Media coverage on questionable contracting at state agencies has deservedly drawn public and legislators’ concern.

Absolutely, investigate deeply into what’s going on and make the necessary corrections. But let’s also recognize that contracting done well is an important component of good public service.

Dennis Borel, executive director for the Coalition of Texans with Disabilities.
Dennis Borel, executive director for the Coalition of Texans with Disabilities.

Texas is undeniably a great state. Yet, not all we do is great, like Texas’ commitment to its most disadvantaged populations, including people with mental illness.

The fact is, Texas’ mental health care spending and outcomes are historically among the lowest in the U.S. Thankfully, we might be moving away from that trend: in 2013, the Texas Legislature made much needed progress by appropriating an unprecedented amount of funding for mental health services. According to a recent study by Mental Health America[1], Texas is no longer at the bottom of the barrel by several measures. However, we’re still in the lowest five in terms of access to mental health care.

Now, the Texas Health and Human Services Commission (HHSC) is looking to contract out the operation of the Terrell State Hospital to Correct Care Recovery Solutions. Some will question if this public-private partnership is also progress. I say the administrative entity is not the right question; rather it is quality of care that is the true measure of progress.

North Texas’ Terrell State Hospital is a state-operated facility with an unfortunate track record in care. The facility drew a very serious regulatory finding called Immediate Jeopardy, meaning that people at the hospital are in immediate jeopardy of serious harm. This finding also carries the potential forfeiture of critical federal funds. If care at Terrell is substandard now, what hope would there be for improvement with a big loss of funding?

On a larger scale, the recent report by the Texas Sunset Commission on the Department of State Health Services (DSHS) elevated and enumerated the many problems that exist in effectively serving Texas’ mental health consumers. Sunset described DSHS as being spread too thin and set up to be a “jack of all trades and a master of none”. Sunset strongly recommended that HHSC and DSHS “immediately review and streamline human resources policies to ensure state mental health hospitals are appropriately staffed…”

So, we have an in-depth Sunset study recommending system changes and specific regulatory findings on Terrell State Hospital. Does it not make sense to look for new ways to address mental health services there?

I’m keeping an open mind about what the Commission is trying to accomplish. And while recent “no-bid” contracting at the agency has been making headlines, we simply cannot afford to toss aside any option that might improve services and access to care for people with mental illness. Consumers and families deserve better.

What do we know about Correct Care Recovery Services and their tentative contract award? HHSC followed a very standard, competitive bid process, evaluating multiple vendors’ proposals, allowing for a public question and answer period and now negotiating with Correct Care to determine if the contract represents the best value—this, too, can and should mean quality of care.

In contacting advocacy groups in communities where Correct Care operates mental health facilities, reports were very positive, in particular, on linkages to advocates and transparency. Our community is an important voice in the process and can help ensure that Texas’ mental health services and needs of the clients are met and improved.

Staff with the Coalition of Texans with Disabilities are pictured at the state Capitol in Austin.
Staff with the Coalition of Texans with Disabilities are pictured at the state Capitol in Austin.

While the state leaders examine current, pending and former HHSC contracts; it’s my hope that they not overlook what will be in the best interest of one of Texas’ most underserved populations – persons with mental illness.

Quality of care cannot and must not be compromised, but nor can we simply accept the status quo. If done well, there is considerable promise of a better Terrell State Hospital.