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State and Local Stakeholders Discuss Mental Health Placements

Laura Nicholes, Senior Legislative Liaison

HB 205 by Rep. Ruth Jones McClendon (D-San Antonio) relates to the allocation of beds in and the commitment of certain persons to certain mental health facilities. The bill, as filed, seeks to require the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) to establish separate allocations and separate funding for designated forensic and civil mental hospital beds. Civil beds are used by individuals who are unable to make sound decisions about their own health and forensic beds are for individuals who have committed a crime and are not competent to stand trial. 

State and local stakeholders who work in and with the various dimensions of the mental health system have been discussing how to best quantify the mental health needs across the state and adequately fund each type of bed so that civil capacity does not come up short when forensic needs are greater. “Presently, the courts and the mental health centers are in competition for allocation of these beds, of which many counties face a shortage,” said McClendon in her district newsletter. 

District Judge Orlinda Naranjo issued a ruling in January 2012 finding that keeping incompetent individuals in jail for an unreasonable amount of time violates their due process rights as guaranteed by the Texas Constitution. The court granted a permanent injunction against DSHS requiring that a detainee determined incompetent to stand trial has access to a state mental health hospital bed no later than 21 days from the date DSHS receives notice of a criminal court’s commitment order. Since the ruling, DSHS has expanded the number of forensic beds being used to restore competency to criminal defendants by converting civil beds to meet the needs and 21-day requirement of the court. The order, however, does not address inmates with intellectual disabilities who are ordered to state supported living centers; some jails are encountering extraordinary waits for transferring those inmates out of the jail. 

McClendon said, “I am glad that the filing of H.B. 205 has beamed the spotlight at a long-standing problem with the state’s system of addressing mental health needs. The state Legislature cannot ignore the need for mental health diagnosis and treatment programs on the front end, thinking the costs could be shifted from the state level to city and county facilities. If we do, it will only come back around full circle to the state in the form of increased incarceration costs in the state’s prison system, and people who needed help will not have received it.”     

HB 205 has not yet been referred to a committee. McClendon is a member of the House Appropriations and Transportation Committees and is chairwoman of House Rules and Resolutions Committee.