State Funding

Coordinated Statewide Behavioral Health Expenditure Proposal

The Statewide Behavioral Health Coordinating Council (SBHCC) is comprised of the 26 state agencies and institutions of higher education that receive state funding for behavioral health services. Each entity provides some level of mental health/substance use services or mental health/substance use education and training. This may be provided directly by the funded entity or through contracted services. In FY 2024, SBHCC member agencies and institutions of higher education received $6 billion in behavioral health funding, including Medicaid behavioral health funding.1

Along with the SBHCC, the Health and Human Services Commission (HHSC) has made great strides in identifying and coordinating behavioral health services funding through the initial development and annual updating of the Coordinated Statewide Behavioral Health Expenditure Proposal. The legislation-mandated proposal links funding to the strategies included in the Statewide Behavioral Health Strategic Plan. The SBHCC is also required to analyze all the member agencies’ exceptional items requests related to behavioral health to ensure that they are coordinated and non-duplicative. All these efforts are to better align existing state and local services, reduce duplication, and utilize funding more efficiently.

Between the FY 2023 expenditure proposal and FY 2024 expenditure proposal, the Department of Agriculture, Texas Education Agency, and University of Texas Health Science Center at San Antonio were added due to having appropriated behavioral health-related funding in Article IX, Section 10.04(d) for fiscal years 2024 and 2025.

The coordinated expenditure proposal for FY 2024 is shown below.

Coordinated Statewide Behavioral Health Expenditure Proposal Summary (2024)2

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Table Notes

1Office of the Governor (OOG) – OOG’s behavioral health funding included in this proposal differs from amounts included in Section 10.04 for several reasons. 1) The Edward Byrne Memorial Justice Assistance Grant Program, Crime Victim Assistance Program, Violence Against Women Program, and the Juvenile Justice & Delinquency Prevention Program are federal formula grant programs. The annual award amounts provided to the OOG are based on congressional appropriations and federal formulas that are subject to change year-to-year. 2) These funding sources are also competitive grant programs that support a wide array of initiatives including behavioral health and non-behavioral health services. Actual expenditures related to behavioral health will vary yearly based on the grant applications submitted, state and local priorities, and whether those projects intend to support behavioral health-related activities.

2 Texas Veterans Commission (TVC) – This proposal differs from the amounts included in Section 10.04 as the amount reported in TVC’s 2022-23 Legislative Appropriations Request (LAR) does not include the costs associated with employee benefits costs for fiscal year 2023. The numbers reported for the fiscal year 2023 Expenditure Proposal Report Draft includes all costs, to include employee benefit costs. The SBHCC plans to report all costs in 2024-25 LAR amounts. 

3 Department of Family and Protective Services (DFPS) – DFPS’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 due to updated financial data. 

4 Department of State Health Services (DSHS) – DSHS’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because amounts listed in Section 10.04 were based on estimates included in DSHS’s LAR. The amounts included in this proposal are actual amounts. 

5 Health and Human Services Commission (HHSC) – HHSC’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because amounts listed in Section 10.04 were based on estimates included in HHSC’s LAR. The amounts included in this proposal are actual amounts. 

6 Texas Department of Criminal Justice (TDCJ) – TDCJ’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 because amounts listed in Section 10.04 were based on estimates included in TDCJ’s LAR. The amounts included in this proposal are actual amounts.

7Texas Juvenile Justice Department (TJJD) – TJJD’s behavioral health funding amounts included in this proposal differ from the amounts included in Section 10.04 due to the increase in regional diversion authorization applications and placements costs.

8Texas State Board of Pharmacy includes Prescription Monitoring Program which was added in fiscal year 2022.

Expenditure Proposal Summary by Service Type Category3

General Appropriations Act – House Bill 1 (Bonnen/Huffman)

The general appropriations bill, or the General Appropriations Act (GAA), is the state’s budget and is the only legislation the legislature is required to pass each biennium. During the 88th legislative session, House Bill 1(Bonnen/Huffman) was passed as the general appropriations bill.  It must be approved by both the Texas House of Representatives and the Texas Senate, certified by the Comptroller, and signed by the Governor. The governor has line-item veto authority, meaning they can remove singular items from the budget without the entire bill being vetoed.

The GAA is divided into administrative sections, called articles, under which agencies are organized. The majority of state mental health and substance use funding is appropriated through Article II to the Texas Health and Human Services Commission (HHSC). The general appropriations bill includes funds from a variety of sources, including both state (“General Revenue”) and federal (“Federal Funds”).

Budget Adjustments

The enacted appropriations bill may be adjusted after it takes effect by the Legislature to reduce or adjust appropriations. These adjustments may be a result from the appropriations bill itself including provisions allowing agencies to make discretionary transfers between appropriations items, subject to various limitations or prior approval by the governor and LBB.4

Further, these adjustments may reflect certain Article IX (General Provisions) appropriations into relevant agency bill patterns; other legislation enacted during the regular or subsequent special session(s) that affect appropriations; supplementary budget allocations; and the Governor’s vetoes.5

The budgeted amounts in an agency’s Legislative Appropriations Request (LAR) reflect the most recent budget accounting for any adjustments.

Mental Health and Substance Use State Appropriations

Over the past decade, overall funding for behavioral health services has increased, although there have been ebbs and flows in specific budget items. The below charts show funding trends of specific HHSC budget strategies over the last four fiscal bienniums.

Article II: Health and Human Services Commission

Budget Strategy Funding Trends: All Funds6

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*Prior to FY20-21, funding for Community Mental Health Grants was included within Community Mental Health Crisis Services.

**Cost of operations (this does not include construction and planning costs for facilities; these costs are included in the supplemental appropriations).

