Texas children’s hospitals ask lawmakers to prioritize youth behavioral health in 2023


Boram Kim


Children’s hospitals in Texas are looking to the 88th Legislature to prioritize the behavioral and developmental health of children, adolescents, and teens.


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Hospital officials are looking to 2023 to build out infrastructure and services to meet the mental health needs of children, which they say are greater than ever. 

“The piece that’s unique to this [legislative] session is really focusing on kids’ mental and behavioral health,” said Christina Hoppe, Senior Director of Public Policy for the Children’s Hospital Association of Texas (CHAT). “It’s a huge priority for us, a huge issue facing the country as a whole. And we have some specific things in Texas that we’re hoping for.

We are looking for some long-term strategy. Hopefully, one of our legislative agenda items is to get a 10-year strategic plan specific to kids’ mental health. We have one in the state already, but it’s really focused more on adults and the systems that serve them.”

While funding for behavioral health exceeds $8.5 billion in FY 2022, much of it has been earmarked to address gaps in the delivery system geared toward adult mental health. Hoppe says a 10-year plan focused on the immediate and long-term needs of kids can hopefully direct more funding. 

CHAT’s seven not-for-profit members have been working to secure funding for various initiatives and infrastructure projects. 

Texas Children’s Hospital, the nation’s largest children’s hospital, announced earlier this month an $11 million project to launch community-based mental health programs and initiatives with the goal of meeting patients and families where they are to prevent behavioral health issues from escalating into more serious health threatening episodes. 

“These services are desperately needed, and we are committed to providing them because we believe that the behavioral and developmental health of children, adolescents and teens is just as important as their physical well-being,” said Dr. Kirti Saxena, Chief of Psychiatry at Texas Children’s Hospital and Associate Professor of Psychiatry and Behavioral Sciences at Baylor College of Medicine.

Texas Children’s outlined training frontline pediatricians on behavioral healthcare and embedding more child psychiatrists, psychologists, and behavioral health specialists in their clinical settings as priorities moving forward. 

Lawmakers have already filed several bills to address mental health and safety in schools, including Senate Bill 113, which would allow school districts to partner with their local mental health authority to provide campus mental health assessments and services that are covered by the state’s Medicaid program. 

“We’re hoping that with some support from the legislature, we can expedite those [projects on behavioral health] and get them up and running as [quickly] as possible,” Hoppe said. “Because we are really seeing an increase in the need for kids’ mental and behavioral health services at every level of care.

Texas has put some resources into the community level of care, and we’re really thankful for that. But there’s also a need in the highest acuity, people coming into the emergency rooms that are really in crisis. And so we’re hoping that we can put some resources into that highest level of care, and then start filling in the gaps so we can look at the entire continuum of care.”

Children’s hospitals are the only place where kids facing serious medical conditions, such as organ transplantation and cystic fibrosis, have access to that care.

While behavioral health needs are urgent, Hoppe says she will be working with legislators both old and new during the session to continue to advocate on behalf of her members and their patients. 

“When you look at how the care is paid for in a children’s hospital in Texas, over 50% of the days of care are paid for by the Medicaid program,” Hoppe said. “We also do a lot of advocacy and education around the Medicaid program and how absolutely important it is to kids in Texas, and not only for kids where that’s their source of insurance, but because of how big of a payer it is.

When things happen to Medicaid, it can impact the entire hospital system. [The Medicaid] program makes sure that all kids can continue to get access to that type of comprehensive care.”