Month: June 2023

Categories
General Healthcare Costs Healthcare Disparities Public Health

Let Me Be Brief: Medicaid Expansion in Texas

A series of briefs by Texas Medical Students

By: Ryan Sorensen, Aaron Pathak, Aishani Khosia

What is Medicaid?

Medicaid is a program established by the federal government in 1965 as a solution to the coverage gap that many marginalized groups faced due to the inaccessibility of private health insurance.¹ Funded jointly by the federal and state government, Medicaid became an option for health insurance for low-income, older, and disabled members of society. While partly federally funded, the program criteria, benefits, eligibility, etc all falls under the ruling of each state.2

In 2010, passage of the Affordable Care Act developed an even more comprehensive reform, with the goal of making insurance coverage and healthcare access accessible to a greater population. The ACA called for Medicaid expansion,3 which if adopted by each state would allow for more flexible eligibility- addressing the existing coverage gap that continues to remain an issue. Expansion of Medicaid would allow for individuals to be eligible to receive benefits through Medicaid on an income-basis, as long as household income did not exceed 138% of the established Federal Poverty level.4

How would Medicaid Expansion help Texans?

Texas leads the nation in the number of uninsured individuals in the state, with a reported rate of 18% according to data collected in the 2021 Census.5 For many who do not qualify for Medicaid or receive employer-sponsored health insurance, the barrier to insurance lies in the high cost of marketplace plans. With over 5 million uninsured individuals in Texas, Medicaid expansion would allow for increased access to care and improved health outcomes by expanding eligibility to include underserved and vulnerable populations above the poverty line.6

The pivotal 2002 report: Care without Coverage released by the Institute of Medicine has since been strengthened by findings that continue to show a direct relationship between mortality risk and the lack of health insurance.7 A literature review by the Kaiser Family Foundation showed that ACA expansion was correlated with better health outcomes and was specifically related to improvements in areas of cancer diagnosis and treatment, transplants, smoking cessation, behavioral health, and treatment of opioid disorders.8 Health insurance and health outcomes are undeniably interconnected, making Medicaid expansion a necessary legislative agenda to improve the health of Texans and address existing health inequities.9

A current bill to specifically advocate for is: Bill SB 343- Relating to the expansion of eligibility for Medicaid to all individuals for whom federal matching money is available. This bill was introduced by Nathan Johnson in January, and it was read in April and referred to the Health and Human Service Senate Committee for review.

How has the TMA advocated in the past?

The TMA for many years has advocated for the expansion of medicaid through the promotion of articles that show the health benefits of medicaid expansion in Texas. In 2019, 2020, and 2021 the TMA published articles showing public support, public health benefits, and fiscal benefits of allowing medicaid expansion in Texas.10 Furthermore, former TMA President Dr. Doug Curran testified in support of HB 565 introduced by Representative Coleman in the 2019 legislative session, although the bill did not make it past committee.11 TMA Policies 190.032 (Medicaid Coverage and Reform) and 190.036 show the TMA’s support in accepting additional funds from the federal government for increasing Medicaid access while also urging the government to develop new, more sustainable systems than the current Medicaid expansion plan.12,13 TMA Policy 190.037 (Medicaid Work Requirements) also states that the TMA opposed any lifetime
limits or reduction in access for Medicaid enrollees.14 Through medical student advocacy, it is important to support these lobbying efforts by the TMA in passing Medicaid expansion. It is important for the MSS to increase knowledge about the coverage gap between Texas’ current Medicaid system and the income needed to afford health insurance from the Affordable Care Act marketplace to decrease our state’s uninsured population.The federal government is slated to pay 90% of the total costs of Medicaid expansion,15 greater than the normal 50-78% that the federal government pays for current enrollees. This expansion will not only make healthcare more accessible for low-income Texans who fall in the coverage gap, but also increase the fiscal stability of safety-net hospitals that currently have to pay for people in this coverage gap through increased local property taxes.