Budget Strategy Funding Trends: General Revenue (GR)7,8,9,10***

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***GR encompasses by both GR and GR-D

Note:  In order to compile strategy level of budget detail, agency’s LARs are utilized, whereas the initial enacted state appropriations act is reflected in all other appropriations data throughout this Guide.

Budget Strategy Funding Trends: Federal Funds11,12,13

Note:  In order to compile strategy level of budget detail, agency’s LARs are utilized, whereas the initial enacted state appropriations act is reflected in all other appropriations data throughout this Guide.

Budget Riders

Budget riders are legislative directives that instruct agencies on how to spend certain appropriated funds. Riders do not typically provide additional or new funding. While there are many more directives to agencies described through riders, the below are related to mental health and substance use.

Article II – HHSC

Article II Budget Riders

Rider #4: Cost Comparison of Residential and Nonresidential Services – Directs HHSC to analyze state and federally funded residential and nonresidential services in the Home and Community-based Services (HCBS) waiver program, the Texas Home Living waiver program (TxHmL), and Intermediate Care Facilities for Individuals with IDD (ICF/IDD). Requires a report no later than August 31, 2024.

Rider #9: Increase Consumer Directed Services – Directs HHSC to educate STAR+PLUS HCBS consumers on the Consumer Directed Services option to increase the percentage of individuals who choose this option. HHSC is responsible for collecting annual data from each Managed Care Organization (MCO) and compiling a report which will be made public and given to the Texas Council on Consumer Direction.

Rider #12: Medically Dependent Children Program (MDCP) and Youth Empowerment Services (YES) Waivers – Includes funding for MDCP and YES waiver services for clients enrolled in the STAR Kids program. This does not create an entitlement to waiver services.

Rider #19 : Interest List Reporting – Directs HHSC to post information related to waitlists for HCS, Community Living Assistance and Support Services (CLASS), Deaf-Blind Multiple Disabilities (DBMD), TxHmL, and MDCP and STAR+PLUS on its website.

Rider #21: HHSC Cost Containment – Directs HHSC to develop and implement cost containment initiatives to achieve savings of at least $450,000,000 in GR for FY2024-25 throughout the HHS system and submit an annual report by December 1. Requires the initiatives to include:

  • Increasing fraud, waste, and abuse prevention and detection;
  • Seeking to maximize federal flexibility under the Medicaid program;
  • Achieving other programmatic and administrative efficiencies; and
  • Savings from services that include emergency telemedicine services for individuals with intellectual and developmental disabilities.

Rider #23: Medicaid Provider Rate Increases – It is the intent of the Legislature that when Medicaid provider rates are increased as a result of a legislative appropriation, managed care organizations reimburse the full amount of the appropriated funds to providers, to the extent allowed by federal laws and regulations.

Rider #26: End-of-Year Waiver Slots Funding – Informational listing identifying funding for:

  • STAR+PLUS HCS: $941,304,984 in GR and $1,466,089,763 in federal funds in FY24 for 60,806 waiver slots and $959,074,381 in GR and $1,481,532,677 in federal funds for FY25 for 61,293 waiver slots;
  • MDC Program: $424,602,498 in GR and $655,792,377 in federal funds in FY24 for 6,107 waiver slots and $435,754,842 in GR and $665,965,477 in federal funds in FY25 for 6,187 waiver slots;
  • HCBS: $506,167,919 in GR and $809,066,632 in federal funds in FY24 for 28,517 waiver slots and $520,315,970 in GR and $823,292,564 in federal funds in FY25 for 29,089 waiver slots;
  • CLASS: $121,797,093 in GR and $227,925,475 in federal funds in FY 2024 for 6,282 waiver slots and $124,808,692 in GR and $231,135,832 in federal funds in FY 2025 for 6,388 waiver slots;
  • DBMD: $7,324,801 in GR and $12,371,962 in federal funds in fiscal year 2024 for 310 waiver slots and $7,502,401 in GR and $12,520,210 in federal funds in fiscal year 2025 for 314 waiver slots; and
  • TxHmL: $25,555,609 in GR and $47,605,478 in federal funds in fiscal year 2024 for 2,934 waiver slots and $27,307,262 in GR and $50,256,534 in federal funds in fiscal year 2025 for 3,085 waiver slots.
  • An additional $50,000,000 in GR to increase waiver slots and reduce interest lists.

Rider #27: Medicaid Coverage Unwinding – Allocates $31,098,585 in GR and $61,253,821 in federal funds in FY24 and $6,794,845 in GR and $14,178,839 in federal funds in FY25 for temporary FTEs to support increased workload for the unwinding of continuous Medicaid coverage. The positions are intended to be phased out by June 30, 2024.

Rider #28: 2-1-1 Texas Information & Referral Network (TIRN) – Allocates $375,000 in GR and $379,420 in federal funds each fiscal year for staff retention and hiring at each Area Information Centers, and allocates $375,000 and $684,143 in federal funds each fiscal year for technological improvements.

Rider #30: Attendant Wages Funding – Informational listing identifying funding for:

  • Base wage for personal attendant services: $773,185,216 in GR and $1,176,676,992 in federal funds over the biennium to increase to $10.60 per hour for FY24-25.
  • Attendant care rate enhancement program: $4,493,605 in GR and $7,405,221 in federal funds in FY25 for.
  • Individualized and specialized services rate enhancement program: $6,246,285 in GR and $9,479,424 in federal funds each fiscal year to increase to $0.05 per level.
  • Directs HHSC to evaluate the rate enhancement program paid in Medicaid to providers to increase reimbursement for direct and attendant care services.

Rider #41: Contingency for Behavioral Health Funds – Instructs the comptroller to not allow the expenditure of certain funds if the planned expenditure does not satisfy the requirements of the Statewide Behavioral Health Strategic Plan and Coordinated Expenditures.

