How Did Behavioral Health & Trauma Fare in the 86th Texas Legislature?

DID YOU KNOW?

  • Behavioral health is a term used to refer to the connection between physical and mental health and a person’s behavior
  • At least 25% of Texas children have experienced multiple adversities that are likely affecting their ability to succeed at school.
  • Half of all mental health conditions have presented before age 14.
  • 68% of removals in 2017 were related to parental substance use.

Welcome to the fourth and final part of our look at how child protection legislation fared in the 86th Texas Legislature. We began this series in May with our top-priority bills, followed by an examination of prevention and early intervention legislation and child protection systems.

Today’s post looks at bills affecting behavioral health and trauma. For a PDF version of this post, click here.

Behavioral Health and Trauma Background

Challenges with mental health can be both a cause and a consequence of early childhood adversity. Therefore, both prevention and healing require adequate systems of care to ensure children and their parents have access to mental health care and services that incorporate trauma-informed approaches that can be both healing and protective.

In the 86th Legislative Session and in the wake of the shooting at Santa Fe High School and Hurricane Harvey, the momentum around school safety and trauma offered an opportunity to take a meaningful look at the capacity issues in our communities and the ways in which our schools might better facilitate access to care and incorporate strategies that allow children with a trauma history to engage productively and thrive.

Schools are often the first point of contact for students with behavioral health issues, and undiagnosed mental health conditions can negatively impact the academic performance, behavior, and school attendance of students.

Like all diseases, care works best with early intervention when symptoms are less severe and there is less need for more intense treatments, specialists, and medications. However, most schools lack adequate training or staff to address student needs, and most communities in Texas have a shortage of mental health and substance use providers to which families and children might be referred for treatment.

Stress and trauma, both acute (e.g. Hurricane Harvey) and chronic (e.g. abuse/neglect), can place children in “fight or flight” mode. This course overwhelms the brain, including its stress hormone cortisol, and impairs a child’s ability to self-regulate and engage in higher-order thinking. These adverse childhood experiences can disrupt normal development and lead to a higher risk of both mental challenges (e.g. depression and suicidality) and physical challenges (e.g. heart disease and stroke) throughout the lifespan. However, the negative impacts can be mitigated if students are equipped with protective factors through healthy relationships, safe environments and access to care, when needed.

Behavioral health care investments and programs are spread across state agencies including:

  • Health and Human Services Commission
  • Department of State Health Services
  • Department of Family and Protective Services
  • Texas Department of Criminal Justice
  • Texas Juvenile Justice Department
  • Texas Education Agency
  • Texas Department of Housing and Community Affairs
  • Texas Veterans Commission
  • Texas Workforce Commission

In addition to state entities, behavioral health services are provided at the local level in jails, hospital emergency departments, schools, local mental health authorities, various nonprofit agencies, public health clinics and other settings, with people frequently moving between service systems.

The goal of behavioral health policies is recovery. Recovery is an ongoing process that enables individuals to mitigate the negative effects of their challenges and trauma and become empowered to make beneficial choices, engage in healthy relationships and create a successful life.

Behavioral Health in the 86th texas legislature

Top-Priority Bills Passed

House Bill 1 – The General Appropriations Act

Champions: Sen. Jane Nelson and Rep. John Zerwas

HB 1 funding for behavioral health includes programs or services directly or indirectly related to the research, prevention, or detection of mental disorders and disabilities, and all services necessary to treat, care for, supervise, and rehabilitate persons who have a mental disorder or disability, including persons whose mental disorders or disabilities result from alcoholism or drug addiction. Funding for behavioral healthcare to support programs at 23 state agencies and associated costs within Medicaid and the Children’s Health Insurance Program total $7.8 billion for 2020-2021. Some of these services include:

  • funding for inpatient client services at state hospitals and community hospitals;
  • deferred maintenance projects at state mental health hospitals;
  • outpatient services provided through local mental health authorities and local behavioral health authorities;
  • substance abuse prevention, intervention, and treatment services for adults and children;
  • mental healthcare and substance abuse treatment for incarcerated offenders;
  • mental healthcare services for veterans; and
  • Mental Health Care Consortium.