Fast Facts

  • Medicaid expansion in Texas would provide health insurance coverage to approximately 2 million low-income Texans who are currently uninsured.16
  • States that have expanded Medicaid have seen improvements in health outcomes, including lower rates of mortality, better access to preventive care, and improved management of chronic conditions.17
  • Expanding Medicaid in Texas could help address health disparities by providing access to healthcare for low-income and minority populations who are disproportionately
    uninsured. 18
  • Medicaid expansion in Texas would also save taxpayers money by reducing the amount of uncompensated care provided by hospitals and other healthcare providers.19
  • Expanding Medicaid in Texas would result in significant net fiscal benefits for the state. According to a report by the Urban Institute, the federal government would cover 90% of the costs of expansion, and the state would save money on healthcare and other programs that currently serve uninsured individuals.20
  • The Texas Hospital Association has estimated that Texas hospitals would see a $34 billion reduction in uncompensated care costs over a 10-year period if Medicaid were expanded.21
  • Expanding Medicaid in Texas would generate more than $100 billion in economic activity and create 200,000 jobs over 10 years, according to a study by the Perryman Group.22

References

  1. Center on Budget and Policy Priorities. (n.d.). Introduction to Medicaid. https://www.cbpp.org/research/health/introduction-to-medicaid.
  2. Medicaid.gov. (n.d.). Home. https://www.medicaid.gov/medicaid/index.html.
  3. HealthCare.gov. (n.d.). Affordable Care Act (ACA) – Glossary.
    https://www.healthcare.gov/glossary/affordable-care-act/.
  4. Kaiser Family Foundation. (2023). Status of State Medicaid Expansion Decisions: Interactive Map.
    https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/#:~:text=The%20Affordable%20Care%20Act’s%20(ACA,FMAP)%20for%20their%20expansion%20populations.
  5. Mykyta DCand L. (2022). Decline in share of people without health insurance driven by increase in public coverage in 36 states. Census.gov. https://www.census.gov/library/stories/2022/09/uninsured-rate-declined-in-28-states.html
  6. Rachel Garfield, K.O. (2021). The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid – Issue Brief – 8659-10. KFF. https://www.kff.org/report-section/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-issue-brief-8659-10/#endnote_link_508791-3.
  7. Kilbourne AM. (2005). Care without Coverage: Too Little, Too Late. J Natl Med Assoc. 97(11), 1578.
  8. Guth, M. (2023). The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020 – Report. KFF. https://www.kff.org/report-section/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-report/.
  9. Sommers BD, Baicker K, Epstein AM. (2012). Mortality and access to care among adults after state Medicaid expansions. New England Journal of Medicine. 367(11), 1025-1034. doi:10.1056/nejmsa1202099.
  10. Texmed. (n.d.). Medicaid Expansion. https://www.texmed.org/Search/Keywords/?Keyword=Medicaid+expansion.
  11. Doolittle, D. (n.d.). More than 1 million more Texans could be covered, report shows. Texmed. https://www.texmed.org/Template.aspx?id=50436.
  12. Texmed. (n.d.). Medicaid Expansion: Why It Matters to Texas. https://www.texmed.org/Template.aspx?id=43009&terms=medicaid%20expansion.
  13. Texmed. (n.d.). Medicaid Expansion: FAQs. https://www.texmed.org/Template.aspx?id=46586&terms=medicaid%20expansion.
  14. Texmed. (n.d.). Medicaid Expansion: Economic Impact. https://www.texmed.org/Template.aspx?id=48322&terms=medicaid%20expansion.
  15. Center on Budget and Policy Priorities. (n.d.). Medicaid Expansion: Frequently Asked Questions. https://www.cbpp.org/research/health/medicaid-expansion-frequently-asked-questions.
  16. Kaiser Family Foundation. Medicaid in Texas. Retrieved from https://www.kff.org/medicaid/state-indicator/texas/
  17. Kaiser Family Foundation. The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review. Retrieved from https://www.kff.org/medicaid/report/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/
  18. National Academies of Sciences, Engineering, and Medicine. Accounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors. Retrieved from https://www.nap.edu/catalog/23635/accounting-for-social-risk-factors-in-medicare-payment-identifying-social
  19. The Commonwealth Fund. The Cost of Not Expanding Medicaid in Texas. Retrieved from https://www.commonwealthfund.org/blog/2019/cost-not-expanding-medicaid-texas
  20. Urban Institute. The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis. Retrieved from https://www.urban.org/sites/default/files/publication/32696/413136-The-Cost-and-Coverage-Implications-of-the-ACA-Medicaid-Expansion-National-and-State-by-State-Analysis.PDF
  21. Texas Hospital Association. The Economic Benefit of Expanding Medicaid in Texas. Retrieved from https://www.tha.org/Public-Policy/State-Federal Issues/Medicaid-Expansion
  22. The Perryman Group. Economic and Fiscal Benefits of Medicaid Expansion in Texas. Retrieved from https://www.texmed.org/Template.aspx?id=47027
Categories
General Healthcare Costs

