Category Archives: Texas Legislation

SB 44 study of children with a serious emotional disturbance

Please see below for an important message from Dr. Monica Faulkner of the Child and Family Research Institute of the University of Texas at Austin.

“Based on your agency’s work with children and families, I am writing to ask you to help direct parents, caregivers and professionals to our study regarding the needs of children with serious emotional disturbances. The Department of Family and Protective Services (DFPS) and the Department of State Health Services (DSHS) have partnered with the Child and Family Research Institute at the University of Texas at Austin’s School of Social Work to conduct a study mandated by the Texas Legislature to examine the needs of families who have a child with a serious emotional disturbance.

As part of our study, we are seeking parents and other stakeholders to participate in an online survey and/or participate in interviews about their experiences. Input from parents will be used to identify existing service gaps and the needs of families. Specific details about our project can be found on our website.

If you have questions about this research, I am more than happy to address any questions or concerns. Please contact me at MFaulkner@austin.utexas.edu or (512) 471-7191.

For more information about this project, please visit: http://www.SB44needsassessment.org

PLEASE FORWARD THIS INFORMATION TO RELEVANT LISTSERVES, INDIVIDUALS AND GROUPS.”

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Adult Mental Health Awareness Poetry Contest: Deadline May 2

In observance of Mental Health Awareness Month this May, the Texas Department of State Health Services Mental Health and Substance Abuse Division, Mental Health America of Texas, and the National Alliance on Mental Illness (NAMI) – Texas are holding their Third Annual Statewide Adult Mental Health Awareness Poetry Contest open to adults with or in recovery from mental illness and their adult family members and friends.
Last year, more than 80 poems were received from across Texas for the contest, written by those living with and recovering from mental illness, their friends, and their families. Five winning entries were selected, along with six poems given honorable mention.
Children and adolescents interested in participating should submit entries to the Creativity Contest; please see http://www.dshs.state.tx.us/mhsa/greenribbon2014/ for details.

Guidelines
• Poems should express the experience of living with mental illness, living with a family member with mental illness, or having a close friend with mental illness.
• Entries must be 200 words or fewer.
• Entries must be typed or legibly handwritten.
• Entrants must be Texas residents who are 18 or older as of May 1, 2014.
• The submission deadline is May 2, 2014. All entries must be received on, or postmarked by, May 2, 2014.

Submissions
Each entry must include the following:
• Name, address, phone number, and e-mail address (if available). We will only contact you if your poem is chosen to ask for your permission to post it online. All entries will be reviewed with respect to privacy and winning entrants may ask that their work be posted anonymously.
• Please submit your poem by email, with your contact information, to LitCenter@dshs.state.tx.us, or send by postal mail to:
Mental Health and Substance Abuse
Texas Department of State Health Services
RE: Mental Health Month Poetry Contest
Mail Code 2083
909 W. 45th Street
Austin, TX 78751
Awards
Prizes and certificates will be awarded to the poems selected as winners, and the top five poems will be announced May 20, 2014, and with the author’s permission, they will be posted on the DSHS MHSA (http://www.dshs.state.tx.us/mhsa/awareness/amh/poems2014/), Mental Health America Texas (http://www.mhatexas.org) and NAMI Texas (http://www.namitexas.org/) websites.

Texas State of Mind Conference

WATCH LIVE TOMORROW

A live conference on mental health issues in Texas featuring:

-The Honorable Joe Straus, Speaker of the Texas House of Representatives
-The Honorable Jane Nelson, Chair, Committee on Health and Human Services, Texas Senate
-Dr. Kyle Janek, Executive Commissioner, Texas Health & Human Services Commission
-The Honorable Nathan Hecht, Chief Justice of the Supreme Court of Texas

APRIL 16th
Streaming live from
http://www.texasstateofmind.org
starting at 8:30 a.m.

TJP Jailhouse Stories

This spring 2014, Texas Jail Project is launching a new project called
“Jailhouse Stories: Effects of Pretrial Detention”
which will collect accounts about what happens to people held in county jails before they are tried for a crime. If you have a story about what you or your loved one experienced while in jail, please contact TJP to set up an interview! Contributors can remain anonymous – it’s just important for your voice to be heard. Jailhouse Stories will be shared with media outlets, lawmakers, and social leaders to educate Texas about the need to incarcerate less, create more diversion programs, and improve conditions in local jails.

TO SEND US YOUR STORY, connect at:
Texas Jail Project
http://www.texasjailproject.org
email: Info@texasjailproject.org
call: 512.597.8746
write: 1712 E. Riverside Drive, Box 190; Austin, TX 78741

What is the Texas Jail Project?
Texas Jail Project (TJP) works to ensure healthier, humane conditions in our local jails and advocates for improved accountability for jailers. On an average day, about 67,000 people – mothers, fathers, brothers, sons, sisters, and daughters – are incarcerated in 246 county jails across Texas. Almost 60% of those being held have not been convicted and are being held pretrial. Many must deal with the difficulties of being in jail while also facing the challenges of addictions or mental health disorders.

