Texas Health and Human Services is embarking on a multiyear project to expand, renovate and transform the state hospital system. State hospitals provide inpatient psychiatric care for adults, adolescents and children and are important for people requiring psychiatric services. Throughout the process of building an effective state hospital system, HHS will focus on finding new ways to maximize the investments made in behavioral health.

In fiscal year 2018, HHS began the first phase of changes 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, including stakeholders, advocates, and higher education and health-related institutions

Design and Philosophy

HHS established three guiding principles for the improvement projects:

  • Unparalleled care
  • Easy access
  • Systems-based continuum of care

Unparalleled Care

Texas state hospitals were built when mental health care and even office space had different needs. The planned renovations and new buildings will incorporate the latest design elements, complementing cutting edge services.

The design of behavioral health facilities can affect treatment and care. Projects funded in association with this plan will have a design-focus on up to date mental health care.

Easy Access

HHS developed a plan based on the idea that people and their families are better served when services are available close to home. Our plan allows us to provide services in locations that lack adequate inpatient psychiatric treatment in their region and to incorporate technology that can help bridge geographic gaps, especially in areas where psychiatric staff are difficult to recruit.

Systems-Based Continuum of Care

This goal focuses on the array of mental health services and the effective use of alternatives to inpatient psychiatric treatment.

The HHS plan recognizes that the inpatient care provided at the state hospitals should not be the first line of treatment for a person. Texans need access to the full array of mental health services of which state hospitals are a critical component.

Comprehensive Inpatient Mental Health Plan

HHS submitted a comprehensive inpatient mental health plan to the governor and legislature. The request was to replace or significantly repair state hospitals and other state-funded inpatient mental health facilities and to improve behavioral health service delivery.

Read the Comprehensive Inpatient Mental Health Plan (PDF), submitted on Aug. 23, 2017.

Significant Milestones

  • Spring 2018: HHS executes contracts to begin work on Phase I projects.
  • Jan. 8, 2018: HHS announces the release of $47.7 million for inpatient psychiatric care system improvements.
  • Dec. 18, 2017: The Legislative Budget Board and the governor approve the use of $47.7 million for various projects.
  • Fall, 2017: HHS submits the Comprehensive Inpatient Mental Health Plan, the initial plans for transformation of the state hospital system, including a request to expend funds to the governor and legislature.
  • Aug. 10, 2017: HHS holds a public hearing to receive input on the state hospital system and mental health service delivery in Texas.
  • June 12, 2017: Governor Abbott signs S.B. 1 into law and approves the appropriation of $300 million to HHS for the construction or significant repair of the state hospitals.

Timeline

As outlined in the Comprehensive Inpatient Mental Health Plan, the State Hospital Improvement initiative consists of three phases. HHS is currently in Phase I, which involves expanding capacity as quickly and strategically as possible. The Phase I projects focus on:

  • Hospital improvements for which pre-planning has already occurred
  • Hospitals where major renovations can bring beds online as soon as possible
  • Hospitals that will support maximum security units

Phase I Projects

State hospital construction projects consist of two to three stages:

  • Pre-planning: the exploratory stage where community need, resources, and specific facility design elements are developed with stakeholder involvement
  • Planning: the architectural and engineering plan design and development
  • Construction: the final stage of building or renovation

Each of these stages may take anywhere from one to three or more years.

Rusk State Hospital

Planning for the construction of a new Maximum Security Unit and a new non-MSU at Rusk State Hospital is currently underway. Construction of the MSU is due to begin March 2019. This unit will have the capacity for 100 MSU beds, which will replace 40 MSU and 60 non-MSU beds. The non-MSU will have the capacity for 100 beds, which will replace 100 non-MSU beds on the current Rusk campus. Construction of the non-MSU is dependent on additional legislative appropriations and is due to begin October 2021. Phase II schedule assumes a delay in the start of construction of the non-MSU unit (Phase II) until construction of the MSU unit (Phase I) is complete to limit the impact to hospital capacity during the construction process.

