Rusk State Hospital for the mentally ill was opened in 1919 by the conversion of the Rusk Penitentiary building into a hospital for the care of the "Negro insane." During the first year of operation, some of the old penitentiary buildings were renovated, reconstructed, and converted into wards and hospital buildings, and 600 patients were admitted. Early in its history the institution included a general hospital for the care of the acutely sick, an infirmary for aged and decrepit cases, a tubercular hospital for the care of White men and women, and a tubercular hospital for Black men and women. A chapel and recreational hall were later added. The institution operated its own garden, farms, hog ranch, and poultry farm, which supplied much of its needs. With a capacity of 2,426, the Rusk Hospital had an enrollment in 1946 of 2,308 patients. The average daily census of patients at Rusk State Hospital in 1964 was 1,942; by 1967, 1,886 patients were housed there, and a maximum-security unit for the criminally insane was a part of the facility. In 1970 Rusk State Hospital received accreditation by the Joint Commission on Hospital Accreditation and approval to receive Medicare and Medicaid benefits from the United States Department of Health, Education, and Welfare. More and better-trained professional workers were added, and a student practicum program was instituted with Stephen F. Austin State University and North Texas State University. In 1970 the hospital served thirty counties in the East Texas-Gulf Coast area through eight units. The average daily census for 1970 was 1,796. Since 1972–73, when the hospital had a population of 1,950 patients, different methods of treating the mentally ill, which emphasize outpatient programs and deinstitutionalization, have resulted in reduced populations. In 1982–83 the hospital had 952 patients; in 1992, only 442. See also TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION.