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The Appropriations S/C on Article II met on February 19, 2019 to hear testimony on House Budget recommendations for Information Technology, the Family First Prevention Services Act, community-based care, behavioral health, and Early Childhood Intervention.

This report is intended to give you an overview and highlight of the discussions on the various topics the committee took up. It is not a verbatim transcript of the hearing but is based upon what was audible or understandable to the observer and the desire to get details out as quickly as possible with few errors or omissions.

 

Information Technology in Article II

Victoria Ford, HHSC

  • Link to HHSC IT presentation
  • Provides overview of IT and security structure at HHSC.
  • Currently restructuring IT department, hiring new FTE to oversee data architecture, software strategy, etc.
  • Before HHSC can put forward IT restructure exceptional items in the LAR, need to have process for QAT review & outline capability, after this it moves to planning, etc.; QAT provides feedback along the way
  • Provides overview of HHSC IT project portfolios
  • Data governance as a concept developed as HHSC was developing the enterprise data warehouse
  • Davis – Unsure how much knowledge the Committee has about the enterprise data warehouse
    • Data warehouse was an attempt to centralize data, turned out to be an extraordinary expense, HHSC wasn’t able to develop a project that got approval from all required entities to implement (federal government, etc.)
    • Project was stopped in 2016 and was brought in to reassess what is needed, industry has realized that building a large single warehouse is inefficient
    • Looking at interoperable systems, have an exceptional item to restore some funding & assessment is scheduled for 2019
  • Effort to modernize and create interoperable system is tied to several exceptional items designed to incorporate legacy system data
  • HHSC has been instructed to build a performance management system.
  • Ford provides and overview of select HHSC IT-related exceptional items (EI), details for EI in HHSC’s IT presentation 10-14
  • EI #13 for HHS IT Security, designed to help support IT system from a security perspective.
  • Davis – Presentation says EI #13 is necessary to comply with state and federal law, would like to know what state and federal law requires? What would be the consequences of not funding?
    • Trey Wood, HHSC and Steve Buche, HHSC are called to assist in answering questions regarding HHSC’s IT exceptional items
    • Item includes remediation and assessment of security systems
  • Davis – Is this personnel or additional technology? HHSC is asking for more than 50 FTEs
    • Item has 4 components: 1) Office of Civil Rights corrective action plan, 2) security certificate management, 3) security scanning & 4) risk assessment
    • Provides history of dispute with the Office of Civil Rights corrective action plan, there is a fine and corrective action plan in lieu of paying the fine
  • Davis – Is any part of this EI for payment of any fine?
    • No, will need to start paying fine every year until corrective action is taken, so taking action avoids paying the fine
  • Davis – Will you be doing this internally or will you be hiring an outside vendor?
    • Both to help get it done in a timely fashion
    • Ford – We will use staff augmentation to help, but design and implementation of plan is in house
  • Davis – And you say you need 50 additional FTEs once the correction plan is in place?
    • IT FTEs and Staff Aug that will continue to diminish over the course of the process.
  • Capriglione – Does this affect this specific section or is it throughout the agency?
    • US HHSC is specifically looking at legacy data, but need to ensure the rest of the agency meets the standards.
  • Capriglione – Does this affect the rest of the agency’s front-facing websites?
  • Davis – According to the presentation, you are creating this platform, will you be outsourcing this creation or is it internal?
    • Uses a combination of HHSC staff and staff augmentation contractors to help get the program started.
  • Davis – Are you working with QAT to determine what the cost will be?
    • We do our own market analysis and research on our own, but we use QAT standards for costs.
    • Part of the analysis is to see cost in other sectors of industry and have cost assessment ready for 2021.
  • EI #14 for system-wide business enablement platform.
  • EI #31 for Performance Management and Analytics System.
  • EI #49 for seat management, i.e., new equipment, tablets, phones, computers.
  • Davis – Is this just for HHSC?