WHAT WE DO

 DIRECT SUPPORT: TJP receives hundreds of complaints and questions that illustrate ongoing issues and unmet needs in county jails. We try to respond to each, while posting content on our website that provides family and friends with helpful information on how to aid their loved one in receiving fair treatment while they are being held.

 ADVOCACY: TJP represents the concerns of inmates and their families to the Texas Commission on Jail Standards (TCJS) and the Texas legislature, providing feedback on the standards and processes regulating jails. TJP especially seeks to represent those from special populations who need improved care: mentally ill people, women (particularly pregnant inmates), veterans, and substance abusers.

 PUBLIC EDUCATION: Informing the public about county jails is a vital part of bringing positive reform to the current system. TJP has participated in rallies and vigils that help raise awareness of unjust conditions and has contributed articles for various media sources. For years the popular “Inmate Stories” section of our website has educated, validated, and empowered by giving voice to those who have been impacted by the local criminal justice system.

Sharing Mental Health Information: Details of the New HIPAA Privacy Rule

Sharing Mental Health Information: Details of the New HIPAA Privacy Rule

Date: April 16, 2014, 2:00pm – 3:00 p.m. Central Time

Presenters: Sherri Morgan, Christina Heide, and Marissa Gordon-Nguyen, HHS/Office for Civil Rights; and Kate Tipping, SAMHSA

Register for free at http://www.thenationalcouncil.org/events-and-training/webinars/

The Department of Health and Human Services Office for Civil Rights recently issued guidance on the HIPAA Privacy Rule and sharing information related to mental health. Learn from experts in health information privacy about this new guidance, including privacy protections for mental health records and psychotherapy notes and circumstances in which the Privacy Rule permits providers to share patients’ information with others. Presenters will discuss when family, friends, and others involved in care can access treatment information, when law enforcement and other professionals need to know information, and circumstances when other laws may apply – such as where drug and alcohol abuse treatment facilities and schools are involved.

HB 1023 Workforce Shortage Draft Report: Policy Recommendations Outline

HB 1023 Draft Report: Policy Recommendations Outline
NAMI Texas
Greg Hansch (email me for copy of full report) – ghansch@namitexas.org
2.17.14

Comments on these policy recommendations are due back to DSHS by April 1st. Please advise on the comments NAMI Texas should make.

1. General Shortage of Mental Health Providers (the state shortage of mental health providers should be addressed through improved employee recruitment and retention and the reorganization of service delivery).
a. incentives for workers:
-early exposure to career opportunities in the field and the special populations served
-mentoring by behavioral health specialists
-training stipends
-minority fellowships
-loan repayment programs
-adequate wages
-intern sites across professions

b. expansion of medical education
-robust expansion of graduate medical education
-increase availability of funded residency slots (psychiatry in particular)
-targeting graduate medical and undergraduate pre-medical students with specialty clerkships
and curriculum tracks.

c. reconsideration of scope of practice and integrated care
-existing practitioners should be deployed to use the best of their abilities and each profession
should be granted a maximum amount of reasonable responsibility.
-team-based care, collaborative care organizations, and medical/health homes
-physicians cede some simpler tasks and practice ‘at the top’ of their training, allowing other
professions to fill in the gaps through role extension.
-expanding the capacity and roles of other health care providers.
2. Maldistribution of the Mental Health Workforce
a. targeted recruitment
-recruit and retain needed health care professionals to underserved areas quires rewarding
personal and professional environments. “home-grown products” more sustainable.
-clinical rotations in underserved areas and appropriate education preparation for rural practice.
location of university departments and/or teaching clinics in rural areas, the provision of rural
-clinical experiences for medical students, and rural and scarce skills allowances for
practitioners.
-for geriatric specialties, multiple providers in an underserved area should consider forming
networks that would allow them to act as a single underserved site.

-b. telemedicine
-increase use of telepsychiatry and tele – mental health services
-look at Medicare and Medicaid reimbursement for tele-health services of psychiatrists, nurse
practitioners, clinical nurse specialists, physician assistants, clinical psychologists, and clinical
social workers.
-Texas Medical Board has rules for out-of-state practitioners to practice telemedicine in Texas,
but other relevant licensing boards do not.

3. Lack of Diversity – health care consumers have better therapeutic relationships and stronger retention rates when using a practitioner of their own race/ethnicity

a. Target Recruitment
-efforts to recruit minorities into health professions should be expanded.
-should be accompanied by efforts to improve the education attainment of minorities at large.
-Psychiatric care in the U.S. and Texas is and will continue to be dependent upon the services of
international medical graduates.