Let Me Be Brief: Graduate Medical Education (GME) Funding

A series of briefs by Texas Medical Students

By: Parker Davis, Ashlynn Mills, Priya Patel

The history of graduate medical education (GME) funding is complex with many competing interests, from teaching hospitals and government agencies that foot the bill to faculty physicians and residents themselves. The establishment of Medicare in 1965 marked the beginning of significant federal subsidization of residency training.1,2,3 Initially uncapped, financial support from Medicare was meant to be a temporary measure until more permanent systems of GME funding could be established.4 Today, Medicare remains the single largest monetary contributor to residents’ education. Direct graduate medical education (DME) covers resident and faculty salary and benefits, plus administrative overhead.5 Indirect graduate medical education (IME) was established to help alleviate the additional costs of running a teaching hospital related to a more complex patient panel and research expenses.4 However, concerns about inflating healthcare costs and the looming threat of a physician surplus in the 1980-90s prompted the curtailing of GME spending. Thus, the formulas used to calculate a hospital’s DME provided full funding for each “Full-Time Equivalent” (FTE; employed resident) only for the duration of the initial residency period or 5 years, whichever was shorter. PGY-6+ residents comprised only a fraction of an FTE, and the hospital received less money per senior resident.6 Additionally, the Balanced Budget Act of 1997 limited the number of residents at a given hospital that were eligible for DME, limiting a hospital’s maximum DME by the number of residents it employed in 1996.7

As indications for a national physician shortage emerged in the early 2000s, the conversation surrounding GME began to change. The focus became how to reconcile the myriad of funding streams and best support the growth of the next generation of physicians while eliminating excess spending. Even as the American Association of Medical Colleges (AAMC) was calling for expansion of medical school seats across the country, the 2010 Simpson-Bowles Commission recommended a reduction in average GME compensation, an attempt to reign in government spending in the midst of the economic recession.6 More recently, the US Department of Health and Human Services aimed to integrate GME funding streams from Medicare, Medicaid, and the Children’s Hospital into a single consolidated program, distributed jointly by the Centers for Medicare & Medicaid Services (CMS) and the Health Resources and Services Administration.8

The Texas Medical Association (TMA) was established to lobby on behalf of physicians at the state and federal levels to promote physician autonomy, protect the patient-physician relationship, and minimize regulatory intervention in the practice of medicine from insurers and other nonmedical entities. Created in the late 1970s, the Medical Student Section (MSS) is a voice for medical students within the TMA with the goal of improving medical education and advocating for the future of medicine.9 In the saga of GME, one of the TMA’s primary objectives has been to retain graduates of Texas medical schools in Texas. TMA advocacy has focused on supporting the growth of GME, both financially and in terms of the total number of seats.10,11,12 The acuity of the physician shortage was emphasized with the national population growth rate and was again highlighted during the COVID-19 pandemic, as patients experienced long wait-times and shortage of resources. In response, six new medical schools have opened in Texas since 2016, and some of the established nine medical schools have increased their class sizes.

However, even as the number of Texas medical school graduates is rising, the number of residency positions available remains stagnant.13 More positions are necessary to increase the physician workforce, which calls for an increase in GME funding. The TMA postulates a target ratio of 1.1:1 first-year GME slots per medical school graduate.14 Not only does this ratio provide enough residency spots for every medical student in Texas, it also gives graduates from out-of-state schools a reason to consider Texas when deciding where to bring their talents. Conversely, allowing the number of positions to dwindle provides a catalyst for a mass migration of graduates out of the state, taking with them a substantial revenue stream. It is thus imperative that GME remains a top priority for lawmakers. The consequences of allowing funding to fall by the wayside are too drastic to ignore. For the sake of the nation’s health, legislators must ensure that medical school graduates have the opportunity to take that necessary next step toward becoming a physician.

