Roughly a third of the state’s psychiatric beds are offline.

Industries all over are mired in staffing shortages. But the problems in the state’s network of psychiatric hospitals are particularly distressing, with significant repercussions for patients, county jailers and taxpayers.


(26) comments

C. Patterson

Affordable Care Act gutted medicare/ medicade for mental health care. No more subsidies to states and do those facilities closed

Emilio Nicolas

You are misinformed: Remember that Abbott refused the additional Medicare funds when offered. For current Medicare mental health benefits, see Plenty of other Medicare benefit information is available.

Emilio Nicolas

Correction: Abbott declined additional Medicaid funds (not Medicare).

George Croix

I sympathize with folks with mental health issue beyond their control but am a little bit tired of people messing themselves up then soaking up funds that should be available to help non self-induced cases.

For one example, frying your brain with dope was YOUR choice…yet the fallout reaches many more..

Imo, as always

Don Schlessinger


Jim Forsythe

Our prison and jails have not been able to provide the help with mental health that their prisoners have needed in the past. But Galveston County has started a new program that started in the last few years, that is a step in the right direction, Galveston County Mental Health Court.

The mission of the Galveston County Mental Health Court is to improve the quality of life for people with mental illness charged with crimes and make more effective use of the community’s limited criminal justice and mental health resources. Mental health court is an alternative to the status quo, working in partnership with leaders in the mental health system and local and state policymakers. We have designed a problem-solving mental health court that departs from the traditional model used in most criminal proceedings. Instead, as a team, under the judge’s guidance, prosecutors, defense attorneys, and mental health service providers connect eligible defendants with community-based mental health treatment and, in lieu of incarceration, assign them to community-based supervision. Why is this court important? Because about 37 percent of people in prison have a history of mental health problems. More than 24 percent have been previously diagnosed with major depressive order, 17 percent with bipolar disorder, 13 percent with a personality disorder and 12 percent with post-traumatic stress disorder. Unfortunately, the rest of Texas is not doing the same. Texas, like most of the rest of the country, has switched from putting those with mental illness in a hospital institution to putting them into a correctional institution. The Harris County Jail treats more psychiatric patients than all of the state-run hospitals combined. Texas has 254 counties, each with its own jail and funding. Although the 8th Amendment's prohibition of "cruel and unusual punishment" guaranteed prisoners an entitled right to health care, the provision of said health care varies markedly among counties.

I remember when I was working, my insurance did not have very good mental health coverage. Now with my Medicare coverage I have much better coverage. Why do I have better coverages, because of the changes thru the Affordable Care Act. "The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage. The law requires that most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services. Also required are rehabilitative and habilitative services that can help support people with behavioral health challenges."

George Croix

As usual, one has to get to the very bottom of an article in the MSM news to get to the point.

I picked the Texas Tribune, a notoriously conservative publication, in the MAGA capitol of Texas...Austin....

"Texas has the nation’s highest number of uninsured residents, estimated at 5 million, and also has the country’s biggest share of residents — at least 18% — who are not covered.

When uninsured people show up in emergency rooms, the hospitals care for them and then are reimbursed in part by the 1115 Medicaid waiver, which has brought some $30 billion to Texas in the past decade for uncompensated care, mental health programs and similar services."

Pay close attention to the use of 'resident's and 'uninsured people', rather than using 'citizens' or 'legal residents'...

Texas could...could... provide a LOT more for it's citizens and legal residents if it wasn't providing for a large portion of Central America, and other globally sourced peoples here for visa-less sightseeing and resource using...

America first....

Bus tickets to visit the DC and NY at twice the price, and those folks are big advocates for illegal immigration...well. they, not as much...


Jim Forsythe

George, from the link you provided it looks like Texas wants the Federal Government help.

The waiver was initially set to expire this October, President Donald Trump granted a 10-year extension — a move some healthcare advocates said was a way to provide political cover for Republicans who have refused to expand its Medicaid program to include more working poor adults.

A federal health care program that Texas uses to help pay for health care for uninsured Texans — worth billions of dollars annually — is safe for another decade after the federal government said Friday that it would stop fighting the Trump-era agreement to extend the program beyond its expiration date later this year.

Texas Gov. Greg Abbott also criticized the federal government's opposition to the waiver extension but welcomed the Friday decision to let it continue until 2030.

What is in the Texas 1115 Transformation Waiver, it provides the federal authority for operations of most of the state’s Medicaid managed care programs, including STAR, STAR+PLUS, STAR Kids, and the Children’s Dental Program. Managed care directed payment programs—the Uniform Hospital Rate Increase Program (UHRIP) and the Quality Incentive Payment Program (QIPP)—both operate within the 1115 waiver under authority conferred in 42 Code of Federal Regulations (CFR) 438.6(c). These programs provide additional funding to hospitals and nursing homes through increases in managed care reimbursement for hospital and nursing home services.

