The Joint Commission on Health Care held its first meeting of 2025 on Wednesday, May 21, adopting a revised work plan for the remainder of the year and receiving an update from its staff on a previously-directed study of the fentanyl crisis in Virginia, as well as an update from Department of Behavioral Health and Developmental Services Commissioner Nelson Smith on the planned closure of Hiram Davis Medical Center.
The Commission had previously directed its staff to undertake three studies in 2025:
- Policy Solutions to the Commonwealth’s Fentanyl Crisis: This study will analyze fentanyl prevalence and fentanyl overdoses in the Commonwealth, to include an examination of fentanyl use in the context of other addiction trends in recent history. Staff are charged with determining which prevention, intervention, and treatment strategies implemented in Virginia are succeeding, and developing recommendations to reduce the prevalence of fentanyl and the number of fentanyl overdoses in the Commonwealth.
- Access to pharmacy services in Virginia: This study is required to identify areas in Virginia that constitute pharmacy deserts, determine factors that affect access to pharmacy services, and develop policy options to improve such access. This study will also incorporate concepts from unsuccessful 2025 legislation that sought to address this issue; the bill would have created a program to provide financial assistance to independent pharmacies in rural and medically- underserved areas.
- Transportation-related barriers to health care: This study will analyze transportation barriers to health care in Virginia, the factors that contribute to such barriers, and the populations most affected, and will also include identification and evaluation of existing interventions and programs that address such barriers, and recommendations for strategies that Virginia could implement.
At its May 21 meeting, the Commission approved the addition of two narrowly-scoped studies to staff’s 2025 workplan, based on areas of interest previously discussed by the Commission and 2025 legislation that was referred to the Commission for consideration. In addition to the three studies discussed above, staff will undertake a study of the potential implementation of a Medicaid-funded food and nutrition benefit in Virginia, as well as a study of potential strategies for legislative oversight of Medicaid program spending (to include approaches adopted in other states).
Commission staff provided an interim briefing on the study of policy solutions to the fentanyl crisis, outlining key research questions and methods and providing a brief history of fentanyl overdose deaths relative to overdose deaths caused by other opioids in recent years, noting that fentanyl overdose deaths dropped significantly in the last two years after a sharp increase during the COVID-19 pandemic, appearing to return to pre-pandemic levels. Staff have identified numerous evidence-based strategies being implemented to reduce fentanyl overdose deaths; staff analysis is focusing on strategies that promote prevention, intervention, treatment, and recovery, with a particular interest in how successful strategies can be sustained over time. A full briefing will be provided at the Commission’s September meeting. Written public comment on the study may be submitted prior to close of business on Friday, May 30; comments may be provided via email (jchcpubliccomments@jchc.virginia.gov) or U.S. Mail (411 E. Franklin Street, Suite 505, Richmond, VA 23219).
Statutes outlining the Commission’s authority require its involvement in any planning process for the proposed closure of a state hospital. As previously reported, the Department of Behavioral Health and Developmental Services is planning to close Hiram Davis Medical Center by the end of 2027. This facility has not undergone any substantial renovations in the 50 years since it was opened and has HVAC and electrical systems, as well as elevators, at the end of their useful lives; major repairs would require staff and patients to be displaced for up to 24 months. In accordance with Code requirements, a State and Community Planning and Consensus Team has been convened, which will be providing a plan to ensure continuity of care as alternative placements are developed for current patients. This plan is required to be provided to the Governor, the Commission, and the “money committees” by November 1. The Department is anticipating that the 30 patients being served at the hospital as of July 2025 will opt for placements in group homes, nursing facilities, intermediate care facilities, or homes on the campus of the Southeastern Virginia Training Center, which would offer skilled nursing care. Discussions in the State and Community Planning and Consensus Team have focused on supporting patients in this transition, to include developing or enhancing community services, and assisting staff, ideally in finding other positions within the Department.
The Commission also received a briefing from Mike Tweedy, Senior Legislative Fiscal Analyst at the Senate Finance and Appropriations Committee, on key health and human resources items in the recently-signed 2025 Appropriation Act.
The Commission’s next meeting is scheduled for June 18.
VACo Contact: Katie Boyle