Rider #42: Mental Health Outcomes and Accountability – Requires HHSC to place 10% of the funds allocated to Local Mental Health Authorities (LMHAs) and Local Behavioral Health Authorities (LBHAs) at risk. Allows HHSC to recoup funds for failure to achieve outcome targets set by HHSC.

Rider #43: Mental Health Appropriations and Federal Matching Opportunities – Directs HHSC to include in mental health services (adults, children, and crisis services) contract provisions that GR funds must be used as much as possible to draw down additional federal dollars through the 1115 Transformation Waiver or other federal matching opportunities. Requires a legislative report December 1 of each fiscal year. Does not relieve LMHAs or LBHAs of any HHSC contract requirements.

Rider #44: Mental Health Peer Support Re-entry Program – Allocates up to $1 million in GR for the biennium to maintain a mental health peer support re-entry program that uses certified peer support specialists to ensure individuals transition from the county jail into clinically-appropriate community-based care.

Rider #45: Mental Health Services Waiting Lists – Directs HHSC to submit a report on the current waiting list and related expenditure data for community mental health services for adults, community mental health services for children, forensic state hospital beds, and maximum-security forensic state hospital beds. Data shall be submitted November 1 and May 1 of each fiscal year.

Rider #46: Mental Health Program for Veterans – Allocates $3,956,000 in GR each fiscal year to administer the mental health program for veterans. Requires a legislative report December 1 of each fiscal year.

Rider #47: Consolidated Reporting of Opioid-Related Expenditures – Directs HHSC to submit a report of annual expenditures from the previous fiscal year for all opioid abuse and misuse-related programs at HHSC, DFPS, and DSHS no later than June 1 of each year.

Rider #48: Community Mental Health Grant Programs – Informational listing identifying:

  • $10 million in GR each fiscal year for a grant program for mental health services for veterans and their families;
  • $40 million in GR each fiscal year for a grant program reducing recidivism, arrest, and incarceration among individuals with mental illness and to reduce wait time for forensic commitment;
  • $5 million in GR each fiscal year for a grant program reducing recidivism, arrest, and incarceration among individuals with mental illness and to reduce wait time for forensic commitment in the most populous county;
  • $27.5 million in GR each fiscal year for the community mental health grant program;
  • $16.5 million in GR each fiscal year to provide grants for Healthy Community Collaboratives; and
  • $7.5 million in GR each fiscal year for an innovation grant program to support community-based initiation for children and families. With the passage of SB 26 (Kolkhorst/Jetton), an additional $7.5 million in GR each fiscal year is allocated.

Report is required by November 1, 2024.

Rider #49: Community Mental Health Block Grant (MHBG) – Directs HHSC to report the use of the federal MHBG funds from the previous fiscal year including an itemized list and detailed description of each activity, if an activity was funded by COVID-19 related awards, expenditures by funding stream, and the amounts expended, unexpended and unobligated business no later than June 1 of each fiscal year.

Rider #50: Substance Abuse Prevention and Treatment Block Grant (SABG) – Directs HHSC to report the use of the federal SABG funds from the previous fiscal year including an itemized list and detailed description of each activity, if an activity was funded by COVID-19 related awards, expenditures by funding stream, and the amounts expended, unexpended and unobligated business no later than June 1 of each fiscal year.

Rider #51: Outpatient Integrated Care Clinic Project – Appropriates $6 million in GR in FY 24 to HHSC to partner with an acute care hospital with child and adolescent psychiatric inpatient beds in Jefferson County to establish a clinic utilizing the Collaborative Care Model.

Rider #52: Additional Mental Health Funding – Informational listing identifying GR funding for:

  • HHSC Frontline Staff Salary Increases
    • State Supported Living Centers: $101,729,614 in FY24 and $101,729,070 in FY25; and
    •  State Hospitals: $67,340,974 each fiscal year.
  • Expansion of Community Inpatient Beds
    • State Hospital Contract Beds: $4,197,500 each fiscal year to contract for 20 competency restoration beds and $4,068,000 each fiscal year for 16 beds;
    • John S. Dunn Behavioral Health Sciences Center: $4,730,400 each fiscal year to increase funding for 144 beds and $6,132,000 each fiscal year for 24-bed expansion to address forensic waitlist;
    • Purchased Psychiatric Beds: $99,098,599 each fiscal year to maintain current capacity and for 193 additional state-purchased beds, including 70 in rural communities and 123 in urban communities. Of this funding, $13.7 million is required to be used in Uvalde, and 20 contracted beds for children in DFPS conservatorship;
    • Inpatient Capacity Expansion: $45,834,616 each fiscal year to contract for 150 competency restoration beds; and
    • Sunrise Canyon: $2.9 million each fiscal year to increase funding for inpatient beds at Sunrise Canyon Hospital.
  • Step-down Housing and State Hospital Transitions
    • State Hospital Transition Teams: $2.5 million each fiscal year to establish teams to support individuals at-risk of state hospital re-admission through coordinate and needs in the community; and
    • Step-down Housing Expansion: $8.5 million each fiscal year for step-down housing for individuals transitioning into the community.
  • Crisis Services
    • Crisis Stabilization Facilities
      • $14 million each fiscal year to fund up to 5 crisis stabilization facilities;
      • $2.5 million in FY24 to the LMHA servicing Montgomery, Walker and Liberty counties;
      • $4 million each fiscal year to the LMHA servicing Galveston County; and
      • $4 million each fiscal year to the LMHA servicing the Heart of Texas region.
    • Youth Crisis Respite: $5,750,000 each fiscal year to fund four youth-serving crisis respite units and pilot three peer-run units
    • Youth Mobile Crisis Outreach Team (MCOTs): $7 million each fiscal year to establish youth MCOTs, including four teams for children served by DFPS
  • Programs for High-Risk Youth
    • Multisystemic Therapy (MST): $15,225,000 each fiscal year;
    • Coordinated Specialty Care (CSC): $2.1 million each fiscal year; and
    • Uvalde Community: $5 million in FY25 to start and operate a new Uvalde Behavioral Health Campus.
  • Administration and Oversight Funds:
    • Contracted Inpatient Beds: $585,121 in FY24 and $546,529 in FY25
    • Mental Health Grants: $1,071,316 in FY24 and $970,0505 in FY25
    • Budget Execution/ MST, CSC and Uvalde: $411,332 in FY24 and $368,585 in FY25
    • Crisis Services: $345,191 in FY24 and $321,875 in FY25
    • Innovation Grants: $88,079 in FY24 and $80,306 in FY25