The managed care directed payment program, the Network Access Improvement Program (NAIP), provides pass-through payments to participating physician practices in health- related institutions and public hospitals through managed care. NAIP operates within the 1115 waiver under authority conferred in 42 CFR 438.6(d). Under federal law, pass-through payments to physicians must be phased out by July 1, 2022, and pass-through payments to hospitals must be phased out by July 1, 2027.

Texas takes care of people in need of medical care. Things may have changed in regard to what will happen on the dates I posted, as Trump 10-year extension may have included this.

What this thread is about is mental health in our jail system. If you want to debate Immagration, we can in a different thread.

George Croix

"What this thread is about is mental health in our jail system. If you want to debate Immagration, we can in a different thread."

Jim, old buddy, unless mental health costs ZERO..NOTHING...NADA..., then any revenues spent on anything else where funds should not have to be spent, like illegal immigration and it's costs to us all, and undoubtedly our LARGEST expense we should not have to be funding, TAKES AWAY from funds that could be routed to things Texas needs, like mental health facilities vs prisons and jails trying to do it. Ignoring that pretends that the whole neighborhood showing up for a family backyard BBQ is irrelevant to the available hot dogs and chips....

Good luck with telling me what to write about, and when and where.....

Nothing has changed except my 'waste' line....and hairline...and bank balance....and....

Carlos Ponce

The laws on the books TODAY were voted on by a bi-partisan Congress, signed by a president. But if the party in control refuses to obey the LAWS ON THE BOOKS......

Jim Forsythe

My take on Immagration is nothing is going to be solved until all sides sit down and come up with a policy that we, the USA will follow from now on. Changing it every time we get a party in power will never work, just has it not worked up till now.

Illegal immigration will continue to be a problem until the people in DC decide to act for us and start acting in do what is right and not what each party wants.

This review some of what I said in the past.

Make the employers responsible for the people they have working for them (if not USA citizen) and require them to report when an employee does not show up to work and if they are on an education visa, the school would have to report their daily ware abouts. A daily report would be required and if this is too hard to do, they do not need the employee, or the student does not need to be in the USA. If the school or the employer does not comply, give them a stiff fine and if it is a second occurrence, they should be looking at jail time for not reporting.

The same with renting, banking using a Credicard, make the person in charge of each have to report what is happing at their place of business.

Since we have a lot of jobs that are not being filled, we need a program to find employees for business that need them. This could come from a pool of green card holders.

Do not let this become a way to hire cheap help, while USA citizens are still wanting jobs. The VP for Mogas values, the values on A side with the big hand wheels, told me that when he was working in Australia, that if a person came and worked in Australia, it was allowed only if no one could be found that could do that job.

Even with that they had more requirement.

We also need to rework our travel visas, and make sure no one overstays the amount of time they said they were going to be in the USA.

George Croix


At least 75% could be solved by finishing the darn wall, and forcing as much CURRENT law into play as possible by ONLY allowing entry, by existing law, at ports of entry. Send ALL others back, if they get in.

And round up the recent 'guests' and gotaways, too...

They could be caught easier if this Admin. were handing out CBP support, rather than illegal alien travel vouchers

It's not at all about what we CAN do as much as what our elected leaders want to do....

And everyone coming here isn't looking for a job....many are bringing their business with them and killing Americans stupid enough to do dope....

Joe Biden and Alejandro Mayorkas are now one of the all time biggest human trafficking and drug pushing enabling teams.

It's just deflection to keep pretending otherwise....

George Croix


The actual scheme in play right now, imo, of welcoming come one come all is to get the next Census to show 'growth' along the border and thus more congressional representation and thus more possibility of more blue, or even more votes if amnesty got 'earmarked' into something else.

Must really be a downer to Joe and company that he's so incompetent that he's lost that opportunity...

Jim Forsythe

One can argue numbers all day long, but no President has stopped the problem.

Apprehensions on the southwest border peaked in 2000 at 1.64 million and have generally declined since, with some fluctuations. In 2017, apprehensions hit the lowest level since 1972, but they spiked in fiscal year 2019 at 851,508 and fell back down to 400,651 in fiscal 2020.

Due to the COVID-19 pandemic, the number of immigrants detained at the Southern border decreased significantly. However, as infection numbers began to decrease in 2021, the number of detainees and undocumented immigrants increased.

Then there the population in the USA.

The illegal immigrant population of the United States peaked by 2007, when it was at 12.2 million and 4% of the total U.S. population. Estimates in 2016 put the number of unauthorized immigrants at 10.7 million, representing 3.3% of the total U.S. population. Since the Great Recession, more illegal immigrants have left the United States than entered it, and illegal border crossings were at the lowest in decades until 2021, when a record of 1.7 million people were caught trying to cross the southern border illegally Since 2007, visa overstays have accounted for a larger share of the growth in the illegal immigrant population than illegal border crossings, which have declined considerably from 2000 to 2018. In 2012.As of 2016, approximately two-thirds of unauthorized adult immigrants had lived in the U.S. for at least a decade.