Some notable increases in investment are found in the table below:

Behavioral Health2020-21 Base BudgetAdditional Investment and House Bill 1 FINAL% Difference
Department of Family and Protective Services for Purchased Client Services$52.8 million$24.4 million; $77.3 million total46.2% +
Health and Human Services Commission$3 billion$303.7 million; $3.3 billion total10.3% +
University of Texas Health Science Center at Tyler$8 million$5.5 million; $13.5 million total68.3% +
* Higher Education Coordinating Board$0$100 million total100% +
Department of Criminal Justice$515.8 million$9.8 million; $525.6 million total1.9% +
Juvenile Justice Department$175.5 million$3.6 million; $179.1 million2.0% +

*Funds available to the newly created Texas Mental Health Consortium to be distributed to health-related institutions of higher education for expanding the mental health workforce and for psychiatric fellowships. The Consortium is created through SB 11.

Safe and Healthy Schools Initiatives

Funding for school safety programs includes an additional $343.5 million to expand children’s community mental health, grants to mental health professionals at local mental health authorities provided by HB 19, school safety infrastructure enhancements, a new school safety allotment provided by SB 11; school district reimbursement of post-disaster expenditures, and customized school safety programming and other services.

HB 18 – Trauma Informed Schools

Champions – Rep. Four Price & Sen. Kirk Watson

HB 18 will increase awareness of mental health among public school students and educators, reduce the stigma of mental health issues, and provide more resources on mental health and substance abuse for educators. Through integration in district policy, staff training and continuing education requirements, HB 18 ensures that school staff are adequately trained to understand the impact of trauma on students, implement strategies to minimize the negative impacts, and maximize academic opportunities in an environment of safety and connection, making referrals when needed and with parental consent.

Other Priority Bills Passed

TexProtects Goal – Address students’ mental health needs by increasing access to care and implementing trauma-informed approaches in school environments

House Bill 19 – Rep. Four Price / Sen. Kirk Watson

HB 19 requires local mental health authorities to employ a nonphysician mental health professional to serve as a mental health and substance use resource for school districts. These professionals will act as a resource for school district personnel by
helping increase awareness of mental health and co-occurring mental health and substance use disorders, assisting with the implementation of mental health or substance use initiatives under state law or agency rules, and ensuring awareness of certain recommended programs and practices and treatment programs available in the district. The bill will also require the professionals to help personnel facilitate on a monthly basis training regarding mental health first aid, the effects of grief and trauma, and prevention and intervention programs that will help students cope with pressure to use illicit substances.

HB 811 – Rep. James White / Sen. royce West

HB 811 requires that school districts take into consideration whether a child is in the conservatorship of the state or is homeless when making decisions concerning disciplinary actions including suspension, removal to a disciplinary alternative education program, expulsion or placement in a juvenile justice alternative education program, regardless of whether the decision concerned a mandatory or discretionary action.

HB 906 – Rep. Senfronia Thompson / Sen. Beverly Powell

HB 906 establishes the Collaborative Task Force on Public School Mental Health Services to study and evaluate state-funded mental health services provided at school districts or open-enrollment charter schools. The task force will also evaluate mental health services training provided to educators and the impact of the provided mental health services. The task force will share its findings and recommendations with the governor, lieutenant governor, House speaker, and the TEA by Nov. 1 in each even numbered year until 2025.

SB 11 – Sen. Larry Taylor / Rep. Greg Bonnen

SB 11 is the 86th Legislature’s answer to increasing school safety. It includes many provisions related to safety, security, and emergency preparedness and response. In addition, the bill requires a trauma-informed care policy to address methods for increasing staff and parent awareness of trauma-informed care and the implementation of trauma-informed practices and care by district and campus staff. The policy will also address available counseling options for students affected by trauma and grief. In addition, SB 11, amended with language from Sen. Nelson’s SB 10, creates the Texas Child Mental Health Care Consortium to leverage the expertise and capacity of the health-related institutions of higher education in order to address urgent mental health challenges and improve the mental health care system in this state in relation to children and adolescents.

SB 712 – Sen. Eddie Lucio Jr. / Rep. Morgan Meyer

SB 712 provides guidance by naming extreme aversive interventions that may not be used on any student, under any circumstances. By clarifying what behavior modification techniques are prohibited and providing direction on positive alternatives. SB 712 will improve the safety and wellbeing of students, especially those with special needs. The companion to this bill is HB 3630.

TexProtects Goal – Improve access to mental health care, substance use prevention and treatment, and evidence-based treatments and approaches for survivors of childhood adversity

HB 2813 – Rep. Four Price / Sen. Jane Nelson

HB 2813 ensures the continued existence of the Texas Statewide Behavioral Health Council by codifying it in statute. The council is charged with developing and monitoring the implementation of a five-year statewide behavioral health strategic plan and developing a biennial coordinated statewide behavioral health expenditure proposal. This work helps state agencies coordinate and reduces duplication of services, improves the quality and accessibility of services, and saves taxpayer dollars.