  • EI #30 for Data Center Services
  • Davis – It says this EI is to comply with federal and state law, what laws are we not complying with?
    • Required to put our items into the state datacenter from previous state statute
    • Puts HHSC into compliance with DIR contract, remediates legacy systems, etc.
  • Davis – Asking for quite a few FTEs for this, is this process to be completed internally?
    • This includes both, requires large staff lift to give attention to 400+ applications
  • EI #12 is for telephone technology upgrade.
  • Davis – Is EI #12 for across the agency or just HHSC?
    • Just HHSC.
  • EI #47 for CAPPS HCM and Financial Upgrades.
  • Capriglione – We have been focused on security at HHSC, how do some of your EIs help with the procurement and contract management function?
    • We have been working to capture our IT environment in total. We have a strategy for that, all these upgrades make that more effective. We are just too early in the process to understand what the changes would look like.
  • EI #9 for the enhancement of procurement and contract management function.
  • Davis – What specifically is the $14.3 million IT GR for?
    • We are updating our system but are planning for our future updates to effectively enhance our procurement and contract management. The rest of the EI is for staff in our procurement department and for oversight of contracts.
  • EI #38 is for Foster Care Litigation, anticipating a ruling from the U.S. Fifth Circuit Court of Appeals.
  • Davis – What is the IT portion of this?
    • We may have to upgrade of our regulatory system and have a case management system for every child in cps.
  • Davis – Is there an executive commissioner for HDIS?
    • No, we have an acting executive commissioner.
  • Davis – How are they handling the services now?
    • We are using the rehab works system from TWC, so we are building our own instance of the system. (EI #50)
  • EI #26 is to enhance state hospital and SSLC services through technology.
  • Davis – Could someone expand on what this EI is for? I was told the state hospitals have excellent it, so what is being asked here?
    • This is for improving cable and phone lines to put in the ability to do telecommunications.
  • Davis – I was told we have the most advanced health care IT system.
    • The request is for IT training and support for staff
  • EI #17, 21, 24 to comply with statutory requirements for IDD System Redesign.
  • Davis – What type of technology change is needed to incorporate a rate increase?
    • We can get back to you on this piece.
  • Davis – For EI 24, my question again is why do you need FTEs for a one-time online portal?
    • We would get the IT staff for the one-time improvement.
  • Davis – Are we in jeopardy to lose federal funds?
    • It is related to a lawsuit, so the result could be losing federal dollars.
  • EI #37 is for one-time funds to open and begin operations of clinics at six SSLCs.
  • EI #43 ensure state oversight of community programs for individuals with disabilities.
  • EI #44 is to enhance real-time behavioral health data sharing.
  • Davis – What technology is needed for EI #44?
    • Would be for data sharing between the agency and law enforcement.
  • EI #15 is for state or federal changes to system improvements in MCD.
  • Davis – So EI #15 is for money, just-in-case?
    • No, federal and state law changes constantly, so we are anticipating these costs.
  • EI #18 relates to the fair hearing process for Medicaid Managed Care.
  • Davis – In terms of the appeal and fair hearing process, is that part of the agency?
    • It is a unit within the legal division.
  • Davis – Asked for information on the number of FTEs and costs for the appeal and fair hearing process division.
  • EI #23 is to make necessary electronic visit verification system improvements.
  • Davis – Why is your presentation blank in terms of IT funds?
    • I believe most of the costs are related to it.
  • Sheffield – What exactly is being planned for EVV?
    • We can get that plan to you.
  • EI #46 is to collect and expand mortality reviews process for individuals with IDD. This would allow for the community setting.
  • Davis – What is the specific IT component for EI #46?
    • It is for system analytics program.
  • EI #32 would automate Child Care Licensing new license types.
  • Hefner – How do we arrive at these IT cost estimates?
    • Based on our current costs, we estimate the number of hours and time it would cost to implement the programs.
  • EI #41 is for enhanced background check. Would provide funding for an automation change to allow the CCL to comply with background check requirements.

