The Legislative Budget Board has published a Legislative Primer on Managing and Funding State Mental Hospitals in Texas.
The conclusion of the report:
State Mental Hospitals (SMH) face managerial and fiscal challenges in meeting the needs of Texans with severe mental illness. Three significant challenges are addressing the growing forensic population, managing outside medical costs, and maintaining aging infrastructure. One of the major problems associated with the growing forensic population is the longer lengths of stay, often more than 90 days for forensic patients in SMHs.
These longer lengths of stay and the overall increase in the forensic population has led to longer wait times and waiting lists at SMHs for forensic beds. Total outside medical costs, which include the provision of medical and dental services at the SMHs, have increased by 57.4 percent since fiscal year 2006. Because of the IMD exclusion, the majority of these costs are not covered by Medicaid. All of the SMHs in Texas are currently TJC accredited, however, repair and renovation of aging infrastructure is often necessary to maintain accreditation and safeguard federal funds. Addressing all of these challenges will require critical short and long-term policy and fiscal decisions. Decisions made regarding the SMHs will likely affect the state mental health delivery system as a whole. Maintaining or expanding community based care may be favorable but a decision to do so is tempered by the reality that for many persons with severe mental illness, community-based care is not an option.
A complete copy of the report: http://www.lbb.state.tx.us/Health_Services/Mental%20Hospitals%20in%20Texas%20Primer%20Complete%20Report%200211.pdf