Fast Facts

  • The $2.3 trillion Consolidated Appropriations Act of 2021 authorized relief funding for community development financial institutions. It provides funding for 1,000 new Medicare-supported GME slots beginning FY 2023, adding up to 200 positions annually.15 In 2021, Texas graduated almost 2,000 medical students.16 Texas needs to stabilize the physician workforce by allocating additional funds to the 2024-2025 Texas Higher Education Coordinating Board’s (THECB) physician development programs. Health related institution formula funding recommendations for the 24-25 Biennium provide the lowest percent increase for both Instruction and Operations (18.8%) and GME funding (19.3%). 17 These areas directly impact the ability of the state to attract faculty and residents to fill the much needed and growing physician workforce gap.
  • The 84th Texas Legislature, Regular Session, consolidated the Unfilled Residency Position Program, the New and Expanded Residency Program, and the Resident Physician Expansion Program into the single GME Expansion Program. The funding allowed the new positions created in 2014 and 2015 to be maintained and to provide enough funding to support the addition of approximately 130 new residency positions.
  • The 86th Texas Legislature, Regular Session, provided $157.2 million to support GME Expansion Programs. As a result, an estimated 2,000 residency positions received funding support in FY 2020 and FY 2021.
  • While adding new residency positions and programs is admirable and will contribute to the state’s 1.1 to 1 ratio goal, it is also important that the state’s existing residency programs receive adequate funding and support.
  • The closing of two family medicine residency programs resulted in reduced access to health care in the communities of Wichita Falls and Corpus Christi, further contributing to physician distribution challenges.

Funding Requested

  • Additional funding requested: $34 million for the State GME Expansion Grant Program to maintain residency positions created through the program to date, and to maintain the1.1:1 state target ratio. GME Expansion Program funding has supported the creation of 472 new first-year residency positions between 2014 and 2021 to accommodate the increase in the number of medical graduates resulting from the opening of new medical
    schools.
  • Additional funding requested: $20.5 million to replace recent budget cuts to the Family Practice Residency Program and enable annual grants of $15,000 per family medicine resident.18
  • $1 million to activate the State Rural Training Track Grant Program for creation of rural residency training programs (HB 1065 passed in 2019 but was not funded).
  • $30 million one-time endowment to sustain the State Physician Education Loan Repayment Program and recruit physicians to the state’s most underserved areas.
  • $2.14 million for the Joint Admission Medical Program so it can keep pace with recent increases in medical school enrollments.

Related Bills (congress.gov)

No currently proposed Texas Legislature (capitol.texas.gov).

  1. H.R. 9424 – 117th Congress
    Introduced in House (12/05/2022)
    Creating Access to Residency Education Act of 2022
    Sponsor: Castor, Kathy [Rep.-D-FL-14] (Introduced 12/05/2022) Cosponsors: (0)
    Committees: House – Energy and Commerce
    This bill requires the Centers for Medicare & Medicaid Services to award matching funds to teaching hospitals or other graduate medical education training programs for medical residency
    training programs in states where there are fewer than 44 medical residents per 100,000 people. Recipients must cover one third of the costs for primary care residency training programs and
    one half of the costs for programs in other fields.
    Latest Action: House – 12/05/2022 Referred to the House Committee on Energy and Commerce.
  2. H.R. 3671 – 117th Congress
    Introduced in House (06/01/2021)
    Doctors of Community Act or the DOC Act
    This bill reauthorizes and provides mandatory funding for graduate medical education programs operated by teaching health centers.
    The bill sets out funding levels through FY2033. Funding for FY2034 and beyond equals the preceding fiscal year’s amount adjusted for medical inflation.
    Latest Action: House – 06/02/2021 Referred to the Subcommittee on Health.
    S.1958 — 117th Congress (2021-2022)
    Introduced in Senate (06/07/2021)
    Doctors of Community Act or the DOC Act
    DOC Act
    Sponsor: Murray, Patty [Sen.-D-WA] (Introduced 06/07/2021) Cosponsors: (8)
    Committees: Senate – Health, Education, Labor, and Pensions This bill reauthorizes and provides mandatory funding for graduate medical education programs operated by teaching health centers. The bill sets out funding levels through FY2033. Funding for FY2034 and beyond equals the preceding fiscal year’s amount adjusted for medical inflation. Latest Action: Senate – 06/07/2021 Read twice and referred to the Committee on Health, Education, Labor, and Pensions
  1. H.R.8508 – Rural Physician Workforce Production Act of 2022 – 117th Congress (2021-2022)
    Sponsor: Rep. O’Halleran, Tom [D-AZ-1] (Introduced 07/26/2022)
    Committees: House – Ways and Means; Energy and Commerce
    Latest Action: House – 07/26/2022 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined
    by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
  2. H.R.949 — 117th Congress (2021-2022)
    There is one summary for H.R.949. Bill summaries are authored by CRS.
    Introduced in House (02/08/2021)
    Expanding Teaching Health Centers Act of 2021
    This bill provides funding through FY2023 to the Department of Health and Human Services to establish and expand medical residency training programs at teaching health centers.
    Latest Action: House – 02/09/2021 Referred to the Subcommittee on Health. (All Actions)

