Bexar County has officially transitioned the responsibility for jail intake mental health and substance use screenings from the Center for Health Care Services (CHCS) to University Health. This change ends a six-year contract with CHCS and marks the first time since the Justice Intake and Assessment Annex (JIAA) opened in late 2018 that both medical and behavioral health assessments will be managed by a single provider.
Previously, CHCS conducted mental health screenings while University Health oversaw medical intake within the facility. Once detainees were admitted to the jail, University Health took charge of both medical and behavioral health treatment. The shift to University Health took effect on October 1, 2023, following a recommendation from Bexar County’s Office of Criminal Justice.
In October 2023, Bexar County commissioned a study by the University of Texas Health Science Center at Houston to evaluate the efficiency of the JIAA in processing detainees and directing individuals with behavioral health or substance use needs into appropriate treatment programs. The study, led by Dr. Alexander Testa, revealed issues including fragmented communication and overlapping responsibilities among various agencies operating within the annex.
Dr. Testa’s team recommended consolidating the screening and treatment processes under one provider or establishing a coordinated system that would integrate behavioral health assessments into the existing medical intake already conducted by University Health. The findings prompted Bexar County’s Department of Public Health to explore options to enhance the county’s diversion efforts.
Dr. Andrea Guerrero, Director of Bexar County Public Health, explained the rationale behind the decision: “University Health provides the physical services in the JIAA, but they also are the mental health providers once someone moves over to the jail. The logical conclusion was that University Health would be better suited to provide both functions.”
The proposal to change providers was initiated in August 2023 and received approval for the 2026 fiscal year budget on September 9, 2023. University Health President and CEO Edward Banos described the transition as a significant opportunity for improving continuity of care. He stated, “This is an opportunity where we see a better continuity of care in the sense that we’re going to do these assessments on intake, and if they do need required psychiatric services, they’ll either get that provided by us in the jail or go to another appropriate facility.”
Despite the planned transition, the change came as a surprise to CHCS. Jelynne LeBlanc Jamison, President and CEO of CHCS, noted the organization was unaware that a change in provider was under consideration. “We were notified the day before the county went to Commissioners Court to recommend that they contract with University Health for JIAA assessment services,” she said.
While CHCS had conducted mental health screenings at the annex for years, Jamison acknowledged the need for improvements within the current system. “There’s no systemic process, there’s no obvious step one or step two,” she said, referring to the challenges highlighted in the study. Following the announcement of the contract change, CHCS managed to review the report and invited Dr. Testa to present his findings to their board.
As of September 30, 2023, CHCS concluded its role in the annex. Most of its staff were reassigned to other programs, while University Health began conducting screenings the following day. Banos reported that the transition was abrupt, with no transitional period established. “But Dr. Guerrero and her staff at the county really helped,” he added, recognizing their commitment to ensuring staff were adequately trained.
University Health is expected to fully take over staffing responsibilities by November 10, 2023. Guerrero emphasized that the decision to consolidate screenings was discussed with both agencies before the budget approval. “We informed CHCS prior to the first court date where we made the first presentation in August,” she noted.
While CHCS remains an essential partner in the county’s behavioral health network, its role in mental health assessments at the JIAA has shifted to University Health to streamline processes and enhance diversion capabilities. Jamison stated that CHCS will continue to focus on other mental health programs, including jail-based competency restoration initiatives and assisted outpatient treatment.
Looking forward, Jamison expressed hope for ongoing community discussions regarding the need for a diversion center and a psychiatric hospital for Bexar County. “I’ve had optimistic conversations about the need for a diversion center and support for prioritizing a psychiatric hospital,” she said.
As the transition unfolds, it remains to be seen whether the consolidation will effectively address the structural issues identified in the UTHealth study. Jamison voiced her concerns, stating that without improvements in technology, staffing, and leadership, the intended benefits of the transition may not materialize.