SB 429 – Sen. Eddie Lucio, Jr. / Rep. Eddie Lucio III

SB 429 requires the Statewide Behavioral Health Coordinating Council, under the direction of the Health and Human Services Commission (HHSC), to develop a comprehensive plan to increase and improve the workforce in Texas to serve individuals with mental health and substance use issues. By Sept 1, 2020, HHSC will need to start implementing the plan.

SB 633 – Sen. Lois Kolkhorst / Rep. William Lambert

SB 633 requires HHSC to form local mental health authority (LMHA) groups in rural areas and develop a mental health services development plan for each group. Public mental health services are primarily provided through HHSC contracts with LMHAs. These entities provide or arrange crisis, community mental health, and substance use services; jail assessments; and services for individuals with intellectual and developmental disabilities. This bill increases service access, especially in rural counties, by requiring regional coordination and planning to reduce government costs and negative impacts to individuals in crisis.

SB 821 – Sen. Jane Nelson / Rep. Four Price

SB 821 amends a children’s advocacy center’s duties and a multidisciplinary team’s membership and response. These centers assess victims of child abuse and their families to determine their need for services related to the investigation of child abuse and provide those services. This bill updates the Family Code to more clearly align statute with current practices, standards, services, and operations of children’s advocacy centers, increase accountability, and strengthen access to services.

SB 1177 – Sen. JosÉ Menéndez / Rep. toni Rose

SB 1177 permits a Medicaid Managed Care Organization to offer medically appropriate, cost-effective, and evidence-based services from a list approved by the state Medicaid managed care advisory committee and included in the contract in lieu of mental health or substance use disorder services specified in the state Medicaid plan. This will provide flexibility to providers and access to evidence-based and cost-effective services without additional cost to the state.

SB 1564 – Sen. Royce West / Rep. Stephanie Klick

SB1564 aligns Texas Medicaid policy with federal law by using the federal definition of a “qualifying practitioner.” This will allow more practitioners to prescribe and be reimbursed for buprenorphine, a common medication-assisted treatment for substance use disorders. Currently, a large number of Texans who have a substance use disorder do not have access to providers who are able to prescribe them the common opioid antagonist buprenorphine.

Missed Opportunities for Behavioral Health and Trauma

Creating the Texas Mental and Behavioral Health Research Institute

Through HB 10, this research institute would have been able to lead the charge on child and adolescent mental health by funding research, increasing awareness of best practices, and fostering statewide collaborations. This institute would coordinate with the Mental Health Care Consortium to accelerate community access to information, treatments, and training related to behavioral health and substance use. The related HJR 5 would have created a revenue source for this research and increased access to care.

How Did Child Protection Systems Fare in the 86th Texas Legislature?

DID YOU KNOW?

  • In 2018, there were 280,874 reports of suspected child abuse/neglect to Statewide Intake. 66,370 or 24% of those reports were confirmed.
  • Child maltreatment will cost Texas an estimated $1.75 billion in CPS expenditures in FY 2019 and over $55 billion in total costs across the victims’ lifetimes.
  • 43% of children who complete Family Based Safety Services programming with their families are reconfirmed as victims of abuse within 5 years.

Welcome to the third part of our look at how child protection legislation fared in the 86th Texas Legislature. We began this series in May with our top-priority bills., followed by an examination of prevention and early intervention legislation.

Today’s post looks at bills affecting Child Protection Systems, and next we will conclude with Mental Health and Trauma. For a PDF version of this post, click here.

Child Protection Systems Background

In the 85th Texas Legislative Session (2017), Governor Greg Abbott declared child protection to be an emergency item. That session resulted in unprecedented child protective services (CPS) reforms and investments including:

  • Increases in kinship care through enhanced financial assistance;
  • Expansion of community-based foster care;
  • Treatment-based foster family care in most regions;
  • Salary increases; and
  • Additional hires that lowered caseloads

While those reforms made real progress for the safety of Texas children, there was significant work left to do in the 86th Legislative Session (2019) and much less political will to do it. However, opportunities for continued investment in best practice and improvements to child safety were plentiful. Opportunities presented to the 86th Legislature included:

