Health and Human Services Commission

Overview

The Texas Health and Human Services Commission (HHSC) is one of two state agencies that make up the Texas Health and Human Services (HHS) system. HHSC oversees over 200 programs, certain regulatory functions, and operates and oversees ten state hospitals and 13 state-supported living centers (SSLCs).1 HHSC provides a multitude of acute and long-term services and programs to more than 7.5 million Texans every month.2

HHSC delivers mental health and substance use programs, contracts, and services across various divisions within the Chief Program and Services Office (CPSO). The CPSO is made up of Behavioral Health Services, Health and Specialty Care System (HSCS), Access and Eligibility Services (AES), Family Health Services, and Community Services.

In 2022, there were several organizational changes within HHSC impacting the authority and delivery of behavioral health services within the agency.3,4,5,6,7

  • HHSC realigned to eliminate Health, Developmental and Independence Services (HDIS) and reallocated programs and services into the two newly formed Family Health Services and Community Services.
  • Behavioral health services for individuals with intellectual and developmental disabilities (IDD) were transferred from the previously named IDD and Behavioral Health Services (IDD-BHS) to Community Services, ultimately renaming IDD-BHS to Behavioral Health Services.
  • Medicaid and CHIP (MCS) Services was elevated to its own department and is no longer within CPSO.

According to HHSC, these changes “bring together expertise and fosters a focus of continuum of care for the populations [they] serve,” and “ensures all populations served get the focus they need, strengthen coordinated supports, and improve the way clients navigate the HHSC system.”8 Further, the agency states this will not have any effect on staff or programs.9

Behavioral Health Services

Behavioral Health Services (BHS) oversees the administration, delivery, and implementation of a number of mental health and substance use programs, grants, contracts, waivers, and services for both adult and children.10 The department contracts with the 37 Local Mental Health Authorities (LMHAs) and two Local Behavioral Health Authorities (LBHAs), home and community-based providers, and substance use organizations throughout the state to administer many of these services.11 HHSC delegates the responsibilities of a mental or behavioral health authority to the 39 LMHA/LBHAs which ensures the provision and continuity of services for individuals with mental illness. LMHA/LBHAs, also known as community centers, are locally governed components of the HHSC service delivery system that provide mental health services in their local service area within their designated geographical region.12 All 254 Texas counties are located within a local service area and are served by at least one community center. The list of authorities and service area map can be found here.

Texas contracts with LMHAs/LBHAs to provide Medicaid state plan services to individuals who meet criteria. This includes the YES Waiver, a Medicaid 1915(c) home and community-based waiver program for children ages 3 to 18 years old with have significant mental health challenges. Waiver enrollment vacancies are allocated by service area to LMHA/LMBHAs, determined by HHSC using information on population size, community need, and local infrastructure.13

The distinction between LMHA and LBHA is that an LBHA is given the authority to support equitable planning in both mental health and substance use.14 While some LMHAs provide substance use services, BHS contracts with 250 other substance use providers to provide prevention, intervention, and treatment services.15 Outreach, screening, assessment, and referral (OSAR) providers serve each of the 11 Texas Health and Human Services regions, providing information about substance use services.16 Many OSARs are incorporated into LMHA/LBHAs or can be subcontracted to community providers through the LMHA/LBHA.17 The list of OSARs and regions served can be found here.

BHS services include outpatient mental health services, community-based hospital services, the full continuum of substance use disorder services, and crisis services, including crisis hotlines and mobile crisis outreach teams. The department also oversees peer support and recovery services, veterans’ mental health, rural mental health, disaster response, and the coordination of forensic and jail diversion.18

BHS is also responsible for administering state and federal grant initiatives that fund behavioral health programs, services, and providers. Federal grants include the Community Mental Health Block Grant (CMHBG), the Substance Abuse Prevention and Treatment Block Grant (SAPT), disaster grants, opioid response grants, and COVID-19 grant funding.19 There are currently four legislatively directed state grant initiatives. These grants include:

  • The Community Mental Health Grant Program;
  •  The Mental Health Grant for Justice-Involved Individuals;
  • Texas Veterans + Family Alliance; and
  • Health Community Collaboratives.20

Additionally, the Office of Mental Health Coordination (OMHC) reports directly to the deputy executive commissioner of the BHS Department. OMHC is tasked with providing broad oversight for state mental health policy as well as managing cross-agency coordination of behavioral health programs, services, and expenditures. According to HHSC, “guiding the work of OMHC is the Texas Statewide Behavioral Health Strategic Plan developed by the Statewide Behavioral Health Coordinating Council (SBHCC) with support from state agencies, state universities and the judiciary.”21

The office developed a website to provide consumers, families, and providers with up-to-date information on mental health and substance use programs and services. More information is available at www.mentalhealthtx.org.