Sources

  1. House report number 213, 89th Congress, 1st session. https://www-govinfo-gov.foyer.swmed.edu/app/details/STATUTE-79. (1965), Accessed 13th February 2023.
  2. Guss D, Prestipino AL, Rubash HE. Graduate medical education funding: a Massachusetts General Hospital case study and review. J Bone Joint Surg Am. 2012;94(4):e24. doi:10.2106/JBJS.K.00425
  3. Stevens R. American medicine and the public interest. New Haven and London: Yale University Press; 1971.
  4. Schuster BL. Funding of Graduate Medical Education in a Market-Based Healthcare System. Am J Med Sci. 2017;353(2):119-125. doi:10.1016/j.amjms.2016.11.027
  5. Solomon IH, Normandin E, Bhattacharyya S, et al. Neuropathological Features of Covid-19. N Engl J Med. 2020;383(10):989-992. doi:10.1056/nejmc2019373
  6. He K, Whang E, Kristo G. Graduate medical education funding mechanisms, challenges, and solutions: A narrative review. Am J Surg. 2021;221(1):65-71. doi:10.1016/j.amjsurg.2020.06.007
  7. Iglehart JK. Medicare, graduate medical education, and new policy directions. N Engl J Med. 2008;359:643-50.
  8. HHS.gov. FY 2019 Budget & Performance.
    https://www.hhs.gov/about/budget/fy2019/index.html?language=es. Published 2019. Accessed February 13, 2023.
  9. TMA House of Delegates. “TMA 2025 Goals.” TMA 2025 Goals, Texas Medical Association, 10 Apr. 2019, https://www.texmed.org/goals.aspx.
  10. Texmed.org. 200.016 Graduate Medical Education.
    https://www.texmed.org/Template.aspx?id=43064. Published 2016. Accessed February 15, 2023.
  11. Texmed.org. 200.045 Needed Growth in Graduate Medical Education Programs. https://www.texmed.org/Template.aspx?id=43093. Published 2017. Accessed February
    14, 2023.
  12. Texmed.org. 205.022 Federal Title VII Graduate Medical Education Grant Program. https://www.texmed.org/Template.aspx?id=43034. Published 2022. Accessed February 14, 2023.
  13. Price, Sean. “Unfreezing GME: A Boost to Federal Funding for Residencies by Sean Price Texas Medicine October 2021.” Texmed, Texas Medical Association, Oct. 2021,
    https://www.texmed.org/Template.aspx?id=57888.
  14. Sorrel, Amy Lynn. “Legislative Priority #1: Scope of Practice Encroachments, Graduate Medical Education Funding.” Texmed, Texas Medical Association,
    https://www.texmed.org/Template.aspx?id=60988.
  15. Robeznieks, A. (2022, March 16). 1,000 new GME slots are coming. CMS must not hamper their use. American Medical Association. Retrieved February 14, 2023, from
    https://www.ama-assn.org/education/gme-funding/1000-new-gme-slots-are-coming-cms-must-not-hamper-their-use
  16. Michas, F. (2022, June 8). Total Medical School graduates in the U.S.by State. Statista.
    Retrieved February 14, 2023, from https://www.statista.com/statistics/1270398/total-
    medical-school-graduates-in-the-us/
  17. Formula advisory committees – Texas Higher Education Coordinating Board. (n.d.). Retrieved February 14, 2023, from https://www.highered.texas.gov/about-us/advisory committees/formula-advisory-committees/
  18. https://reportcenter.highered.texas.gov/reports/legislative/graduate-medical-education-
    report-an-assessment-of-opportunities-for-graduates-of-texas-medical-schools-to-enter-
    residency-programs-in-texas-fy2020/

