Lawmakers made progress on only eight of more than 30 recommendations aimed at improving children’s behavioral health in Texas, according to a recent report.
The Statewide Behavioral Health Coordinating Council released the Children’s Behavioral Health Strategic Plan in December 2024. Advocacy group Texans Care for Children found that legislators partially or fully implemented less than a third of the plan’s recommendations during the last session.
“We know that six percent of Texas youth are entering the foster care system due to unmet mental health services or care,” said Muna Javaid, senior policy associate for child protection with Texans Care for Children. “To avoid institutionalization or youth entering the juvenile justice system or the foster system, the more that we support and fund these community-based services, the less likely that that will be the outcome.”
One of the report’s most pressing concerns involves funding for the Youth Empowerment Services (YES) waiver, a Medicaid program designed to support children with serious mental, emotional, and behavioral challenges while keeping them in their homes and communities rather than institutional settings.
The 2024 strategic plan recommended providing the Texas Health and Human Services Commission with funding to increase reimbursement rates and reduce administrative barriers for the program. Instead, lawmakers cut $1.3 million from the YES waiver, Javaid said.
“[The lost funding] is significant because we know that there has been a sharp increase in families that are asking for YES waiver services,” she said.
Despite rising demand, the report found the number of children served by the program is declining. Inquiries increased 43% between 2021 and 2023, while enrollment dropped by nearly 20%, leaving almost 900 children waiting for services. The waiver also lost nearly 400 providers between 2020 and 2023.
“Those numbers are continuing to decline and that is partly due to financial challenges [and] low funding levels,” Javaid said. “The program could help more youth, but there just aren’t enough providers to deliver the services.”
Advocates hope restoring and increasing YES waiver funding will become a legislative priority in 2027, after it was not addressed in 2025.
“The [2024 strategic plan] was released a month before the legislative session began, so maybe it left limited time for legislators to really fully digest it and translate it into policy,” Javaid said. “There was also uncertainty around Medicaid policy at the federal level, so it may have created some hesitation to commit to long-term investments. But ultimately, we’d love to see … that funding cut reinstated next session.”
The report also highlighted areas of progress. Lawmakers invested an additional $40 million to expand mobile youth crisis outreach teams, doubling the number from eight to 16.
“It’s just been wonderful with the eight teams that we’ve had, but this session, they basically doubled that number,” Javaid said. “Now, we have 16 youth crisis outreach teams, which is a huge step forward.”
Legislators also allocated $32.7 million for multi-systemic therapy, an internationally recognized intervention for children at risk of entering the juvenile justice system because of serious behavioral issues.
“It’s really cost effective. It’s a great intervention,” Javaid said. “That investment is going to go a long way.”
Still, the funding only partially met the strategic plan’s recommendation. Texas currently has 23 multi-systemic therapy teams, but meeting statewide demand would require about 140.
Javaid said significant support is still needed, even in areas that saw increased investment. While some recommendations could be addressed administratively, several related bills ultimately failed during the session.
The report identified additional gaps, including expanding Medicaid coverage for community-based services, strengthening the behavioral health workforce, and ensuring crisis services are available around the clock.
“A lot of these recommendations are about some of those more intensive mental health services,” Javaid said. “We know that Texas parents are desperately looking for services to help their children get healthy, go to school, sleep in their own beds at night instead of entering psychiatric hospitals.”