Health and Specialty Care Services

The Health and Specialty Care System oversees the operation of state hospitals and state-supported living centers (SSLCs) across Texas. There are 13 SSLCs that provide campus-based direct services and supports to people with IDD. Locations and information on each SSLC can be found here.

As of February 2024, there are 11 state hospitals across the state, with one – Waco Center for Youth, only serving teens ages 13-17.22 Over the last several legislative sessions, state hospital capacity, infrastructure, and geographical availability has been a state priority. According to HHSC, “the Texas Legislature has invested more than $2.5 billion for replacement and renovation of the hospitals across the state, including new hospitals in Houston, Dallas, Lubbock and Amarillo.”23 Information on state hospital locations, projects’ statuses, bed capacity, and more can be found here.

More details on state hospitals and forensic mental health is in our Policy Environment section.

Access and Eligibility Services

AES provides eligibility determination for a number of state programs including Medicaid, Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), temporary assistance for needy families (TANF), and other state-funded programs. AES also completes determinations for Supplemental Security Income (SSI). While SSI and SSDI are federally funded programs, disability determination for these services is conducted by the state through contracts with the federal government.

Family Health Services

Family Health Services was created in 2022 and encompasses a number of programs supporting the mental health and well-being of Texas families. Among the programs are the SMART Innovation grant program created during the 88th legislative session (SB 26, Kolkhorst/Jetton), Maternal Behavioral Health, Early Childhood Intervention (ECI), Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Child Advocacy Centers (CAC) and Court Appointed Special Advocates (CASA), and the Office of Disability Prevention for Children. Additionally, the passage of SB 24 (88th, Kolkhorst/Frank) will move the Prevention and Early Intervention (PEI) program from DFPS to HHSC under Family Support Services effective September 1, 2024.24,25

Community Services

In 2022, Community Services was created during the realignment of CPSO and focuses on people with disabilities, special health care needs, and older adults. The department consists of many programs transferred from HDIS as well as IDD services. Community Services is responsible for aligning services provided through Area Agencies on Aging, Aging and Disability Resource Centers, Local Intellectual and Developmental Disability Authorities (LIDDAs), and Centers for Independent Living.

Like LMHA/LBHAs, Texans across the state are served by their designated LIDDAs. HHSC delegates authority and responsibility to LIDDAs as the single point of access to certain state-funded IDD services.26 There are 39 LIDDAs across Texas, 38 of which are also the LMHA/LBHA that provide or contract to provide an array of services and supports within their service area. These services and supports include community-based services, service coordination, crisis support, and are responsible for enrolling eligible people into appropriate Medicaid programs or interest lists, such as ICF/IDD and SSLCs, the Home and Community-based Services (HCBS) waiver, and Texas Home Living (TxHmL) waiver.27,28

Organizational Chart

To view the HHSC organizational chart, visit this page.

