BILL ANALYSIS
By: McClendon
Culture, Recreation, & Tourism
BACKGROUND AND PURPOSE
H.B. 2524 would enable the launching of a pilot project in Bexar County to provide medical and mental health care through intervention and detoxification units. In Bexar County, a large number of people with mental illness or substance abuse problems are being "treated" through incarceration rather than through less-expensive options. The Bexar County Jail routinely has 450-550 inmates who have persistent mental illnesses and/or a substance addiction, and of the 11,179 inmates screened, approximately 60% showed signs of mental health disorders compounded by a substance addiction. These people often are in jail for misdemeanors such as public intoxication, panhandling, or vagrancy.
In 2005, several agencies within Bexar County developed the Crisis Care Center at the downtown campus of the University Health system to reduce the costs to law enforcement, wasted time in emergency rooms and inappropriate incarcerations. This jail diversion program has been so successful that it has won awards in the last year from the National Council of Community Behavioral Health Centers and the Gold Award of the American Psychiatric Association.
Specifically, there is no facility where a debilitated person can be assessed and provided with immediate treatment. H.B. 2524 will allow for the development of a pilot project in Bexar County, in which the Department of State Health Services (DSHS) will assist in the construction of such a facility. It will be connected to the new $21 million University Health Care Center, adjacent to the Bexar County Jail.
Beyond the significant costs associated with jail/prison overcrowding, it is significantly more expensive to house mentally ill or addicted inmates than general population inmates. But since law enforcement officials have no other alternatives, they frequently either arrest such people or take them to emergency rooms – another costly option.
There are also significant systemic costs associated with processing these people through the criminal justice system, like extended processing times for law enforcement officers and extra court services. And because such inmates rarely receive the treatment they need, they are more likely to be arrested again once they are released.
Unfortunately, there are very few comprehensive resources available to address the problem. Furthermore, mental health treatment is limited to three "single diagnosis" disorders: severe depression, schizophrenia, and bipolar disorder. As a result, over half of these individuals receive no treatment of any kind.
H.B. 2524 will provide the authority for Bexar County to respond to this dilemma.
RULEMAKING AUTHORITY
This bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS
SECTION 1. (a) DSHS shall develop a pilot project in Bexar County to address jail overcrowding by diverting persons with mental illness or substance abuse problems to inpatient and outpatient services using a public safety triage and detoxification unit.
(b) Requires that, in developing the pilot project, DSHS:
(1) shall assist in the construction of the unit through which inpatient and outpatient mental health and substance abuse treatment services may be administered; and
(2) contract with the Bexar county local mental health and mental retardation authority or a nonprofit foundation for the provision of assessment and services to homeless or referred persons with mental illnesses and/or substance abuse problems.
(c) Allows DSHS and certain participating local and county agencies to enter into agreements regarding implementation procedures and the duties of each participating entity.
(d) Requires DSHS to submit a report no later than November 1, 2008, to the governor, lieutenant governor, and speaker of the house of representatives a report regarding:
(1) the quality of services provided through the pilot project;
(2) the cost-effectiveness of providing mental health and substance abuse services in coordination with a jail diversion program;
(3) recommendations for establishing similar programs throughout the state; and
(4) any other relevant information as determined by the department.
(e) This section expires September 1, 2009.
SECTION 2. If, before implementing any provision of this act, a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.
SECTIONI 3. Effective date.
EFFECTIVE DATE
This Act takes effect September 1, 2007.