 

Hank Whitman, DFPS

  • Link to DFPS IT presentation
  • IMPACT is the current casework management tool used by DFPS.
  • Agency began updating IMPACT in 2015, Phase II of the project is still in progress. Challenge with meeting completion dates.
  • Phase I was for updates to statewide intake process, to add features for external access for CASA, and to improve the submission process for background checks.
  • Phase II focuses on system improvements and usability for caseworkers.
  • Infosys is the current contractor.
  • IPS will begin to complete the remaining work of IMPACT, but they will not be able to meet the deadline within the contract period. The agency will have to complete the last part in-house.
  • No exceptional item for IMPACT in the LAR because base budget includes $6 million.
  • Contractors did not have the expertise to complete the requirements of the project. Phase I came in 320 days late, Phase II will be 394 days late.
  • There were significant coding issues in the initial software, which the contractor had to fix.
  • There have been no coding issues with the current contractor, but there are project management and transparency issues.
  • Davis – Can you elaborate on the contracting exceptional item request?
    • We actively try to manage contracts but, with additional contracts that are happening, we need FTEs to focus on IT contracts.
  • Davis – Can you expand on EI 9F?
    • It is necessary to comply with a lawsuit ordered on appeal.
  • Capriglione – Phase I was Accenture and they were off by about a year. Why do you think the second contractor did not understand what the project entailed?
    • Their struggle to meet timelines was a sign for us that they did not understand the complexity of our project.
  • Capriglione – This is happening in another committee too, are there transparency problems with your current contractor.
  • Capriglione – How big is this Phase II project in dollars?
    • $15 million.
  • Capriglione – Seems like there are three different parts in Phase II, you are letting the vendor finish the first two, and completing the last piece in house?
    • Because of the issues we have had with contractors, we will not extend the contract and bring the work in house.
  • Capriglione – Do you have the funds to do it in-house?
    • It will take longer, but yes.

 

Wanda Thompson, DSHS

  • Introduced current technology projects at DSHS
  • Exceptional item for $54 million dollar for laboratory requests. This item would update software and capacity for laboratory servers.
  • Davis – What would happen if the LIMS failed?
    • It would have a dramatic effect on public health.
  • Davis – There could be a serious effect if the lab is unable to communicate the results of testing, correct?
  • Exceptional item to stabilize NEDSS.
  • Turner – What is the difference between NEDSS system and THISIS?
    • THISIS receives reports that NEDSS processes. THISIS is for TB, HIV, STD.
  • Exceptional item for IT upgrades to modernize public health data accessibility.

 

Sylvia Hernandez Kauffman, Inspector General

  • Link to OIG IT presentation
  • 2 priorities for the OIG – MFADS and ASOIG
  • Provides overview of MFADS (Medicaid Fraud and Abuse Detection System), fraud detection system is required by federal law & $5 million in funding will be used to enhance system
  • Davis – Are you tracking date of denials, priori authorizations, etc.?
    • We’re brining the data in now & will be determining how data is used
  • OIG received a free case management system from the federal OIG’s Homeland Security Office, working with HHSC IT to finalize business requirements and estimated cost is $500k at this time
  • ASOIG (Automated System for OIG) is a legacy system and much of the financial information is still being calculated manually; currently working with HHSC IT on changes to assist investigators, requesting $1.8m in GR & $3m in AF to fix ASOIG
  • Presented exceptional item requests related to information technology.

 

David Flores, TCCO

  • Provides overview of TCCO and update on TCCO IT projects, TCCO uses HHSC IT to provide IT services for the agency, TCCO has 1 IT FTE; no exceptional items related to IT.

 

Richard Corbell, LBB

  • Provided an overview of the Quality Assurance Team (QAT).
  • Project observations:
    • Unless an agency has the expertise, agencies have problems contracting major information resources projects.
    • When agencies understate project costs to align with funding levels, project planning, management, and communication is weakened.
    • Agencies appear reluctant to cancel contracts or projects when deliverables are late within the initial scope of the project.
    • Agencies’ self-reported monitoring reports show project timelines were generally pushed in excess of one year due to funding and timing constraints.
  • Capriglione – Highlights scatterplot in LBB presentation. Most projects are within budget and over schedule or over budget and over schedule.
  • Capriglione – Do you see more agencies going to the agile model?
  • Capriglione – Do you think the agile model provides a risk to the agency where they might not complete their projects.
    • That is a fair statement.
  • Davis – Texas has several early intervention programs, but the Family First would be for

