01. Executive Summary

Austin State Hospital Redesign Executive Summary

Texas has committed to improving public mental (brain) health care with several years of significant investments. Toward that commitment, the 85th Legislative Session initiated replacement of the Austin State Hospital (ASH) with the new facility then serving as a platform to improve the entire continuum of care linked to the hospital. Support from the Texas Legislature led the Health and Human Services Commission (HHSC) to partner with Dell Medical School (Dell Med) of the University of Texas at Austin to lead the ASH Redesign. The initial investment of $15.5M produced a Master Plan in December 2018 to guide ongoing advances in Central Texas mental health care (2018 ASH Redesign report). The Master Plan proposed several solutions with an HHSC request and Legislative decision to build a modern ten unit, 240-adult bed hospital on the campus that will support the ASH service area.

The ASH Redesign continued with support and investment from the 86th Legislature, appropriating $165M of the total $304.6M cost for the new hospital in order to initiate construction. The 3-year construction timeline presented the Legislature an opportunity to fund the project across two biennia. The plan, then, is to appropriate the final $124.1M during the 87th Legislative Session in order to complete the hospital.

With these considerations in mind, the ASH Redesign team established four recommendations for the next two years to optimize the function of the new hospital investment.

1. Complete the new Austin State Hospital construction

   • Obtain the final funding, $124.1M, of the total project cost of $304.6M.

   • Complete construction of the new ASH and open in June 2023.

2. Increase Functional Bed Capacity – i.e., optimize the use
   of the new hospital

   • Strategy 1: Increase opportunities for hospital discharge by rapidly creating alternative residential care and housing options by identifying private, philanthropic, or alternative public funding to support the growth of the continuum of care.

   • Strategy 2: Reduce forensic hospitalizations by creating a roadmap
     that provides alternatives to ASH for competency restoration.

   • Strategy 3: Engage academic and service area experts to optimize efficient, evidence-based treatment in ASH that facilitates recovery in order to support smooth transitions to care in the least restrictive environment necessary, thereby returning people to their community.

3. Expand Peer Engagement

   • Strategy 1: Continue to enhance engagement into the ASH Redesign process
     of people from diverse ethnic, racial, sexual orientation, gender identity,
     and disabilities background.

   • Strategy 2: Work to ensure that ASH has a robust financially sustainable peer support program.

4. Sharing the History of ASH

   • Strategy 1: Share the history of ASH with the community.

   • Strategy 2: Create a space for collection management and interpretation.

   • Strategy 3: Preserve environmental aspects of the campus.

The remaining funding is a top priority of the ASH Redesign as opening the new hospital on time is the critical next step toward improving mental health care in Central Texas. Concurrently, increasing the functional bed capacity efforts must continue in order to create a more efficient system and one that will support an optimal use of the hospital investment. The combination of these efforts will establish Texas as a leader in brain health care for all.