Children enrolled in the state's health insurance program will get dental, vision and mental health benefits, and adults on Medicaid will have a better chance of getting counseling now that the Legislature has restored some of the cuts it made during a budget crunch two years ago.

But parents will still have to renew their children's enrollment in the insurance program every six months.

Doctors and hospitals won't get any more money for serving Medicaid patients. And nursing home residents on Medicaid won't get an increase in their monthly allowance of $45.

Money for those areas didn't make it into the $19.1 billion in state funds that the Legislature approved for health and human services programs for the next two years in the budget lawmakers sent to Gov. Rick Perry this week.

The state will spend about 14 percent more, including federal money, in those areas over the next two years than in the current budget. But Texas still ranks 45th in the nation in per-capita spending on public health, 46th in mental health spending and last in the number of children with health insurance.

"There are some who believe we are spending too much in this area. There were many of us who believe we did a lot of good but wish we could have had a lot more," Sen. Judith Zaffirini, D-Laredo, who played a crucial role in the writing of the health and human services budget, said on the Senate floor over the weekend.

The partial restoration of budget cuts got some praise from advocates for low-income Texans.

"These decisions are a step in the right direction and will absolutely help low-income families in accessing health care," said Beth Atherton, director of Insure.a.kid, which helps sign up families for the Children's Health Insurance Program. "We are still concerned about barriers to enrollment, but we hope the Legislature will keep the momentum strong and reduce these barriers in the next session."

Atherton was referring to a 90-day waiting period and a review of a family's assets, including the value of its cars, put into place two years ago. Those measures were part of lawmakers' efforts to help deal with a $10 billion budget deficit in 2003.

CHIP coverage also went from 12 months to six months, and advocates said the hassle of renewing so often has contributed to the number of people dropping out of the program: Enrollment went from 507,259 in September 2003 to 326,809 last month.

State officials say that a number of factors contributed to the decline but that they can't say definitively what led to decreased enrollment.

Efforts to return to the longer eligibility period were unsuccessful, though lawmakers did eliminate monthly premiums. Instead, families will pay an income-based enrollment fee every six months.

Some cuts were also restored to Medicaid, the federal-state health insurance for poor pregnant women, children and elderly and disabled people.

Medicaid makes up about one-fourth of the state's current $126 billion budget and nearly three-fourths of the budget for the agency that runs the program, the Health and Human Services Commission. Those figures include both state and federal money.

Adults in the program will again get podiatry, eyeglass and hearing aid benefits. They will be able to receive counseling through psychologists, social workers, licensed professional counselors and licensed professional marriage and family therapists, options eliminated in 2003.

After those cuts were made, adult Medicaid recipients were limited to receiving counseling from psychiatrists, which proved challenging because few psychiatrists offer that service.

Nursing home residents on Medicaid and doctors and hospitals drew the short straw this year. Despite efforts to restore it to $60, the personal needs allowance for nursing home residents will stay at $45 a month.

"You've got people in nursing homes, and 60 percent of them do not have visitors," said Candice Carter, associate state director of the American Association of Retired Persons in Texas. "They don't have the family members who come in and they bring them the things that that person needs. I actually challenged the Legislature and I challenged the governor to look in their budget and say, 'I can live on $45 a month to provide for basic personal needs.' "

Doctors and hospitals won't see the amount of money they receive for providing Medicaid services go up, either. In 2003, the Legislature cut the rate at which doctors are reimbursed by 2.5 percent and hospitals by 5 percent.

Lawmakers pleased advocates for Texans with disabilities by adding money to reduce waiting lists for five community-based programs for disabled people on Medicaid. The lists have grown since 2003 because lawmakers didn't include money to reduce them.

There will be enough money to reduce the waiting lists, which have more than 100,000 names on them, by 7,000 over the next two years.

Some people have been waiting more than 10 years for services, which can include help from nurses or personal assistants, and medical supplies and equipment people with disabilities need to live at home.

"This is the first time they have attempted to reduce the waiting list for these community services in recent memory," said Dennis Borel, executive director of the Coalition of Texans with Disabilities.

Children's health insurance

What's changing:

• State will again pay for dental, vision and all mental health services.

• Monthly premiums will be replaced by an enrollment fee every six months and will be based on income.

What stays the same:

• Value of families' vehicles and bank accounts will still be used to determine eligibility.

• Families will still have to reapply every six months instead of every year.