According to the Legislative Budget Board (LBB), the fiscal implications of HB 1621 are currently indeterminate due to the absence of a comparable existing program and the variable nature of potential grant awards. While the bill mandates that the Health and Human Services Commission (HHSC) administer a matching grant program to support technological upgrades at mental health hospitals, the actual cost of providing state-funded grants is unknown. This uncertainty arises because the scope, number, and size of grants will depend on the number of eligible hospitals, the range of technological enhancements proposed, and the varying needs based on hospital type, location, and services offered.

Despite the undefined grant funding cost, the LBB estimates administrative expenditures for HHSC. The agency would likely require two new full-time equivalents (FTEs), Program Specialist VI positions, to manage and oversee the grant program. These personnel costs, including salaries and travel, are projected at $311,604 in General Revenue for fiscal year 2026 and $292,772 for fiscal year 2027. Additionally, HHSC anticipates needing approximately $10,000 annually to maintain the program in the state’s Grant Management System.

From a local perspective, the bill may carry significant fiscal implications for participating hospitals. The committee substitute version of the bill requires a 100% non-state funding match for any awarded grant. Hospitals seeking participation would need to secure external funding from private, philanthropic, or federal sources, which could pose a barrier for under-resourced or rural providers. While this match requirement reduces the burden on state appropriations, it could limit program accessibility and introduce disparities in participation based on fundraising capacity. Overall, while the administrative costs to the state are modest and foreseeable, the total fiscal outlay for grants and the full impact on hospital systems remain unknown at this time.

HB 1621 would establish a state-administered matching grant program under the Health and Human Services Commission (HHSC) to assist hospitals that provide mental health care in upgrading their technology infrastructure. While the bill is intended to help hospitals meet federal interoperability standards under the 21st Century Cures Act, its implementation would grow the scope and administrative footprint of state government, raise concerns about future fiscal obligations, and potentially distort the private healthcare market. For these reasons, Texas Policy Research recommends that lawmakers vote NO on HB 1621.

First, the bill creates a new and permanent program within HHSC with ongoing responsibilities, including rulemaking, grant administration, program oversight, and biennial reporting. Though the aim is narrowly focused on mental health hospital technology, this establishes a new state function where none previously existed. In doing so, the bill expands the role of government in a domain traditionally addressed by private-sector investment, philanthropy, or federal assistance. While hospitals would be required to match 100 percent of the grant amount with non-state funds, the state is nonetheless obligated to provide public money without a defined funding cap, limit on program size, or sunset provision.

The fiscal note clearly states that the cost to the state is “indeterminate,” with significant General Revenue appropriations anticipated to launch and sustain the program. Furthermore, HHSC would need to hire new staff (2.0 FTEs) to implement and manage the program, adding to ongoing administrative costs. Without legislative direction to limit, phase out, or reassess the program at regular intervals, this initiative risks becoming a permanent line item in the state budget. From a fiscal responsibility standpoint, a vote against the bill is consistent with the view that public programs should be limited in scope, precisely defined, and carefully monitored.

Additionally, HB 1621 may unintentionally create competitive imbalances in the health care marketplace. Only hospitals that are licensed under Chapter 241 or 577 of the Health and Safety Code, and capable of raising non-state matching funds, would be eligible. This framework may favor larger hospital systems or those with greater access to philanthropic networks, while leaving out rural, community-based, or smaller nonprofit mental health providers. A conservative approach to policy resists such distortions and favors free enterprise over government-facilitated advantages.

While the bill does not impose new regulatory mandates on individuals or businesses, it does subject participating hospitals to new compliance obligations tied to HHSC’s rules and federal interoperability standards. In practice, the regulatory footprint of the program could expand over time as rules are refined, eligibility criteria evolve, and administrative oversight increases. This indirect regulatory growth, though voluntary at first, could become burdensome, particularly for hospitals less equipped to navigate complex reporting requirements.

Finally, the bill sets a precedent for further state involvement in hospital technology initiatives. Today, it is mental health facilities; tomorrow, it could be general hospitals, outpatient providers, or private clinics. Even well-intentioned legislation should be carefully scrutinized for long-term structural implications. Government should not step in to subsidize or manage sectors of the economy where market solutions, philanthropic contributions, or existing federal programs can suffice.

In conclusion, while improving mental health care is an important goal, HB 1621 pursues it through a model that expands government, creates open-ended fiscal obligations, lacks limiting principles, and intervenes in the marketplace.

• Individual Liberty: The bill supports individual liberty to a degree by promoting improvements in patient access to digital health records, consent management tools, and secure health information systems. These upgrades can empower patients to make more informed decisions, manage their own care, and engage with providers more effectively. It could also reduce delays in treatment due to outdated technology, improving patient autonomy in the mental health system. However, because the bill encourages alignment with federal health data interoperability standards (under the CURES Act), there is an indirect concern about future government involvement in patient health data. Without strong, specific patient data privacy protections embedded in the bill, expanded digital systems could expose individuals to new surveillance or data-sharing risks, which would undermine liberty over time.
• Personal Responsibility: By requiring participating hospitals to contribute a 100% non-state match in funding, the bill reinforces the principle that institutions should take ownership of their own modernization and investment needs. Hospitals cannot receive a dollar of state support unless they raise the same amount independently, encouraging local initiative, fiscal prudence, and stewardship. This matching requirement helps avoid an entitlement-style funding model and instead incentivizes responsible planning and external fundraising. In this regard, the bill affirms personal responsibility at the institutional level.
• Free Enterprise: The bill could interfere with a level playing field in the healthcare marketplace. By providing public grant funds (even with matching requirements) only to hospitals licensed under Chapters 241 and 577, it favors larger or institutional providers that can more easily secure matching funds. Smaller, independent, or rural mental health providers may be functionally excluded, unable to compete for the same public dollars. This government favoritism risks distorting market incentives and violates the principle that businesses should thrive or fail based on merit, efficiency, and private investment, not based on access to public subsidy. Over time, such programs can entrench government-backed winners and marginalize innovators or leaner operators.
• Private Property Rights: The bill doesn’t directly alter or restrict property rights. However, by incentivizing hospitals to overhaul technology systems in accordance with federal standards, it could encourage de facto uniformity in software systems and digital platforms. If not carefully guarded, this can create pressure on providers to adopt proprietary systems or standards that reduce customization and institutional independence. Additionally, increased digital oversight and patient data centralization may raise future property rights concerns if health data is handled or shared in ways not fully controlled by the provider or patient.
• Limited Government: The bill clearly expands the scope of state government by creating a new, ongoing program administered by the Health and Human Services Commission (HHSC). It adds new duties, rulemaking authority for the executive commissioner, staff positions, and recurring legislative reporting. There is no sunset clause or spending cap, meaning the program could persist indefinitely without legislative reauthorization. Conservatives who prioritize a restrained government will see this bill as a clear departure from that principle. Rather than scaling back or consolidating functions, the bill adds a new one, creating a lasting government footprint in an area (healthcare technology) that could and should be addressed through the market.

• SB 151 (Similar To)