Family First Prevention Services Act

Eric Fenner, Casey Family Programs

  • Provides overview of Casey Family Programs
  • Provides overview of the Family First Prevention Services Act; goal is to promote prevention in foster care
  • Difference between Family First and prevention/early intervention
    • Prevention and early intervention is through outside contracts, can be used before a child is eligible for foster care
    • Family First requires that a child is eligible for foster care
  • Services must be promising, supported, or well-supported. Well-supported is most evidence-based of those three, at least 50% of state services must be well-supported.
  • Davis – What types of services or programs would be eligible for this money? Federal match rate is large, for Texas could be 60%. As a state what can we do?
    • Fenner – More and more children are coming into care due to parents with substance abuse issues. Providing treatment for parents would be a good use of those funds/
    • Davis – Would that be for medication, treatment?
    • Fenner – For treatment yes. Another aspect to look at is mental health for these kids and their parents. Keeping parent and child together while the parent is in treatment is valuable.
    • Davis – You said neglect was number one reason why children enter foster care, would the state need to investigate what is the root cause of neglect? Would nurse-family partnerships be eligible for these funds?
    • Fenner – Using family first to purchase services in certain communities will reduce the number of children coming into care.
  • Preferable for most people to have a child with a relative instead of in foster care system
    • Texas does better than national average at kin placement
  • Davis – We spent a great deal of time and resources last session focused on kinship care. I believe that even if a child is placed with a relative they’ve never met, outcomes are still better than in a non-kin environment.
    • Fenner – HB 4 is a clear demonstration of the legislature’s commitment to kinship care.
  • Fewer children coming to care for physical abuse, more are coming for neglect, which is driven by drug abuse.
  • Davis – State needs to make sure we are properly using federal dollars and getting the best outcomes for children.

 

Kristene Blackstone, DFPS

  • Link to DFPS FFPSA presentation
  • Implementation was delayed to September 2021 in order to receive proper federal guidance
    • Can proceed without penalty if begin before Sept. 2021
    • Delay means TX cannot draw down additional federal match for prevention services
  • Feds have identified 13 programs that will be approved for prevention funds
  • Davis – Are those 13 programs in Texas?
    • Blackstone – Some of them are being used across the state. We will be conducting a study to see which are being used.
    • Davis – When will that begin and end?
    • Blackstone – Starting in spring, will take about a year to complete.
    • Davis – You said ACF has identified 13?
    • Blackstone – Yes, we expect them to add more
    • Davis – For licensing standards, TX licensing doesn’t meet fed guidelines?
    • Blackstone – With FFA new licensing standards have been released. There is a requirement for each adult caregiver in a foster home to have a physical to certify they can care for additional children. There is also a requirement to immunize children that we don’t have in Texas.
    • Davis – How does Texas implement those standards?
    • Blackstone – We feel confident about our standards and they are keeping kids safe.
    • Davis – Do you believe that not requiring vaccination is keeping kids safe? It seems that would be important.
    • Blackstone – The standards just came out and we are still reviewing those. If our current standards are not approved we would need to look at what that means for licensing new homes.
    • Davis – I thought they didn’t meet the requirements?
    • Blackstone – Ours are not consistent with fed standards, but we can submit them by March 31 for review by the feds.
  • Placement policy in Texas requires consideration of least restrictive care.
  • 86ht legislature redesigned foster care system through community-based care.
  • Kinship caregivers in TX have access to case management services
  • Provide parents with evidence-based parenting classes, mental health and substance abuse services.
  • Davis – Are there any outcome metrics for the pilot program in El Paso?
    • Blackstone – It is too soon to say, the program is to reduce recidivism and there has not been enough time to measure.
  • Davis – Have other states delayed implementation?
    • Blackstone – Yes 15-19 have delayed. Some of the states that are going ahead without delay have had programs to accredit their programs for some time now.
    • Blackstone – We have taken the latest possible date on our implementation, but we can start earlier without penalty.
  • Davis – What is the status of the UH study?
    • Blackstone – Have not had a chance to read it.
  • Federal government has been eager for Texas to build an electronic system.
    • There will be 20 grants awarded
  • Exception item to continue expansion of community based care.