  • Maintenance – In order to maintain the salary increases, caseloads, and investments in community-based care despite a growing child population and increasing number of child abuse reports and victims, lawmakers had to invest additional dollars or risk losing ground on the changes made last session.
  • Pressure from the federal class action lawsuit – In 2015, Judge Janis Jack proposed significant changes to the CPS system to ensure the constitutional rights and due process of children in the care of the state in response to a class action lawsuit filed on behalf of 12,000 children in long-term foster care. While some of the proposals were overturned by the 5th Circuit Court of Appeals as overreach, the findings have consistently made clear that the state has work to do to ensure the safety, health, and constitutional rights of children in the conservatorship of the state.
  • Family First Prevention Services Act – This session presented a new opportunity to leverage federal funds made available through the federal Family First Prevention Services Act in two significant ways. First, it makes available new prevention funding to help strengthen families before a crisis by investing in mental health, substance use prevention and treatment, and in-home parenting programs. Second, it requires that federal dollars for children in care be spent on family-like settings and treatment centers that are offering accredited and high-quality care. In order to leverage those dollars most effectively, the Legislature had the opportunity to invest in planning and improved quality that would ready the state for implementation.

Child Protection in the 86th texas legislature

Top-Priority Bills Passed

House Bill 1 – The General Appropriations Act

Champions: Sen. Jane Nelson, Sen. Lois Kolkhorst, Rep. John Zerwas, REp. Sarah DAvis

General Overview – Although we did not see the urgent and comprehensive focus on child welfare this session that we did in the 85th, there was continued attention on child protection issues. Lawmakers viewed their role this session as one of a gatekeeper – ensuring that the large-scale changes of last session continued to move forward and that implementation was monitored closely. Despite a cut in state funds, when federal funds were included, the Department of Family and Protective Services (DFPS) budget grew by 6.1%. In their budget, lawmakers showed continued support for community-based care, increasing the use of kinship care, and the needs of older foster youth.

Area of Budget2020-21 Base BudgetHouse Bill 1 FINAL% Difference
Child Protective Services$3.7 billion$3.8 billion2.2% +

Statewide Intake – At DFPS, statewide intake is the front door for the public to report suspected abuse. Additional investments will improve child safety by minimizing hold times on the statewide intake line. Long wait times can result in dropped calls and increase the risk of abuse going unreported. Investments in this biennium will support salary increases of $6,000, resulting in lower turnover and subsequently, a higher level of experience in the workforce.

Area of Budget2020-21 Base BudgetAdditional Investment & House Bill 1 Final% Difference
Statewide Intake$45.9 million$4.3 million
$50.2 million total
8.5% +

Caseloads – The maintenance of manageable caseloads is paramount to ensuring the safety of children who are interacting with the child protection system. Investments for CPS direct delivery staff will help to maintain lower caseloads per worker for most caseworkers.

Area of Budget2021 Base Budget & Average Daily CaseloadAdditional Investment, House Bill 1 Final, & Projected Average Daily Caseload% Difference
CPS Direct Delivery Staff$1.4 billion$148 million
$1.6 billion total
9.1%
CPS Investigations13.6 cases13.6 billion
CPS Family Based Safety Services10.2 cases9.3 cases
CPS Conservatorship25 cases23.5 cases

Projected caseloads are included in HB 1 and are estimates from the Legislative Budget Board; DFPS will prepare its own analysis.

Community-Based Care – The Legislature provided funding to continue rolling out Community-Based Care (CBC), formerly named “Foster Care Redesign,” which changes the way the state delivers foster care services. Under CBC, a private contractor (called a “Single Source Continuum Contractor [SSCC]”) is responsible for building and managing foster care capacity and placements for a specific service region in the state. CBC has been rolled out in Region 3B (seven-county area including Tarrant County), Region 2 (30-county area in North and North-central Texas that includes Wichita Falls and Abilene) and Region 8A (Bexar County). Additional investments this session will provide resources to expand into Region 8B (16 counties surrounding Bexar), and Region 1 (41 counties in Panhandle), as well as add case management work to the existing contracts.

2020-21 Base BudgetAdditional Investment and House Bill 1 Final% Difference
Community-Based Care$434.5 million$66.9 million
$501.4 million total
15.4% +0

Foster Care Provider Payments – Foster care families and other providers are essential to building capacity in the foster care system so it meets the current demand, as well as ensuring positive outcomes for children and youth in conservatorship of the
state. The Legislature provided additional investment of $12 million in foster family support, certain residential providers and emergency shelters.

