San Antonio State Hospital more than $600,000 over budget

San Antonio State Hospital more than $600,000 over budget (Photo: SBG San Antonio)

The San Antonio State Hospital (SASH) has had more than 2 dozen unauthorized departures since last year; those are mentally ill patients, some who are criminal defendants.

This is one of several issues the current legislature is having to take into consideration as they work on the future budget.

In 2015, projected expenses for SASH were $48,263,406. The hospital exceeded the budget by $179,322.

In 2016, SASH was allocated 4 million more and they still went over budget by $648,059.

SASH spokesperson, Christine Mann said this is not significant given the fact that the legislature appropriates funding for all the state hospitals and the individual hospitals routinely update their budget as needs are identified.

"It's not unusual for not only this hospital, but also the other 9 hospitals to come in over budget," said Texas State Senator Carlos Uresti. "You're trying to guestimate based on historical trends based on the number of beds that you have and the type of patient that's going to come in, that's going to cost X, but it usually costs Y, and we have to make up the difference."

The largest "over and above" budget expense was for Professional Fees and Services.

$4,191,627 was allocated for the 2 year period and during that time SASH went over budget by more than $800,000.

Mann noted that in 2016, 1.3 million dollars was spent on outside medical and 1.5 million dollars went to contracted staff.

"They're not just treating these patients that come in for a mental illness disorder, that individual that comes in if they suffer from let's say diabetes or if they have a heart attack, the State Hospital is responsible for providing that medical care as well," Uresti said.

SASH is also facing a critical nursing shortage, with an expected registered nurse turnover rate of more than 50% in 2017.

There is also a shortage of forensic beds; space for those charged with a crime who are not fit to stand trial.

"When they're not available in the system, we have to contract out to private providers hence the reason why you see the state hospital going over budget, because that comes out of their budget and they're paying a higher rate," Uresti said.

Uresti said the legislature will be funding more forensic beds in the current session and they will also have some decisions to make about whether to fund new buildings.

Some of the existing buildings on the SASH campus are 75 to 80 years old.

"I think there's a general consensus that it's time to start thinking outside the box and to build some new facilities, smaller facilities that are more efficient and obviously more effective," Uresti said.

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