Hillcrest facility could meet state's mental health needs
Local, state officials back plan to turn former hospital into state mental health facility
Waco Tribune-Herald - 8/26/2017
Local and state leaders are backing a plan that would convert the vacant former Hillcrest Baptist Medical Center into a state-owned mental health facility, a proposal that could ease a statewide mental health crisis and add 1,000 new jobs to the area.
Trying to reverse a troubling trend that has left shortages in mental health beds across the state, Texas lawmakers appropriated $300 million during the past session to upgrade inpatient mental health services.
Charles Smith, executive commissioner of the Texas Health and Human Services Commission, has recommended that $1 million of that go toward buying the former Hillcrest hospital building on Herring Avenue and another $1 million go to architects, consultants and others to draft plans to renovate the nine-floor, 600,000 square-foot facility.
If plans go as local officials hope, the state will buy the facility this year, then the Legislature will appropriate $65 million in the next legislative session to turn the vacant building into a 339-bed mental health hospital. The facility could become one of the 10 largest employers in Central Texas over the next four to six years, officials said.
Led by State Rep. Charles "Doc" Anderson, R-Waco, the proposal has been driven by Baylor Scott & White Waco President Glenn Robinson, McLennan County Judge Scott Felton, Waco City Manager Dale Fisseler, Baylor Scott & White board member and civic leader Lyndon Olson Jr., Waco businessman Bill Clifton and Heart of Texas MHMR officials.
"We have been planning and we have been hoping this would come to fruition," Robinson said. "We learned early in this past session that the Legislature was doing a great amount of work to develop appropriations to expand mental health beds. So we contacted Doc, and he just immediately wrapped his arms around the project."
In less than a week after Anderson got to work on the proposal, the deputy commissioner for Health and Human Services, a chief nursing officer and an operations director at state mental hospitals and the architect who works with the state on medical facility renovations spent a full day touring the Herring Avenue facility. Afterward, they made favorable recommendations to the executive commissioner, Robinson said.
The HHS commissioner could not be reached for comment Friday.
Robinson said Baylor Scott & White is proposing to sell the building and about 14 acres of land to the state for $975,000. Robinson said Baylor Scott & White promised city of Waco officials it would demolish the building if it still is vacant in 2018, about three years after it closed.
Fisseler said the city has extended that deadline and will continue to work with the health care system and the state to try to make the proposal a reality. While city leaders feared what the vacant facility would mean for the surrounding neighborhoods, the proposed mental health hospital will energize the area with psychiatrists, psychologists, nurses and other employees looking for homes near the hospital, Fisseler said.
"If you think about building a brand new facility somewhere, then the taxpayers and rate payers are on the hook for extending the infrastructure down to it," Fisseler said. "What we have here is great infrastructure, and we are actually redoing the water storage facility there, but if you don't re-utilize those things, if it just gets torn down, all that infrastructure is just sitting there basically unused and we have already paid for it. So this really establishes the use of those facilities that the taxpayers and rate payers have already paid for."
Robinson said the proposal makes sense to the state because Texas sorely needs mental health beds to accommodate increasing needs. It is is also getting the facility at a relative bargain because building a new, 300-bed facility would cost a minimum of $300 million, he said.
Anderson said the state could choose to fund the project in stages, so lawmakers wouldn't have to appropriate the entire $65 million at once to renovate the whole building. If they choose to fund a third of the project at first, the number of jobs created would be closer to 300 initially, he said.
HHS officials estimate it would cost $190 million per biennium to operate the facility. According to HHS figures, if the state agency purchases the building but renovation funds are not appropriated, HHS will own the facility and be responsible for upkeep of the vacant building, estimated at a cost of $490,000 per year.
Baylor Scott & White Hillcrest Medical Center moved into its new building near Interstate 35 in 2009. It left behind only its skilled nursing facility, an inpatient rehab facility and outpatient rehab services. Those departments left the building almost two years ago, but officials have left heating and cooling systems on and have a full-time maintenance worker taking care of the facility, Robinson said.
Hospitals, police agencies, city and county jails and mental health care providers have waged an uphill battle for years about what to do with the burgeoning number of people with mental health issues, many with symptoms exacerbated by drug abuse.
When police receive calls about people showing symptoms of mental health problems, even if a person has committed no crime or a minor offense such as criminal trespassing, city and county law enforcement officials struggle with finding facilities to accept them, especially in the state's overcrowded mental hospitals.
Officers can be tied up for hours with a mental health patient or be forced to drive for hours at a time to take them to a facility with a bed open.
Up to 30 percent of all patients brought to acute-care hospitals have underlying mental health issues, Robinson said. Those facilities are ill-equipped to care for them, so many patients just wait in emergency rooms across the state for hours or days until another facility is found to accept them, he said.
McLennan County officials have tried to stem the problem by having MHMR officials assisting at the county jail and through a district attorney's office mental health diversion program, designed to keep those with mental health issues who may have committed minor infractions out of the criminal justice system.
That is why the proposed facility in Waco would be so important, Robinson said. It would increase the number of beds available to mental health patients in a centrally located area along a major interstate, he said.
There are eight hospitals in the state providing inpatient psychiatric services to a mix of patients committed under civil or criminal orders. Those include facilities in Austin, Big Spring, El Paso, Rusk, San Antonio, Terrell, Wichita Falls and Harlingen.
The facilities in Austin, El Paso, Wichita Falls, San Antonio and Terrell also provide inpatient psychiatric services to children and adolescents. The North Texas State Hospital in Vernon and the Kerrville State Hospital are maximum-security inpatient facilities for those sent for psychiatric treatment through the criminal justice system, while the Waco Center for Youth provides adolescent residential treatment services, according to HHS.
The facility in Waco is proposed to be a transitional facility and would not accept patients who have been involved with the criminal justice system, the officials said.
"Transitional care is a new model," Robinson said. "I can see the Hillcrest Herring campus being that type of care. Patients may have been at another hospital and are getting better. They no longer need acute services and want to get back to loved ones close to them. They would transfer to a transitional facility until they are ready to be released and get back to their loved ones."
Anderson said it is important to legislative leaders that local authorities and the community support the project when they decide whether it will be funded.
Besides being a perfect use for a huge vacant building, the added jobs and other ancillary benefits to the local economy, the new facility also could provide opportunities for area nursing programs, including those at McLennan Community College, Hill College, Temple College and Navarro College, to "retool" their departments to produce psychiatric nurses and psychiatric technicians, who could go on to work at the facility, officials said.
Baylor Scott & White has its own teaching program in Temple, which could expand its residency program to include the new facility in Waco, Robinson said. The residents could go on to supplement state staffing requirements at the Waco hospital, he said.
Olson and Clifton said mental health issues have been ignored and underfunded by the Legislature for too long, adding that few want to consider the controversial matter until it involves a member of their family. Anderson said the Legislature initially proposed $750 million toward mental health facilities, but that number dwindled to $300 million as the session continued.
Olson credits a major initiative by the Meadows Mental Health Policy Institute, which spent millions of dollars to fund a comprehensive study over the past five years, to open lawmakers' eyes to the mental health crisis.