Fast Facts

  • The 2024-25 HHSC appropriation of all funds was over $93 billion and comprised approximately 29 percent of the state’s entire budget.29
  • In January 2024, approximately 4 million individuals were enrolled in Medicaid. This was a decrease of almost 2 million individuals from May 2023, a majority being children.30
  • The Public Health Emergency (PHE) from COVID-19 allowing continuous Medicaid coverage without renewal ended March 31, 2023. As of February 2024, 2,082,090 Texas residents have been disenrolled from Medicaid, of which 64 percent are children without disabilities.31
  • In Texas, children without disabilities account for 69 percent of Medicaid enrollment but only 30 percent of program spending on direct healthcare services.32
  • In May 2022, Medicaid covered approximately 51 percent of births, 50 percent of children across the state, and 57 percent of nursing home residents in Texas.33
  • In 2022, the uninsured rate for Texans was 16.6 percent.34
  • In January 2021, the Centers for Medicare & Medicaid Services (CMS) approved a 10-year extension of the 1115 Transformation Waiver. Though this was later challenged by CMS, their rescission letter was withdrawn in 2022 and as of March 2024, the extension remains in effect until September 2030.35,36
  • In Texas’ 1115 Waiver extension, the Delivery System Reform Incentive Payment (DSRIP) was authorized through September 30, 2021.37
  • Under the renewal, the DSRIP pool was $3.1 billion each year in federal fiscal years 2018 and 2019, $2.91 billion in 2020, $2.49 billion in 2021, and $0 in 2022.38 One major focus of DSRIP was behavioral health.
  • From 2012-July 2020, 297 providers have earned $19.23 billion to support DSRIP projects.39
  • While no new DSRIP funds were made available after September 2021, CMS approved Texas to continue disbursement of approved DSRIP program funds through January 2024. This extension allows close out of DSRIP program operational requirements and distribution of the remaining performance-based incentive payments to participants.40
  • The Directed Payment Program for Behavioral Health Services is one of four directed payment programs (DPPs) HHSC submitted to CMS for approval as part of its DSRIP Transition Plan. CMS approved DPP BHS for state fiscal year (SFY) 2024 on July 31, 2023.41
  • As of December 2023, Texas had only met about 56.7 percent of the state’s need of mental health professionals and 211 counties were designated as either full or partial Health Professional Shortage Areas for Mental Health (HPSA-MH).42,43
  • As of November 2023, there were 968 individuals waiting for a maximum-security forensic state hospital bed, with the average of 659 days on the waiting list.44
  • As of November 2023, there were 1,200 individuals waiting for a non-maximum-security forensic state hospital bed, with the average of 233 days on the waiting list.45
  • As of August 2022, Texas needs approximately 2,494 staff to bring all state hospitals beds online.46
  • In Texas, opioid-related overdose deaths increased from 2,546 in 2021 to 2,782 in 2022.47
  • A comprehensive census of recovery homes does not exist, but a recent study estimated there are 907 recovery homes in Texas. Oxford House™ is the largest recovery housing provider with nearly 280 homes in Texas.48
  • From FY 2021-22, the number of postpartum depression screenings completed in HHSC programs increased from 7,972 to 8,192. During this same time, the number of claims related to postpartum mental health increased from 12,036 to 12,022.49
  • In Q2 FY 2024, an average of 28,800 children per month received community mental health services by LMHAs/LBHAs across Texas.50
  • The Youth Empowerment Services (YES) waiver served 2,526 children in FY 2022.51
  • From April 2021 to March 2022, over 2,600 children were placed on a waiting list for YES waiver services.52 As of October 2022, there were 528 youth on the YES Waiver inquiry list statewide.53
  • In 2022, more than 500,000 children and adults with intellectual and developmental disabilities (IDD) live in Texas.54
  • As of December 2023, there were over 117,000 individuals with IDD on the Medicaid home and community-based services (HCS) waiting list.55
  • Some individuals with IDD may wait up to 13 years on interest lists for HCS waivers.56
  • The HHSC’s Behavioral Health Services division and Health and Specialty Care System (HCSC) division have established contracts directly with hospitals and indirectly through LMHAs to create a network of community beds to supplement the capacity of the state hospitals. The 2024-25 General Appropriations Act, H.B. 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 52) appropriated funds to maintain the existing contract beds and to add an additional 166 competency restoration beds to serve the forensic population.57
  • As of February 2024, there are 19 OSARs operating across Texas.58
  • DSRIP payments ended in Federal FY 2023. Between FY2014-20, 461 DSRIP projects were funded by over $3.3 billion.59
  • At the end of FY 2023:
    • 527 LMHA and LBHA employees and contractors were active Mental Health First Aid (MHFA) trainers;
    • the average number of active trainers at each LMHA and LBHA was 13; and
    • 70 MHFA trainers left the program.60
  • In FY 2023, the MHFA program and statewide partnerships resulted in 33,346 people trained, including:
    • 168 LMHA and LBHA employees and contractors as new instructors;
      16,624 higher education employees, public school district employees, and school resource officers;
    • 15,295 people from the community who were not higher education employees or employees of a public school district;
      1,259 teenagers trained in teen MHFA; and
    • 6,454 service members, veterans, and their immediate family members.61
  • In FY 22, HHSC oversaw four state-funded matching grant programs supporting community mental health:
    • The Community Mental Health Grant Program served 43,096 unduplicated Texans, trained 1,606 individuals in behavioral health topics, supported 52 grantees across 155 counties, initiated 55 community-based projects, and received $25,500,000 in HHSC-awarded funds.62
    • The Mental Health Grant for Justice-Involved Individuals served 31,254 unduplicated Texans through 37 projects across 45 counties. This was supported by 22 grantees utilizing $25,000,000 in HHSC-Awarded Funds.63
    • The Healthy Community Collaborative Grant Program served 7,245 unduplicated Texans across 13 counties through 6 grantees, utilizing $12,500,000 in HHSC-Awarded funds.64
    • The Texas Veterans + Family Alliance Grant Program served 9,703 unduplicated Texans, trained 2,523 individuals in behavioral health topics, across 185 counties through 17 grantees, utilizing $10,000,000 in HHSC-Awarded funds.65
  • As of 2022, about 852,000 Texas children were uninsured, and about 400,000 of those children were eligible for Medicaid or CHIP.66
  • Effective March 1, 2024, HB 12 (Rose/Kolkhorst) extended Medicaid and CHIP postpartum coverage from two to 12 months, making Texas the 43rd state to extend this coverage.67
  • According to Governor Greg Abbott’s office, Texas projects approximately 137,000 women will benefit from 12-months postpartum coverage in fiscal year 2025.68


