Changes to Texas State Hospitals

Since 2017, the Texas Legislature has invested more than $2.5 billion to replace and renovate hospitals across the state, including new hospitals in Houston, Dallas, Lubbock and Amarillo. These projects are part of an overarching plan to modernize and provide wider access to inpatient psychiatric care in Texas.

The Health and Specialty Care System’s transformation of inpatient psychiatric care is founded on three bedrock principles: systems-based continuum of care, unparalleled treatment and easy access.

Systems-Based Continuum of Care

• State hospitals provide inpatient psychiatric care for adults, adolescents and children.
• Texans need access to the full array of mental health services. Although state hospitals are a critical component in providing those services, inpatient care at state hospitals should not be the first line of treatment.

Unparalleled Care

• Renovations and new facilities will incorporate the latest design elements, complementing cutting-edge services.
• New and renovated state hospitals are designed to allow for more natural light and include therapeutic outdoor spaces, single rooms and enhanced safety features for a healing-focused environment.

Easy Access

• People are better served when services are available close to home. HHSC works alongside community partners to support peoples' needs as close to their homes as possible.
• HHSC incorporates technology to bridge gaps in service areas that lack sufficient options for inpatient psychiatric treatment.

Who We Serve

• Texas state hospitals provide a variety of inpatient psychiatric services for children, adolescents and adults.
• Many patients come to the state hospital after interacting with the criminal justice system, either because they were determined to be incompetent to stand trial due to their mental health needs or a jury found them not guilty by reason of insanity.
• Others may have been referred by a local mental health authority or non-criminal court proceeding.
• Some patients with more complex needs may require a maximum-security setting, which includes extra security features such as fencing, secure entryways, increased video monitoring and additional security and direct care personnel.
• All patients at state hospitals are met with compassion, care and professionalism by staff.

State Hospital Construction Projects

In Planning

New 75-Bed Non- Maximum-Security Unit Bed Hospital in Panhandle, Amarillo

• Summary: HHSC is planning to add a 75-bed non-maximum-security hospital in Amarillo.
• Status: The project is currently in the planning and design phase.
• Cost/Budget: $159 million approved by the 88th Texas Legislature.
• Site Selection: HHSC is working with Texas A&M University in selecting the new hospital site.
• Schedule: Planning and design began December 2023, and construction is slated for late 2024 or early 2025.

New 50-Bed Maximum-Security Hospital in Lubbock

• Summary: HHSC is planning to add a 50-bed maximum-security unit in Lubbock.
• Status: The project is currently in the planning and design phase. HHSC is in the process of choosing a vendor for Construction Manager at Risk (CMAR).
• Cost/Budget: $121 million approved by the 88th Texas Legislature.
• Site Selection: HHSC is working with the Texas Department of Criminal Justice to lease land for the new hospital.
• Schedule: Planning and design began February 2024 and construction is slated for late 2024 or early 2025.

Terrell State Hospital – 250-Bed Replacement Hospital

• Summary: HHSC is planning to build a replacement for Terrell State Hospital that will have 250 beds: 50 maximum-security, 140 non-maximum security, 35 adolescent and 25 civil.
• Status: Planning and design of the new hospital is progressing and conceptual plans are being developed.
• Cost/Budget: $573 million approved by the 88th Texas Legislature.
• Site Selection: The new hospital will be built on the existing Terrell campus.
• Schedule: Planning and design began December 2023, and construction is slated for late summer 2024.

North Texas State Hospital – Wichita Falls Campus 200- Bed Replacement Hospital

• Summary: HHSC is planning to build a replacement hospital for the North Texas State Hospital – Wichita Falls campus that will have 200 beds: 24 maximum-security, 136 non-maximum security, 24 adolescent and 16 civil.
• Status: Planning and design of the new hospital is progressing, and conceptual plans are being developed.
• Cost/Budget: $452 million approved by the 88th Texas Legislature.
• Site Selection: The new hospital will be built on the existing campus.
• Schedule: Planning and design began November 2023, and construction is slated for late summer 2024.

El Paso Psychiatric Center Expansion

• Summary: HHSC will expand the El Paso Psychiatric Center by 50 non-maximum-security beds.
• Status: HHSC chose an architectural and engineering firm to oversee planning and design.
• Site Selection: HHSC is in the process of selecting a site.
• Cost/Budget: $50 million approved by the 88th Texas Legislature for pre-planning, planning, land acquisition and initial construction.

Rio Grande State Center Expansion

• Summary: HHSC will expand the Rio Grande State Center State Hospital by 50 maximum-security beds. This new unit will be located on the existing Rio Grande campus.
• Status: Planning and design for the 50-bed unit is progressing, and HHSC is conducting the CMAR selection process.
• Cost/Budget: $120 million approved by the 88th Texas Legislature.
• Schedule: Planning and design began February 2024, and construction is slated for late 2024 or early 2025.

San Antonio State Hospital (SASH) – Conversion of 40 forensic beds to 40 maximum-security beds

• Summary: HHSC will renovate an existing 40-bed forensic unit at SASH to a 40-bed maximum-security unit.
• Cost/Budget: $15 million approved by the 88th Texas Legislature.
• Schedule: Planning and design began summer 2023. Solicitation for construction is slated for mid-May, and construction is anticipated to begin in late summer.

Under Construction

Austin State Hospital - Replacement Hospital

• Summary: HHSC is working with Dell Medical School at The University of Texas at Austin to design and build a 240-bed hospital to replace the current one on campus. 
• Capacity Added: This is a replacement project for 240 existing adult beds.

