As Texas lawmakers prepare for the 2025 legislative session, mental health advocates are urging them to prioritize replacing expiring COVID-19 relief funding, which has been a critical source of financial support for community mental health programs. The Texas legislature faces a substantial $20 billion budget surplus, but with competing demands, including school vouchers, campus security, and Medicaid reforms, there is concern that mental health funding may not receive the attention it requires.
The federal pandemic relief funding, part of the 2021 American Rescue Plan, was a lifeline for many mental health initiatives across the state. It provided Texas with $203.4 million in mental health grants and an additional $252.8 million for substance abuse prevention and treatment. These funds enabled a variety of programs, including telepsychiatry services in schools and libraries, community mental health services in churches, and peer-to-peer support programs. These services helped mitigate the impact of the mental health provider workforce shortage in Texas, which has led to long waitlists for mental health care.
Critical Mental Health Programs at Risk
Alison Mohr Boleware, policy director at the Hogg Foundation for Mental Health, emphasized that there is no formal funding mechanism to replace the American Rescue Plan dollars. “Many stakeholders and advocates are raising the alarm on what will happen if funds are not replaced,” she said. The Texas Child Mental Health Care Consortium, which was bolstered by federal relief funding, is also at risk, as it has played a significant role in improving mental health care systems for youth in the state.
Opportunities for Legislative Action
Despite the challenges, there is a growing recognition that the Texas Legislature has made significant strides in mental health over the past decade. As the 2025 session approaches, stakeholders see an opportunity to build on that progress. Andy Keller, president and CEO of the Meadows Mental Health Policy Institute, highlighted that this session presents an opportunity for further investments in mental health, particularly to address workforce shortages and enhance access to care.
Several key bills related to mental health are already on the table for the upcoming legislative session, including:
Increasing Medicaid Providers: Texas has one of the highest percentages of counties designated as mental health professional shortage areas, especially in rural, border, and frontier regions. Senate Bill (SB) 469 would allow social workers with master’s degrees who are awaiting clinical licenses to treat Medicaid patients, potentially adding over 1,500 new providers to the Medicaid system. This move is seen as crucial to addressing the mental health provider shortage. Additionally, House Bill (HB) 154 would increase Medicaid reimbursement rates for mental health and substance use services, helping to address the issue of providers refusing to accept Medicaid due to low reimbursement rates.
988 Suicide Hotline Funding: Since its launch in 2022, Texas’ 988 suicide hotline has seen a significant increase in demand, receiving more than 380,000 calls in 2023, the second-highest call volume in the nation. However, the system’s funding is inadequate. SB 188 would establish a trust fund to support the 988 hotline, helping to ensure it can continue to operate effectively. The state allocated $14 million in fiscal year 2024, but the estimated operating costs for 2023 were $21 million.
Mental Health in Schools: Chronic absenteeism in Texas schools has worsened since the COVID-19 pandemic, with one in five students considered chronically absent. Bills filed for the upcoming session aim to address this issue by requiring school districts to collaborate with Communities in Schools, the state’s largest provider of school-based behavioral health services. The organization has requested an additional $10 million in annual state funding to support its efforts, particularly in tackling absenteeism and improving student well-being.
The Need for Immediate Action
As federal COVID-19 relief funding expires on December 31, mental health advocates are calling on Texas lawmakers to act swiftly to replace the lost funds and ensure that critical mental health programs continue to operate. The $350 billion from the American Rescue Plan was a crucial resource for Texas’ mental health infrastructure, and without it, many vulnerable populations risk losing access to essential services.
The Texas legislature will need to balance a wide range of priorities in the upcoming session, but mental health advocates stress that maintaining and expanding mental health services must be a top priority. The funding decisions made in the 2025 session could have a lasting impact on the state’s ability to address the growing mental health needs of its residents.
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