Policy Concerns

  • Improving access to community-based mental health and/or substance use services to reduce utilization of more punitive, expensive, and restrictive settings to receive care.
  • Reducing wait list time for inpatient and community-based mental health and substance use services beyond the initial assessment or evaluation.
  • Ensuring resources are available to implement recommendations set forth in the Children’s Mental Health Strategic Plan.
  • Improving enrollment of children eligible for, but not enrolled in, Medicaid and CHIP.
  • Continuing the investment in mental health and substance use services following the expiration of federal COVID relief funds.
  • Expanding Medicaid, or another innovative coverage solution, to ensure individuals with mental health and/or substance use conditions have access to treatment, services, and supports.
  • Reducing the number of uninsured persons in Texas, the highest rate in the country.
  • Addressing the mental health and substance use workforce shortage, particularly the availability in rural areas.
  • Improving availability of affordable, safe, and supportive housing for individuals living with mental health and/or substance use conditions.
  • Implementing voluntary recovery housing certification in Texas to ensure individuals in recovery have access to high quality, safe, and affordable housing.
  • Ensuring access to appropriate recovery support services for individuals receiving medication-assisted treatment (MAT) for substance use.
  • Expanding opportunities for peer support specialists, recovery coaches, and family partner support services.
  • Improving recovery-oriented supports with increased availability of peer recovery coaches, Recovery Community Organizations (RCOs), and community-based aftercare.
  • Allowing Certified Family Partners (CFP) to be eligible for Medicaid reimbursement for their services.
  • Extending eligibility for Medicaid reimbursed peer support services to youth under 21.
  • Addressing the waitlist for services for children available through the YES Waiver.
  • Monitoring efforts of the state hospital redesign to ensure a comprehensive continuum of supports and services.
  • Coordinating cross-agency efforts to address the mental health needs of individuals with intellectual and developmental disabilities (IDD).
  • Improving access to trauma-informed training across HHSC divisions specific to children and adults with intellectual disabilities.
  • Improving access to youth crisis services, including emergency respite.

Legislative Overview

The 88th Texas Legislature finally concluded after four special sessions focused on a variety of social issues. During the regular session, there was a whirlwind of activity with many mental health and substance use issues rising to the forefront. The Uvalde tragedy, youth mental health, workforce challenges, and high substance use overdose deaths were top of mind for many lawmakers.

Ultimately after negotiations and compromises, legislators landed on both some sizable wins and opportunities for improvement on policy issues that would impact Texans. Notably, the Texas budget a significant investment into mental health and programs within HHSC, including increased funding to multiple existing community-based grant programs and $2.3 billion for state hospital infrastructure.

On the other hand, a number of policy solutions and budget recommendations were not adopted, including school mental health efforts and policies to support both suicide prevention and substance use issues in Texas communities. Further, efforts to expand access to peer support specialists, recovery coaches, and certified family partners did not pass. A remaining concern will be the end of several federal funding streams impacting the provision of behavioral health support to Texans. Over the next biennium, federal funds to Texas from the PHE continuous Medicaid coverage, DSRIP project payments, and supplemental COVID-19 funding that will conclude in FY 25.

Passed

HB 1 (BONNEN/HUFFMAN) – GENERAL APPROPRIATIONS TO HHSC FOR MENTAL HEALTH AND SUBSTANCE USE FUNDING

HB 1 funding for mental health and substance use supports the services administered by HHSC throughout the state and are allocated through Article II of the state’s budget. Additional detailed funding information can be found in the Funding section of this guide. The legislature made several decisions, making substantial investments into the state’s crisis system, state hospitals, and community matching grant programs. Some highlights include:

  • Support for the increased workload from unwinding of continuous Medicaid coverage (Rider 27);
  • Rate enhancements for personal attendant services and individualized and specialized services rates (Rider 30);
  • An appropriation to maintain mental health support re-entry program (Rider 44);
  • Requires HHSC to submit a report on wait lists and expenditures for adult and youth community mental health, forensic state hospital beds, and maximum-security beds biannually (Rider 45);
  • Increased funding for community mental health grant programs, including grant programs focused on veterans, justice-involved individuals, communities, Health Community Collaboratives, and a new grant program focused on children’s mental health (Rider 48);
  • Expansive new and increased funding for a number of initiatives including staff at SSLCs and state hospitals; state-purchased inpatient psychiatric beds; step-down housing and state hospital transition teams, crisis stabilization facilities, youth crisis respite, youth mobile crisis outreach teams, certain programs and therapies for youth with significant mental health concerns (Rider 52);
  • Directs HHSC to evaluate and propose reimbursement rates for SABG-funded substance use services (Rider 53);
  • Allows HHSC to identify and use availability at SSLCs for IDD crisis respite (Rider 84); and
  • Directed HHSC to study workforce in state hospitals and SSLCs (rider 95).

