Wednesday, February 17, 2010

Cutting state psych hospital budgets could backfire

The last post focused on budget cuts proposed by Texas criminal justice agencies, but in the San Antonio Express News I noticed this possible cut in the human services sector that could give county jails a lot of problems if enacted:
Some agencies had made their proposals public earlier, including human services agencies that could save $303 million in state spending through such cuts as reducing Medicaid reimbursements for health-care providers and serving fewer patients at four state psychiatric hospitals, including the one in San Antonio. Those cuts would cost the state another $238 million in federal matching funds.
About half of the beds in state psych hospitals are "forensic beds" which are used for competency restoration, or ensuring mentally ill people are stable and on their meds before they're tried. Texas has struggled to keep down the waiting list for these beds, and there have been times when jails must hold pretrial defendants many months before a state hospital bed opens up. This is both bad for the mentally ill defendant (sometimes very bad) and creates resource, staffing and classification problems for jails that drive Sheriffs nuts. Besides forfeiting federal matching funds, eliminating psych beds as suggested would create even more jail costs for local, county taxpayers.

This example shows how interrelated a great deal of criminal justice spending is, and how cuts to one part of the system can cause even greater costs for others. Shifting expenses from state hospitals to already overburdened county jails won't mitigate the state's responsibility to provide restoration services to incompetent defendants, it just gums up the system and pointlessly soaks taxpayers for services the state is ultimately still obligated to supply.


Anonymous said...

Last I heard Texas was 48th or 49th in mental health spending. I guess they are trying for last place.

Anonymous said...

MH waste in Texas is aweful. It needs to trimmed back much more. What a waste.

gravyrug said...

12:29, I hope that's sarcasm. The mental health system in Texas certainly doesn't "waste" any money on keeping sufficient competent and well trained staff. I know the ones there are trying (most of them), but the numbers they're trying to serve completely overwhelm the system. The people I've known who have had to deal with the system have routinely had serious problems being seen in the first place, and are sometimes barely able to get their meds. And these are the ones who are together enough to actually work at it. There is little to no outreach to catch the ones who can't make it in to the office. Just not enough staff to do it.

Anonymous said...

As a medical professional, I sincerely pray no more money is taken from mental health.

I remember the last time State Hospitals were closed and very ill people were turned out on the street and the elderly who were not turned out were placed in nursing homes, and many of the nursing homes were not of the best caliber, thus no one won. Closing or taking more money from mental health is not the answer.

Many of us, who work in the medical field realize, mental illness is connected to physical illness and the two are not separate conditions. There is a brain deficiency, which if treated in many cases can be over come. There are certain cases when the treatment is rendered too late and the ill person cannot over come the illness. These are the people who need to be confined in mental hospitals and not turned out in a world they are unfamiliar with.

For Anonymous (12:29:00 PM) to say "MH wasted in Texas is awful, you do not trim something "awful" back, mental health needs to be supported and funded.This attitude is why mental health is not treated as an illness,ignorance of a disease and the treatments for the diease or not the answer.

PirateFriedman said...

Always good to see any government program cut, in this era of Obamacare and and Obamanomics.

But of course, we might just see an increase in prison costs, which sucks.

Anonymous said...

Excuse me, Pirate Rothbard, you seem confused. The money spent on Mental Health does not come from anyone but you and I and the rest of us. President Obama is not involved in this at all and it appears you have good health insurance. Well, good for you, why don't you share your healthcare with the millions who do not have excess to healthcare due to job loss?

PirateFriedman said...

"The money spent on Mental Health does not come from anyone but you and I and the rest of us. "

Exactly, stolen from the taxpayers.

"President Obama is not involved in this"

Didn't say he was. Merely pointed out that the freedom is taking a beating because of Obama and his many plans.

"why don't you share your healthcare with the millions who do not have excess to healthcare due to job loss"

Actually, I don't have heatlhcare, but I may add myself to my wife's plan next year.

As far as sharing, I share when my conscious calls for it. But of course, taxation is not sharing, it is stealing.

Anonymous said...

Pirate....I agree. I'm so tired off paying others mortages that bought above their salaries. I'm tired of working so hard and paying for deadbeats on welfare and gimmie gov't tricks. As long as we go along with it the gov't and others will take every penny we have for their own benefit and personal goals.

Anonymous said...

Yes, whenever prison is involved there is victimization. While I am not for 12 trillion dollar deficits, and agree that bailing business and individuals out of debt is bad policy and not the business of the federal government, taking money from state hospitals and mental health is always a bad idea.

Anonymous said...

Taxpayers would be outraged
if they were appraised of the medical and dental care
delivered to inmates. We really need to consider the
need for restricting care to urgent situations, not acne meds, dandruff shampoo, root canals, etc.
I have seen no one write about the health care available that is funded by taxpayers who cannot do the same for themselves, but pay for felons. It is outrageous.