Helpful Resources

  1. https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Texas_Legislature/312018_Physician_Workforce.pdf
  2. https://reportcenter.highered.texas.gov/reports/data/formula-funding-recommendations-
    2024-2025/
  3. https://reportcenter.highered.texas.gov/reports/legislative/the-graduate-medical-
    education-report-october-
    2022/?muraadminpreview&muraadminpreview&mobileformat=true
  4. Texmed.org. 205.024 Medicare and Medicaid Graduate Medical Education Funding.
    https://www.texmed.org/Template.aspx?id=43036. Published 2016. Accessed February 14, 2023.
Categories
General Healthcare Costs Healthcare Disparities Mental Health Public Health

Let Me Be Brief: Addressing The Texas Mental Health Crisis

A series of briefs by Texas Medical Students

By: Jasmine Liu-Zarzuela, Isreal Munoz, Rozena Shirvani

Background

Addressing the Texas mental health crisis is a multifaceted challenge that requires the coordination of various entities and an approach that addresses the underlying causes. Some of the most important aspects of addressing the national mental health crisis is increasing access to mental health care services, improving mental health literacy among the general public, and promoting a collaborative effort between various sectors of society, including government agencies, healthcare providers, schools, employers, and community organizations.¹ Collaboration can help ensure that mental health resources are accessible, that policies and regulations support mental health, and that individuals receive the care and support they need to maintain appropriate mental health.

In accordance with the mental health of minors, The American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP) and the Children’s Hospital Association (CHA) declared a National State of Emergency
in Children’s Mental Health in 2021.² It is estimated that 16.5% of children under 18 have at least one mental health disorder, but about 49% did not receive treatment or counseling from a professional.³ To combat this, the 86th Texas Legislature created the Texas Child Mental Health Care Consortium that funded the Texas Child Health Access Through Telemedicine (TCHATT) initiative, which provides telehealth services at no cost to the school or students, such as mental health evaluations, short term therapy, psychiatric care, and referrals to long term treatment to students of participating districts.4 It is important to support funding for these initiatives as they aim to have resources in every school district in Texas; however, only about a third are estimated to be involved.4

TMA Policy

In June 2022, The TMA submitted written testimony that emphasizes the increasing need for mental health resources in Texas, particularly with the aftermath of the COVID-19 pandemic and incidences of gun violence, such as the Uvalde incident.5-8 In fact, Texas has had more school shootings than any other state since 2012 with 43 incidents.9 In this testimony, TMA strongly encourages the importance of firearm safety promotion, mental health investments, and adolescent, family, and community interventions that foster resilience in the midst of childhood adversity. A key issue for the TMA agenda at the 2023 legislative session is preventing suicide and supporting Texans’ mental health. The TMA also has many policies aimed at increasing funding and coverage for services including:

  • 55.033 Children’s Mental and Behavioral Health- supports improved
    access to mental health services and payment systems that fully integrate mental health care services in primary care10
  • 145.019 Mental Health Equitable Treatment and Parity- supports lobbying state and federal government to increase scope of limited parity laws to include all mental health disorders and supports state funding for pilots to improve treatment 11
  • 215.019 Public Mental Health Care Funding & 215.020 Improved Funding for Mental Illness and Substance Use Disorder(s) – supports increasing funding from Texas Legislature for the mental health care system 12,13
  • 100.022 Emergency Psychiatric Services- supports funding to sustain and expand state investments to redesign mental health crisis services 14

Fast Facts

  1. 198 (out of 254) Texas counties are considered Health Professional Shortage Areas for mental health.15
  2. An additional 23 Texas counties are considered a mental health Health Professional Shortage Area for low-income populations. 15
  3. 221 of 254 (87%) of Texas counties lack adequate mental health resources. 15
  4. Among adults with serious mental illness, only 64.8% received mental health services in the past year. 16
  5. The economic burden of mental illness in the United States is estimated to be $193.2 billion in lost earnings per year. 17

 Current Bills

Senate Bill 672 is a current bill that advises Texas Medicaid to construct a mental health collaborative care model.