Supervised Independent Living (SIL) and Preparation for Adult Living (PAL) – DFPS provides both SIL and PAL programs to assist older youth in their transition toward a successful and self-sufficient adulthood. Without supportive housing and access to training and resources, youth are more likely to be involved in the criminal justice system, are at higher risk of teen pregnancy, have lower high school graduation rates and are more likely to experience homelessness and unemployment. SIL increases of $1.8 million will support case management services for children with more complex needs and increase the rates paid to providers for services. PAL increases of $1.5 million will support 10 additional specialist positions.

HB 475

Champions – Rep. Donna Howard and SEn. Kirk Watson

HB 475 will ensure that pregnant and parenting foster youth receive basic information about ways to keep their child safe and promote healthy attachment, child development, and maternal health if they cannot or choose not to participate in Project Helping through Intervention and Prevention (HIP). Project HIP makes available evidence-based, in-home parenting programs to pregnant and parenting foster youth; however, it is voluntary and not currently available statewide.

Other Priority Bills Passed

TexProtects Goal – Efficiency and Best Practices in CPS and Foster Care

Senate Bill 195 – Sen. Charles Perry / Rep. Tan Parker

SB 195 requires DFPS to update their case tracking system to allow DFPS to keep statistics regarding alcohol and controlled substances when funds are available. This detailed information will allow the department to better understand the correlations between substance use and child abuse/neglect as well as the impacts of prenatal exposure to alcohol and controlled substances on children.

SB 781 – Sen. Lois Kolkhorst / Rep. Ben Leman

SB 781 will establish regulations for child safety, runaway prevention, quality contracting, and strategic planning for facilities that provide 24-hour care to children such as residential treatment centers and emergency shelters. The strategic plan outlined in the bill will help ensure that state agencies are prepared for the implementation of the federal Family First Prevention Services Act.

TexProtects Goal – Increased Use of Kinship Care

HB 1884 – Rep. Ina Minjarez / Sen. Carol Alvarado

HB 1884 requires that when a child is placed with a relative or other designated caregiver, the caregiver is informed, by the court, of the option to become verified by a licensed child-placing agency and of the permanency care assistance program. This opportunity can make available additional resources to the caregiver and as a result, increase stability for children.

HB 3390 – Rep. Scott Sanford / Sen. Angela Paxton

HB 3390 ensures that adequate steps are taken to identify any potential caregiver for a child before that child is placed in foster care. The bill also expands the definition of a designated caregiver to include a person who had a longstanding and significant relationship with the family of the child and requires that the child and parent both be asked to share any relatives or potential caregivers.

TexProtects Goal – Improved Services to Foster Youth Aging Out of Care

HB 53 – Rep. Ina Minjarez / Sen. Beverly Powell

HB 53 will require DFPS to collaborate with the Office of Consumer Credit Commissioner and the State Securities Board to develop an expanded financial literacy education program for foster youth. Experiential training will include filing taxes, using insurance, identity and credit theft, budgeting and civic engagement.

HB 123 – Rep. James White / Sen. Kirk Watson

HB 123 eases the burden of obtaining personal identification documents for foster children by waiving the fee, exempting the requirement for a parent signature and allowing the use of the DFPS regional office in lieu of a permanent address.

HB 1702 – Rep. Donna Howard / Sen. Kelly Hancock

HB 1702 requires institutions of higher education to make publicly available the contact information for their foster care liaison officer and information regarding support services available to students who were formerly in conservatorship. In addition, the name of any student who was formerly in conservatorship will be provided to the foster care liaison officer by their institution at the beginning of each semester.

TexProtects Goal – Cross-Sector Collaboration and Child Protection Systems

HB 72 – Rep. James White / Sen. Angela Paxton

HB 72 allows adopted children with chronic health conditions to continue to have access to the healthcare they would have had if they had remained in conservatorship if the adoptive parents opt-in. Foster children who transition into adoptive placement often experience gaps in medical care, and these gaps can have serious negative health consequences for children with severe disabilities.

HB 621 – Rep. Victoria Neave / Sen. Judith Zaffirini

HB 621 expands existing statutory protections against employer retaliation for a professional’s good faith reporting of child abuse or neglect by defining “adverse employment action” to mean any action that affected an employee’s compensation, promotion, transfer, work assignment, or performance evaluation, or any other employment action that would dissuade a reasonable employee from making or supporting a report of abuse or neglect.