HB 12 (ROSE/KOLKHORST) – 12 MONTH POSTPARTUM MEDICAID COVERAGE

Extends Medicaid for Pregnant Women coverage from 60 days to 12 months postpartum for eligible people.

SB 897 (WEST/ROSE) – OPIOID ANTAGONIST PROGRAM

Allows colleges to be included among the entities allowed to be provided opioid antagonists by HHSC opioid antagonist program.

SB 24 (KOLKHORST/FRANK) – TRANSFER OF PROGRAMS FROM DFPS TO HHSC

Transfers prevention and early intervention services currently provided by DFPS to HHSC, consolidates certain support programs within HHSC under a new family support services program, and provides for the establishment of the Thriving Texas Families Program as the continuation of the current alternatives to abortion (A2A) program.

SB 63 (ZAFFIRINI/RAYMOND)– GUIDE FOR LOVED ONES OF VETERANS

Requires Health and Human Services Commission and Texas Veterans Commission to create an instruction guide for family members and caregivers of veterans with mental health conditions, which must be available on both agency’s websites.

HB 299 (MURR/JOHNSON) – VOLUNTARY ACCREDITATION FOR RECOVERY HOUSING

Defines “recovery housing” in statute and establishes a voluntary accreditation process that is consistent with industry standards and best practices.

HB 729 (ROSE/WEST) – STATEWIDE INTELLECTUAL AND DEVELOPMENTAL DISABILITY (IDD) COORDINATING COUNCIL* (VETOED BY THE GOVERNOR ON JUNE 18, 2023)

Establishes a statewide intellectual and developmental disability (IDD) coordinating council, which will develop a strategic plan to address the needs and gaps in service of Texans with IDD.

SB 26 (KOLKHORST/JETTON) – CHILDREN AND FAMILY MENTAL HEALTH GRANT PROGRAM AND LMHA PERFORMANCE AND FINANCIAL AUDITS

Among its provisions, creates a matching grant program for children’s mental health, admission and transition of care for certain individuals, and performance and financial audits of LMHAs.

Did Not Pass

HB 465 (THIERRY) – MEDICAID DOULA COVERAGE PILOT

Would have required HHSC to create a pilot program in the areas of Texas with the highest maternal mortality and morbidity needs for Medicaid coverage of doula services.

HB 1367 (MOODY) – COMMUNITY RECOVERY ORGANIZATIONS

Would have defined “community recovery organizations” and allowed Medicaid reimbursement provided by peers in these organizations.

HB 1898 (JETTON/KOLKHORST) – CHILDREN’S HOSPITALS BEHAVIORAL HEALTH BEDS

Would have established a grant program at HHSC to fund mental and behavioral health expansion at certain children’s hospitals.

HB 3724 (THIERRY) – MATERNAL MENTAL HEALTH PEER SUPPORT PILOT

Would have directed HHSC to develop a maternal mental health peer support program in five Texas counties for women with a mood or anxiety disorder that occurs during pregnancy or within 12 months postpartum, collect data, and issue an annual report.

HB 4702 (CAMPOS/ZAFFIRINI) – IDD PEER SUPPORT SPECIALISTS

Would have directed HHSC to define and develop IDD peer specialist certification and develop a stakeholder work group for the adoption of these rules.

HB 4356 (TALARICO) – OFFICE OF YOUTH SAFETY AND REHABILITATION

Among its provisions, would have established the Office of Youth Safety and Rehabilitation under HHSC and would have been tasked with developing and implementing a plan to complete a staggered closure of TJJD facilities by September 2030.