4. Outdated Educational Content and Teaching Methods – need for innovative practices, inter-professional collaboration, and improved quality of care. Roles and activities of health care workers must likely be reorganized to maximize the productivity of the workforce.

a. Curriculum Changes
-higher education programs and accrediting bodies must update curriculums.
-academic medical centers must embrace the innovation imperative and address the projected
workforce shortages. These efforts should identify and employ ‘disruptive innovations’ that will
spark true workforce innovative growth and increased efficiency
-Programs will require additional faculty and greater leadership development among existing
faculty, but must also seek to align changing elements of the education system and health
system with each other and with patient care needs.

b. Expanded Training in Clinical Settings
-Psychiatry clerkships and electives should be expanded and made available to students
entering medical school who have not yet chosen a specialty.
-Psychiatry residents and fellows should receive specific training in telepsychiatry delivery,including such diverse topics as program sustainability, model of health service delivery, program
infrastructure development, legal and regulatory issues, administrative strategies,
technical applications, quality of service, and clinical outcomes assessment.
-inclusion of child psychiatry and developmental-behavioral pediatric training in primary
care residency (though it has been shown that few primary care practitioners feel capable of
diagnosing or treating psychopathology in children or adolescents)
-For psychologists, a greater concentration of academic training and workplace experience
should occur in the clinical psychological setting, including the expansion of rotations for
psychologists in the primary care setting.
-Doctoral psychology training programs should: find ways to maximize the expertise of their
faculty; provide greater teaching and supervisory renumeration; maximize the knowledge and
skills of their students; and create and expand clinic relationships and affiliations.
-Community health centers have been presented as offering an ideal place for psychological
training in primary care behavioral health as these efforts would be available to patients with
fewest resources and greatest needs.
-Nursing faculty should share and build new curricula for RNS entering psychiatric nursing.

5. Insufficient Data to Inform Workforce Planning – Effective planning must involve the sustained investment on iterative collection of data on population need, models of health care delivery, and workforce productivity.

a. Assessment of Mental Health Service Nees
-Need sufficient demand models for Texas’ mental health workforce – should consider the local
morbidity of mental illness, mental health service utilization rates for both patient with serious
mental illness and the population at-large, and the proportion of mental health needs currently
being met by primary care providers.
-Greater need to distinguish between spatial (geographic barriers to care and aspatial (social
organizational) variables in the description of patient need. Measurements of shortage should
conceptualize access using more nuanced means, including the prevalence of mental health
disorders, the extent of need among those in need, the extent primary care providers can meet
mental health needs, and the mismatch between the level of need and the services provided.

b. Workforce Development Data
-Greater consideration of factors affecting workforce development and distribution are
needed.
-More and better data should be collected on the level of service provided for different levels
of health and illness and the productivity of providers should be measured.
-Greater investments on the activity and productivity of health workers are needed to ascertain
the effectiveness of staffing levels.
-More extensive and complete minimum data requirements, including race, ethnicity, and
languages spoken would allow a better understanding of provider ability to meet population
needs.

new solitary confinement resources – please share

“The National Alliance on Mental Illness says the TDCJ’s current system of long-term solitary confinement has been shown to cause mental health disturbances, suicide, depression, paranoia, psychosis and other antisocial behaviors. Greg Hansch, the policy coordinator for NAMI Texas, said it fosters an unsafe environment for both inmates and staff. “Sticking with the status quo is alarming,” Hansch said.”

Source: http://www.kbtx.com/home/headlines/Advocates-Urge-Prison-Officials-to-Reconsider-Death-Row-Isolation-242676051.html

“A dozen advocacy groups — among them, the Texas Defender Service that represents death row convicts, the guards’ union, the Texas Criminal Justice Coalition, the National Alliance on Mental Illness-Texas, the Texas Civil Rights Project, American Civil Liberties Union of Texas, Texas Inmate Family Association and various Catholic and interfaith religious groups — are asking for Texas prison officials to allow contact visits with family members, communal recreation activities between death row prisoners, work assignments, participation in group religious services, TV viewing, arts and crafts, and phone calls to family and attorneys.”

Source: http://www.mystatesman.com/news/news/local/should-texas-death-row-inmates-have-more-privilege/nc6pw/?icmp=statesman_internallink_textlink_apr2013_statesmanstubtomystatesman_launch

“Mental health advocacy organizations such as Mental Health America of Texas and the National Alliance on Mental Illness of Texas likewise have described a pressing need for administrative segregation reform. Administrative segregation has been shown to exacerbate mental health disturbances, assaultive and other antisocial behaviors, and chronic and acute health disorders.[3] Psychological effects can include anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, psychosis[4], and increased risk of suicide[5]. The social difficulties and mental health conditions that are related to administrative segregation can also cause severe problems with reentry and reintegration, contributing to the costly problem of recidivism in Texas. In light of recent the Texas Department of Criminal Justice data indicating a significant increase in the number of individuals with mental illness living in administrative segregation, mental health advocates have pinpointed this as a major concern for Texas communities and Texans living with mental illness.”

Source: http://texasinterfaithcenter.org/article/administrative-segregation-policy-brief