Rider #53: Rates: Reimbursement for Federal SABG Services – Identifies the intent of the Legislature that HHSC evaluate the rate setting methodology for reimbursement for services provided by SABG recipients and propose new rates no later than October 1, 2023 with an opportunity for public comments on the proposed rates.

Rider #54: Local Authority Workforce Capacity – Directs HHSC to allocate $11,935,624 each fiscal year to local mental health authorities, local behavioral health authorities, and local intellectual and developmental disability authorities proportionally based on FY23 funding levels.

Rider #55: Contracted Mental Health Beds at University of Texas Health Science Center at Tyler (UT Tyler) – Directs HHSC to allocate $889,800 in GR in FY24 and $887,683 in GR in FY25 to increase the bed-day rate for inpatient mental health contracted beds at UT Tyler.

Rider #56: Rural Hospital Telepsychiatry Consultations – Directs HHSC to appropriate $3.7 million in GR in each fiscal year for telepsychiatry consultations at rural hospitals, and contract with a statewide organization to aggregate telepsychiatry consultations.

Rider #79: Funding for Child Advocacy Center Programs and Court Appointed Special Advocate Programs – Allocates $29,827,834 in GR, $5 million in GR – Dedicated Sexual Assault Program No. 5010, and $6,948,063 in federal funds each fiscal year for contracting with a statewide organization for training, technical assistance, evaluation, and fund administration for local children’s advocacy center programs. Allocates $15,950,500 in GR, and $13,500 in License Plate Trust Fund Account No. 0802, each fiscal year for contracting with a statewide organization for training, technical assistance, and evaluation for the benefit of a local volunteer advocate program. Requires HHSC to submit a report December 1 of each fiscal year of expenditures.

Rider #83: Unexpended Balances: Intellectual and Developmental Disabilities (IDD) Crisis Funding – Allocates $14 million in GR each fiscal year allocated for crisis intervention and respite services, that if unexpended and unobligated balances remain as of August 31, 2024, are appropriated for the same purposes for FY25.

Rider #84: Crisis Intervention and Respite Services – Allows HHSC to identify and use any available SSLC space for crisis respite services to individuals with IDD provided by HHSC, the local intellectual and developmental disability authority, or other entity that operates a crisis respite program under contract with HHSC.

Rider #85: Multi-Assistance Center Demonstration Project – Appropriates $7.5 million in GR each fiscal year to support a demonstration project providing comprehensive medical, therapeutic, and non-medical services to adults and children with special needs in Bexar County and the South Texas region.

Rider #91: Behavioral Support Specialists at State Supported Living Centers – Requires San Angelo SSLC and Mexia SSLC to provide behavioral support specialists to assist the alleged offender residents with any specialized educational needs.

Rider #92: State Supported Living Center Oversight – Directs HHSC to provide notification when an SSLC reaches substantial compliance with a section of the Department of Justice Settlement Agreement and is no longer subject to monitoring in that area. Requires HHSC to report of all monthly expenditures by SSLC service costs no later than April 1 and October 1 of each fiscal year, and data on cost reductions no later than April 1 and October 1 of each fiscal year.

Rider #93: Maximum Security Salaries – Directs a 6.8% increase for salary rates of employees working in Maximum Security or Behavioral Management Units at state hospitals and SSLCs.

Rider #95: State Hospital and State Supported Living Center Workforce – Directs HHSC to evaluate compensation levels, turnover and vacancy rates and patterns, use of contractors and position type, and recruiting efforts at the state hospitals and state supported living centers. Requires a report by August 31, 2024.

Rider #96: Expenditure Reporting at the State Hospitals – Requires HHSC to report monthly expenditures for each State Hospital no later than April 1 and October 1 of each fiscal year.

Rider #104: State Hospital Salary Funding – Appropriates $17,530,335 in GR each fiscal year to maintain funding for salary increases to address staffing challenges. If by December 1, 2023, HHSC is unable to hire enough staff to allow offline state hospital beds to be utilized, HHSC may instead allocate the funding to contract for additional competency restoration beds.

Rider #107: State Hospital Cost Study – Directs HHSC to analyze data provided by the University of Texas Health Science Center at Houston on operating cost data for all state-contracted inpatient mental health hospital beds and issue a report by September 1, 2024.

Rider #108: One-time Funding for Facility Inflationary Costs – Appropriates one-time amounts to address increasing costs for SSLCs and mental health state hospitals, including $4,518,050 in GR in each fiscal year for SSLCs, $2,764,946 in GR each fiscal year for state hospitals, and $202,177 in GR each fiscal year for community mental health hospitals.

Rider #109: State Hospital Forensic Waitlist – Identifies the intent of the legislature for HHSC to prioritize forensic admissions to state hospitals to the waitlist. Directs HHSC to report on each state hospital’s census, including the breakdown of civil, forensic, and maximum-security patients by October 1 of each fiscal year.