The planning and construction phases will overlap. The construction phase starts while design details are completed.

Rusk Maximum Security Unit (Phase I)

  • Planning phase: June 2018 - January 2020
  • Construction phase: March 2019- September 2021
  • Move in phase: October 2021- The actual date hospital can begin admitting patients

Rusk non-MSU (Phase II)

  • Planning phase: June 2018 - January 2020
  • Construction phase: October 2021 – February 2024 - This timeline is dependent upon additional legislative appropriations.
  • Move-in phase: October 2024 – The actual date the hospital can begin admitting patients. This timeline is dependent upon additional legislative appropriations.

Kerrville State Hospital

Renovation of four existing buildings on the Kerrville State Hospital campus will add 70 new MSU beds. Architectural planning is underway and construction is slated to begin in May 2019.

  • Planning phase: March 2018-April 2019
  • Construction phase: May 2019- January 2021
  • Move in phase: February 2021 – The actual date the hospital can begin admitting patients

Continuum of Care Campus in Houston

HHS is partnering with UT Health Houston to build a new hospital with a minimum of 228 beds. Construction is scheduled to begin March 2019.

  • Planning phase: March 2018- August 2019
  • Construction phase: March 2019- November 2021
  • Move in phase: December 2021 – The actual date the hospital can begin admitting patients

Austin State Hospital

HHS will build a new minimum of 240 bed hospital to replace the current Austin State Hospital. Pre-planning (the exploratory phase where community need, resources, and specific building design features are considered) is currently underway in partnership with Dell Medical School at The University of Texas at Austin. Construction is scheduled to begin October 2019.

The planning and construction phases will overlap. The construction phase starts while design documents details are completed.

  • Pre-planning phase: February 2018- December 2018
  • Planning phase: December 2018- November 2020
  • Construction phase: October 2019 – May 2023 – This timeline is dependent upon additional legislative appropriations.
  • Move in phase: June 2023 - The actual date hospital can begin admitting patients. This timeline is dependent upon additional legislative appropriations.

San Antonio State Hospital

HHS will build a new 300-bed hospital to replace the current San Antonio State Hospital. Pre-planning (the exploratory phase where community need, resources, and specific building design features are considered) is currently underway in partnership with UT Health San Antonio. Construction is scheduled to begin in October 2019.

In addition to the project to replace SASH, HHS is renovating an existing building on campus in order to add 40 non maximum security unit beds in the near term. Architectural planning is underway and construction is scheduled to begin in January 2019.

San Antonio State Hospital (New)

The planning and construction phases will overlap. The construction phase starts while design documents details are completed.

  • Pre-planning phase: February 2018- December 2018
  • Planning phase: December 2018- November 2020
  • Construction phase: October 2019 – November 2022 – This timeline is dependent upon additional legislative appropriations.
  • Move in phase: December 2022 - This is the date the hospital can begin admitting patients. This timeline is dependent upon additional legislative appropriations.

San Antonio State Hospital Renovation

  • Planning phase: February 2018- December 2018
  • Construction phase: January 2019 - February 2020 - This timeline is dependent upon additional legislative appropriations.
  • Move in phase: March 2020 - This is the date the hospital can begin admitting patients. This timeline is dependent upon additional legislative appropriations.

Other Potential Projects to Increase Access

In areas of the state in need of additional access to the state’s inpatient mental health facilities, including the Dallas Fort Worth Metroplex and the Panhandle, HHS intends to explore options to increase access in fiscal year 2019.

Phase II and Phase III Projects

Phase II and Phase III will build on Phase I by moving projects from planning to construction stages, as well as initiate new projects based on legislative direction and appropriations.

Previous State Hospital Studies and Related Reports

To Get Involved or Learn More

Email: HHS_Transformation@hhsc.state.tx.us