Policy UpdatesTexas House Committee on Human Services – SB 1177

Texas House Committee on Human Services – SB 1177

SUMMARY – On May 14, 2019, Monica Thyssen, MMHPI Senior Director of Health Policy, was invited testimony on SB 1177 at the Texas House Committee on Human Services.  Senate Bill 1177, relating to offering certain evidence-based services in lieu of other mental health or substance use disorder services by a Medicaid managed care organization, was filed by Senator José Menéndez.  

Intensive mental health services for children and youth are critical. Through our statewide work supporting the needs of children, youth, and their families, as well as our in-depth assessments of the children’s system of care across the state we have identified substantial gaps in the availability of intensive home and community-based mental health services for children and youth with the most serious mental health challenges.

We have also found that most of the intensive, evidence-based practices (EBPs) that are known to have good outcomes for children and youth with the highest mental health needs (and their families) are not covered by the state under Medicaid – despite the fact that these services can be cost effective, especially when compared to inpatient hospitalization or residential care. Today, the primary evidence-based intensive intervention available to children and youth with intensive needs is Wraparound Service Coordination (Wraparound).

SB 1177 (Menéndez) would make EBPs available in all of its Medicaid managed care programs by updating the managed care contracts to include EBPs “in lieu of” other services. Similar language already exists in the current managed care contracts, which allows MCOs to provide inpatient services for acute psychiatric conditions in a free-standing psychiatric hospital “in lieu of” an acute care inpatient hospital setting for individuals between the ages of 21 and 64.