Social service agencies and the Texas Legislature alike are looking for ways to move people off waiting lists to receive services for mental health care, and intellectual and developmental disabilities (IDD).
As the 85th Legislature began in January, Texas House Speaker Joe Straus, R-San Antonio, said funding mental health care was one of his priorities.
“I think first of all mental health is a tremendous problem for our state and really any state,” Rep. John Zerwas, R-Richmond, said. “Some of that is funding, but some of that is are we really delivering services in the most cost-effective way?”
At the same time lawmakers want cost-effective care, people are also waiting for service.
Locally, Texana Center, which is a designated local intellectual and development disability authority, or LIDDA, contracts with the state to provide a wide range of mental and behavioral health, autism and IDD services.
The center is based in Rosenberg and serves 15,000 people throughout a six-county area, including Fort Bend, Austin, Waller, Matagorda, Colorado and Wharton counties.
Texana provides services for 8,000 people with intellectual and developmental disabilities but has an interest list of 4,500 that people can wait on for 10 years or longer, Texana CEO George Patterson said.
Mental Health
Patterson said some of Texana’s waits for outpatient mental health services flow fairly quickly, but a larger problem is having room for those experiencing a mental health crisis.
Three years ago, Texana opened a crisis center in Fort Bend County that has 22 beds—eight for emergency detention and 14 for residential needs, he said.
“Those 22 beds are the only beds in our six-county region for inpatient services and that’s a real crisis in the state of Texas because the state hospital system is full,” Patterson said.
He said since there is no wait in an emergency situation for those who threaten to harm themselves or others, often those people end up in jail or in a hospital emergency room where they wait three or four days to be placed elsewhere.
At the Fort Bend County level, a relatively new division for behavioral health services created in 2010 aims to relieve some of the traffic into jails and hospitals working with those experiencing mental illness.
“The problem is that the state hospitals are really being challenged because they have so many forensic referrals from the criminal justice system that they have limited beds for the civil commitments,” said Connie Almeida, Fort Bend County director of behavioral services.
IDD and autism needs
Across Texas, there are 79,560 people on an interest list to receive home- or community-based program services like Texana’s that provide long-term care and support in a noninstitutional setting, according to a count from the Texas Department of Aging and Disability Services.
Texana’s 10-year wait list includes those who are interested in a range of services from vocational to residential. “They sign up to say, ‘I’m interested in getting services,’” Patterson said. “Of course by the time those people on the interest list have gotten off of it, there are thousands and thousands more who have just gotten on it within five, six, seven years who have a 10-year wait.”
Under the IDD umbrella, some community-based centers like Texana also work with those with an autism spectrum disorder.
Texana provides a program for autistic children called applied behavioral analysis, but there is a wait list for that, too.
Revamping the system
Social service agencies and lawmakers are looking for creative solutions to solve the issues of big spending and wait lists.
“We’ve got numerous programs out there that are addressing specific populations, and we really probably need to step back and look at a more transformational way of looking at these services,” Zerwas said.
Zerwas said funding this year for mental health looks promising despite an expected decrease in revenue.
“Overall, we are proposing to spend about $162 million more into mental health-type services over and above what we typically have, and that’s been consistent with what we have done since 2013 in increasing the amount of money dedicated to mental health conditions,” he said.
Texana is also trying a new approach. The organization is fundraising for a community college-like facility so it can provide training and life-skill classes for clients with IDDs.
The move is a shift away from group homes and services that do not allow for the movement of people in and out of services as quickly, said Tracey Shaw, Texana’s director of development and community relations.
