Williamson County sees dramatic change in mental health care options

Aug. 26--ROUND ROCK -- One morning last week, a 17-year-old boy with bipolar disorder needed to check into a mental health facility, and the closest adolescent unit was in Austin. Williamson County Deputy Rick Romero spent more than three hours fighting traffic and filling out paperwork to get the teen the help he needed.

"I see it all the time," Romero said. "People take their medication and they feel good, then they stop taking the medication because they feel fine."

For years, getting help for those Williamson County residents meant a time-consuming trek to the psychiatric hospitals in Austin. But that's all changing.

Earlier this year, Rock Springs Hospital opened in Georgetown for adults, and its adolescent unit will start accepting patients this week. Add in the Georgetown Behavioral Health Institute, which opened earlier this month, and there are now nearly 200 mental health beds in a county that previously had four.

Already, the benefits are emerging: People in crisis have been more willing to go voluntarily to a mental health facility, knowing they'll be closer to home. Williamson County deputies are getting back on the road much quicker, too. Last year, they logged 7,201 hours moving patients to Travis County. So far this year, it's been 436 hours.

"The sooner we can get our deputies back into rotation, the better," said Lt. Rob Germillion, who oversees the Williamson County Sheriff's Crisis Intervention Team, a group of specially trained deputies who help people in mental distress.

Deputies from as far as Bastrop and Caldwell counties are even bypassing the Austin hospitals in favor of the available beds in Williamson County.

On the flip side, Williamson County emergency rooms are seeing more patients bound for mental health facilities. The local ERs have always seen some of the patients on their way to Austin's mental health hospitals, but other patients were screened at Austin ERs for intoxication or injuries that might be the true cause of a patient's distress. Now the Williamson County ERs are seeing virtually all of the patients heading to local mental health facilities.

St. David's Georgetown Hospital has one room that is equipped to handle someone in crisis, and those patients often require 24-hour supervision, said Dr. Jonathan Conner, the hospital's medical director. He said the ER is not a good place for those in crisis: It's loud, it's bright, and it's stressful. Their presence stresses out other patients and staff members.

"I'm fairly neutral about the new facilities," Conner said of Rock Springs Hospital and Georgetown Behavioral Health. "On one hand, it's good to have more capacity to deal with mental health patients, but it draws more of those folks in as well. If you build it, they will come."

Sheriff's officials and mental health coordinators have struggled for years to find beds for uninsured and indigent patients. While private mental health facilities, such as Rock Springs and Georgetown Behavioral Health, are not required to accept uninsured or indigent patients, they often do. Some reimbursements are available through county programs or through Medicare or Medicaid. But reimbursements often don't cover the full cost of care.

"We have an obligation not to discriminate in that way," said Dr. Ed Prettyman, CEO of Rock Springs. "Ultimately, the community is our customer."

Financially speaking, the arrival of these two psychiatric hospitals is a mixed bag for Williamson County. Without as many trips to take residents to the hospitals in Austin, Williamson County is saving deputy staffing and fuel. The county also won't have to pay Travis County as much to handle the civil proceedings for Williamson residents who are being committed involuntarily.

Last year, Williamson paid Travis more than $67,000 to process commitment cases at Austin State Hospital. Now Williamson is handling many of those commitment hearings itself. And officials hope that other counties will pay Williamson to do the same.

Law enforcement agents are allowed to hold someone in crisis in a mental health facility for 48 hours without a warrant. If a facility wants to hold the person longer than that, it has to file an application with county court. A full 90-day commitment requires several hearings before a judge.

Since March, Williamson County has handled 42 such commitment cases, a 244 percent increase over last year.

So the county is looking to add a sheriff's deputy, two staffers to the county attorney's office and one person to the county clerk's office and spend $10,000 on court-appointed attorneys to represent people in commitment proceedings in county court.

Until this year, Bluebonnet Trails Community Services had the only mental health beds for those in crisis in all of Williamson County. The nonprofit coordinates medical, dental and mental health care for indigent, uninsured and low-income people in eight counties surrounding Travis County.

Ideally, Rock Springs and facilities like it would be able to contract with the state and counties to provide care for the uninsured, said Andrea Richardson, executive director of Bluebonnet Trails.

"The state hospitals are already overwhelmed," Richardson said. "Rather than building more foundations and more structures, we can use the ones in place in the community."

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About the facilities

Georgetown Behavioral Health Institute, which opened this month, is a 118-bed psychiatric hospital for adults. It also provides outpatient programs and partial hospitalization programs. The facility, at 3101 S. Austin Ave. in Georgetown, is owned by the privately held Signature Healthcare Services LLC, based in Corona, Calif. For more information, call 512-819-1100 or visit www.georgetownbehavioral.com.

Rock Springs Hospital, which opened in February, is a 72-bed behavioral hospital offering mental health and inpatient and outpatient addiction treatment to adolescents, adults and their families. The hospital, at 700 SE Inner Loop in Georgetown, is owned by Springstone, a Louisville, Ky., company. For more information, call 512-819-9400 or visit www.rockspringshealth.com.

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