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Texas HHS releases plan for improving state’s mental health services

State of Reform

Texas Health and Human Services has published the Comprehensive Plan for State-Funded Inpatient Mental Health Services. The plan, which is a requirement of the 2018-19 General Appropriations Act, outlines HHS’s vision for the state hospital system and inpatient mental health care.

According to HHS’s website, the changes are designed to

  • Enhance the safety, quality of care and access to treatment for Texans with mental health issues
  • Expand capacity and reduce waiting lists for inpatient psychiatric treatment, particularly for maximum security units
  • Increase collaboration with potential partners, particularly higher education and health-related institutions

Texas’ mental health system is an aging system, and as facilities are closed for repairs, capacity and treatment are hindered. In August, 70 beds were unavailable due to repairs and 150 beds were unavailable due to staffing shortages. Currently, more than 100 people are waiting to inpatient care beds and more than 500 people are waiting for forensic beds, most of whom are waiting for a maximum security bed.

HHS has identified three guiding philosophies in developing the plan

  1. patients should receive high-quality, evidence-based treatment;
  2. individuals should be able to easily access state-funded inpatient care;
  3. and a successful mental health care system requires true integration between various partners across the state.

Projects to improve the state hospital system will be evaluated on optimal locations to address need, operational resources, partnership opportunities, and stakeholder input.

The three phased approach will go into FY 2024.

The goal for Phase I is to expand capacity as quickly and strategically as possible. Some projects include:

  • Building a new stand-alone maximum security unit (MSU) at Rusk State Hospital
  • Adding MSU beds by renovating buildings at Kerrville State Hospital
  • Expanding the Harris County Psychiatric Center
  • Planing for the replacement of the Austin and San Antonio State Hospitals
  • Renovating a vacant 40-bed unit at the San Antonio State Hospital
  • Purchasing the vacant Hillcrest Hospital in Waco

HHS is requesting the immediate authorization and release of $44.5 million for Phase I projects, which are scheduled to begin in FY 2018.

HHS expects that with the Phase I projects, the MSU waiting list will reach zero in August 2023. As of July, the list was over 300 people, and is expected to continue growing by nine people per month.

Possible projects for Phases II and III include

  • Replacing or rebuilding the North Texas – Vernon and Terrell State Hospitals
  • Building a new psychiatric hospital in the Dallas-Forth Worth metroplex in partnership with UT Southwestern
  • Additional projects in East Texas and Rusk State Hospital
  • Building a regional hospital in the Panhandle

The cost for the various projects being considered totals $293.5 million in Phase I, $1.13 billion in Phase II, and $906 million in Phase III. The ongoing operating cost per biennium is estimated at $607 million.

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