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Commonwealth's Counties

Legislation requiring Community Services Boards to provide mental health and substance abuse services in jails fails to move forward; discussions expected to continue

HB 1487 (Stolle) and SB 878 (Dunnavant) would have required local Community Services Boards (CSBs) to provide mental health and substance abuse services for individuals incarcerated in local and regional jails (HB 1487 was amended to provide that the CSB would deliver these services upon the request of the sheriff or regional jail superintendent).  The bills also provided that previously incarcerated individuals could continue to receive services from the CSB that delivered services in the jail or from the CSB serving the locality in which the individuals reside after being released.  The bills would have directed the Board of Corrections to establish standards for the provision of mental health services in local and regional correctional facilities, to include the requirement that each sheriff enter into an agreement with the local CSB and that each regional jail superintendent enter into an agreement with each CSB serving the localities participating in the regional jail (SB 878 was amended to preserve the option for sheriffs or jail superintendents to contract with private providers for the services).  The bills provided that the CSB would bill the local or regional jail for its services.

HB 1487 was left in the House Appropriations Committee after a subcommittee recommended that the bill be continued to 2019.  SB 878 was tabled in the same subcommittee.  Provisions requiring the development of standards for the provision of mental health care in local correctional facilities, to include substance abuse services, were later added to a separate bill dealing with the provision of medical or mental health care for inmates who are unable to consent to treatment, but that legislation failed to emerge from a conference committee before adjournment of the session.

VACo had expressed concerns during the session about HB 1487 and SB 878 and how state funding would support the provision of services that the legislation would mandate, or whether the services would be expected to be funded from existing state allocations, with additional costs to be absorbed by the localities.  The Department of Planning and Budget noted in its Fiscal Impact Statement for HB 1487, “Because of the varying ways in which mental health treatment is currently provided in jails, it is unknown if the amount currently spent by local and regional jails will offset the cost of CSBs providing the services, particularly if transportation costs must be figured in.”

Although the legislation was not enacted this year, the issue will continue to be a topic of discussion.  The topic of health care in correctional facilities is under review by the Joint Commission on Health Care, and the Joint Subcommittee to Study Mental Health Services in the 21st Century is also examining the appropriate structure and financing of the CSB system.

VACo recognizes the need to provide health care, including mental health care, to inmates in a cost-effective manner, and worked during the session with a coalition of stakeholders on a package of budget amendments that would assist with connecting individuals to services in the community when they are discharged from jails.  The budget amendments would provide the infrastructure needed to streamline inmates’ enrollment in Medicaid so that their inpatient hospitalization could be covered during their time in jail and so that eligible inmates could be immediately enrolled in Medicaid upon release – a particularly important element in the reentry process for inmates with serious mental illness who may be eligible for the GAP program (which provides a limited package of Medicaid benefits for individuals with serious mental illness who would otherwise not qualify for the full Medicaid program).  These amendments were incorporated into the House budget during the session, and VACo will advocate for their inclusion in any final budget agreement.

VACo Contact: Katie Boyle



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