Texas lawmakers to consider spending $1.2 billion on state hospitals

Austin State Hospital (DSHS Website Photo)
Austin State Hospital (Department of State Health Services Photo)

AUSTIN (KXAN) — The Texas legislature will soon decide the future of state hospitals, and by doing so, arguably the safety of patients in those hospitals, as well.

In the latest draft of the state budget, the funding for state hospitals — adopted by the Conference Committee — was $875.5 million for the next two years. That’s in addition to $300 million more for state hospitals and $160 million for state supported living centers and critical repairs at state hospitals.

“About half of the hospitals in our state hospital system have been recommended for replacement,” said Greg Hansch, the public policy director for the National Alliance on Mental Illness, or NAMI Texas. The Austin State Hospital, he says, is one of them.

“There aren’t enough beds available for everyone who needs treatment,” said Hansch. “If a person needs a bed, they aren’t particularly likely of getting one — especially if they’re civilly committed. Most of the beds now in our state hospital system are taken up by people who are referred through the criminal justice system.”

Hansch says staffing is just one aspect of the problem.

“There isn’t enough staff and they have trouble recruiting an adequate workforce of healthcare professionals to serve at the state hospital,” he said. “If there aren’t enough providers, then that can easily have an impact on patient safety, on patient well-being.”

Whether state hospitals can improve, Hansch says, may depend on the financial investment decided by lawmakers this session.

“If this funding makes it all the way through, it’s going to be a really big step in the right direction,” said Hansch. “Increasing our investment is going to result in better care, in more beds being available, and in patient safety.”

Over the last five years, there have been 393 cases of sexual abuse reported at the state hospital. Only five of those reports were ever substantiated. Overall, there have been a total of 2,717 cases of abuse/neglect reported at ASH, with only 160 (six percent) of those cases substantiated.

Statewide, of the 1,826 cases of sexual abuse reported at all 10 state hospitals, only 23 (one percent) were substantiated. For all cases of abuse/neglect reported statewide at the hospitals over the past five years — numbering 19,147 cases — only 1,197 (6 percent) were substantiated by the Department of Family and Protective Services.

On behalf of the Austin State Hospital, representatives with the Texas Health & Human Services Commission tell KXAN News that ASH has made many improvements since 2011, and are always looking for ways to make their patients safer and to reduce the risk for abuse.

According to HHSC, state hospital system improvements and policy changes have gone into effect since 2011. Some of these include:

  • More than 500 surveillance cameras have been purchased and installed in Texas state hospitals. The cameras are primarily positioned in high-traffic areas, such as hospital entrances, common areas, hallways, day rooms and other areas where patients interact.
  • A database has been created that helps the state track allegations and identify patterns that may be emerging. HHSC works with the Department for Family and Protective Services, or DFPS, to spot trends of repeated allegations or investigations.
  • More than 300 windows on doors to offices and treatment rooms at state hospitals have been added to increase visibility of patients and physicians. Most of the windows are 2 feet by 3 feet in size and are positioned in the top half of the door so employees walking by will have a clear line of vision in our hospital treatment and therapy rooms.
  • No unplanned individual therapy is to be conducted outside usual and customary times unless two staff members are present in the immediate vicinity.
  • Ensured employees are trained on reporting abuse.
  • All sexual abuse allegations are reported to DFPS for investigation. This includes patient on patient allegations.
  • Staff who are under investigation for sexual abuse or physical abuse are reassigned to other areas or placed on emergency leave during the investigation.

State operating procedures on allegations of abuse, neglect and exploitation of patients were last updated in 2014, according to officials with the Texas Health and Human Services Commission.

For a complete number of DFPS investigations at state hospitals in Texas, click here.

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