Article III- Texas Education Agency (TEA)

While TEA does not have any dedicated strategies for student mental health or school climate, there are funded programs that may contribute to student mental health and well-being. The amounts below reflect only the program, not the strategy in its entirety as strategies are far more encompassing.

Program/Support SB 1 
FY 2022/23 (87th session passed budget) 		HB 1 
FY 2024/25 (88th session passed budget) 		Difference 
Mental Health Services in Out of School Time – included in Strategy A.2.1  
$0		$5,000,000 $5,000,000 
Amachi Texas – included in Strategy A.2.2 $5,000,000 $10,000,000 $5,000,000 
Disability Community-Based Support – included in Strategy A.2.3 $1,974,600 $1,974,600 $0 
School Safety Allotment – included in Strategy A.1.1* $100,000,000 $100,000,000 $0 
Communities in Schools – included in Strategy A.2.4 $61,043,632 $68,840,532 $7,796,900 
Best Buddies – included in Strategy A.2.4$500,000 $2,000,000 $1,500,000 
Customized School Safety Programming – included in Strategy B.2.2 $2,000,000 $2,000,000 $0 
*Note: The School Safety Allotment’s allowable uses include mental health and “school climate” uses. 

Article III TEA Budget Riders

Rider #3: School Safety Funding within Foundation School Program – Allocates $9.72 per student in average daily attendance, estimated to be $50,000,000 in each fiscal year.

Rider #16: Non-educational Community-based Support Services – Allocates $987,300 each fiscal year to non-educational community-based support services for certain students with disabilities.

Rider #17: Professional Development for the Provision of Access to the General Curriculum for Students with Disabilities in the Least Restrictive Environment – Directs TEA to use 10.5% of federal discretionary funds awarded through Individuals with Disabilities Education Act (IDEA) during the biennium for capacity building, including professional development and support, for school districts to provide learning in the least restrictive environment for students with disabilities and Multi-Tiered Systems of Support (MTSS) for struggling learners in general education. Requires legislative reports no later than August 21, 2024 and 2025.

Rider #21: Communities in Schools – Allocates $30,521,816 in GR and $3,898,450 in Temporary Assistance for Needy Families (TANF) funds in FY24 and $30,521,816 in GR and $3,898,450 in TANF funds in FY 24 to the Communities in Schools Program. Additionally, $943,892 in TANF funds each fiscal year will be allocated for administrative purposes of the program. Transfer of GR funds for providing administrative support may not exceed $100,000 for the 2024-25 biennium.

Rider #32: Early Childhood Intervention (ECI) – Allocates $16,498,102 each fiscal year from the Special Education allotment to be set aside and transferred to HHSC to support ECI eligibility and comprehensive and transition services. Directs TEA to enter into a memorandum of understanding (MOU) with HHSC no later than October 1, 2024.

Rider #33: Funding for Regional Education Service Centers – Allocates $11,875,000 each fiscal year to be distributed to ESCs for providing professional development and other technical assistance services to school districts, with additional distributions to school districts serving fewer than 1,600 students. A legislative report on expenditures, savings, services, staff, programs, and funding transferred from TEA is due no later than December 1st of each even numbered year.

Rider #41: Student Success Initiative/Community Partnerships – Allocates $5,245,000 each fiscal year to school districts in the most struggling neighborhoods and with high percentages of students struggling with state assessments to implement a comprehensive program by leveraging academic, community, and governmental supports.

Rider #46: Amachi Texas – Allocates $5 million in GR each fiscal year to the Amachi Texas program to mentor youth of incarcerated parents in coordination with Big Brothers Big Sisters Lone Star and other community-based resources for training, services, and funding.

Rider #63: Funding for Customized School Safety Programming – TEA Commissioner shall allocate $1 million in GR each fiscal year to a non-governmental organization with an established safe school institute to provide customized school safety programming.

Rider #66: Athletic Programs for Students with Disabilities – Allocates $1.9 million each fiscal year to provide grants for organizations that provide comprehensive early child development to adult transition programs with data-based health, social, leadership, transition and athletic programs for students with intellectual disabilities.

Rider #85: Fentanyl Contamination Training – Allocates $2,611,722 in FY24 from the Opioid Abatement Account No. 5189 to provide training created by The University of Texas Health Science Center at San Antonio by ESCs to school staff on the dangers of fentanyl contamination.

Rider #86: Best Buddies – Allocates $1 million each fiscal year to support the Best Buddies program.

Rider #88: Mental Health Services in Out of School Time – Allocates $2.5 million each fiscal year to fund the Texas Partnership for Out of School Time (TXPOST) to implement mental health programs in community-based out of school time (OST) and statewide intermediary infrastructure to support OST programs and professionals.

Article III- Higher Education

Institutions of Higher Education do not always have dedicated strategies for mental health and well-being. The amounts shown below reflect funds dedicated to a program that address these integral components to student learning and campus environment, as well as workforce-related strategies that are conducted by the Texas Higher Education Coordinating Board (HECB) or an institute of higher education. 

Article III- Higher Education Budget Riders

HECB #27: Family Practice Rural and Public Health Rotations – Allocates $113,957 each fiscal year for one month rural or public health rotations for family practice residents.

HECB #40: Autism Grant Programs – Directs HECB to distribute funding to autism research centers that provide behavioral health services and trainings. Allocates $2,055,000 per fiscal year for parent-directed treatment to serve 750 children; $950,000 each fiscal year for Board-certified Behavioral Analysts Training for teachers and paraprofessionals to serve 2,547 children; $700,000 each fiscal year for research and evaluation of treatment models; and $150,000 each fiscal year for administrative support.

