After directing staff to convene a stakeholders process to help designate a local behavioral health authority, or LBHA, Travis County commissioners received recommendations for how to improve substance use disorder services.

“This is not a new topic or one with easy answers,” said Lawrence Lyman, director of research and planning for the county’s health and human services department, at a July 23 Commissioners Court meeting. “While the headlines are grabbed by different conditions, different drugs, from time to time, the underlying questions have persisted for a long, long time.”

In the state of Texas, there are two LBHAs, which support equitable planning for and coordination across mental health and substance use service.

The Texas Health and Human Services Commission is responsible for designating local behavioral health authorities. The agency accepts applications from local mental health authorities interested in taking on the additional responsibility.

Integral Care has served for 50 years as the local mental health authority for Travis County.

However, designating an LBHA was not among the staff’s recommendations.

“While that was the trigger for a lot of this staff … it also quickly became clear that [designating an LBHA] gets ahead of ourselves,” Lyman said, adding that an LBHA may be part of the county’s strategy in the future.

Instead, after receiving feedback from stakeholders and residents, staff recommended the county undertake a needs assessment to identify a baseline for future improvements; create a single, coordinated planning process that spans the full continuum of substance use disorder services; and implement a government structure to assure accountability.

These recommendations have emerged in past such planning processes around substance use disorder services in Travis County, Lyman said.

“I’m not sure if it makes me happy that we’ve done things right, or it makes me sad that we keep coming back to the same recommendations,” he said.

Staff also recognized that progress has been made.

“Despite the fact that we’ve had some challenges around planning, governance and organization, our community has moved forward in several areas to improve [substance use disorder] treatment, services and interventions,” said Laura Peveto, who directs the county’s office of children services.

Peveto cited the Austin Recovery-Oriented System of Care Initiative, increased access to medication-assisted treatment, the provision of Naloxone to prevent overdoses and the Austin Sobering Center as indicators of progress.