Funding

HHS Funding Trends: All Funds69,70,71,72,73

References

  1. Texas Health and Human Services. (2024). Health and Human Services Commission strategic plan for Fiscal Years 2025 to 2029, part I. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-strategic-plan-2025-2029-part-1.pdf ↩︎
  2. Texas Health and Human Services Commission. (2022). Legislative appropriations request for Fiscal Years 2024 and 2025. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-legislative-appropriations-request-2024-2025.pdf ↩︎
  3. Texas Health and Human Services. (n.d.). Deputy Executive Commissioner: Family health services, Rob Ries.  Retrieved October 19, 2022, from https://www.hhs.texas.gov/about/leadership/executive-teams-organizational-chart/chief-program-services-officer-michelle-alletto/deputy-executive-commissioner-family-health-services-rob-ries ↩︎
  4. Texas Health and Human Services. (n.d.). Deputy Executive Commissioner: Community services, Haley Turner. Retrieved October 19, 2022, from https://www.hhs.texas.gov/about/leadership/executive-teams-organizational-chart/chief-program-services-officer-michelle-alletto/deputy-executive-commissioner-community-services-haley-turner ↩︎
  5. Texas Transition Legislative Oversight Committee. (2021).  Report to the 87th legislature. https://house.texas.gov/_media/pdf/committees/reports/oversight/TLOC-Report-2021.pdf ↩︎
  6. Texas Health and Human Services Commission Executive Council. November 17, 2022 meeting [Video]. https://texashhsc.new.swagit.com/videos/189884 ↩︎
  7. Texas Health and Human Services Commission Executive Council. August 18, 2022 meeting, Agenda item 1e, Michelle Alletto [Video]. https://texashhsc.new.swagit.com/videos/179135 ↩︎
  8. Ibid. ↩︎
  9. Ibid. ↩︎
  10. Texas Health and Human Services. (n.d.). Local mental and behavioral health authorities. Retrieved May 19, 2024, from https://www.hhs.texas.gov/providers/behavioral-health-services-providers/local-mental-health-authorities ↩︎
  11. Texas Health and Human Services. (2022). Intellectual and development disability and behavioral human services Fiscal Year 2022 in review. https://www.hhs.texas.gov/sites/default/files/documents/idd-bhs-annual-report-fy-2022.pdf ↩︎
  12. Texas Health and Human Services. (n.d.). Community mental health contracts. Retrieved May 19, 2024, from (https://www.hhs.texas.gov/providers/behavioral-health-services-providers/behavioral-health-provider-resources/community-mental-health-contracts ↩︎
  13. Texas Health and Human Services. (2023). Youth Empowerment Services (YES) Waiver policy manual. https://www.hhs.texas.gov/sites/default/files/documents/policy-manual-youth-empowerment-services.pdf ↩︎
  14. Integral Care. (2019). Local Behavioral Health Authority (LBHA). https://integralcare.org/wp-content/uploads/2019/03/Local-Behavioral-Health-Authority-faq-011619.pdf ↩︎
  15. https://www.hhs.texas.gov/providers/behavioral-health-services-providers/behavioral-health-provider-resources/senate-bill-126-mental-health-substance-abuse-public-reporting-system ↩︎
  16. Texas Health and Human Services. (n.d.). Mental health and substance abuse public reporting system. Retrieved May 19, 2024, from  https://www.hhs.texas.gov/services/mental-health-substance-use/mental-health-substance-use-resources/outreach-screening-assessment-referral ↩︎
  17.  Tex. Health. & Safety. Code § 1001.001. https://statutes.capitol.texas.gov/Docs/HS/htm/HS.1001.htm ↩︎
  18. Texas Health and Human Services. (2022). Intellectual and development disability and behavioral human services Fiscal Year 2022 in review. https://www.hhs.texas.gov/sites/default/files/documents/idd-bhs-annual-report-fy-2022.pdf ↩︎
  19. Texas Health and Human Services. (n.d.). Behavioral health services grants. Retrieved May 19, 2024, from https://www.hhs.texas.gov/business/grants/behavioral-health-services-grants ↩︎
  20. Texas Health and Human services. (2022). Behavioral health collaborative matching grant program. https://www.hhs.texas.gov/sites/default/files/documents/behavioral-health-matching-grants-primer.pdf ↩︎
  21. Texas Health and Human Services.  (n.d.). Office of mental health coordination. Retrieved May 19, 2024, from https://www.hhs.texas.gov/about/process-improvement/improving-services-texans/behavioral-health-services/office-mental-health-coordination ↩︎
  22. Texas Health and Human Services.  (n.d.). State hospitals. Retrieved May 19, 2024, from https://www.hhs.texas.gov/services/mental-health-substance-use/state-hospitals ↩︎
  23. Statewide Behavioral Health Coordinating Council. (2023). Coordinated statewide behavioral health expenditure proposal FY 2024. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2024.pdf ↩︎
  24. Texas Health and Human Services. (2024). Family health services [PowerPoint slides]. https://www.hhs.texas.gov/sites/default/files/documents/feb-2024-bhac-agenda-item-5.pdf ↩︎
  25. Ibid. ↩︎
