Bexar County Transfers Jail Mental Health Screenings to University Health

Bexar County has officially shifted the responsibility for jail intake mental health and substance use screenings from the Center for Health Care Services (CHCS) to University Health. This transition, which took effect on October 1, 2023, concludes a six-year contract with CHCS and consolidates medical and behavioral health assessments under one provider for the first time since the Justice Intake and Assessment Annex (JIAA) opened in late 2018.

Previously, CHCS managed mental health screenings, while University Health oversaw medical intake within the facility. Once detainees were moved to the jail, University Health assumed responsibility for both medical and behavioral health treatment. In October 2023, Bexar County’s Office of Criminal Justice commissioned a study from the University of Texas Health Science Center at Houston. The study aimed to evaluate how effectively the annex processed detainees and diverted individuals with behavioral health or substance use needs into treatment programs.

Study Findings Prompt Provider Change

The evaluation, led by Dr. Alexander Testa, presented its findings in February 2024, revealing fragmented communication, inconsistent data sharing, and overlapping responsibilities among the various agencies operating within the annex. Testa and his team recommended consolidating screening and treatment under a single provider or establishing a coordinated process to integrate behavioral health assessments into the medical intake already conducted by University Health.

Following a review of these findings, Bexar County’s Department of Public Health began exploring ways to implement the recommendations and strengthen the county’s diversion efforts. “University Health provides the physical services in the JIAA, but they also are the mental health providers once someone moves over to the jail,” stated Dr. Andrea Guerrero, Bexar County Public Health Director. “The logical conclusion was that University Health would be better suited to provide both functions.”

Bexar County Public Health made its recommendation to change providers in August, with the transition approved for the 2026 fiscal year budget on September 9. University Health President and CEO Edward Banos described the change as part of an initiative to improve continuity of care, emphasizing that assessments conducted upon intake will ensure that individuals receive necessary psychiatric services, either within the jail or at appropriate facilities.

CHCS Reaction and Future Plans

The transition came as a surprise to CHCS, which had managed the mental health screenings for several years. Jelynne LeBlanc Jamison, CHCS President and CEO, noted that they were unaware of any discussions regarding a change in provider. “We were notified the day before the county went to Commissioners Court to recommend that they contract with University Health,” Jamison explained.

After the contract change was announced, Jamison reviewed the study’s report and invited Testa to present his findings to the CHCS board. He highlighted the lack of a systematic process within the JIAA, which raised concerns regarding the effectiveness of the new arrangements. Although Jamison acknowledged the intent to streamline operations, she questioned whether simply changing providers would address the structural issues identified in the study.

Despite these concerns, University Health began conducting screenings on October 1, with Bexar Public Health assisting in staffing the annex during the training of 11 new positions. Banos expressed gratitude for the county’s commitment during the transition, stating, “Kudos to the county for picking up a contract that seemed to have ended rather abruptly.”

While CHCS has concluded its role in the annex as of September 30, 2023, it remains a critical partner in the county’s broader behavioral health network. Jamison confirmed that CHCS continues to operate other mental health programs, including a jail-based competency restoration initiative and assisted outpatient treatment for the courts. The organization aims to expand diversion options outside the jail.

As CHCS continues its focus on outpatient services, Jamison remains hopeful about future discussions regarding the establishment of a diversion center and psychiatric hospital for Bexar County. She emphasized the importance of addressing the technological and procedural challenges highlighted in the UTHealth study, stating, “If they don’t address the staffing and leadership required, then none of it will matter.”

The ongoing developments in Bexar County’s mental health services will be closely monitored as University Health fully integrates its capabilities by November 10, 2023, to ensure that the intended improvements in care and treatment are realized.