budget Board authorizes use of $13.4 million for state hospitals
On February 16, 2006, the Legislative Budget Board authorized the HHSC Executive
Commissioner to expend $13.4 million to expand the capacity of state mental health
hospitals, allowing DSHS to move funds from fiscal year 2007 to address immediate
needs relating to the capacity of the hospital system. During the past year, the state's
mental health hospital system has consistently operated at levels exceeding capacity,
which compromises the effectiveness and efficiency of treatment and the safety of
patients and hospital staff. Ninety-six forensic beds have been added to the state hospital
system, adding 24 beds to Austin State Hospital, San Antonio State Hospital, Terrell
State Hospital and North Texas State Hospital - Wichita Falls Campus. By March 8,
2006, these beds were full. The total number of forensic beds in the system is now 738.
An additional 103 beds have been approved for civil commitments. DSHS is currently
working on staffing to support the changes.
For more information, contact KennyDudley, State Hospital Director, Mental Health and Substance Abuse Services Division,
at 512/206-4616, or e-mail
kenny.dudley@...
Provider of Last Resort
House Bill 2292 modified the way that local mental health and mental retardation
authorities ensure the delivery of mental health and mental retardation services byrequiring them to be the providers of last resort. The local authority must make every
reasonable attempt to solicit the development of an available and appropriate provider
base that is sufficient to meet the needs of consumers in its service area before it can
provide services itself.
During the first half of 2004, the Texas Department of Mental Health and Mental
Retardation required local mental health and mental retardation authorities to conduct
preliminary inventories of available providers in their areas through a Request for
Information process and develop local plans on how to address needs through a
combination of outsourcing and direct care. Due to concerns about the applicability of
certain provisions of HB 2292, Executive Order RP-45 was issued on June 17, 2005.
Therein, Governor Perry directed the HHSC Executive Commissioner to request an
Attorney General’s opinion regarding the provider of last resort requirement as it applied
to the provision of mental health services.
On March 16, 2006, the Attorney General issued an opinion (Opinion GA-0416). That
opinion held that the provisions in HB 2292 that require the local mental health and
mental retardation authority to be the provider of services only as a provider of last resort
also applied to the provision of mental health services. In response to this opinion, DSHS
is continuing the implementation of HB 2292 and will work closely with the MHMR
authorities and interested stakeholders to ensure that the intent of the legislation is
achieved for the benefit of all recipients of mental health services.
For more information,contact Joe Vesowate, Assistant Commissioner, Mental Health and Substance Abuse
Services Division, at (512) 206-5797, or e-mail
joe.vesowate@....Texas Mental Health Transformation Initiative
Mental Health Transformation is still in an early phase of development. The Governor’s
Transformation Work Group had its third meeting on March 9
th. The central topic of themeeting was how each agency was addressing the mental health needs of veterans,
especially those returning from combat in Afghanistan and Iraq. Kathryn Kotrla, MD,
presented on the Veteran’s Administration activities to engage in transformation at the
federal and state levels. Each representative also described their agency’s activities in
support of veterans. The consumer representatives emphasized the importance this work
has on consumers and family members. The next meeting is scheduled for May 19, 2006
.Additional information about the grant is available at
http://www.dshs.state.tx.us/mhtransformation.shtm
. For more information, contact DaveWanser, Deputy Commissioner for Behavioral and Community Health Services, at (512)
458-7375, or e-mail
dave.wanser@....Substance Use School Survey
DSHS conducted its statewide school survey of substance use among students in grades
4-6 and grades 7-12. The survey measures a wide range of self-reported licit and illicit
substance use. The survey assists DSHS in identifying areas of need and provides
information for the planning process. Major findings include:
•
Tobacco, alcohol, and a number of illicit drugs show extensive decreases in 2004,authorities ensure the delivery of mental health and mental retardation services by
requiring them to be the providers of last resort. The local authority must make every
reasonable attempt to solicit the development of an available and appropriate provider
base that is sufficient to meet the needs of consumers in its service area before it can
provide services itself.
During the first half of 2004, the Texas Department of Mental Health and Mental
Retardation required local mental health and mental retardation authorities to conduct
preliminary inventories of available providers in their areas through a Request for
Information process and develop local plans on how to address needs through a
combination of outsourcing and direct care. Due to concerns about the applicability of
certain provisions of HB 2292, Executive Order RP-45 was issued on June 17, 2005.
Therein, Governor Perry directed the HHSC Executive Commissioner to request an
Attorney General’s opinion regarding the provider of last resort requirement as it applied
to the provision of mental health services.
On March 16, 2006, the Attorney General issued an opinion (Opinion GA-0416). That
opinion held that the provisions in HB 2292 that require the local mental health and
mental retardation authority to be the provider of services only as a provider of last resort
also applied to the provision of mental health services. In response to this opinion, DSHS
is continuing the implementation of HB 2292 and will work closely with the MHMR
authorities and interested stakeholders to ensure that the intent of the legislation is
achieved for the benefit of all recipients of mental health services.
For more information,contact Joe Vesowate, Assistant Commissioner, Mental Health and Substance Abuse
Services Division, at (512) 206-5797, or e-mail
joe.vesowate@....Texas Mental Health Transformation Initiative
Mental Health Transformation is still in an early phase of development. The Governor’s
Transformation Work Group had its third meeting on March 9
th. The central topic of themeeting was how each agency was addressing the mental health needs of veterans,
especially those returning from combat in Afghanistan and Iraq. Kathryn Kotrla, MD,
presented on the Veteran’s Administration activities to engage in transformation at the
federal and state levels. Each representative also described their agency’s activities in
support of veterans. The consumer representatives emphasized the importance this work
has on consumers and family members. The next meeting is scheduled for May 19, 2006
.Additional information about the grant is available at
http://www.dshs.state.tx.us/mhtransformation.shtm
. For more information, contact DaveWanser, Deputy Commissioner for Behavioral and Community Health Services, at (512)
458-7375, or e-mail
dave.wanser@....Substance Use School Survey
DSHS conducted its statewide school survey of substance use among students in grades
4-6 and grades 7-12. The survey measures a wide range of self-reported licit and illicit
substance use. The survey assists DSHS in identifying areas of need and provides
information for the planning process. Major findings include:
•
Tobacco, alcohol, and a number of illicit drugs show extensive decreases in 2004,while use of inhalants increased among younger grades.
•
Alcohol continues to be the most widely used substance, with 68% of grades 7-12students reporting lifetime use and 33% past-month use.
•
About 24% of high school seniors said they had driven a car after drinkingalcohol.
•
40% of grades 7-12 students have smoked marijuana at some point in their lives,making it the most commonly used illegal drug among students.
•
Students whose parents disapprove of teen alcohol use are 62% less likely to havereported drinking in the past month.
•
About 8.3% of grades 7-12 students reported using codeine cough syrup to gethigh at some point and 3.3% did so in the past month.
Additional information regarding this study can be found at:
http://www.dshs.state.tx.us/sa/RecentResearchStudies.shtm.
or by contacting Liang Y.Liu, Mental Health and Substance Abuse Services Division, at 512/206-5953, or e-mail
liang.liu@....
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