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

December 20, 2016

The Joint Subcommittee to Study Mental Health Services in the 21st Century met on December 6, along with two of its workgroups, to adopt its package of recommendations for the upcoming General Assembly session.  The Joint Subcommittee voted to put forward 12 legislative and budget requests for the 2017 session, and discussed longer-term areas for study, including a mechanism for continuing the Joint Subcommittee’s work after its current legislative mandate expires on December 1, 2017.  

The following proposals were included in the package of requests for 2017:

  • Requiring Community Services Boards (CSBs) to provide same-day mental health screening and outpatient primary care screening and monitoring services by 2018, and phasing in a suite of additional required services by 2021, including crisis services for individuals with mental health or substance use disorders, psychiatric rehabilitation, and peer support services.  Commission members expect to request funding for the top two priorities (same-day access and outpatient primary care screening) in the upcoming session and develop a plan for funding the remaining services in the next several years.  The Governor’s budget, released on December 16, also makes same-day access a priority and includes $8.2 million in FY 2018 to provide this service in 25 of the 40 CSBs.
  • Allowing information sharing between the judicial system and the Department of Behavioral Health and Developmental Services (DBHDS) regarding involuntary admission proceedings.
  • Requesting DBHDS and the Department of Medical Assistance Services (DMAS) to study the existing Involuntary Mental Commitment Fund to improve its use, including its potential use for voluntary inpatient treatment.
  • Directing the Joint Commission on Health Care to study options for increasing the use of telemedicine for mental health services.
  • Requiring that all persons admitted to local jails be screened for mental illness using a standardized assessment tool.  Individuals who appear to have a mental illness would be assessed by a qualified mental health professional within 72 hours of the initial screening.  The Governor’s budget includes $4.2 million to provide grants to local and regional jails for costs associated with mental health screening in these facilities.
  • Requiring the Commissioner of Behavioral Health and Developmental Services to develop a plan to provide discharge planning services for persons to be released from local and regional jails.
  • Providing the Board of Corrections with the authority to review deaths in local jails. The Governor announced on December 14 that legislation providing such authority will be introduced at his request this session.
  • Clarifying the ability of physicians to prescribe controlled substances via telemedicine.
  • Directing the development of an alternative model for the provision of transportation for individuals subject to an emergency custody or involuntary admission order that would not require transportation by law enforcement.
  • Requesting an appropriation of $10 million for permanent supportive housing for individuals with serious mental illness; funding would be targeted to rental subsidies and supportive services for the most frequent users of high-cost treatment, such as inpatient treatment in state psychiatric hospitals.
  • Requiring the Department of Housing and Community Development, in consultation with stakeholders, to develop and implement strategies for housing individuals with serious mental illness.
  • Requiring DMAS to research and recommend strategies to obtain Medicaid reimbursement for services included in permanent supportive housing.
  • An additional item of discussion — requiring that 20 percent of the Housing Trust Fund be spent on temporary rental assistance, permanent supportive housing, and foreclosure counseling — will be discussed further at a future meeting before the Joint Subcommittee makes a final recommendation.

As part of the subcommittee’s discussion of future areas of study, the Joint Subcommittee’s chairman, Senator Deeds, expressed a desire to examine the overall structure of service delivery in the state, describing the existing CSB system as a “loose confederation” with services that vary among regions depending upon localities’ ability to provide financial support.  Members discussed ways to ensure that the work of the subcommittee continued beyond its scheduled final report, with Senator Deeds advocating for oversight of mental health to be housed at the Joint Commission on Health Care and other members advocating for a temporary extension of the Joint Subcommittee or for its establishment as a standing body, similar to other existing commissions.  House Appropriations Chairman Chris Jones, who was in attendance at the meeting, addressed the Joint Subcommittee and suggested that a two-year extension of the Joint Subcommittee’s work would likely be acted upon favorably by the General Assembly.    

VACo Contact: Katie Boyle

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