Even if the wall was complete, the problem would not decrease, as more people would just overstay visas or other means.

As I have stated before, when someone want something bad enough, they will get it.

Jim Forsythe

What you missed is that crossing the border is not the only way people come to USA. Many use our visa system and just do not leave when they should, which adds to our problem.

Carlos Ponce

Normally they would use border agents to go after Visa overstays but they're too busy on the Biden ordered welcome wagon.[rolleyes]

George Croix

One tried…

That next to last sentence is very interesting…..

Did I miss something today, and the influx of thousands daily suddenly stopped…?

That wall is for incoming, not outgoing….

Jim Forsythe

What you missed is that crossing the border is not the only way people come to USA. Many use our visa system and just do not leave when they should, which adds to our problem.

Jim Forsythe

To fix our problem, laws need to change. What we do now is just put Band-Aids on the problem.

A lot of people think if the wall had just been complete but that is the problem, completion. The wall did not increase very much in length because of the problem of getting the rights to build. The footprint of the wall is 40 miles longer than it was before Trump took office.

Those who have tracked the construction closely say fencing mostly has been built where there was least resistance, where the federal government already owned the land — particularly in Arizona and New Mexico. Far less has been built in areas of Texas, especially, where private landowners have fought condemnation of their land in the courts. As of July 2020, the federal government had acquired 135 tracts of privately owned land, but was still working to acquire 991 additional tracts, almost all of them in the Rio Grande Valley and Laredo sectors in South Texas.

Even if Trump was still President, the chances of the wall being completed would be almost zero, because of the problems of acquiring the land.

George Croix

Eminent domain.

Declare National emergency.

Good reason to do so.

Hell, Pay big bucks and LEASE right of way for 200 years.

Money talks.

Right now, it’s saying it’s likely cheaper than paying for another few million dependents

Carlos Ponce

"The footprint of the wall is 40 miles longer than it was before Trump took office." It's the quality and location, Jim, not the length. That hop - over fence wasn't doing much so it was replaced.

George Croix

Even better.

Give everybody coming this way a free MAGA cap….Biden would send the Army the next day…..

Carlos Ponce

" but no President has stopped the problem."

Jim needs to ask the CBP and ICE agents which president made the best effort to "stop the problem". They have an answer Jim doesn't want to hear.[whistling]

Carlos Ponce

"The problem is increasing, just as it has for many years under many Presidents." There goes Jim again, chasing his own tail.

FACT: Under President Trump, the illegal immigrant problem was being dealt with and conditions were improving.

"The CBP recorded 310,531 apprehensions and 216,370 inadmissible cases by officers in the fiscal year, a 23.7 percent decline from Obama’s last year in office.

The sharp decline in the number of illegal border crossings “reflects the Administration’s commitment to enforce the rule of law as directed in the President’s executive order: Border Security and Immigration Enforcement Improvements, issued Jan. 25 [2017],” the CBP noted.

Question is why Jim refuses to acknowledge the improved border control made by President Trump? The answer is obvious.[rolleyes]

Jim Forsythe

DC just wants to point and say, we need to do something about the Immagration problem, but they do not fix the problem. Effort has not fixed the problem because we need all to come up with one Immagration plan for the USA and quit changing what we do, each time we get a new president.

Just as I said, no President has stopped the problem. The problem is increasing, just as it has for many years under many Presidents.

Each year the problem gets worse.

Apprehensions at the U.S.-Mexico border in fiscal year 2019 were more than double the total in fiscal year 2016 and almost triple the total in fiscal year 2017.

Total deportations by ICE hovered around 400,000 annually in each of the first four years of Obama's presidency. That did not even slow the problem.

In one year of Biden’s leadership, apprehensions of illegal aliens at the southern border soared to over 2 million.

Maybe what any president, now or in the past has done about illegal Immagration is ok by you, but we are have a larger problem each year. About half of the problem is from visa overstayers.

A report released by the Center for Migration Studies of New York finds that from 2016-2017, people who overstayed their visas accounted for 62 percent of the newly undocumented, while 38 percent had crossed a border illegally.

DC knows that we have a visa overstay problem.

"Half of everyone that’s here illegally (in the US) came here legally on a visa and have overstayed their visa," McCarthy, a Republican from Bakersfield, said at a Public Policy Institute of California event in Sacramento on Aug. 15, 2018.

“Robert Warren of the Center for Migration Studies of New York, a former director of the Immigration and Naturalization Service’s statistics division who has studied visa overstays for decades, has done the most recent work on the issue. He estimated that, as of 2018, 46% of people in the country illegally overstayed visas.

George Croix

I give up.

The Border Is Secure.

We redefine everything else, why not borders….

One bit of silver lining is law abiding Hispanics are turning on Biden big time….that really messes up the reason for the open invitation….

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