Status

• Construction: 96.78% completed.
• Building construction is near completion. The exterior fencing, landscaping and other site structure work is being completed.
• Building systems are being tested along with all new equipment.
• Interior finishes are being installed, and all the work is being completed or corrected to meet design specifications.

Cost/Budget

• Phase I - $15.5 million in planning and pre-planning approved by the 85th Texas Legislature.
• Phase II - $165 million for construction approved by Texas 86th Legislature.
• Phase III - $124.1 million for construction approved by the 87th Legislature.
• Total - $304.6 million.

Schedule

• The estimated completion date for construction has been revised to April 2024 due to a long lead time for some materials and labor shortages.
• Opening: June or July 2024.
• A ribbon-cutting ceremony is scheduled for May 15, 2024.

Photos, Videos and Virtual Tours

• Access the Austin State Hospital construction video.
• Open House Presentation (PDF).
• Map of the construction areas on campus (PDF).

San Antonio State Hospital

Summary

HHSC is building a 300-bed hospital to replace the current facility at San Antonio State Hospital (SASH) and renovating another building to add 40 new beds on campus.

New Hospital Replacement Project

Capacity Added: This project will replace the existing 262 beds, adding 38 beds.

Cost/Budget

• Phase I - $14.5 million for planning and pre-planning approved by the 85th Texas Legislature
• Phase II - $190.3 million for construction approved by the 86th Texas Legislature.
• Phase III – $152.4 million approved by the 87th Texas Legislature.

Status

• Construction is 99% completed.
• The facility reached substantial completion in January 2024, with the exception of minor work being completed and confirmed.
• HHSC held a ribbon-cutting ceremony on April 9, 2024.
• Staff and patients are preparing to move in to the new hospital building.

Schedule

• Construction completion: January 2024.
• Current replacement hospital opens May 2024.
• Ribbon-cutting ceremony held April 9, 2024.

Maximum Security Unit Conversion

Capacity added: 40 non-maximum-security beds added to SASH in March 2021 are now being converted into 40 maximum-security beds.

Cost/Budget

Phase II - $15 million for planning and construction approved by the 88th Texas Legislature.

Status

• The final bid documents for construction are estimated to be issued in May 2024.

Schedule

• Current estimated construction start date: July 2024.
• Estimated construction completion date: July 2025.

See a video on SASH construction.

Texas Behavioral Health Center at UT Southwestern

Summary

HHSC partnered with the UT Southwestern Medical Center in Dallas to design, construct and operate a new 200-bed psychiatric hospital in the Dallas-Fort Worth metroplex.

Children’s Health provided $200 million to fund approximately 92 additional beds at the hospital exclusively for treating children and adolescent patients.

Capacity added: 292 beds (200 adult and 92 pediatric).

Cost/Budget

• $282.5 million for the adult wing approved by the 87th Texas Legislature.
• Additional $102 million approved by the 88th Texas Legislature.
• $200 million for the pediatric wing donated by Children’s Dallas. Children’s will be increasing the gift amount to fund the increased cost of design and construction of the pediatric beds.

Status

• Construction of the adult unit is on schedule.
• Construction of the pediatric unit has started.

Schedule

• Substantial completion of the adult unit is expected in July 2025.
• Substantial completion of the pediatric unit is expected in January 2026.

To Get Involved or Learn More

Email HHSC Health and Specialty Care.

Completed Projects

John S. Dunn Behavioral Sciences Center

Summary: HHSC and UTHealth Houston worked together to build, design and operate the 264-bed John S. Dunn Behavioral Sciences Center in Houston's Texas Medical Center.

Capacity added: 264 beds

Cost/Budget: $126.5 million

Status: 100% complete

Schedule

• Construction completed: February 2022.
• The first unit opened in April 2022.

See a video of the John S. Dunn Behavioral Sciences Center construction.

Kerrville State Hospital

Summary

Kerrville State Hospital campus buildings 612 and 613 have been renovated and 70 maximum-security unit beds have been added.

Capacity added: 70 new maximum security unit beds

Cost/Budget

• $30.5 million for design and renovation
• $8.6 million from deferred maintenance funds to add programming and therapy spaces to support patients staying in the maximum-security unit wing.

Status

Phase I: The 70-bed patient unit opened in April 2023.

• Substantial construction completion: June 2022.
• Move-in ready and operational: April 2023.
• Accepted first patients: April 2023.

Phase II: Programming and administrative spaces

• Substantial completion: December 2023.
• Move-in: February 2024.

View a video on the Kerrville State Hospital project.

Rusk State Hospital

Summary

Construction projects at Rusk State Hospital added a new maximum-security unit with 100 beds, a new non-maximum-security unit with 100 beds, and a replacement administration building.

Capacity added: The three-story, 227,368-square-foot patient complex includes a 100-bed non-maximum-security unit, and 100-bed maximum security unit. This 200-bed unit will increase the number of maximum-security beds from 40 to 100. The hospital’s overall capacity will stay the same.

Cost/Budget

200-bed patient building

• $98.8 million approved by the 85th Texas Legislature for planning and construction of the maximum-security unit.
• $90.1 million approved by the 86th Texas Legislature for construction of the non-maximum-security unit.
• $3 million approved by the 86th Texas Legislature for demolishing the five buildings.

Administration building

• $10.7 million

Status

• Construction completed for the 200-bed new patient unit.
• The administration building is complete and operating.

Schedule

• Construction completion: May 2023.
• Ribbon-cutting ceremony held June 7, 2023.
• The administration building opened September 2021.

Watch a video on the Rusk State Hospital construction.