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Harris County pleads its case to the state

Grits ran into some Harris County officials in Austin the other day and got some information from them about their lobbying efforts with the Lege. Not too surprisingly, it’s mostly focused on mental health services.

Harris Couty is primarily worried that cuts to community supervision, diversion programming and mental health services for adults and children go so deep that the state won’t even qualify to receive federal matching funds. A document from the Harris County Commissioners Court further suggests that, from a fiscal standpoint, state spending for mental health should prioritize funding for the “least expensive services” i.e., community based services, because they are eligible for federal matching funds through either Medicaid or Mental Health Block Grants, or even (in the case of Medicare), fully paid by the feds. Those types of services should be maintained or increased, they argue, while decreasing use of Crisis Services and state mental hospitals, which are not eligible for federal matching funds, through prevention, diversion, and community-based programming.

I’ve been aware for years that the state pays 100% out of general revenue for mental and acute health care for the incarcerated, while indigent people with serious health problems on the outside are typically served through programs either paid for or matched by the feds. That makes a big difference, in aggregate, regarding how much their health care costs in the state budget, especially for the seriously ill. But I hadn’t considered that the same distinction applies to Crisis Services and state mental hospitals. (Half of Texas’ state mental hospital beds are designated as “forensic beds” and there’s already a months-long waiting list to get treatment for defendants who’ve been declared incompetent by the courts to stand trial.)

As always, there’s plenty of detail, so click over and see what’s being said. One point to note, in that recent story about Harris County’s budget for the upcoming year, there was this tidbit:

Because three-quarters of the budget is spent on salaries, deep cuts are almost certain to result in layoffs. Constables, in particular, have warned of hundreds of possible layoffs. Precinct 4 Constable Ron Hickman, under the proposal, would see his budget slashed $3.1 million despite his warning that as many as 100 jobs could be at stake.

And in Grits’ post, we learn this:

Also from ’07-’10: Constables transported 32% more patients in psychiatric crisis from one facility to another,” and “The number of persons in psychiatric crisis that the Constables picked up pursuant to court order (Mental Health Warrant) increased by 55%.

Seems to me that could be a problem. Anyway, check it out.

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One Comment

  1. David Mayes says:

    It should also be noted that at least 60% of the budget at Pct 4 Constables office is not provided by Harris County but in fact sent to the county by MUD districts, HOA’s, and grant programs. How can they ask for a cut in money they dont even provide?