HECB #46: Texas Child Mental Health Care Consortium (TCCMHC) – Allocates $140,277,958 in GR in FY24 and $140,277,954 in GR in FY25 to be used for the following programs of the TCCMHC:

  • Child Psychiatry Access Network (CPAN): $47,240,559
  • Texas Child Access Through Telemedicine (TCHATT): $142,082,790
  • Workforce Expansion: $43,081,465
  • CAP Fellowships: $10,628,783
  • Coordinated Research: $27,575,459
  • Central Operation Support Hub: $6,283,094
  • External Evaluation: $1,000,000
  • Administration: $2,663,762

HECB #50: Educational Loan Repayment Programs – Identifies $14 million each fiscal year to the mental health loan repayment program.

HECB #57: Forensic Psychiatry Fellowship Program – Allocates $2.5 million each fiscal year to support the development or expansion, and administration of forensic psychiatry one-year fellowship training programs and to support the salaries and benefits of the training physicians.

HECB #59: Social Work Workforce Study – Directs the HECB to study and report on the state’s current social work workforce landscape and needs no later than November 1, 2024.

UT SA #6: Opioid Abuse and Treatment – Allocates one-time $9,067,982 each fiscal year from GR – Dedicated Account No. 5189 to support overdose prevention, education, and overdose reversal medication access for law enforcement, distribution through health care providers, educational programming and distribution through schools, and distribution through community organizations.

UT SA #7: Fentanyl Education – Appropriates $500,000 in FY24 and $100,000 in FY25 from the Opioid Abatement Account No. 5189 for UT-San Antonio to coordinate with regional ESCs to develop and distribute evidence-based training for public school employees on the dangers of fentanyl contamination.

UT Tyler #7: Mental Health Workforce Training for Underserved Areas – Allocates $6,730,000 in GR each fiscal year to support mental health workforce training programs in underserved areas including, but not limited to, Rusk and Terrell State Hospitals.

UT Tyler #8: Contingency for Behavioral Health Funds – Requires behavioral health funds to satisfy the requirements of the Statewide Behavioral Health Strategic Plan.

Article IX – Contingencies and Other Provisions

Contingency riders are legislative directives that instruct agencies on how to spend certain appropriated funds if/when legislation passes. Contingency riders typically do not provide additional or new funding. Provisions are instructions included in the appropriations bill that may apply to multiple agencies. Typically, these provisions are used to restrict the amount and conditions under which appropriations may be expended. 

Article IX – Contingency Riders

Sec. 10.001: Full Application for Health Coverage – Requires all state agencies that have children in their custody (to the fullest extent permitted by federal law and regulations), to apply for Medicaid or CHIP, unless the children have otherwise been provided health insurance.

Sec. 10.004: Statewide Behavioral Health Strategic Plan and Coordinated Expenditures

  • Informational Listing of Behavioral Health and Substance Abuse Services Appropriations across state agencies, including federal funds and estimated Medicaid and CHIP expenditures, totaling $4,750,849,413 for FY24 and $4,614,671,775 for FY25. A breakdown of expenditures by article, agency, and method of finance can be found on page IX-57 of HB 1.
  • Statewide Behavioral Health Coordinating Council (SBHCC) – Identifies the state agencies and other entities responsible for appointing a member to serve on the SBHCC, and requires at least quarterly meetings.
  • Statewide Behavioral Health Strategic Plan – The purpose of the SBHCC shall be to implement the five-year Statewide Behavioral Health Strategic Plan, including an inventory of behavioral health programs and services, and provide annual reports no later than December 1 of each fiscal year.
    • Collaborating with the Board of Pharmacy and Medical Board, the SBHCC shall create a sub-plan related to substance abuse.
  • Coordination of Behavioral Health Expenditures – The SBHCC shall submit a coordinated statewide expenditure proposal for each agency by September 1, 2023 for FY24 and July 1, 2024 for FY25 to be considered for approval by the Legislative Budget Board (LBB).
  • Report on Exceptional Item Request – The SBHCC shall submit a report to the Executive Commissioner of HHSC and the LBB regarding a review of all behavioral health exceptional item requests submitted with each agency’s legislative appropriation request no later than January 15, 2025.
  • Report on Suicide and Suicide Prevention – The SBHCC shall provide updates to the report required from HB 3980 (86th) on suicide and suicide prevention in the state to include data and recommendations specific to veterans and foster youth no later than September 1, 2024.
  • Children’s Mental Health Strategic Plan – The SBHCC shall develop a strategic plan for behavioral health of children and youth, including descriptions of service providers; strategies to identify and address gaps in care; discussion of workforce shortages; information on funding and reimbursement; and data and expenditure information no later than December 1, 2024.

Sec. 17.15: Information Listings of Pro-Rata Share of Texas Opioid Settlement Receipts Received by Municipal Areas and Regions – Provides the pro-rata share to be received by municipal area and region from the 15% allocation agreed upon during the opioid settlement agreement. Listing begins on page IX-86 of HB 1.

Sec. 17.30: Comal County Mental Health Facility – Appropriates $1 million in GR in FY24 for operational costs for a mental health facility operated by the local mental health authority serving Comal County.

Sec. 17.31: Sunrise Canyon Operational Funding – Appropriates $636,850 in GR each fiscal year to increase funding for existing Sunrise Canyon Hospital inpatient beds.

Sec. 17.32: Community Services Grant – Appropriates $5 million in GR in FY24 to make a grant to a non-profit organization operating as a 501(c)(3) in the greater Houston area for the purposes of providing community crisis pregnancy services, foster care outreach, and community services.