 

DFPS – Community Based Care

Angelica Ramirez, State Auditor’s Office

  • Audited ACH contract requirements and oversight of ACH over its providers.
    • ACH was following contract requirements, documentation should be improves
    • Oversight was satisfactory, but documentation should be improved
  • Davis – It seems that the management response was ‘no you’re wrong we do document’?
    • Ramirez – Yes.
    • Davis – And you stand by your report, where do we go from here?
    • Ramirez – We were trying to communicate that additional documentation might be necessary
    • Davis – Do you feel that was communicated and acknowledged?
    • Ramirez – There was some disagreement, we have followed up and there have been certain changes to their processes.
    • Davis – What other follow-up will you do?
    • Ramirez – We will continue to assess it as it grows.

 

Kristyn Scoggins, State Auditor’s Office

  • Dept developed processes to oversee ACH contracts
  • Dept analyzed ACH’s financial information
  • ACH did not monitor one foster care provider for 18 months, the Dept’s documentation did not indicate this and it is unclear if the Dept’s processes would have identified that issue
  • Audited ACH’s monitoring process over providers, ACH should improve documentation of those activities.
  • Davis – I do hope the agency can see that it can be an issue if you have not performed oversight in 18 months. It seems they are following oversight processes but are not documenting properly.

 

Kristene Blackstone, DFPS

  • Link to DFPS community-based care presentation
  • Looked at other state programs, Texas-specific data for a redesign of the foster care system
  • SB 218 from 82nd session codified redesign
  • Legislation from 85th session expanded community based care model
  • 12 quality indicators for community based care
    • Partially influenced by youth in the system
  • Reviewed financing system for community based care programs
  • Davis – of you haven’t monitored a provider over 18 months that does not seem like best practice?
    • Blackstone – In that case the provider did not have any children during those 18 months. But we did implement a change in regard to that.
  • Program is live in 38 counties. Anticipate a spring release in another area, contingent on funding from legislature.
  • Turner – There are financial incentive to ensure kids spend the least amount of time in foster care as possible?
    • Blackstone – Yes that is a new service
    • Turner – Can we determine how that is working?
    • Blackstone – It is too soon, we are still in phase 1.
  • Davis – There have been issues with HHS contract procurement and oversight, as you move into stage 2 you need to be vigilant about vendors and procurement. You do not want to be in the same situation as HHS is in with managed care.

 

Behavioral Health

Sonja Gaines, HHSC

  • Link to HHSC IDD/behavioral health presentation
  • Investment in delivery services has paid off
  • Office of mental health coordination has responsibility for veteran matching grants
  • Over 5 million served by agency
  • Mental health services
    • Help with adults with serious mental illness
    • Work with children with serious emotional disturbances
  • Behavioral health disaster team was important during Harvey
  • Davis – During Harvey the local medical societies were also helpful to many people in the shelters.
  • Have an array of services for children out-patient and case management
  • Matching grant program to address unique challenges across the state in rural or frontier counties.
    • $100m in GR expended across 100 organizations in 230 counties.
    • Served over 100,000 Texans
    • Early returns show that 1600 have been diverted from criminal justice system, 1500 have shown clinical improvement.
  • Federal opioid funds have been beneficial
  • Davis – For substance abuse disorder services, it looks like people who are identified as being at risk are youth and adults living in rural and border communities?
    • Gaines – We do not have service centers in rural and border communities, and the longer people have to wait for services the worse the problems will get.
    • Davis – Are we providing medication assistance treatment for opioid addiction?
    • Gaines – Medically assisted treatment, using Methadone or similar medications is the gold standard for treatment
    • Davis – During the interim I heard those medications were not used as much as they could be?
    • Gaines – We have been increasing the percentage of people getting treatment who are receiving those medications.
  • OSARs serve around 30,000 people a year throughout the state.
  • Local IDD authorities play large role in providing case management services
  • Over 500,000 individuals with IDD, many of those have a mental health condition
  • Less than 2% of people receiving out-patient services are ending up in hospitals
  • EI 11 for $43.9m, partially funded through HB 1
    • Meets need for individuals who are eligible for out-patient mental health services
  • Turner – Portion of EI already funded in HB 1 for $12m is targeted to children, would the remaining portion be for children or adults?
    • Gaines – Unfunded portion is related to the adults. Portion that is already funded is for children.
    • Turner – And that $12m is to ensure there is no waitlist on the children’s side?
    • Gaines – Yes. Any additional above that $12m would not be used to cover children.
  • EI 19 for $10.5m to address capacity for Behavioral Health Services, support specialty care programs
  • EI 20 for $2.7m, prevents kids from going into foster care system. Expand program to 50 beds, will clear waiting list.
    • Davis – Is this something that might be eligible for federal Family First funds?
    • Gaines – DFPS is actively involved in that, I do not know as much about those funds.
  • EI 21 for $45.8m, address challenges in regard to reimbursement rates on substance abuse item
    • Davis – Why do you need $3.5m for IT, what kind of technology do you need for a rate increase?
    • Ed Sinclair, HHSC – Currently program uses daily bundle rate structure. The funds would be to structure those rates correctly and for the treatment rates.
  • EI 22 for $46.4m, maintain and expand IDD community crisis continuum of care for individuals with IDD and co-occurring behavioral health diagnoses.
  • EI 27 for $39.4m, purchase 75 additional psychiatric hospital beds and funding for staff and support.
  • Sinclair – EI 44 for $0.4m, support enhanced data sharing between HHSC and Behavioral Health Outpatient Data Warehouse and DPS enforcement telecoms system

