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Bexar County Judge Peter Sakai says reusing state hospital as psychiatric facility may not be enough

San Antonio Express News logo San Antonio Express News 3/21/2023 Scott Huddleston, Staff writer

Bexar County Judge Peter Sakai worried Tuesday that a planned 300-bed mental health facility could be filled up before it even opens. 

The county approved a $250,000 contract with HKS Inc. to examine reusing the old San Antonio State Hospital as a psychiatric facility that includes 87 beds for children and helps people who are homeless, transient or repeatedly cycling through the jail. The funding is from the American Rescue Plan Act.

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Although the move could relieve jail overcrowding and reduce the number of low-level offenders in the Bexar County Jail who suffer from mental health issues, Sakai said it won’t be enough to address a need for more psychiatric beds that is growing exponentially. 

There are 200 to 300 inmates in the jail with mental health problems, he said. 

“That means that thing is full” upon opening, assuming the county moves forward with a reuse master plan and secures funding in future years, Sakai said.

“Are we just building bigger jails for that particular population?” he asked. “I know we’ve got great ideas, but can we execute?”

Tuesday’s action follows discussions for more than a year on reusing the old state hospital at 6711 S. New Braunfels Ave. on the South Side. Some buildings are in good shape and recently have had new roofs and ventilation systems. The study will consider the need for wraparound services and supportive housing.   

HKS was the highest-ranked team among four consultant teams to respond last year based on qualifications and experience. A new three-story, $357 million state hospital is expected to open in 2024.  

Commissioner Rebeca Clay-Flores urged the county staff to move quickly and help the county leverage funds from the state for the facility and the city for permanent supportive housing. 

“It seems like the state is working faster than the city” on local mental health needs, she said.

The study’s findings could be ready in three months, said Dan Curry, the county’s facilities management director.

County officials have said the new psychiatric complex could include “step-down” housing for individuals who have completed rehabilitative programs but still need supportive services.

During discussions last year by the Commissioners Court, then-County Judge Nelson Wolff warned the concept of a county psychiatric facility is a “very expensive endeavor” yet has “great potential” for the campus, which dates to 1892.

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Wolff said some of the newer buildings are in generally good shape, even though a 2014 structural analysis found 80 percent of the facility was in “critical condition.”

But he cautioned that getting them up to state standards could be costly.

Curry said the study would provide only a general estimate of the cost of renovating the old hospital campus. It will offer “all the options” for the next steps in the process, including a more rigorous analysis of cost estimates based on design, construction and programming requirements. 


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