  26.  Texas Human Health and Human Services. (2022). Texas statewide intellectual and developmental disabilities strategic plan. https://www.hhs.texas.gov/sites/default/files/documents/statewide-idd-strategic-plan-jan-13-2022.pdf ↩︎
  27. Texas Council of Community Centers. (2022). Intellectual and Developmental Disability (IDD) system landscape. https://txcouncil.com/wp-content/uploads/2022/10/Funding-IDD_Priorities-CLEAN-090121.FINAL60.pdf ↩︎
  28. https://mentalhealthtx.org/idd-services/ ↩︎
  29. Texas Health and Human Services. (2024). Health and Human Services Commission strategic plan for Fiscal Years 2025 to 2029, part I. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-strategic-plan-2025-2029-part-1.pdf ↩︎
  30. Texas Health and Human Services Commission. (2023). Healthcare statistics, Medicaid and CHIP enrollment: Monthly Medicaid and CHIP enrollment by risk group [Excel]. https://www.hhs.texas.gov/sites/default/files/documents/monthly-enrollment-by-risk-group.xlsx ↩︎
  31. Kaiser Family Foundation. (2024). Medicaid enrollment and unwinding tracker – state enrollment and unwinding data.  https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-state-enrollment-and-unwinding-data/ ↩︎
  32. Stephens, S. & Wood, T. (2022). Presentation to the House Select Committee on Health Care Reform, August 5, 2022 [PDF]. Texas Health and Human Services Commission. https://www.hhs.texas.gov/sites/default/files/documents/presentation-health-care-reform.pdf ↩︎
  33. Ibid. ↩︎
  34. United State Census Bureau. (2022). American Community Survey, selected characteristics of health insurance coverage in the United States [data table]. https://data.census.gov/profile/Texas?g=040XX00US48 ↩︎
  35. Texas Health and Human Services. (n.d.). Waiver renewal. Retrieved May 19, 2024, from  https://www.hhs.texas.gov/regulations/policies-rules/waivers/medicaid-1115-waiver/waiver-renewal ↩︎
  36. Centers for Medicare & Medicaid Services. (n.d.). Texas healthcare transformation and quality improvement program. Retrieved May 19, 2024, from  https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83231 ↩︎
  37. Centers for Medicare & Medicaid Services. (2021). Texas healthcare transformation and quality improvement program demonstration approval. U.S. Department of Health & Human Services. https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-cms-approval-01152021.pdf ↩︎
  38. Texas health and Human Services. (2022). Funding impacts of the delivery system reform incentive payment program transition. https://www.hhs.texas.gov/sites/default/files/documents/funding-impacts-dsrip-transition-report.pdf ↩︎
  39. Texas Health and Human Services. (2021). DSRIP transition plan milestone: Support further delivery system reform. https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/Waivers/medicaid-1115-waiver/dsrip-support-delivery-system-reform.pdf ↩︎
  40. Texas Health and Human Services. (2021). DSRIP transition partner engagement & executive waiver committee quarterly meeting. https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/Waivers/medicaid-1115-waiver/dsrip-partner-engagement-plan-sept-2021.pdf ↩︎
  41. Texas Health and Human Services. (n.d.). Directed Payment Program for Behavioral Health Services (DPP BHS). Retrieved May 19, 2024, from https://www.hhs.texas.gov/providers/medicaid-business-resources/medicaid-chip-directed-payment-programs/directed-payment-program-behavioral-health-services-dpp-bhs ↩︎
  42. Health Resources and Service Administration. (2023). Designated health professional shortage areas statistics, first quarter of Fiscal Year 2024 designated HPSA quarterly summary. U.S. Department of Health and Human Services. https://data.hrsa.gov/default/generatehpsaquarterlyreport ↩︎
  43. Health Resources and Service Administration. (2022). Shortage areas. U.S. Department of Health and Human Services. Retrieved October 13, 2022, from https://data.hrsa.gov/topics/health-workforce/shortage-areas ↩︎
  44. Texas Health and Human Services. (2023). Report on waiting lists for mental health services. https://www.hhs.texas.gov/sites/default/files/documents/mhs-waiting-lists-nov-2023.pdf ↩︎
  45. Ibid. ↩︎
  46. Schalchin, S. (2022). Presentation to Senate Health and Human Services Committee on the Health and Specialty Care System workforce, August 23, 2022. Texas Health and Human Services Commission. https://www.hhs.texas.gov/sites/default/files/documents/senate-health-and-human-services-presentation-hscs-workforce.pdf ↩︎
  47. Texas Department of State Health Services. (n.d.). Drug related deaths. Retrieved March 14, 2024, from https://healthdata.dshs.texas.gov/dashboard/drugs-and-alcohol/drug-related-deaths ↩︎
  48. Texas Health and Human Services Commission. (May 2022). Housing choice plan. https://www.hhs.texas.gov/sites/default/files/documents/housing-choice-plan-report.pdf ↩︎