Sec. 17.35: Additional Funding for Article III-Higher Education – Informational listing of appropriations to institutes of higher education, including $1.5 million to Texas A&M University System Administration for a study on mental health services for children and adolescents, and $1,750,000 to Midland College for mental health workforce.

Sec. 18.01: American Rescue Plan Act (ARPA) Appropriations – Directs all unobligated fund balances and money received by the state from the Coronavirus State Fiscal Recovery Fund (42 U.S.C. Section 802) established under ARPA (estimated to be $5,449,900,000) to be appropriated to the Texas Department of Criminal Justice for salaries, benefits, or other eligible agency expenditures.

Sec. 18.03: Contingency for House Bill 9 and House Joint Resolution 125 – Allocates $1.5 billion in GR for FY24 to the Texas Comptroller of Public Accounts for the development and funding of broadband and telecommunications services and a constitutional amendment creating the broadband infrastructure fund to assist in the financing of broadband and telecommunications services projects.

Sec. 18.40: Contingency for Senate Bill 26 – To implement the provisions of the legislation, HHSC is appropriated:

  • $13,478,811 in GR and $1,1575,590 in federal funds
  • Capital budget authority is increased by $3.3 million in FY24 and $9 million in FY25
  • 11 FTEs each fiscal year

Sec. 1677: Contingency for Senate Bill 1677 – To implement the provisions of the legislation, HHSC is appropriated $1.5 million each fiscal year to provide mental health services in regional behavioral health centers or jail diversion centers.

Sec. 1878: Contingency for Public Education Funding – Within the information listing of appropriations made throughout SB 1, $300 million in GR is allocated for school safety.

Supplemental Appropriations – SB 30 (Huffman/Bonnen) 

The supplemental appropriations bill appropriates funds for one-time costs. Funding for important inpatient mental health and substance use services was included in the supplemental appropriations bill. 

Supplemental Appropriations

Section 3.02 – HHSC: New Capacity for Mental Health Services and Inpatient Facilities  $33,600,000 in GR for construction of a behavioral health campus in Uvalde, TX;

  • $21,400,000 in GR for a grants management system;
  • $101,890,000 in GR for constructing a 200-bed adult unit at the new state hospital in Dallas, Texas, with at least 75% of the beds to be used for forensic purposes;
  • $138,773,054 in GR for an electronic health record system upgrade for state hospitals;
  • $50,000,000 in GR for deferred maintenance for state facilities;
  • $14,000,000 in GR for state facilities emergency repairs;
  • $121,000,000 in GR to construct a 50-bed maximum security unit (MSU) on the existing SSLC campus in Lubbock;
  • $15,000,000 in GR to renovate a unit at the State Antonio state hospital into a 40-bed MSU;
  • $159,000,000 in GR to construct a 75-bed state hospital, with at least 50 forensic beds;
  • $120,000,000 in GR to construct a 50-bed MSU in the Rio Grande Valley;
  • $573,000,000 in GR to construct a 250-bed replacement at the Terrell State Hospital, including 50-bed MSU, 140 forensic beds, 35 adolescent beds, and 25 civil beds;
  • $452,000,000 in GR to construct a 200-bed replacement for North Texas State Hospital – Wichita Falls, including a 24-bed MSU, 136 forensic beds, 24 adolescent beds, and 16 civil beds;
  • $50,000,000 in GR for pre-planning, planning, land acquisition, and initial construction of a new 50-bed El Paso State Hospital, with 50% of the beds to be forensic;
  • $45,000,000 in GR to construct 30 additional beds at the Sunrise Canyon facility in Lubbock, Texas, with at least 50 forensic beds;
  • $100,000,000 in GR for a one-time community mental health program for county-based collaboratives that must:
    • Construct jail diversion facilities, step-down facilities, permanent supportive housing, crisis stabilization units, and crisis respite units, not including office space; and
    • Provide a local match of 25% if the collaborative includes a county with a population of less than 100,000, 50% if the collaborative includes a county with a population of at least 100,000 but less than 250,000, or 100% of the grant amount if the collaborative includes a county with a population of 250,000 more;
  • $175,000,000 in GR for a one-time grant program to construct or expand a mental health inpatient facility to have at least 50% forensic capacity, using only donated land, to increase inpatient bed availability for forensic patients ordered to a state hospital for competency restoration. Of these funds:
    • $85,000,000 for construction of up to 100 inpatient beds by a hospital located in the Rio Grande Valley region that, as of June 1, 2023, is:
      • Licensed as a general hospital;Has a Level 1 trauma designation;Is located in a county with a population of more than 300,000; andHas fewer than 100 licensed psychiatric beds;
      $50,000,000 for construction of no more than 100 inpatient beds by Montgomery County to expand the existing Montgomery County Mental Health Facility; and
    • $40,000,000 for construction of up to 60 inpatient beds by Victoria County;
  • $4,712,356 in GR to make Child Care Licensing Automated;
  • $64,000,000 in GR to construct 72 beds, with 36 forensic beds and 36 civil beds, at the Baptist Hospital in Beaumont, Texas; and
  • $15,852,990 in GR to establish a one-time children’s hospitals construction grant program that may only be used to construct inpatient mental health beds for children and the grantee must provide a local match at least equal to:
    • 25% of the grant amount for construction in a county with a population of less than 100,000;
    • 50% of the grant amount for construction in a county with a population of at least 100,000 but less than 250,000; or
    • 100% of the grant amount for construction in a county with a population of 250,000 or more.

Section 3.03 – Facilities Commission: Permian Basin Behavioral Health Center $86,700,000 in GR to the Texas Facilities Commission to construct a 100-bed comprehensive behavioral health center, with 40 forensic beds, to serve the Permian Basin region.

