Texas Teens Cover - Senate

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CHAPTER 4 JANUARY 2001
Policy Implication: Increase opportunities for improved insurance coverage for
mentally ill teens.
In recent years, a number of new state insurance options —the Texas Healthy
Kids program, the federal Children’s Health Insurance Program (CHIP), and
revised Medicaid options— have emerged. Texas needs to study how the new
changes, which are already in place, can be used to optimize existing federal
funding for mentally disabled teens. This should be at the local level, with the
Children’s Mental Health Plan, school districts, and others, because treatment
decisions are frequently made at the local level, and at the state level.
Policy Implication: Improve the identification of Texas funds and programs which
treat mentally ill teens.
One barrier in Texas is to clearly identify amounts and sources of funds that all
agencies use to provide mental health services to adolescents and children. The
1990 report of the Texas Mental Health Association was the last effort to
comprehensively identify funding amounts by agency. The Senate Interim
Committee on Gangs and Juvenile Justice in 1998 surveyed agencies on at-risk
funding. A more comprehensive budget study could identify lists of programs
and expenditure, per capita costs, and sources of funding, by residential and
non-residential care. This would provide a road map for policy makers to
understand the current mental health system for children and adolescents in
Texas and develop way to streamline services and make more efficient use of
existing funds.
Policy Implication: Monitor emerging issues.
Under a recent U.S. Supreme Court decision, Olmstead v. L.C., (119 S.Ct.
2176(1999)) states are required under the Americans with Disabilities Act (ADA)
to provide community-based treatment for persons with mental disabilities
under certain circumstances. While it is too early to determine the effect of this
decision on educational, residential, and other services for mentally disabled
teens, the decision could potentially affect the range and availability of services
that states will be mandated to provide. Additionally, in a recent announcement,
the federal government has instructed states to restore Medicaid benefits to
children who lost health insurance after their parents left the welfare system. 60
Texas should monitor this issue, because the announcement may also affect
children who lost Supplemental Security Income (SSI) benefits, and thus lost
Medicaid benefits, as a result of a more stringent SSI review of their medical
problems. Many of these children were receiving SSI due to developmental or
behavioral problems, and may be more likely to have had emotional
disturbances.
1 USDHHS 1998d (in section “Mental, Emotional, and Behavior Problems are Real”).
2 NIMH 1999b.
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SENATE RESEARCH CENTER Safe Passages: Texas Teens on the Road to Adulthood - 81