State Hospitals | Texas Health and Human Services
Archived: 2026-04-23 16:46
State Hospitals | Texas Health and Human Services
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State Hospitals
State hospital facilities are Medicare-certified and Medicaid-approved, and are accredited by the Joint Commission.
Submit a complaint on the Joint Commission website.
If you or a loved one is having a mental health crisis, call 911 immediately.
HHS operates nine state hospitals and one residential youth center for people with mental health issues. Facilities are located across the state, and each one serves a different population that may include:
Adults.
Children.
People involved with the justice system.
Admissions
If you are seeking admission to a state hospital or want to discuss whether inpatient hospitalization is appropriate, contact your
local mental health or behavioral health authority.
Role of the LMHA, LBHA
The appropriate local mental health authority (LMHA) or local behavioral health authority (LBHA) screens patients seeking admission to a state hospital to determine the least restrictive place for treatment. This includes private providers.
The LMHA or LBHA gives important facts to the facility, including patient identifying information, legal status, medical and medication information, behavioral data, and other treatment information.
If a person seeks admission to a state hospital without being screened by an LMHA, the hospital conducts an emergency medical screening as part of the Emergency Medical Treatment and Active Labor Act, and consults with the LMHA.
The Emergency Medical Treatment and Active Labor Act is a federal law that requires hospital emergency departments to medically screen every patient who seeks emergency care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay.
The admitting physician has the final authority on admitting a person to a state hospital, and admission is consistent with resources available at the hospital. All patients sent to the facility through court commitments are evaluated for admission.
In general, to be involuntarily admitted, you must show symptoms of mental illness and signs that you are a danger to yourself or others.
No person is denied voluntary admission without thorough documentation and an appropriate referral, as recommended by the screening physician.
What to Expect During the Admissions Process
Almost all hospital admission departments are open 24/7. Admitting procedures include conducting a psychiatric evaluation and nursing assessment, creating a patient record, and creating a photo ID for the patient’s medical record.
Patients are given a booklet, Your Rights in Facilities, and the Admitting Rights Packet
.
Any money and belongings with the patients are recorded and put on file.
Note: Families should take home any valuables and other items the patient doesn’t need during hospitalization. Valuables kept at the facility are at the patients’ and families’ own risk.
Patients should bring no more than five changes of clothing. Bring comfortable items such as sports shoes, loose-fitting clothing that is easy to wash, and comfortable sleeping clothes.
Admission staff search incoming patients and their personal property to make sure all personal items that could be dangerous to the patient or others are removed and held for safekeeping.
How Forensic Admissions Work
If a judge rules that a defendant is incompetent to stand trial:
The judge issues an order for inpatient competency restoration.
The court mails a copy of the commitment order to the state hospital system’s forensic mailbox to add the person to the waitlist for admission to a state hospital.
Patients who need to stay in a maximum-security unit because of the level of the charged offense will be admitted to Kerrville State Hospital, Rusk State Hospital, Vernon State Hospital, or Wichita Falls State Hospital.
All other patients are admitted to one of the other seven state hospitals across Texas, as determined by the county of commitment.
Patients are admitted in the order that their commitment is received.
Email the state hospital system
with questions about the forensic process.
Assessing Patients
The physician assigned to admission duty provides an admission psychiatric evaluation, physical assessment and admitting orders.
Assessments are sensitive and appropriate. Patients go through a physical exam within the first 24 hours of admission to the appropriate treatment program. Other admission procedures include tuberculosis skin testing, appropriate lab tests, and other diagnostics.
Admitted patients receive a dental screening and must provide their past medical history. Staff consider the need for any special precautions, and complete a psychiatric evaluation, nursing assessment, rehabilitation assessment, and social history.
With the patient's permission, a treatment team representative, usually the social worker, initiates contact with the patient's family or significant others. Patients are encouraged to include family members or significant others in their treatment, as appropriate.
State Hospitals Fee Assessment
Charges to an individual served at a state hospital will not exceed the facility’s current daily maximum rate. The Health and Human Services Commission sets the current maximum rate, which reflects the average daily cost of support, maintenance and treatment.
FY 2026 Current Maximum Daily Charge Rate for State Hospital Patients
Facility
Adult Inpatient Services
Child and Adolescent Services
Geriatric Services
Residential Services
Austin
$917
$1,232
$781
NA
Big Spring
$1,036
NA
NA
NA
El Paso
$946
NA
NA
NA
Kerrville
$722
NA
NA
NA
Rio Grande
$1,004
NA
NA
NA
Rusk
$886
NA
$1,088
$446
San Antonio
$921
NA
$1,003
$609
Terrell
$792
$876
$814
NA
Vernon
$773
$1,155
NA
NA
Waco
NA
$841
NA
NA
Wichita Falls
$773
$1,155
$963
NA
Assessing Fees for Minor Patients
The following sources of funds are property from which the state may be reimbursed for a minor patient's support and treatment, and are considered separately in assessing a fee:
Third-party coverage.
Benefits from governmental or non-governmental agencies and institutions.
Child support ordered in a divorce or attorney general proceeding, or a suit affecting the parent-child relationship pursuant to Texas Health and Safety Code sections 552.014 and 593.077.
Real or personal property in the minor patient's guardianship estate or owned by the minor patient.
The net taxable income of the minor patient's parent, in accordance with the
Taxable Income of Parents (PDF)
formula.
Assessing Fees for Adult Patients
The following sources of funds are considered separately in assessing a fee for an adult patient:
Third-party coverage.
Benefits from governmental or non-governmental agencies and institutions.
Real or personal property in the adult patient's guardianship estate or owned by the patient’s spouse.
Monthly gross income (excluding benefits income from governmental or non-governmental agencies and institutions), and income of the spouse, in accordance with the
Adult Individuals in Inpatient Mental Health Facilities (PDF)
formula.
Appealing charges
A patient or legally authorized representative who has provided complete financial information and disagrees with any fees assessed by HHSC can make an appeal.
A patient or representative must contact the reimbursement office of the facility where the patient received services before making an appeal. Reimbursement staff will determine if HHSC received complete financial information and notify the person or representative of the determination.
HHSC recommends that patients or their representatives receive the determination before starting an appeal.
To start an appeal, the individual or representative must complete and submit the
Request for Appeal form (PDF)
to the HHSC Appeals Division. If you’re unable to access the form, contact the facility providing services and request to speak with the Reimbursement Office.
For more information on charges for services in state facilities, read Texas Administrative Code, Title 26, Chapter 910.
Tobacco-Free Facilities
All tobacco products are banned on state hospital property. This includes cigarettes, electronic cigarettes, cigars, snuff and chewing tobacco. Lighters and matches are also banned.
Access to Tobacco
Employees are prohibited from sharing any tobacco products with patients. Employees, volunteers, visitors, vendors, contractors or anyone on the campus who uses tobacco products must make sure patients cannot access or are not offered tobacco. All visitors must store tobacco products and lighters securely out of sight, including tobacco products left in private vehicles parked on hospital property.
Cessation Aids
We permit nicotine patches, nicotine gum, nicotine nasal spray or similar aids designed to help people quit using tobacco. The patient’s doctor, in coordination with the treatment team, will order cessation aids as required. Patients must have a doctor’s order to use them while in treatment. Employees may not share tobacco cessation aids with patients.
Behavioral Health Support in the Community
Behavioral Health Treatment for Mothers
Statewide Behavioral Health Coordinating Council
Stigma and Mental Health
Skip to main content
English
Español
State Hospitals
State hospital facilities are Medicare-certified and Medicaid-approved, and are accredited by the Joint Commission.
Submit a complaint on the Joint Commission website.
If you or a loved one is having a mental health crisis, call 911 immediately.
HHS operates nine state hospitals and one residential youth center for people with mental health issues. Facilities are located across the state, and each one serves a different population that may include:
Adults.
Children.
People involved with the justice system.
Admissions
If you are seeking admission to a state hospital or want to discuss whether inpatient hospitalization is appropriate, contact your
local mental health or behavioral health authority.
Role of the LMHA, LBHA
The appropriate local mental health authority (LMHA) or local behavioral health authority (LBHA) screens patients seeking admission to a state hospital to determine the least restrictive place for treatment. This includes private providers.
The LMHA or LBHA gives important facts to the facility, including patient identifying information, legal status, medical and medication information, behavioral data, and other treatment information.
If a person seeks admission to a state hospital without being screened by an LMHA, the hospital conducts an emergency medical screening as part of the Emergency Medical Treatment and Active Labor Act, and consults with the LMHA.
The Emergency Medical Treatment and Active Labor Act is a federal law that requires hospital emergency departments to medically screen every patient who seeks emergency care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay.
The admitting physician has the final authority on admitting a person to a state hospital, and admission is consistent with resources available at the hospital. All patients sent to the facility through court commitments are evaluated for admission.
In general, to be involuntarily admitted, you must show symptoms of mental illness and signs that you are a danger to yourself or others.
No person is denied voluntary admission without thorough documentation and an appropriate referral, as recommended by the screening physician.
What to Expect During the Admissions Process
Almost all hospital admission departments are open 24/7. Admitting procedures include conducting a psychiatric evaluation and nursing assessment, creating a patient record, and creating a photo ID for the patient’s medical record.
Patients are given a booklet, Your Rights in Facilities, and the Admitting Rights Packet
.
Any money and belongings with the patients are recorded and put on file.
Note: Families should take home any valuables and other items the patient doesn’t need during hospitalization. Valuables kept at the facility are at the patients’ and families’ own risk.
Patients should bring no more than five changes of clothing. Bring comfortable items such as sports shoes, loose-fitting clothing that is easy to wash, and comfortable sleeping clothes.
Admission staff search incoming patients and their personal property to make sure all personal items that could be dangerous to the patient or others are removed and held for safekeeping.
