Texas bill proposes study on psychiatric facility needs

AUSTIN (KXAN) — Senators mulled legislation Tuesday that would authorize an expansive study of Texas’ inpatient psychiatric facilities, capacity and needs.

Senate Bill 719, authored by Sen. Sarah Eckhardt, D-Austin, would direct the Health and Human Services Commission to conduct a study of the current use and future projected needs for inpatient psychiatric beds, including beds for juveniles, adults, people with intellectual and developmental disabilities, and people waiting in jail for competency restoration so they can proceed with their criminal cases.

The study and resulting report would be submitted to the legislature with recommendations.

The state hospital system is “overstrained and over-capacity,” according to Eckhardt. HHSC has long maintained a waitlist for individuals in jail declared incompetent to stand trial and ordered to get psychiatric care before their cases can move forward. That waitlist peaked in 2022 with over 2,500 people on it, many of them stuck in jail for months, or more than a year, before getting treatment.

Lawmakers have approved over $2 billion to revamp and expand state hospitals across the state, with many renovations still ongoing. Meanwhile, Eckhardt said state leaders should approve her bill’s study to better understand what more will be needed going forward.

“This is a knowledge is power moment,” Eckhardt said at the Senate Health and Human Service Committee hearing. “It gives us the ability to look at all of our options out into the future for meeting this demand.”

Eckhardt filed similar legislation that passed the Senate in 2023 but didn’t progress further.

The study could cost an estimated $1.5 million, according to a fiscal note. It calls for point-in-time data to be captured twice, to spot any anomalies. Eckhardt said she would be open to changing that, if the fiscal impact would imperil the measure.

In raising the importance of the study, Eckhardt referenced a state audit report released last November on Texas’ competency restoration system for individuals in jail. The report spotlighted numerous shortfalls and deficiencies, including that more than 50 people who died since 2018 while on the state hospital waitlist.

Several witnesses spoke on, or for, the bill, but none expressly against it at the hearing.

Sen. Charles Perry, R-Lubbock, said he was concerned the bill was prematurely calling for a study of the system before the impact of improvements – which were previously passed into law – have come to fruition.

"What we did last session was predicated on a lot of study, so we're a little early to be here talking about all these crisis points and what we haven't got,” Perry said. “We got it in the pipeline.”

Sonja Burns, an Austin-based mental health advocate, told the committee the study doesn’t go far enough to identify and probe certain populations of people that are currently being left behind by the mental health system.

For example, what are the outcomes following shorter term stays in private psychiatric facilities, Burns asked, and which mental health facilities exclude people with intellectual or developmental disabilities?

Sen. Lois Kolkhorst, R-Brenham, who chairs the Senate’s Health and Human Services Committee, said she was also concerned by the lack of information from local mental health authorities, commonly called LMHAs.

“Quite honestly, I’ve gotten a little fatigued of funding the LMHAs … and I don’t see the results,” Kolkhorst said. “Where are the outcomes? What are the measurable outcomes? Some do a great job; some don't.”