Joint Subcommittee to Study Mental Health Services in the 21st Century Adopts Final Recommendations for 2017

December 21, 2017

The Joint Subcommittee to Study Mental Health Services in the 21st Century met on December 19 to adopt recommendations for the upcoming General Assembly session. Although transportation of individuals experiencing mental health crises was the subject of most of the media coverage of the meeting, the Joint Subcommittee discussed a variety of issues. Below is a summary of the Joint Subcommittee’s recommendations:

Telemental health: Endorsed a request for funding to support the Appalachian Telemental Health Network Initiative, which will serve underserved populations in Southwest Virginia and will include four components: the development and maintenance of a provider directory; provision of workforce training for mental health providers; establishment of the Healthy Appalachia Institute, which will deploy the technology platform and develop a regional referral network of providers; and the expansion of Project ECHO, which links primary care providers with specialists via teleconferencing.

Temporary Detention Order (TDO) Admissions to Private and State Hospitals: Endorsed the creation of a work group to address the increase in TDO admissions to state hospitals, to include identification of barriers to private hospitals admitting more patients subject to TDOs and review of potential crisis care alternatives to inpatient treatment. Community Services Boards (CSBs) will be represented on the work group, along with other stakeholders.

Alternative Transportation for Individuals Subject to TDOs: Endorsed the recommendation of the Task Force created by the General Assembly in 2017 to examine alternative options to law enforcement officers transporting individuals in crisis. The Task Force endorsed a model in which the Department of Behavioral Health and Developmental Services would contract for this service, with an estimated annual cost of $10.2 million to implement the program statewide. Joint Subcommittee members discussed whether to endorse a more limited implementation (pilot projects in two regions of the state) in order to reduce the initial cost of the program before ultimately opting to support a statewide roll-out, with the understanding that a phased approach might be necessary due to budget constraints.

STEP-VA: Endorsed the implementation of STEP-VA, a standard menu of services that will be required to be offered in each CSB, in accordance with statute. The Governor’s budget includes funding to support the first two phases of STEP-VA: same-day access to screening at the 22 CSBs that did not receive funding in the previous biennium, and primary care screening in all 40 CSBs.

Permanent Supportive Housing: Endorsed efforts to expand access to permanent supportive housing for individuals with serious mental illness. The Governor’s budget provides $4.6 million over the biennium for this purpose.

Reduction of State Hospital Census and Financial Realignment of Public Behavioral Health System: Endorsed efforts to reduce the census at state hospitals; the Governor’s budget provides $6.9 million in Discharge Assistance Planning funds, which help transition individuals back to the community. The Joint Subcommittee also endorsed DBHDS’s development of a plan to direct state resources toward enhancement of community-based treatment options and away from reliance on state hospitals.

Options for Funding the Public Behavioral Health System: Endorsed in concept the exploration of funding options, including options available through the Affordable Care Act.

Options for Criminal Justice Diversion in Rural Communities: Supported funding to implement Crisis Intervention Team training for law enforcement in up to six rural communities, and funding for programs that divert individuals at later points in the criminal justice process.

Forensic Discharge Planning: Supported funding for creation of staff positions at CSBs to provide discharge planning in jails, beginning with the five jails with the highest percentage of inmates with mental illness.

Virginia Housing Trust Fund: Supported additional funding for the Virginia Housing Trust Fund as a complement to the proposed additional funding for permanent supportive housing included in the Governor’s budget.

VACo Contact: Katie Boyle

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