The House Appropriations and Senate Finance Committees just finalized updated versions of the state budget bills for the next two fiscal years.
The bills will head to the House and Senate floor soon for debate and approval (and consideration of many budget amendments on the House floor) before going to a House-Senate conference committee to work out the differences between the two chambers’ bills.
The budget bills include a continuation of the commitment made last session to public education and full-day pre-k; continued investments in women’s health programs and maternal health initiatives at the Department of State Health Services; and level funding for children’s public mental health services, Child Protective Services (CPS), and child abuse prevention (Prevention and Early Intervention).
We have a number of outstanding concerns about the proposed state budget — like the Senate bill’s inadequate funding for ECI for toddlers with disabilities, and House and Senate’s proposed cut to HHSC’s Eligibility and Enrollment capacity, which could create delays for kids, pregnant women, and others signing up for health care and other services.
We are also excited — and grateful — to see that the House Appropriations Committee added many of budget riders that we worked on with legislators and partners.
Here are a few of our takeaways from the updated budget bills:
We’re concerned about the funding levels proposed for key priorities in the HHSC budget.
The Senate budget bill shortchanges Early Childhood Intervention (ECI) for babies and toddlers with disabilities and developmental delays. We urge the Senate to adopt the more accurate ECI caseload projections included in the House budget, which are more aligned with the number of children historically served in the program, and to raise its funding level to match that projected caseload. The Legislature took a good step last session to begin restoring funding to ECI, but the proposal in SB 1 essentially amounts to cuts to the ECI program. SB 1 includes a $27 million reduction in funding compared to the FY 2020 - 2021 biennium. Texas is already failing to service all eligible children in large part due to inadequate funding. More reductions will exacerbate the problem and could lead more local ECI programs to shut down. In fact, in a 2020 survey of ECI programs, 1 in 6 ECI programs “seriously considered NOT renewing their ECI contract with the state” due to financial challenges. If Texas fails to invest in children during the critical first three years, a time of rapid brain development, the state will pay the cost in more expensive special education services.
Both the House and Senate propose cuts to HHSC’s Eligibility and Enrollment capacity, potentially creating delays for Texans enrolling in Medicaid for Pregnant Women, Children’s Medicaid, the Children’s Health Insurance Program (CHIP), SNAP food assistance, and other services. HHSC already made cuts to this division in FY 2021 and the agency admitted that it "anticipates significant impacts to eligibility determinations for SNAP, TANF, Medicaid, and CHIP as a result of this reduction." In fact, the average timeline from client application to eligibility determination for SNAP and Medicaid is already getting longer: the average decision time has increased by an extra 12 days for Medicaid and by an extra 6 days for SNAP since 2019. We urge the House and Senate to prioritize and fully fund Eligibility and Enrollment services to ensure that the most vulnerable Texans have access to these critical programs.
The Senate budget bill includes a “cost containment rider” that would make $350 million in unspecified cuts to Medicaid, potentially undermining health care for pregnant women, children, seniors, and Texans with disabilities that rely on the program. We urge the Senate to remove the rider.
The House and Senate budget proposals are a mixed bag on taking advantage of the 2018 federal Family First Act (which takes effect in October) to keep kids safely out of foster care and improve kids’ safety if they do enter foster care.
The Senate bill includes an important requirement for DFPS to track the state’s foster care capacity to serve the populations included in the 2018 Family First Act, including pregnant and parenting youth in foster care, human trafficking survivors and those at risk of being trafficked, and others. The House bill includes a good budget rider to track capacity to serve pregnant and parenting youth in foster care, but it does not include the other placements that serve populations identified in the Family First Act. We urge the House to expand its Rider to include all special populations identified in Family First.
The House bill adds funding to the DFPS “QRTP” pilot, which will develop more high-quality placements for kids in foster care with high needs. The 2018 Family First Act requires foster care facilities serving larger groups of kids to meet a heightened set of standards to continue to receive reimbursement. Having more providers meet those standards would improve safety and support for kids and allow Texas to continue to receive federal funds for these foster care placements after October. We urge the Senate to add similar funding.
House members added a budget rider to define which children are “candidates” for receiving services to help them stay out of foster care. We would like to work with House members to ensure that federal prevention funding available through the 2019 Family First Transition Act, 2018 Family First Act, and Family Based Support Services (FBSS) can support pregnant and parenting youth in foster care, youth referred to foster care from the juvenile justice system, and others.
The Senate added funding to address foster care safety concerns raised in the federal lawsuit against the state’s foster care system. The House bill added funding to address foster care safety concerns for the Health and Human Services Commission, but not the Department of Family and Protective Services. We urge the House to add funding to address the safety issues that each agency is working to resolve.
We’re glad to see a number of helpful budget riders added to the House budget — and we urge the Senate to support similar riders.
In Article III of the budget, the House adopted a rider requested by Rep. Gene Wu that directs the Texas Education Agency to support initiatives that will enhance districts’ ability to attract and retain effective bilingual educators and address lost learning opportunities and achievement gaps among Texas English Learners.
In Article III, the House also adopted a TEA rider requested by Rep. Jarvis Johnson to focus the use of the Safe School Allotment established last session on helping students and educators recover from the social-emotional trauma associated with the COVID-19 pandemic.
In Article II, the House adopted two riders requested by Rep. Donna Howard regarding the Children’s Health Insurance Program (CHIP). One rider would leverage existing CHIP administrative funds to improve outreach and help enroll eligible, uninsured children in coverage. And the other would maximize existing CHIP administrative funds so Texas can implement Health Services Initiatives that use innovative, cost-effective approaches to improve health for kids.
In Article II, the House adopted two riders that are essential for evaluating current policies’ consequences on children’s health and the state budget. One rider requested by Rep. Ann Johnson requires HHSC to evaluate and report on the impact of Texas’ inaccurate, frequent, mid-year eligibility reviews in Children’s Medicaid that remove children from health coverage just a few months after confirming they are eligible. A second rider requested by Rep. Julie Johnson directs HHSC to study the feasibility of requiring private insurers to cover Early Childhood Intervention services. This is critical since, unlike other states and unlike Medicaid managed care in Texas, private insurance companies are not required to provide coverage for specialized skills training and case management for young children with developmental delays.
In Article II, the House adopted a rider that was included in the base bill aimed at improving access to pediatric primary and specialty health care for children age 3 and younger through a cost-neutral, targeted seven percent Medicaid reimbursement increase for health professionals serving young children.
We urge the House to adopt a Senate rider to increase funding for key projects of the Texas Child Mental Health Care Consortium.
The introduced Senate budget bill includes a Texas Higher Education Coordinating Board rider in Article III that increases funding for the Child Psychiatry Access Network (CPAN) and the Texas Child Health Access Through Telemedicine (TCHATT) projects, which would help more kids access mental health care in their doctors’ offices and in their schools. The need for these innovative projects is more important than ever as increases in emotional distress, symptoms of anxiety and depression, and suicidal ideation and attempts among children have been reported in Texas during the pandemic.