How Forensic Admissions Work
If a judge rules that a defendant is incompetent to stand trial:
The judge issues an order for inpatient competency restoration.
The court mails a copy of the commitment order to the state hospital system’s forensic mailbox to add the person to the waitlist for admission to a state hospital.
Patients who need to stay in a maximum-security unit because of the level of the charged offense will be admitted to Kerrville State Hospital, Rusk State Hospital, Vernon State Hospital, or Wichita Falls State Hospital.
All other patients are admitted to one of the other seven state hospitals across Texas, as determined by the county of commitment.
Patients are admitted in the order that their commitment is received.
Email the state hospital system
with questions about the forensic process.
Assessing Patients
The physician assigned to admission duty provides an admission psychiatric evaluation, physical assessment and admitting orders.
Assessments are sensitive and appropriate. Patients go through a physical exam within the first 24 hours of admission to the appropriate treatment program. Other admission procedures include tuberculosis skin testing, appropriate lab tests, and other diagnostics.
Admitted patients receive a dental screening and must provide their past medical history. Staff consider the need for any special precautions, and complete a psychiatric evaluation, nursing assessment, rehabilitation assessment, and social history.
With the patient's permission, a treatment team representative, usually the social worker, initiates contact with the patient's family or significant others. Patients are encouraged to include family members or significant others in their treatment, as appropriate.
State Hospitals Fee Assessment
Charges to an individual served at a state hospital will not exceed the facility’s current daily maximum rate. The Health and Human Services Commission sets the current maximum rate, which reflects the average daily cost of support, maintenance and treatment.
FY 2026 Current Maximum Daily Charge Rate for State Hospital Patients
Facility
Adult Inpatient Services
Child and Adolescent Services
Geriatric Services
Residential Services
Austin
$917
$1,232
$781
NA
Big Spring
$1,036
NA
NA
NA
El Paso
$946
NA
NA
NA
Kerrville
$722
NA
NA
NA
Rio Grande
$1,004
NA
NA
NA
Rusk
$886
NA
$1,088
$446
San Antonio
$921
NA
$1,003
$609
Terrell
$792
$876
$814
NA
Vernon
$773
$1,155
NA
NA
Waco
NA
$841
NA
NA
Wichita Falls
$773
$1,155
$963
NA
Assessing Fees for Minor Patients
The following sources of funds are property from which the state may be reimbursed for a minor patient's support and treatment, and are considered separately in assessing a fee:
Third-party coverage.
Benefits from governmental or non-governmental agencies and institutions.
Child support ordered in a divorce or attorney general proceeding, or a suit affecting the parent-child relationship pursuant to Texas Health and Safety Code sections 552.014 and 593.077.
Real or personal property in the minor patient's guardianship estate or owned by the minor patient.
The net taxable income of the minor patient's parent, in accordance with the
Taxable Income of Parents (PDF)
formula.
Assessing Fees for Adult Patients
The following sources of funds are considered separately in assessing a fee for an adult patient:
Third-party coverage.
Benefits from governmental or non-governmental agencies and institutions.
Real or personal property in the adult patient's guardianship estate or owned by the patient’s spouse.
Monthly gross income (excluding benefits income from governmental or non-governmental agencies and institutions), and income of the spouse, in accordance with the
Adult Individuals in Inpatient Mental Health Facilities (PDF)
formula.
Appealing charges
A patient or legally authorized representative who has provided complete financial information and disagrees with any fees assessed by HHSC can make an appeal.
A patient or representative must contact the reimbursement office of the facility where the patient received services before making an appeal. Reimbursement staff will determine if HHSC received complete financial information and notify the person or representative of the determination.
HHSC recommends that patients or their representatives receive the determination before starting an appeal.
To start an appeal, the individual or representative must complete and submit the
Request for Appeal form (PDF)
to the HHSC Appeals Division. If you’re unable to access the form, contact the facility providing services and request to speak with the Reimbursement Office.
For more information on charges for services in state facilities, read Texas Administrative Code, Title 26, Chapter 910.
Tobacco-Free Facilities
All tobacco products are banned on state hospital property. This includes cigarettes, electronic cigarettes, cigars, snuff and chewing tobacco. Lighters and matches are also banned.
Access to Tobacco
Employees are prohibited from sharing any tobacco products with patients. Employees, volunteers, visitors, vendors, contractors or anyone on the campus who uses tobacco products must make sure patients cannot access or are not offered tobacco. All visitors must store tobacco products and lighters securely out of sight, including tobacco products left in private vehicles parked on hospital property.
Cessation Aids
We permit nicotine patches, nicotine gum, nicotine nasal spray or similar aids designed to help people quit using tobacco. The patient’s doctor, in coordination with the treatment team, will order cessation aids as required. Patients must have a doctor’s order to use them while in treatment. Employees may not share tobacco cessation aids with patients.
Behavioral Health Support in the Community
Behavioral Health Treatment for Mothers
Statewide Behavioral Health Coordinating Council
Stigma and Mental Health