HB 1709 – Rep. Mary González / Sen. José Menéndez

HB 1709 requires school districts to work closely with DFPS to notify when a surrogate parent has been appointed to a child with disabilities who is in conservatorship. Surrogate parents are appointed by school districts when children with disabilities who are under the managing conservatorship of DFPS do not have an available parent or foster parent who is willing or able to serve as the educational decision maker for the child. When a court-appointed surrogate parent is not properly performing their required duties, the district must consult with DFPS to review the appointment and, if appropriate, find a replacement. This bill expands the definitions of who can serve as a surrogate parent and helps ensure transparency and accountability in the system.

HB 1780 – Rep. Rick Miller / Sen. Lois Kolkhorst

HB 1780 requires the court to consider a parent’s good faith attempt to complete a drug rehab program when deciding whether to grant a 6-month extension before terminating parental rights. In light of the overwhelming majority of neglectful supervision cases that involve substance use and the complexity of treatment and recovery, this bill will give parents a chance to break the cycle of drug addiction and keep families together.

HB 2229 – Rep. Jarvis Johnson / Sen. Kirk Watson

HB 2229 adds specific information to a report the Texas Juvenile Justice Department (TJJD) must submit to the Governor, Lt. Governor, and Legislature every even numbered year regarding foster children in the juvenile justice system. This bill requires the report to break down the number of foster children in TJJD custody by age, sex, race, conduct, and first-time offenders. This data will enable advocates and policymakers to better implement programs and practices that can prevent foster youth from entering the justice system.

HB 2737 – Rep. Gene Wu / Sen. Nathan Johnson

HB 2737 will require the Texas Supreme Court to provide annual guidance to judges who preside over juvenile or child protective services cases to establish greater uniformity across the state in how those cases are handled. The issues addressed could include the placement of children with severe mental health issues; changes in placement; final termination of parental rights; release of children detained in
juvenile detention facilities; certification of juveniles to stand trial as adults; and commitment of children to the Texas Juvenile Justice Department.

HB 3809 – Rep. Craig Goldman / Sen. Kirk Watson

HB 3809 will allow suits for personal injury to be brought up to 30 years after the day the cause of action accrued if the injury arose from conduct involving offenses against children including sexual assault of a child, aggravated sexual assault of a child, continuous sexual abuse of a young child, trafficking a child and causing the child to be involved in certain sex crimes, compelling prostitution of a child, and indecency with a child. Currently, the statute of limitations is 15 years. This bill allows more time for child victims to come to terms with their trauma enough to talk about it and bring a civil lawsuit.

Missed Opportunities for Improving Child Protection Systems

Rate Increases

Children who cannot remain safely at home with their parents are removed by CPS. CPS places children in foster care placements when a suitable kinship option is not available. Foster care services may be provided through placement with foster families or through emergency shelters, residential treatment centers, and other programs. Foster care providers are reimbursed by the state at a daily rate based on the type of care that is required to meet the needs of each child. In Texas, these rates do not fully cover the cost of providing foster care services, and providers must secure philanthropic donations that subsidize the rates in order to provide quality foster care. While lawmakers did make some investments in rate increases, in most cases these increases did not keep pace with inflation and actual purchasing power decreased. Insufficient rates contribute to continuing problems in building sufficient capacity to serve children in need.

Trauma-Informed Care

Children who are interacting with the Child Protection System experience trauma at higher rates than their peers and often in patterns that are complex and chronic. Although DFPS currently includes trauma-informed training in programs made available to DFPS employees as well as foster, adoptive, and kinship caregivers, the comprehensiveness and accessibilty of that training may not be sufficient to ensure staff and caregivers have the skills they need to recognize and address the ways that trauma may be affecting a child’s behavior. Unfortunately, the Legislature failed to take action to ensure that the adults who are charged with decision making on behalf of traumatized children, have adequate training to understand the ways trauma can impact biology and behavior or strategies to increase resilience and healing.

Funding for Increased Quality in Foster Care

The Family First Prevention Services Act, which will go into effect in 2021, targets federal funding to evidencebased foster care prevention services and improved foster care that provides the best environment for each child’s unique needs. For children with therapeutic needs, Family First dollars are available for providers who have thirdparty assessment, access to medical staff, and follow-up after transition to assure successful placement. Many Texas providers are not currenly meeting the standards laid out by the bill. This session offered an opportuntiy to invest in programs and services that are being prioritized by Family First so that implementation will be efficient, federal dollars can be maximized, and children will have access to higher quality care.