 

Early Childhood Intervention

Lindsay Rodgers, HHSC

  • Link to HHSC ECI presentation
  • After receiving ECI, 46% of students at risk of needing special ed do not need special ed by kindergarten
  • ROI of $2.5-$17 for every $1 spent on ECI
  • Texas child outcomes consistently exceed national average
  • Davis – Why does TX do better than the national average?
    • Rodgers – We have an outstanding network of providers who deliver quality services
  • 5% of children come into ECI with a developmental delay of at least 25% in at least one area of development. For example, not walking or talking when they should be.
  • Services provided in home, or other community settings
  • ECI model designed to help families continue interventions when service providers are not there.
  • Services must be provided statewide
  • Providers have target number of children in their contracts, if they exceed that number they are still required to serve anyone who comes in for services
    • Davis – This is the main funding problem we have, how can the state continue with this program?
    • Rodgers – It is not considered entitlement at the federal level, but the requirements treat it like an entitlement program. All but 3 of contractors have exceeded the target number of children.
  • Number of contractors has declined.
  • Davis – Why are providers leaving?
    • Rodgers – Largely they do not have sufficient funding amounts.
  • Contractor transitions are difficult for families, if a contractor leaves a part of the state without coverage it is a violation of federal rules.
  • Texas is currently accessing 17 funding sources, more than any other state.
    • Each funding source has different requirements, certain children cannot access certain funding sources.
  • 90% of contractor base took extreme cost saving measures. 36% of them have to contribute funds from other lines of business to keep ECI in the black.
  • Contractors have notified HHSC their programs are unsustainable
  • Contractor exits create legal risks for the state.

 

Trey Wood, HHSC

  • Exceptional item for $70.7m in GR to continue providing ECI services and avoid provider and contractor exits.
  • Davis – What are our options?
    • Wood – WE can’t have a waitlist and have to provide services, if additional patients walk through the door services have to be provided. The total amount of the federal grant has not changed, we can either choose to or not to backfill with GR.
    • Davis – What would happen if we don’t backfill?
    • Wood – We would end up with gaps in coverage and the state could be sued.

 

