Changes to Texas State Hospitals

The Texas Legislature has invested more than $2.5 billion for replacement and renovation of the hospitals across the state, including new hospitals in Houston, Dallas, Lubbock and Amarillo. These projects are a part of the Health and Specialty Care System's transformation of inpatient psychiatric care in Texas. They are 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 of that system, inpatient care at the state hospitals should not be the first line of treatment for a person.

Who we Serve

  • Texas state hospitals provide a variety of inpatient psychiatric services for children, adolescents and adults.
  • Many have 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 our patients are met with compassion, care and professionalism by state hospital staff.

Unparalleled Care

  • The planned renovations and new buildings will incorporate the latest design elements, complementing cutting-edge services.
  • The designs allow for more natural light, therapeutic outdoor spaces, single rooms and enhanced safety features providing an environment for staff and patients to focus on healing.

Easy Access

  • People are better served when services are available close to home. Working alongside community partners to develop an array of services that support peoples' needs as close to their homes as possible is a top priority.
  • By incorporating technology to bridge geographic gaps in areas where psychiatric staff are difficult to recruit, our plan allows us to provide services in locations that lack sufficient inpatient psychiatric treatment.

State Hospital Construction Projects

In Planning

New 75-Bed Non MSU Bed Hospital in Panhandle, Amarillo

  • Summary: HHSC is in the process of procuring the A/E Team for a new, standalone state hospital in Amarillo with 75 non-maximum-security beds.
  • Cost/Budget: $159 Million approved by the 2023 Legislature.
  • Site Selection: HHSC is working with other state agencies to find the site for the new hospital.
  • Schedule: Planning and design will begin in fall 2023 and construction is set to begin late summer 2024.

New 50-Bed Maximum-Security Hospital in Lubbock

  • Summary: HHSC is planning to add a 50-bed maximum-security unit in Lubbock, Texas.
  • Cost/Budget: $121 million approved by the 2023 Legislature.
  • Site Selection: HHSC is working with other state agencies to find the site for the new hospital.
  • Schedule: Planning and design will begin in fall 2023 and construction is set to begin late summer 2024

Terrell State Hospital – 250-Bed Replacement Hospital

  • Summary: HHSC is planning to build a replacement hospital for Terrell State Hospital that will have 250 beds: 50 maximum-security, 140 forensic non-maximum security, 35 adolescent and 25 civil.
  • Cost/Budget: $573 million approved by the 2023 Legislature.
  • Site Selection: The new hospital will be built on the existing Terrell campus.
  • Schedule: Planning and design will begin in fall 2023 and construction is estimated to begin 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 forensic non-maximum security, 24 adolescent and 16 civil.
  • Cost/Budget: $452 million approved by the 2023 Legislature.
  • Site Selection: The new hospital will be built on the existing NTSH- Wichita Falls campus.
  • Schedule: Planning and design will begin in fall 2023 and construction is estimated to begin late summer 2024.

El Paso Psychiatric Center Expansion

  • Summary: HHSC will expand the El Paso Psychiatric Center by 50 non-maximum-security beds.
  • Site Selection: HHSC is in the process of looking for the site for the new hospital at El Paso. HHSC is working with the EL Paso community partners for the availability of the different sites.
  • Cost/Budget: $50 million approved by the 2023 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.
  • Cost/Budget: $120 million approved by the 2023 Legislature.
  • Site Selection: The 50 bed annex will be built on the existing Rio Grande Campus.
  • Schedule: Planning and design to begin in fall 2023 and construction is set to begin later summer 2024.

San Antonio State Hospital – Conversion of 40 forensic beds to 40 MSU beds

  • Summary: HHSC will renovate the existing building 521 at SASH campus to convert the recently 40- Bed forensic unit to 40-Bed MSU unit.
  • Cost/Budget: $15 million approved by the 2023 Legislature.
  • Schedule: Planning and design started in summer 2023 and construction is set to begin in summer 2024.

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 project is a replacement project and will replace the existing 240 adult beds.
Status
  • Construction: 89% completed.
  • Exterior of the building is near completion. The construction of exterior courtyards, fences and site structures is progressing. Road and parking lot construction is in progress.
  • Finishes, millwork is currently being installed. Testing of the building systems has started to begin.
Cost/Budget
  • Phase I - $15.5 million in planning and pre-planning approved by 2017 Legislature.
  • Phase II - $165 million for construction approved by 2019 Legislature.
  • Phase III - $124.1 million for construction approved by 2021 Legislature.
  • Total - $304.6 million
Schedule
  • Revised Estimated Construction Completion: February 2024. (The construction completion is delayed due to the supply chain issue, added time to complete additional work and shortage of skilled labor to perform the work).
  • Replacement Hospital opens: June 2024

Photos, Videos and Virtual Tours

Rendering: Artist's rendering of Austin State Hospital.
ASH Perspective: A perspective view of the new Austin State Hospital. Photo from November 2023.
ASH Interior: Patient Room at Austin State Hospital. Photo from November 2023.
ASH Interior: Patient Room at Austin State Hospital. Photo from November 2023.

San Antonio State Hospital

Summary

HHSC is building a 300-bed hospital to replace the current facility at San Antonio State Hospital 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 2017 Legislature
  • Phase II - $190.3 million for construction approved by 2019 Legislature.
  • Phase III – $152.4 million approved by 2021 Legislature.

