LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION March 8, 2009 TO: Honorable Lois W. Kolkhorst, Chair, House Committee on Public Health FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB620 by Davis, John (Relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.), As Introduced No significant fiscal implication to the State is anticipated. This bill would implement recommendations in the report, "Create a Coordinated State Infrastructure to Support Children's Behavioral Health Services," in the LBB Government Effectiveness and Efficiency Report submitted to the Eightieth Texas Legislature, 2007. The bill would amend the Government Code related to behavioral health services for children. Thebill provides that a Children's Behavioral Health Council (council), administratively attached to theHealth and Human Services Commission (HHSC), is established to provide a coordinated,comprehensive, interagency approach to the development and delivery of behavioral health services tochildren. The council is composed of one representative from nine identified state agencies. Thecouncil is required to engage in specific activities related to childrens behavioral health services. The bill requires HHSC to establish the Childrens Behavioral Health Advisory Committee, composedof representatives from advocacy groups and organizations with expertise in behavioral health issuesinvolving children, and from other family advocates, to assist the council in its duties. The bill requires the council to design an integrated cross-agency funding structure for the provision of behavioral health services to children, authorizes the council to hire a consultant to assist withdesigning the funding structure, and requires the council to submit a report on the designed fundingstructure to the governor and the Legislative Budget Board no later than June 1, 2010. The bill requires HHSC to maximize funding for home and community-based services for childrenwith severe emotional disturbances by providing those services, to the greatest extent possible,through a Section 1915(c) waiver program or other Medicaid program. HHSC is required to identifyeach service it anticipates could be delivered cost-effectively through a Section 1915 (c) waiverprogram or other Medicaid program using existing resources and to seek federal approval as neededno later than September 1, 2010. The bill amends current statute to align with the new requirements. The bill repeals Section 531.421(3), Government Code, relating to the definition of the "consortium" that oversees the TexasIntegrated Funding Initiative. The council is required to develop criteria for and implement theexpansion of the Texas Integrated Funding Initiative pilot project and develop local mental health caresystems rather than the consortium. HHSC and the council, rather than HHSC and the consortium, arerequired to engage in activities related to the Texas Integrated Funding Initiative pilot project. This bill would take effect September 1, 2009.It is assumed that any cost to implement the provisions of the bill would be minimal and can be absorbed within available resources. Creating a coordinated state infrastructure to support local systems of care for children's behavioral health services has the potential to increase the efficient use of existing funds, reduce fragmentation, improve access to and availability of cost-effective community-based services, and reduce long-term spending on institutional care. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies:529 Health and Human Services Commission, 539 Aging and Disability Services, Department of LBB Staff: JOB, CL, JI, DM LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION March 8, 2009 TO: Honorable Lois W. Kolkhorst, Chair, House Committee on Public Health FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB620 by Davis, John (Relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.), As Introduced TO: Honorable Lois W. Kolkhorst, Chair, House Committee on Public Health FROM: John S. O'Brien, Director, Legislative Budget Board IN RE: HB620 by Davis, John (Relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.), As Introduced Honorable Lois W. Kolkhorst, Chair, House Committee on Public Health Honorable Lois W. Kolkhorst, Chair, House Committee on Public Health John S. O'Brien, Director, Legislative Budget Board John S. O'Brien, Director, Legislative Budget Board HB620 by Davis, John (Relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.), As Introduced HB620 by Davis, John (Relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.), As Introduced No significant fiscal implication to the State is anticipated. No significant fiscal implication to the State is anticipated. This bill would implement recommendations in the report, "Create a Coordinated State Infrastructure to Support Children's Behavioral Health Services," in the LBB Government Effectiveness and Efficiency Report submitted to the Eightieth Texas Legislature, 2007. The bill would amend the Government Code related to behavioral health services for children. Thebill provides that a Children's Behavioral Health Council (council), administratively attached to theHealth and Human Services Commission (HHSC), is established to provide a coordinated,comprehensive, interagency approach to the development and delivery of behavioral health services tochildren. The council is composed of one representative from nine identified state agencies. Thecouncil is required to engage in specific activities related to