Call to Action

It is imperative that medical professionals and students acknowledge the rising national mental health crisis and further promote awareness and create policy to ultimately improve health outcomes.

Resources

  1. https://www.apa.org/news/press/releases/2022/11/mental-health-care-strains
  2. https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Texas_Legislatur
    e/TMA-written-testimony-mental-health.pdf

References

  1. Saxena, S., Funk, M., & Chisholm, D. (2020). World Health Assembly adopts resolution on mental health. The Lancet Psychiatry, 7(8), 655-656. https://doi.org/10.1016/S2215-0366(20)30306-5
  2. AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. (n.d.). Aap.org. Retrieved March 17, 2023, from https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/
  3. Spotlight 1: Prevalence of mental health services provided by public schools and limitations in schools’ efforts to provide mental health services. (n.d.). Bing. Retrieved March 17, 2023, from
    https://nces.ed.gov/programs/crimeindicators/ind_s01.asp
  4. Texas child health access through telemedicine (TCHATT). (2021, July 27). MMHPI – Meadows Mental Health Policy Institute; Meadows Mental Health Policy Institute. https://mmhpi.org/project/texas-child-health-access-through-
    telemedicine-tchatt/
  5. Kathirvel, N. (2020). Post COVID-19 pandemic mental health challenges. Asian journal of psychiatry, 53, 102430.
  6. Vadivel, R., Shoib, S., El Halabi, S., El Hayek, S., Essam, L., Bytyçi, D. G., … & Kundadak, G. K. (2021). Mental health in the post-COVID-19 era: challenges and the way forward. General psychiatry, 34(1).
  7. Shanbehzadeh, S., Tavahomi, M., Zanjari, N., Ebrahimi-Takamjani, I., & Amiri-Arimi, S. (2021). Physical and mental health complications post-COVID-19: Scoping review. Journal of psychosomatic research, 147, 110525.
  8. Ren, F. F., & Guo, R. J. (2020). Public mental health in post-COVID-19 era. Psychiatria danubina, 32(2), 251-255.
  9. States With the Most School Shootings. (2022, May 27). Usnews.com. Retrieved March 17, 2023, from https://www.usnews.com/news/best-states/articles/2022-
    05-27/states-with-the-most-school-shootings
  10. 55.033 Childrens Mental and Behavioral Health. TMA Policy . (2022, June 14). Retrieved March 16, 2023, from
    https://www.texmed.org/Template.aspx?id=42554&terms=children+mental+
    health
  11. 145.019 Mental Health Equitable Treatment Parity . TMA Policy. (2022, June 14). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspx?id=42846&terms=mental+health+equitable+treatment
  12. 215.019 Public Mental Health Care Funding. TMA Policy. (2021, July 21). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspxid=43155&terms=public+mental+health+care+funding
  13. 215.020 Improved Funding for Mental Illness and Substance Use Disorders.TMA Policy . (2020, October 29). Retrieved March 16, 2023, fromhttps://www.texmed.org/Template.aspx?id=43156&terms=improved+funding+for+mental+illness
  14. 100.022 Emergency Psychiatric Services. TMA Policy. (2018, August 20). Retrieved March 16, 2023, from https://www.texmed.org/Template.aspx?id=42696&terms=psychiatric+services
  15. Special committee to protect all Texans. (2022). Texmed.org. https://www.texmed.org/uploadedFiles/Current/2016_Advocacy/Texas_Legislature/TMA-written-testimony-mental-health.pdf
  16. Mental illness. (n.d.). National Institute of Mental Health (NIMH). Retrieved March17, 2023, from https://www.nimh.nih.gov/health/statistics/mental-illness
  17. Mental disorders cost society billions in unearned income. (2015, September 19).National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/mental-disorders-cost-society-billions-unearned-income