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Behavioral Health Commission Adopts Workplan, Discusses Key Metrics for Monitoring Progress

The Behavioral Health Commission set its course for the remainder of 2023 at its meeting on May 16 in Charlottesville, building on a strategic planning session held at the end of April and reflecting referrals from the General Assembly, as well as projects undertaken by consensus of Commission members.  Based on the role the Commission expects to play in overall efforts to improve the behavioral health system, priority work for 2023 will involve mapping current initiatives underway among various entities and monitoring the progress of previously-approved initiatives, as well as undertaking two specific projects requested by the legislature.

  • Mapping of current behavioral health initiatives: Staff plans to report in November on work to document current efforts to improve the system, and expects that this task will be an ongoing element of the Commission’s mission.  The goal of this project is to gain an understanding of the totality of efforts underway so that the Commission can determine which initiatives most warrant support, as well as to identify gaps which could be filled.
  • Monitoring of program implementation: Staff also anticipates monitoring of program implementation to be an ongoing task.  An initial briefing is scheduled for September, followed by reports on STEP-VA, Project BRAVO (a redesign of the Medicaid-funded behavioral health services system), and permanent supportive housing (which provides behavioral and primary health care services in addition to stable housing for individuals with mental illness) in November.
  • Expedited diversion to court-ordered treatment: The Commission will receive a briefing in September on staff’s analysis of factors that may limit the effectiveness of a new diversion process that was proposed in legislation in 2023.  This legislation would have allowed a defendant who is charged with certain misdemeanor violations that appear to be associated with the defendant’s mental illness to be considered for transfer from the criminal justice system to a civil process for court-ordered mental health treatment.
  • Maximizing school-based mental health services: This study was directed by the 2022 Appropriation Act, and staff will report in October on findings.  Staff will determine the current reach of services, identify ways to provide services in school settings, and evaluate opportunities to maximize Medicaid funding.  Members encouraged staff to prioritize this work, expressing concerns about the increasingly alarming reports of depression and other mental health concerns among youth.
  • Reporting on behavioral health system metrics: Staff provided updates on several aspects of the behavioral health system, which are proposed to be subjects of ongoing monitoring, and members suggested additional data points to be captured or ways to further refine the data.  Staff’s initial set of metrics included the number of staffed beds at state hospitals, occupancy rates for state hospitals, numbers of individuals on the wait list for civil admission, the number of Temporary Detention Orders executed year-to-date, and numbers of patients on the state hospitals’ Extraordinary Barriers to Discharge List (who are clinically ready for discharge but are delayed in returning to the community, often due to a lack of an appropriate placement), as well as “loss of custody events” in which, for example, an individual was released when no bed could be located before expiration of the TDO.  Commission members and staff discussed tracking several data points in additional detail, such as displaying staffed bed numbers for each hospital, to allow a more detailed analysis of regional and other variations in the behavioral health system.

The meeting slides, which contain the proposed workplan and initial set of metrics for tracking, are available at this link.  The Commission’s next meeting is scheduled for July 18.

VACo Contact:  Katie Boyle

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