Section 4.02 – Texas Education Agency (TEA): School Safety    $1.1 billion in GR to TEA to award grants to assist school districts in implementing school safety initiatives.

Section 8.52 – Higher Education Coordinating Board: Texas Child Mental Health Care Consortium (TCMHCC)     All unexpended and unobligated balances

Additional Funding for Uvalde Response 

Following the mass shooting at Robb Elementary School in Uvalde on May 24, 2022, Governor Greg Abbott signed two budget execution orders in June and October 2022. These orders transferred funds for various initiatives, including school safety and mental health. However, of the more than $515.5 million allocated from the two budget executions, only about $11.5 million directly supported mental health.14

During the 88th legislative session, additional state funds were allocated directly to HHSC to continue the Uvalde response:

  • Purchased Psychiatric Beds: $99,098,599 each fiscal year to maintain current capacity and for 193 additional state-purchased beds, including 70 in rural communities and 123 in urban communities. Of this funding, $13.7 million is required to be used in Uvalde, and 20 contracted beds for children in Department of Family and Protective Services (DFPS) conservatorship.
  • Uvalde Community: $5 million in FY 25 to start and operate a new Uvalde Behavioral Health Campus.

New Capacity for Mental Health Services and Inpatient Facilities: $33,600,000 in GR for construction of a behavioral health campus in Uvalde, TX15

There is consensus among Texans that Uvalde needs funds to support and heal as a community. While advocates applauded funding specifically dedicated to the mental health and well-being of the Uvalde community, there is a call for those state dollars and decisions to be made by the community, for the community to support their healing through this tremendous grief. There is a need for any additional funding to center the community’s voice. More can be read in our op-ed “Listening to All Voices in Uvalde Will Promote True Healing.”16

Medicaid and the Children’s Health Insurance Program (CHIP)

Texas Medicaid and the Children’s Health Insurance Program (CHIP), both of which are managed care and fee-for-service programs, provide significant funding for behavioral health services.

Estimated Behavioral Health Expenditures in Medicaid and Children’s Health Insurance Program (CHIP): FY 2020-202517

Medicaid

CHIP

References

  1. Texas Health and Human Services. (2022). Coordinated statewide behavioral health expenditure proposal, Fiscal Year 2023. Statewide Behavioral Health Coordinating Council. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2023.pdf ↩︎
  2. Texas Health and Human Services. (2023). Coordinated statewide behavioral health expenditure proposal, Fiscal Year 2024. Statewide Behavioral Health Coordinating Council. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2024.pdf ↩︎
  3. Ibid. ↩︎
  4. Texas House Research Organization. (2023). Writing the state budget: 88th Legislature. https://hro.house.texas.gov/pdf/focus/writing88.pdf ↩︎
  5. Legislative Budget Board. (2023). House Bill No. 1 Conference Committee Report (88th Legislature, Regular Session). https://www.lbb.texas.gov/Documents/GAA/General_Appropriations_Act_2024_2025.pdf ↩︎
  6. Hogg Foundation for Mental Health. (2023). Texas 88th legislative session summary of mental health and substance-use legislation. https://hogg.utexas.edu/wp-content/uploads/2023/07/88th-Lege-Summary.pdf ↩︎
  7. Texas Health and Human Services Commission. (2018). Legislative appropriations request for Fiscal Years 2020-2021. https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/budget-planning/lar/hhsc-legislative-appropriations-request-2020-2021.pdf ↩︎
  8. Texas Health and Human Services Commission. (2020). Legislative appropriations request for Fiscal Years 2022-2023. https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/budget-planning/lar/hhsc-legislative-appropriations-request-2022-2023.pdf ↩︎
  9. Texas Health and Human Services Commission. (2022). Legislative appropriations request for Fiscal Years 2024-2025. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-legislative-appropriations-request-2024-2025.pdf ↩︎
  10. Texas Health and Human Services Commission. (2024). Legislative appropriations request for Fiscal Years 2026-2027. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-legislative-appropriations-request-2026-2027.pdf ↩︎
  11. Texas Health and Human Services Commission. (2018). Legislative appropriations request for Fiscal Years 2020-2021. https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/budget-planning/lar/hhsc-legislative-appropriations-request-2020-2021.pdf ↩︎
  12. Texas Health and Human Services Commission. (2020). Legislative appropriations for request Fiscal Years 2022-2023. https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/budget-planning/lar/hhsc-legislative-appropriations-request-2022-2023.pdf ↩︎
  13. Texas Health and Human Services Commission. (2024). Legislative appropriations request for Fiscal Years 2026-2027. https://www.hhs.texas.gov/sites/default/files/documents/hhsc-legislative-appropriations-request-2026-2027.pdf ↩︎
  14. Texas Office of the Governor. (2022, June 28). Budget execution order. https://gov.texas.gov/uploads/files/press/BUDGET_EXECUTION_proposal_from_LBB_and_GOV_order_SOS_IMAGE_2022-06-28.pdf ↩︎
  15. Hogg Foundation for Mental Health. (2023). Texas 88th legislative session summary of mental health and substance-use legislation. https://hogg.utexas.edu/wp-content/uploads/2023/07/88th-Lege-Summary.pdf ↩︎
  16. Martinez Jr., Octavio N. (2023, May 24). Listening to All Voices in Uvalde Will Promote True Healing. UT News. https://news.utexas.edu/2023/05/24/listening-to-all-voices-in-uvalde-will-promote-true-healing/ ↩︎
  17. Texas Health and Human Services. (2023). Coordinated statewide behavioral health expenditure proposal, Fiscal Year 2024. Statewide Behavioral Health Coordinating Council. https://www.hhs.texas.gov/sites/default/files/documents/statewide-bh-expenditure-fy2024.pdf ↩︎

Updated on December 16th, 2024



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