Status

  • Construction of Replacement Hospital: Replacement Hospital is 82% completed.
  • Exterior site work is progressing.
  • Interior finishes like flooring, tile, painting, and millwork are being installed.
  • The punch list process has started to review and confirm the quality of workmanship.

Schedule

  • Current Estimated Construction Completion: January 2024.
  • Current Replacement Hospital opens: May 2024.

Maximum Security Unit Conversion

Capacity added: 40 non-maximum-security beds added March 2021, now converting those 40 beds to maximum-security.

Cost/Budget

Phase II - $15 million for planning and construction approved by 2023 Legislature.

Status: Procurement of the design team in progress.

Access the San Antonio State Hospital construction video.

Rendering: Artist’s rendering of the new hospital project at San Antonio State Hospital.
SASH aerial: An aerial view of the new San Antonio State Hospital.
Photo from August 2023.
SASH Interior: Photo of Care Station at San Antonio State Hospital.
Taken November 2023.
SASH Interior: Photo of Dayroom at San Antonio State Hospital.
Taken November 2023.

Texas Behavioral Health Center at UT Southwestern

Summary

HHSC in partnership with UT Southwestern Dallas is working to design, construct and operate the 200-bed new psychiatric hospital in the Dallas-Fort Worth Metropolitan Area.

Children’s Health, upon learning about the hospital, approached the Health and Specialty Care System about its desire to support the Texas Legislature’s and HHSC’s goal of expanding the state hospital system. Children’s made a gift of $200 million that will add approximately 96 additional beds to the hospital to exclusively treat children and adolescent patients.

Capacity added: Total of up to 292 beds (200 adult beds and 92 pediatric beds).

Cost/Budget

  • $282.5 million for the adult wing approved by the 2021 Legislature.
  • $200 million for the pediatric wing donated by Children’s Dallas.
  • Additional $102 million approved by the 2023 Legislature.

Status

  • Adult Unit:
    • The design documents have been issued for the adult unit. The contractor is in the process of bidding the trade packages for the adult wing.
    • Demolition of the existing structures on site has been completed.
    • Sitework is progressing as per schedule including the utilities.
    • Drilling of piers and preparation for the foundation's adult wing is in progress.
    • Mockups of selected rooms are completed at the construction site and have been reviewed.
  • Guaranteed Maximum Price
    • GMP was approved for the 200-bed adult unit.
  • Pediatric Unit:
    • Amendment to the IAC is executed adding scope of including up to 96 beds for the pediatric unit.
    • The Design Team is working on the Design Development phase for the pediatric unit.

Schedule

  • Estimated substantial completion date: July 2025 for the adult unit.
  • Estimated substantial completion date: January 2026 for pediatric unit.

A rendering of the Texas Behavioral Health Center at UT Southwestern.
TBHC at UT Southwestern: Exterior Photo taken November 2023.

To Get Involved or Learn More

Email HHSC Health and Specialty Care.

Completed

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.

Access the John S. Dunn Behavioral Sciences Center construction video.

Artist's rendering of the John S. Dunn Behavioral Sciences Center Campus in the Texas Medical Center.
The new hospital has 264 beds. Photo from January 2020.
Inside view of the John S. Dunn Behavioral Sciences Center.
Photo from January 2022.

Kerrville State Hospital

Summary

Kerrville State Hospital campus buildings 612 and 613 have been renovated and 70 maximum-security unit beds have been added. Learn more from this video.

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 the individuals staying in the MSU wing.

Status

Phase I: 70-Bed Patient Unit Opened in April of 2023

  • Substantial Construction Completion: June 2022.
  • Move-in Ready and Operational: April 2023
  • Accepted First Patients: April 2023

Phase II: Programming and Administrative Spaces

  • Estimated Substantial Completion: December 2023
  • Estimated Move-in Ready: February 2024

Access the Kerrville State Hospital construction video.

Artist's rendering of Kerrville State Hospital.
Interior at Kerrville State Hospital. Photo from December 2022.

Rusk State Hospital

Summary

Rusk State Hospital has just completed the construction of a new maximum-security unit with 100 beds and a new non-maximum-security unit with 100 beds. Rusk has also replaced the administration building. Learn more from this video.

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

  • $191.9 million for planning, construction, and demolition of an additional five buildings.
    • $98.8 million for planning and construction of maximum-security unit, approved by 2017 Legislature.
    • $90.1 million in for construction of the non-maximum-security unit, approved by 2019 Legislature.
    • $3 million for demolition of five building, approved by 2021 Legislature.

Administration building

  • $10.7 million

Status

  • Construction of the 200-bed new patient unit is completed except for some site work.
  • The administration building is complete and operating.

Construction is substantially completed and building is ready to be occupied.

Schedule

  • Construction Completion: May 2023. The building is move-in ready.
  • Ribbon cutting ceremony on June 7, 2023.
  • The administration building opened September 2021.

Access the Rusk State Hospital construction video.

Rusk Exterior: Photo from the Rusk State Hospital grand opening.
Rusk Exterior: This photo shows the construction progress at Rusk State Hospital. Photo from May 2023.
Rusk Interior: Courtyard for Patient Treatment and Recreation.
Photo from May 2023.
Rusk Interior: Gymnasium for the Patients at Rusk State Hospital.
Photo from May 2023.
Rusk Interior: Photo of a common room for the Patients at Rusk State Hospital.