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Advisory Group on Jail Health Care Standards Begins Work

Work began earlier this week to implement a package of bills approved by the 2019 General Assembly to enhance the care provided to inmates in local and regional jails and to address challenges related to the sharing of inmates’ medical and mental health information between health care providers and jail staff. Two companion bills, HB 1918 (Stolle) and SB 1598 (Dunnavant), are recommendations of the Joint Commission on Health Care and require the Board of Corrections to establish minimum standards for health care services, including medical, dental, pharmaceutical, and behavioral health services, in local and regional jails. HB 1942 (Bell, Robert B.) is a recommendation of the Joint Subcommittee Studying Mental Health Services in the Commonwealth in the 21st Century (often referred to as the “Deeds Commission”) and requires the Board of Corrections to develop behavioral health care standards. The bill specifies certain elements that must be included in the standards, including requirements for screening and assessment, discharge planning, inspections, and payment mechanisms in situations where the Community Services Board provides services within the jail.

VACo supports the provision of appropriate care to individuals who are incarcerated in local or regional jails, but has maintained that state assistance will be essential in meeting any enhanced standards for care. According to a recent report by the Compensation Board, localities are currently providing the majority of funding for mental health care in jails, supplying an estimated 76 percent of funding for such care in FY 2017, while the state contributed only 6 percent. Meanwhile, jail per diem payments, one of the major avenues through which the state assists with costs for inmate care, have been frozen since FY 2011. HB 1942 was amended at VACo’s request to provide that the Board of Corrections would convene a workgroup to determine the cost of implementing the bill, and language in the 2019 Appropriations Act directs the Department of Criminal Justice Services, the Compensation Board, and the Board of Corrections to evaluate the resources needed for local and regional jails to comply with the new standards, to include considering how funding responsibilities should be allocated and how any state funding should be provided.

The advisory group held its first meeting on April 29. Staff from the Department of Behavioral Health and Developmental Services are leading the workgroup on behalf of the Board of Corrections, several members of which are also serving on the workgroup. Several sheriffs, regional jail administrators, representatives of Community Services Boards, representatives of local governments, and state agency staff are participating in the workgroup. It is expected that the group will work first to recommend behavioral health care standards and develop the associated cost estimates, followed by developing proposed medical, dental, and pharmaceutical standards. Recommendations are scheduled to be completed by November 1, 2019.

A set of recommended mental health care standards developed in a separate workgroup in 2018 is expected to form the basis for standards discussed by the new advisory group. These standards are available at this link and range from requirements that most, if not all, jails are likely already meeting (such as a requirement for jails to have a manual or other compilation of policies and procedures regarding mental health care services) to proposals that will likely require additional funding to implement successfully (such as the requirements for discharge planning). In addition to evaluating and refining the 2018 proposals, the advisory group will need to consider the incorporation of additional services; the 2018 proposals deal only with mental health care, while the 2019 legislation contemplates “behavioral health care,” which would include substance abuse treatment services as well.

VACo is participating on the advisory group and will be providing regular updates as the proposed standards are developed.

VACo Contact: Katie Boyle

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