Meeting summary

Quick recap

This meeting focused on updates and discussions regarding behavioral health and substance use disorder policy in Texas. The group discussed legislative developments, including upcoming Senate Health and Human Services Committee hearings on homelessness and substance use disorder, and concerns about ketamine clinic regulations. Sherri reported on conversations with Dr. Carlos Tirado regarding telehealth restrictions for history and physical examinations in detox programs, with Duane offering to connect with Nora Cox from Texas eHealth Alliance about potential advocacy efforts. Anna provided updates on the coalition's participation in the Texas Impaired Driving Task Force and submission of comments to the Public Health Committee. The group also discussed challenges with the OSARs (Opioid Screening Assessment and Referral) system, including inconsistent performance across regions and breakdowns in transition points throughout the treatment continuum. Noelle announced plans to develop a legislative strategy list for the upcoming session and requested input from all participants.

Next steps

Anna

• Share submitted comments to the Committee on Public Health interim in the meeting chat and continue to solicit input from group members for future comments.

Duane

• Reach out to Nora Cox at Texas eHealth Alliance to discuss the issue of telehealth for history and physical exams in detox programs and report back to Sherry and Dr. Tirado.

Noelle

• Continue discussions with TEA and HHSC regarding SB 12 and report back on progress.

Sherry

• Share Nora Cox's contact information with Dr. Tirado for further follow-up on telehealth for H&P in detox, if Duane's initial outreach indicates support or interest.

• Set up a follow-up meeting with Deb Nesbaum (United Healthcare/Optum) via NAATP leadership to discuss accessing and utilizing outcomes data for advocacy purposes.

• Consult with Senator Flores' office about refiling the in-service training bill and consider filing a companion bill in the House, as appropriate.

• Re-engage with Rep. Busey's office to discuss refiling the opioid medication bill and explore meetings with Republican Public Health Committee members for education and support.

Collaboration

• Noelle/Team: Develop and distribute a legislative strategy and list of supported bills/issues for the upcoming session to the group within the next few weeks.

• All Providers/Attendees: Provide input and feedback on legislative priorities and issues (including those carried over from last session) to Noelle and team for inclusion in the upcoming legislative strategy.

• Noelle/Team: Work with HHSC and stakeholders to provide feedback on OSARs and advocate for improved accountability and outcomes tracking in the screening-to-treatment process.

Summary

Legislative Updates on Health Services

Duane provided updates on legislative hearings, noting that the Senate Health and Human Services Committee will cover interim charges related to homelessness and substance use disorder, with efforts underway to secure an invited witness from the field. Guillermo reported that state delegation visits to facilities have begun to engage stakeholders. Sherri discussed ongoing issues with telehealth restrictions for history and physical exams in detox programs, as raised by Dr. Carlos Tirado, and mentioned the need to address antiquated consent requirements for ECT, suggesting collaboration with the Texas Society of Psychiatric Physicians.

Telehealth in Substance Use Treatment

The group discussed challenges with telehealth implementation for substance use treatment, particularly regarding history and physical examinations required within 24 hours of admission to detox programs. Sherri explained that while her organization uses on-site physicians and doesn't currently need telehealth, Dr. Tirado, a medical director for substance use programs, is passionate about changing HHSC rules to allow telehealth H&Ps with RN facilitation. Duane offered to connect with Nora Cox from Texas eHealth Alliance to gauge support for this initiative, noting that TMA has historically opposed telehealth expansion. The discussion also touched on potential collaboration with United Healthcare/Optum to access outcome data that could support advocacy for substance use treatment efficacy.

Legislative Initiatives Planning Session

Sherri discussed several legislative initiatives from the previous session, including plans to contact Senator Flores' office about refiled the in-service training bill and coordinating with NAMI on mental health and substance use benefits legislation. She also mentioned plans to work with Dr. Tirado on meetings with Republican members of the Public Health Committee regarding the opioid medication bill, and to contact Busey's office about refiling their bill. Noelle encouraged everyone to connect and share their priorities for the upcoming legislative session, including items from the previous session.

Texas Impaired Driving Updates

Anna shared updates on recent activities, including a meeting with the Texas impaired driving task force and their partnership with CADES through Texas A&M. She mentioned they submitted comments to the Committee on Public Health interim meeting and encouraged more input from providers. Noelle announced plans to meet with TEA and HHSC next week regarding SB 12, which remains a priority for their legislative agenda.

South Southwest ATTC Meeting Update

Anna reported attending a South Southwest ATTC meeting representing seven states, where she encountered a diverse group including state-level personnel, academic providers, and representatives from recovery support services. Duane shared feedback from a meeting with the Executive Commissioner regarding rate increases, noting that while the discussion was positive, the agency has not yet received budget prioritization instructions from the governor's office and will need legislative support to advance the initiative.

Behavioral Health Policy Roundtable Update

Noelle updated the group on their participation in the Behavioral Health Policy Roundtable hosted by HHSC, noting that SUD is a high priority for their strategic plan and they hope to have it ready with stakeholder feedback by October. The discussion focused on OSARs (Opioid Screening and Assessment Resources), with Jennifer questioning how screening numbers are tracked and whether they lead to actual treatment engagement. Noelle explained that while tracking is required, there's currently limited accountability for outcomes, and HHSC is working to innovate OSARs while addressing inconsistent performance across regions. The group discussed challenges with transition points throughout the continuum and breakdowns in the system, with Carrie sharing an example of Jefferson County using Care Solace as an alternative referral system. Noelle committed to providing a list of legislative priorities for the group's review in the coming weeks.