by Texas Public Employees Association | June 21, 2021
Essential Texans VII: Implementation Mode
If the biennial system at the Texas Legislature likens our state politics to the boom and bust cycle of its energy industry, state employees are the sustainable resources that work year-round, every year.
During a Texas legislative session, state employees in management or expert roles may be called as resource witnesses or invited testimony. In addition to their regular duties, they are tasked with analyzing bills pertaining to their agency functions and broader service area. For example, the Texas Health and Human Services Commission (HHSC) assesses the impact of bills both operationally within its 35,000-person agency, and downstream to healthcare providers in Texas. That makes a busy job — overseeing Medicaid, CHIP, the Supplemental Nutrition Assistance Program, the Temporary Assistance for Needy Families program, the Texas Women’s Health Program, over $16 billion in contracts — even busier.
TPEA spoke with Trina Ita, an HHSC employee who could have remained successful in a clinical setting, yet came to work for the Lone Star State in an administrative role. In her first state job at the Department of State Health Services, a part of the broader HHSC system, Ita wanted to learn everything she could to understand Texas’ healthcare system. A mentor told her she needed at least two years in-agency before scratching the surface of picturing the full puzzle of programs that make Texas’ health agencies. She tells us that 10 years later, she’s still learning.
Ita often jokes that she’s become an official bureaucrat now; this seems to mean (in part) that there’s no need nor time for her to read about the healthcare system given her level of involvement. Through constant consultation with practitioners, administrators, national organizations, and her counterparts in other states, Ita keeps abreast of best practices and trends in the behavioral health space. The jargon-heavy discussion seems to typify her day-to-day operations.
Ita admits, “Sometimes I start at 7 and don’t end until 7 at night, depending on what issue might be presenting, now that we’re in the legislative session.” That schedule might sound all-too familiar to those working around the Legislature, but state employees don’t pop open champagne to celebrate on sine die. They go right into implementation mode.
House Bill 1, 84th Legislature, Regular Session, 2015, (Article IX, Section 10.04) established the Statewide Behavioral Health Coordinating Council.” (Texas Health and Human Services) State employees like Trina Ita implement it.
From November 2016 to April 2018, Ita chaired the Statewide Behavioral Health Coordinating Council (SBHCC) — then a 14 state agency body developed to break down silos. State agencies serve the same people, which invites opportunity for redundancies and inefficiencies in how Texas administers services focused on veterans, substance use, behavioral health, and even Medicaid. In interagency council meetings, you hear of relevant actions you would otherwise miss and can coordinate a better joint approach. The SBHCC drafted the Texas Statewide Behavioral Health Strategic Plan, aiming to make state services administratively burden-free to providers, to the ultimate benefit of Texans in need of behavioral health services.
Now the HHSC Associate Commissioner of Behavioral Health Services, Ita coordinates with the SBHCC she once chaired to implement its strategic plan. As the single state authority rep. for Texas’ mental health and substance abuse block grants, she oversees 1,154 contracts to local mental and behavioral health authorities as well as private sector and non-profit applicants. Block grant funds are intended to cover a wide umbrella of Texans — all 254 counties — who have severe, persistent mental health and substance use disorders. Each day, Ita’s office keeps busy with broadcast communications, technical assistance, and data collection related to its contracts.
As work went remote, Ita’s staff helped healthcare providers adapt with virtual or telephonic services. They started sending providers information on federal and other funding resources. They hosted weekly webinars providing data and guidance to providers. Through these webinars, they gathered data in return. Webinar queries and other surveys sought to construct a basic picture of Texas’ behavioral health provision, taking care to sometimes just ask if provider-staff were okay. These webinars turned into email updates as the Essential Texans working at HHSC got even busier with the 87th Legislature. You can count on them to stay busy.