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State Hospital System and Opportunities for Texas
Mike MaplesDeputy Executive Commissioner
Health and Specialty Care System
State Hospital System
Agenda
• Capacity
• Forensic Shift
• Lengths of Stay
• Wait lists
• Opportunities
8/10/2018 2
State Hospital Capacity
8/10/2018 3
Infrastructure and staffing issues limit capacity.
State Hospital Total Capacity Beds Offline (e.g., staffing &
infrastructure)
Austin 252
Big Spring 200 -16
El Paso 74
Kerrville 218
North Texas -Vernon 351 -70
North Texas -WF 289 -8
Rio Grande 55
Rusk 325 -34
San Antonio 302 -40
Terrell 288
Waco Center for Youth 78
Totals 2,432 -168
SH Forensic Shift
8/10/2018 4
72%
40%
28%
60%
0%
50%
100%
FY2006
FY2007
FY2008
FY2009
FY2010
FY2011
FY2012
FY2013
FY2014
FY2015
FY2016
FY2017
FY2018
% Civil % Forensic
SH Forensic Shift
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2006 2018
Increasing NGRI and IST: 2006 to 2018
Civil/Vol Not Guilty by Reason of Insanity
Incompetent to Stand Trial Specialty
8/10/2018 5
Lengths of Stay
8/10/2018 6
71
170
0
60
120
180
Civil/Vol Forensic
Longer LOS for forensic patients reduces turnover.
Annual SH Admissions
8/10/2018 7
16,415
4,856
1,775
Including 129
misdemeanants
18,190
7,208
0
10,000
20,000
FY2006
FY2007
FY2008
FY2009
FY2010
FY2011
FY2012
FY2013
FY2014
FY2015
FY2016
FY2017
Civil Forensic Total
Forensic Waiting List Trends
8/10/2018 8
268
416
684
0
400
800
F-06 F-07 F-08 F-09 F-10 F-11 F-12 F-13 F-14 F-15 F-16 F-17 F-18 TD
Forensic, non-MSU Maximum Security Overall Forensic
State Hospital System
Opportunities for the State
• Capacity Expansion
• 365+
• Other populations
• Pre-admission timeline
8/10/2018 9
SH Capacity Expansion
8/10/2018 10
Facility and Current Project Estimated Completion
Austin State Hospital Replacement Q4 FY 2023
Kerrville State Hospital 70-bed MSU Q2 FY 2021
Rusk State Hospital 100-bed MSU Q3 FY 2022
Rusk State Hospital 100-bed non-MSU Q3 FY 2020
San Antonio State Hospital 40-bed non-MSU Q3 FY 2020
San Antonio State Hospital Replacement Q2 FY 2023
UTHealth-Houston 228-bed Hospital Q2 FY 2022
Total Beds Being Added: 338 (130 MSU beds)
SH Bed Utilization: 365+
8/10/2018 11
762 of 2245 state hospital
beds (34%) are occupied by long-term patients
Civil: 179
Voluntary: 40
Incompetent to Stand Trial: 346
Not Guilty by Reason of Insanity:
197
365+ Day Stay by Commitment Type
762 Total
Bed Utilization: Other Pop.
8/10/2018 12
Population Number of Patients
Adults 65+ 98
Child/Adolescent 198
Misdemeanors 129
Pre-Admission Process
8/10/2018 13
Pre-admission timeline can delay treatment.
*Non-MSU admissions
0 50 100 150 200 250 300
Arrest to Commitment: 249 days
Commitment to SH Notification: 15 days
SH Notification to Admission: 32 days
Average Time Between Arrest and AdmissionTotal: 296 Days
Thank you
14
Mike Maples
Deputy Executive Commissioner
Health and Specialty Care System
