Use Empty Beds at State Hospitals for Low-Risk Prisoners Needing Alcohol and Drug Abuse Treatment


The state should use empty beds at state hospitals for low-risk prisoners needing treatment for alcohol and drug abuse instead of building new facilities.


Background
New drugs, treatment methods and alternative treatment facilities mean that many people with mental diseases no longer need long-term stays at state hospitals. One recommendation elsewhere in this report would partially eliminate th e need to maintain people with schizophrenia in state hospitals. That recommendation suggests making available to these patients a new drug, Clozaril, which is highly effective at eliminating the disease s symptoms and which would allow approximately 500 patients diagnosed as schizophrenics to return to the community. Another recommendation would move about 500 patients with mental diseases to a more appropriate level of care nursing homes with special psychiatric facilities.

These two recommendations alone would effectively reduce the demand for about 1,000 beds. If these beds were filled instead with prisoners who need alcohol and drug abuse treatment, the state could save the money necessary to build new facilities.

In November 1991, Texas voters approved funds to build 12,000 new prison beds for alcohol and drug treatment. These beds will become available according to the following timetable: 1,500, 1,000 and 9,500, respectively, in fiscal years 1993 through 1995. Th ese target dates coincide with the new availability of the state hospital beds since all 1,000 beds would be available at the start of fiscal 1995.

Since state hospitals were built with secure lock-ups, within nine months from being vacated the state hospital facilities could be made available for occupancy for prisoners needing alcohol and drug treatment. The facilities would require modifications fo r additional security, including the consolidation of empty beds into separate wards or buildings.

Texas has responded to changing needs before by changing the roles of its institutions. For example, the state chest hospitals, which were used to treat only tuberculosis patients until drug advances made that role less important, have moved into other areas of medical treatment.


Recommendations
A. The Legislature should mandate that the Texas Department of Mental Health and Mental Retardation (TxMHMR) consolidate empty beds in secure wards and buildings in state hospitals so that they can be used for prisoners needing alcohol and drug abuse treatm ent.

B. The Legislature should mandate that the Texas Department of Criminal Justice move or parole patients from correctional facilities to these medical institutions as beds become available and should purchase services from TxMHMR for their care and treatment.

These beds could also be available as alternative sentencing options for judges to use for low-risk prisoners.

Implications
These recommendations could allow the state to serve more people who are in need of services more efficiently. The recommendations recognize changes already underway the decline in the need for state hospitals and the increase in the need for alcohol and drug abuse treatment especially for prisoners. The recommendations would relieve the taxpayer of high, long-term debt from building new facilities.


Fiscal Impact
Moving prisoners into empty beds would eliminate the need to build two 500-bed facilities during the 1994-95 biennium, which would save $18.5 million in construction costs. However, an estimated $1.8 million would be needed to modify TxMHMR hospital facilities, which would result in a net savings of $16.7 million. Thus, $16.7 million of general obligation bonds would not need to be issued during the 1994-95 biennium.