Official overseeing state psychiatric hospitals resigns

The associate commissioner in charge of operations and planning for Texas' 10 publicly funded psychiatric hospitals resigned to avoid being fired last month, state records show.

Tim Bray oversaw state mental hospital operations from September 2016 through last month. During that time, the waitlist for beds grew more than 550 percent, from 354 in September 2016 to 2,309 in March, according to a Hearst Newspapers analysis of state data.

According to a letter attached to Bray's personnel file obtained by Hearstthrough a records request, he decided to resign “in lieu of termination.”

It's not clear what prompted the threat of termination from the Texas Health and Human Services Commission. The agency that oversees the state's mental hospitals wrote in a statement that it generally does not comment on personnel matters.

Bray couldn't be reached for comment.

Performance evaluations included in Bray's personnel file described him as an effective leader who was involved in the legislative process, developed a culture of “quality and systemic improvement” at state hospitals and assisted in efforts to renovate the state's psychiatric facilities. The evaluations also praised him for his handling of the COVID-19 pandemic.

But he also was cited in some years for failing to meet deadlines and promote teamwork, as well as being nonresponsive to critical items.

The burgeoning waitlist for psychiatric beds was not mentioned in his evaluations except to say that the goal for the coming year in his 2019-20 evaluation was to “continue gains achieved prior to COVID in waiting list management.”

Last year, a Hearst investigation revealed that the state's mental health system has suffered for years from underfunding and insufficient oversight. The investigation found that the state doesn't have enough hospital beds to serve its growing population, with waitlists that stretch for up to a year. Without a place to go for help, many Texans find themselves in private psychiatric hospitals with numerous safety violations or cycling through the criminal justice system.

The Legislature has been working to add more beds to the strained system. In a 2017 comprehensive plan, the Health and

Human Services Commission — at the direction of the Legislature — proposed numerous projects to expand the number of beds at state-funded psychiatric hospitals. Last year, state lawmakers pumped nearly $400 million into those projects, though there is still a long way to go in funding all 656 beds outlined in the plan.

Bray — who got his law degree in 2001 from Northeastern University in Boston — joined the Department of State Health Services in 2012 as its deputy general counsel after spending four years in the Texas Attorney General's Office.

Before getting his law degree, Bray earned a master's in counseling psychology from the University of New Hampshire and worked as an emergency clinician at a mental health center in that state, providing emergency mental health evaluations and crisis stabilization services.

In his personnel file, Bray states that he left that job because “the frequent interactions with courts on mental health matters persuaded me to pursue law school.”

In September 2016, he became the director of state hospitals for the Department of State Health Services. That position was transferred to the Health and Human Services Commission a year later and, at that time, he was named associate commissioner of state hospitals.

In his first year overseeing state hospitals, Bray was praised for setting “high expectations on the hospital leadership for care and treatment of the people served,” his 2016-17 evaluation stated.

It continued that Bray “problem(sic) solves effectively and works to find the best outcome for the patients involved.”

But Bray was dinged in his 2017-19 performance evaluation for failing to ensure that leadership at Texas' 13 State Supported Living Centers — which provide campus-based services to intellectually and developmentally disabled individuals — was engaged in the implementation of a bill signed by the governor in 2019. That legislation allowed HHSC clinicians to determine the best location for competency restoration for a defendant charged with a violent crime. Before the bill, those defendants were sent straight to one of two maximum security psychiatric units in the state regardless of whether that level of security was necessary.

Bray also was cited for failing to ensure State Supported Living Center leadership was participating in competency training.

“Relationships with state office are strained and often (sic) request(s) are missed,” the evaluation stated

He also did not meet teamwork expectations between the state hospital section, the division and the agency.

“At times the division is unresponsive or misses important deadlines,” the review stated. “Tim needs to be proactive to ensure effective working relationships with division office and other agency leadership. The division has skills and talent to develop innovative ideas, but needs to develop productivity and timeliness expectations.”

The following year, it appeared that those issues were resolved, and the 2019-20 evaluation stated that Bray had “made significant improvements since last evaluation” and had been effective in maintaining costs as well as helped develop the agency's business plan.

The 2019-20 performance evaluation was the most recent conducted, according to the Health and Human Services Commission.

At the time of his resignation, which was accepted March 22 and effective April 8, Bray was making $188,000 per year.

The commission already has begun searching for his replacement. Applications for his position have closed.

Bray