  49. Texas Health and Human Services Commission. (2023). Maternal depression strategic plan for Fiscal Years 2021-2025: Fiscal Year 2023 update. https://www.hhs.texas.gov/sites/default/files/documents/hb253-postpartum-depression-strategic-plan-update-oct-2023.pdf ↩︎
  50. Texas Health and Human Services. (2024). Report on waiting lists for mental health services. https://www.hhs.texas.gov/sites/default/files/documents/mhs-waiting-lists-may-2024.pdf ↩︎
  51. Ibid. ↩︎
  52. Texas Health and Human Services Commission. (February 2022). Public Data Request. ↩︎
  53. Texas Health and Human Services Commission. (N. Weaver, personal communication, October 14, 2022). ↩︎
  54. IDD Strategic Planning Group. (January 2022). Texas statewide Intellectual and Developmental Disabilities strategic plan. Texas Health and Human Services Commission. https://www.hhs.texas.gov/sites/default/files/documents/statewide-idd-strategic-plan-jan-13-2022.pdf ↩︎
  55. Texas Health and Human Services Commission. (2023). Summary of interest list releases-December 2023 [Excel]. https://www.hhs.texas.gov/sites/default/files/documents/interest-list-data-dec-2023.xlsx ↩︎
  56. IDD Strategic Planning Group. (2022). Texas statewide Intellectual and Developmental Disabilities strategic plan [PDF]. Texas Health and Human Services Commission. https://www.hhs.texas.gov/sites/default/files/documents/statewide-idd-strategic-plan-jan-13-2022.pdf ↩︎
  57. Statewide Behavioral Health Coordinating Council. (2023). Coordinated statewide behavioral health expenditure proposal FY 2024. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2024.pdf ↩︎
  58. Texas Health and Human Services. (n.d.). Outreach, screening, assessment and referral. Retrieved May 19, 2024 from https://www.hhs.texas.gov/services/mental-health-substance-use/mental-health-substance-use-resources/outreach-screening-assessment-referral ↩︎
  59. Statewide Behavioral Health Coordinating Council. (2023). Coordinated statewide behavioral health expenditure proposal FY 2024. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2024.pdf ↩︎
  60. Texas Health and Human Services. (December 2023). Report on the Mental Health First Aid Program for Fiscal Year 2023. https://www.hhs.texas.gov/sites/default/files/documents/mental-health-first-aid-program-dec-2023.pdf ↩︎
  61. Ibid. ↩︎
  62. Texas Health and Human Services. (2022). Community mental health grant Fiscal Year 2022 report card. https://www.hhs.texas.gov/sites/default/files/documents/23d0378-cmhg-report-card-fy22.pdf ↩︎
  63. Texas Health and Human Services. (2022). Mental health grant for justice-involved individuals Fiscal Year 2022 report card. https://www.hhs.texas.gov/sites/default/files/documents/mhg-jii-grant-program-report-card-fy22.pdf ↩︎
  64. Texas Health and Human Services. (2022). Healthy community collaborative grant program Fiscal Year 2022 report card. https://www.hhs.texas.gov/sites/default/files/documents/hcc-grant-program-report-card-2022.pdf ↩︎
  65. Texas Health and Human Services. (2022). Texas veterans + family alliance grant program Fiscal Year 2022 report card. https://www.hhs.texas.gov/sites/default/files/documents/tvfa-grant-program-report-card-2022.pdf ↩︎
  66. Alker, J. & Osorio, A. (2023). Medicaid’s pandemic-era continuous coverage protections helped reduce number of uninsured children. Center for Children and Families at Georgetown University.  https://ccf.georgetown.edu/wp-content/uploads/2023/11/ACS-uninsured-kids-2023_11-10-1.pdf ↩︎
  67. Harper, K. B. (2024, January 17). Feds approve 12 months of Medicaid coverage for low-income Texas moms. Texas Tribune. https://www.texastribune.org/2024/01/17/texas-medicaid-postpartum/ ↩︎
  68. Office of Texas Governor Greg Abbott. (2024, January 17). Governor Abbott, HHSC, announce Medicaid, CHIP postpartum coverage extension to 12 months [Press release]. https://gov.texas.gov/news/post/governor-abbott-hhsc-announce-medicaid-chip-postpartum-coverage-extension-to-12-months#:~:text=%E2%80%9CTwelve%20months%20of%20postpartum%20coverage,effect%20on%20March%201%2C%202024 ↩︎
  69. Texas Legislature Online (2017). S.B. 1, General Appropriations Act, 85th Legislature, FY 2018-19.  https://capitol.texas.gov/tlodocs/85R/billtext/pdf/SB00001F.pdf#navpanes=0 ↩︎
  70. Texas Legislature Online (2019). H.B. 1, General Appropriations Act, 86th Legislature, FY 2020-21.  https://capitol.texas.gov/tlodocs/86R/billtext/pdf/HB00001F.pdf#navpanes=0 ↩︎
  71. Texas Legislature Online (2021). S.B. 1, General Appropriations Act, 87th Legislature, FY 2022-23. https://capitol.texas.gov/tlodocs/87R/billtext/pdf/SB00001F.pdf#navpanes=0 ↩︎
  72. [1] Texas Legislature Online (2023). H.B. 1, General Appropriations Act, 88th Legislature, FY 2024-25. https://capitol.texas.gov/tlodocs/88R/billtext/pdf/HB00001F.pdf#navpanes=0 ↩︎
  73. lbid. ↩︎

Updated on December 16th, 2024



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