With a brand new state-run psychiatric hospital open in San Antonio since final 12 months, officers are taking a look at methods to reuse the previous facility because the elevated demand for psychological well being care beds exams the county.
Bexar County commissioners plan to ask the state legislature this session for no less than $60 million in funding to rehabilitate vacant San Antonio State Hospital buildings, that are positioned on the identical Southside campus because the newly-built hospital.
The hope is that it will relieve overcrowding on the Bexar County Grownup Detention Heart and make therapy extra available.
However it’s unclear whether or not the county or the state, or another entity, would function the ability, which might come at a value of $25 million in its first 12 months.
In April 2024, the Texas Well being and Human Providers Fee (HHSC) opened the doorways of a brand new 300-bed State Hospital that changed an growing old psychiatric facility.
The brand new $357 million hospital at 6711 S. New Braunfels Ave. options single-person affected person rooms, furnished frequent rooms and outside areas designed to advertise therapeutic and restoration.
Sufferers can voluntarily admit themselves or, within the case of “forensic sufferers” could be referred by way of the courts when deemed incompetent to face trial or after committing a criminal offense and being discovered not responsible attributable to madness.
It’s common for these sufferers to languish in jail earlier than ever being moved to a hospital for therapy and care. Decreased capability, rising demand and staffing challenges on the jail usually result in prolonged waits and results in overcrowding and delayed look after inmates.
A beneficial resolution outlined in a 2023 research by the Meadows Psychological Well being Coverage Institute and College Well being consists of repurposing vacated state-owned hospital buildings for behavioral well being care and detention-level assist.
After a number of weeks of repeatedly requesting a replica of the Meadows/UH research, a county spokesman stated the report is “proprietary info” and an open information request have to be filed with College Well being.
A College Well being spokeswoman beforehand stated as a result of the county funded the research, it must be offered by that entity.
Commissioners authorised a request for proposals in February 2022 to conduct the state hospital reuse research in an quantity to not exceed $200,000 from the American Rescue Plan Act.
Within the research, in response to the county’s Amenities Administration Division Director Dan Curry, a seven-building restoration village idea got here with a price ticket of $700 million and a psychiatric hospital that might price $880 million.
One other advice requires renovating the gathering of smaller buildings to be used in housing forensic sufferers. The research estimates the price to renovate and set up 300 new, high-acuity beds would are available round $56 million.
“I believe that makes lots of monetary sense, each for the county and it’s a smaller ask for the state,” stated Commissioner Grant Moody (Pct. 3).
There’s just one downside. “So long as [the state] controls that asset and owns that asset, then we don’t have actually a lot capacity to fill these beds [with county patients],” he stated.
At a current commissioner’s courtroom assembly, County Supervisor David Smith stated there are “between 100 and 200 folks within the jail who want these beds,” and in the event that they’re crammed by the state with sufferers from different counties, “they’re now not out there to us.”
“If we don’t run it, we don’t management the prioritization,” Smith stated.
Moody stated he desires to suggest a mannequin through which the state pays for the renovation however permits the county to regulate using two or three of the seven buildings, which might home 40 folks every.
“Then we’d have extra flexibility and talent to fill these beds,” he stated.
The opposite remaining query is who would handle the ability. Moody stated College Well being may very well be one resolution and has shared the Meadows research with the hospital leaders.
College Well being is owned by the folks of Bexar County, stated a spokeswoman. Whereas it’s formally acknowledged because the Bexar County Hospital District, College Well being is a separate governmental entity and a political subdivision of the State of Texas. It’s ruled by a seven-member board of managers appointed by the Bexar County Commissioners Court docket.
Commissioner Moody stated he’s additionally all in favour of an choice to put an estimated $280 million into constructing a jail annex that may very well be used for each inmates and forensic sufferers as wants come up.
“However I believe that that can also be going to be a part of this broader dialogue research round normal inhabitants and what we are able to do on that entrance,” Moody stated.
Over the last legislative session, lawmakers authorised $15 million over two years for renovations to show 40 beds right into a maximum-security unit for psychiatric care.
However the county and the state couldn’t conform to the contract phrases as a result of the county is just not a medical supplier, stated Andrea Guerrero-Guajardo, director of Bexar County’s Preventative Well being and Environmental Providers Division.
Smith informed commissioners that the county might go the route of asking the legislature for renovation funds and later determine which entity would function the ability.
“As a result of it’s going to take years to construct these out anyway,” he stated. “Discovering companions to really function this and funding to do that would be the subsequent large challenges.”
Commissioner Rebeca Clay-Flores (Pct. 1) stated that she doesn’t care who runs the ability so long as extra psychiatric beds are established in Bexar County for each forensic and neighborhood psychological well being care. She helps seeking to College Well being for assist.
Your entire proposal hinges on whether or not the state would make the buildings out there to the county within the first place, Guerrero-Guajardo stated.
“Given a change in management at HHSC, they requested us to pause these conversations so we don’t have full affirmation that these buildings can be out there for this function,” she stated.