Public Testimony

  • Jesse Vooer, Texas Alliance for Child and Family Services – Alliance is developing new programs in response to Families First Act. Support goals of Families First, SB 11 is moving in the right direction.
  • Jennifer Lucy, Tex Protects – Discussed changes from Family First Act. Can improve outcomes for abused children.
    • Davis – Concerned about a workforce shortage of mental health providers.
  • Rachael Cooper, Center for Public Policy Priorities – Many kinship families are left without services, puts placements at risk of failing. Create “navigators” to give families legal advice.
  • Kate Murphy, Texans Care for Children – DFPS must be thorough and deliberate in their response to Family First. Feds will no longer pay for certain kinds of foster care.
    • Davis – I share your concerns.
  • Rachael Kieff, Texas Pediatric Society and Texas Medical Association – In support of investments to implement Family First Act. Prepare this cycle to ensure we can draw down federal funds.
  • Michael Redden, New Horizons – New Horizons the single-source continuum contractor for region 2. Goal is to serve every child in region 2. More children being placed closer to home, with siblings. Community based care has a positive impact on foster care.
  • Katherine Nunnery – Against funding cuts for ECI program. ECI program is very beneficial.
  • Anais Barminco, Children’s Shelter in Bexar County – Family tapestry division in the shelter is two weeks old, already seeing positive results.
    • Cortez – Recommend a tour of the Children’s Shelter, are you looking into expansion of the program?
    • Barminco – yes we are getting ready for stage 2.
  • Andrew Brown, Center for Families and Children – Expand community based care model.
  • Knox Kimberley, Upbring – Support community based care.
  • Andrew Homer, Texas CASA – Discussed community based care, fund CBC in region 3B.
    • Davis – Let us know as CASA what is working and what is not.
  • Gordon Butler, Clubhouse Texas – Support evidence-based rehab programs for adults with mental illness.
  • Tanya Leavell, Hogg Foundation for Mental Health – Support funding for peer services and peer specialists, increase Medicaid rates. Support housing for people with mental illness and substance abuse issues.
  • Name inaudible, Texas Criminal Justice Coalition – Expand substance abuse treatment capacity. Expand allowable use of HB 13 funds to substance abuse disorder, above last biennium’s amount.
  • Shannon Hoffman, Hogg Foundation for Mental Health – Expand ability for individuals with substance abuse disorder to access services. Expand resources for individuals with IDD and co-occurring mental health condition. Support HHSC exceptional item 22.
  • Brian Mares, Texas CASA – Support HHSC exceptional item 20. Support funding for peer-support providers.
  • Curtis Young, Parkland Health and Hospital System – Support funding for additional community beds. Ensure people with severe mental illness have access to health care. Fully fund DFW State Hospital.
  • Greg Hanch, NAMI Texas – Continue to fund improvements to psychiatric hospital system. Support EI 27 for purchase of community in-patient psychiatric beds. Support HHSC exceptional item 19.
  • Cynthia Humphrey, Assoc of Substance Abuse programs – Support HHSC exceptional item 21 for rate increase for treatment providers for substance abuse programs.
  • Lee Johnson, Texas Council of Community Centers – Support HHSC exceptional item 11. Support exceptional item 27 for locally purchased in-patient psychiatric beds.
  • Wendy Johnson, Texas Conference of Urban Counties – Prioritize exceptional item 11. Bail reform will require more mental health services for people being released from jail.
  • Stephanie Rubin, Texans Care for Children – ECI is very effective but is underfunded, GR for ECI is insufficient. $71m critical to properly fund ECI.
  • Heather Allman, Project Ninos ECI Program – Support $71m for ECI funding.
  • Rhonda Shed, Project Ninos ECI – Support $71m for ECI funding.
  • Linda Litzinger, Texas Parents Apparent – ECI very important. Mileage is not compensated, many rural families spend most of their time on waiting lists. Support $71m for ECI funding.
  • Name and organization inaudible – ECI provides valuable services. Support ECI funding. Witness personally benefitted from ECI program.
  • Maribel Berra, Project Grow ECI in Fort Bend – Support ECI funding.
  • Jennifer Cantu – Eligibility requirements for ECI services, important to provide services before child is 3 years old. Support funding for ECI.
  • Lauren Ranjel, Easter Seals – Support funding for ECI. Temporary loss of services can result in permanent loss of skills.
  • Marjon Linnell, Texas Medical Association – Fully fund ECI. Lack of funding puts a strain on ECI providers.
  • Josette Saxon, Texans Care for Children – 1 in 8 Texas high schools students attempted suicide in 2017. State needs to address this issue.
    • Cortez – I have been hearing more and more about this issue from veterans, what kind of work do you do with active duty and retired military?
    • Saxon – Texans Care for Children is an advocacy organization specifically around children’s issues. The Texas Suicide Prevention Council actively engages with military and military families.
    • Cortez – This is a very important issue.
  • Chris Yannis, Methodist Healthcare Ministries – Support SASH construction funds. Support HHSC exceptional item 7 for $323m for full funding. Support full funding for SB 292 and HB 13.