For several years, the County Judges and Commissioners Association of Texas has supported legislative proposals to improve mental health programs. There have been some improvements in state funding. In 2010, Texas ranked 50th among the states in mental health funding; by 2017, we had improved to 40th. Nevertheless, county jails continue to hold more mentally ill persons than all of the state facilities combined, and the backlog of jail inmates awaiting admission to a state facility continues to increase.
Instead of providing sufficient capacity at state facilities to meet this need, the legislature has resorted to mandates upon counties to provide treatment to these citizens. Present law already requires that the county jail file notice to the local magistrate of any reasonabe cause to believe that an inmate has a mental illness. If the magistrate determines reasonable cause, an order is issued to the local mental health authority (LMHA) to conduct an assessment to the magistrate within 96 hours. The county reimburses the LMHA for transport expenses if the inmate is transported for the assessment by the LMHA.
Effective Sept. 1, 2019, House Bill 601 by Rep. Four Price will add new requirements and county expenditures to this procedure. Under this legislation, the LMHA or other mental health provider must conduct an interview with the inmate, either in person in the jail, by telephone, or through a telemedicine service. This legislation requires that the county pay the LMHA or other mental health provider for the interview and report to the magistrate.
To meet this new mandated responsibility, the Commissioners Court has three options: 1) obtain a contract with the LMHA or other mental health provider to provide this service for a negotiated fee; 2) adopt a fee schedule after a public hearing to establish the payment rate; or 3) do nothing and let the judge with jurisdiction over the offense determine the amount of reimbursement. Note that fee schedule amounts may be appealed to the judge.
If your county is presently contracting with the LMHA or other mental health provider, the county may amend its contract to include these services into that agreement. This will provide some budgetary control over the potential cost of this mandate.
For additional information, please call me at 1-800-733-0699.
By Jim Allison