childrens behavioral health services. The bill requires HHSC to establish the Childrens Behavioral Health Advisory Committee, composedof representatives from advocacy groups and organizations with expertise in behavioral health issuesinvolving children, and from other family advocates, to assist the council in its duties. The bill requires the council to design an integrated cross-agency funding structure for the provision of behavioral health services to children, authorizes the council to hire a consultant to assist withdesigning the funding structure, and requires the council to submit a report on the designed fundingstructure to the governor and the Legislative Budget Board no later than June 1, 2010. The bill requires HHSC to maximize funding for home and community-based services for childrenwith severe emotional disturbances by providing those services, to the greatest extent possible,through a Section 1915(c) waiver program or other Medicaid program. HHSC is required to identifyeach service it anticipates could be delivered cost-effectively through a Section 1915 (c) waiverprogram or other Medicaid program using existing resources and to seek federal approval as neededno later than September 1, 2010. The bill amends current statute to align with the new requirements. The bill repeals Section 531.421(3), Government Code, relating to the definition of the "consortium" that oversees the TexasIntegrated Funding Initiative. The council is required to develop criteria for and implement theexpansion of the Texas Integrated Funding Initiative pilot project and develop local mental health caresystems rather than the consortium. HHSC and the council, rather than HHSC and the consortium, arerequired to engage in activities related to the Texas Integrated Funding Initiative pilot project. This bill would take effect September 1, 2009.It is assumed that any cost to implement the provisions of the bill would be minimal and can be absorbed within available resources. Creating a coordinated state infrastructure to support local systems of care for children's behavioral health services has the potential to increase the efficient use of existing funds, reduce fragmentation, improve access to and availability of cost-effective community-based services, and reduce long-term spending on institutional care. This bill would implement recommendations in the report, "Create a Coordinated State Infrastructure to Support Children's Behavioral Health Services," in the LBB Government Effectiveness and Efficiency Report submitted to the Eightieth Texas Legislature, 2007. The bill would amend the Government Code related to behavioral health services for children. Thebill provides that a Children's Behavioral Health Council (council), administratively attached to theHealth and Human Services Commission (HHSC), is established to provide a coordinated,comprehensive, interagency approach to the development and delivery of behavioral health services tochildren. The council is composed of one representative from nine identified state agencies. Thecouncil is required to engage in specific activities related to childrens behavioral health services. The bill requires HHSC to establish the Childrens Behavioral Health Advisory Committee, composedof representatives from advocacy groups and organizations with expertise in behavioral health issuesinvolving children, and from other family advocates, to assist the council in its duties. The bill requires the council to design an integrated cross-agency funding structure for the provision of behavioral health services to children, authorizes the council to hire a consultant to assist withdesigning the funding structure, and requires the council to submit a report on the designed fundingstructure to the governor and the Legislative Budget Board no later than June 1, 2010. The bill requires HHSC to maximize funding for home and community-based services for childrenwith severe emotional disturbances by providing those services, to the greatest extent possible,through a Section 1915(c) waiver program or other Medicaid program. HHSC is required to identifyeach service it anticipates could be delivered cost-effectively through a Section 1915 (c) waiverprogram or other Medicaid program using existing resources and to seek federal approval as neededno later than September 1, 2010. The bill amends current statute to align with the new requirements. The bill repeals Section 531.421(3), Government Code, relating to the definition of the "consortium" that oversees the TexasIntegrated Funding Initiative. The council is required to develop criteria for and implement theexpansion of the Texas Integrated Funding Initiative pilot project and develop local mental health caresystems rather than the consortium. HHSC and the council, rather than HHSC and the consortium, arerequired to engage in activities related to the Texas Integrated Funding Initiative pilot project. This bill would take effect September 1, 2009.It is assumed that any cost to implement the provisions of the bill would be minimal and can be absorbed within available resources. Creating a coordinated state infrastructure to support local systems of care for children's behavioral health services has the potential to increase the efficient use of existing funds, reduce fragmentation, improve access to and availability of cost-effective community-based services, and reduce long-term spending on institutional care. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of LBB Staff: JOB, CL, JI, DM JOB, CL, JI, DM