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Behavioral Health Commission Discusses Key System Metrics, Budget Investments, and School-Based Behavioral Health Pilot Programs

Behavioral Health Commission members took stock of several aspects of the state’s behavioral health system at the Commission’s September 19 meeting, including updates to a set of data points previously designated by the Commission as key indicators for the crisis system; a new dashboard developed by the Department of Behavioral Health and Developmental Services (DBHDS) to track progress toward the Department’s goals; funding included in the recently-enacted state budget revisions; and the implementation of pilot school-based mental health programs in several school divisions.

Staff reported that 107 beds in the state hospital system have been reopened over the last year, with 104 remaining to be reopened to reach the state’s full capacity of licensed beds.  Six of the nine state hospitals are still operating at or above 100 percent capacity, and forensic patients continue to make up the majority of overall state facility patients, with particular concentrations in certain hospitals, notably Eastern State Hospital, where 95 percent of patients are forensic patients.  The wait list for civil admissions has remained at 40 patients or fewer since the fall of 2022, but the average wait time as of the end of FY 2023 is 45 hours.  Staff also presented information on loss of custody events (in which, for example, a patient is released because a TDO expires before a bed can be located), and incidents in which law enforcement drops a patient off at a state hospital outside of the formal process for admitting patients from the wait list.

Commission staff reported on the passage of several bills during the 2023 session that were introduced by Commission members, and Mike Tweedy, Senior Legislative Fiscal Analyst for the Senate Finance and Appropriations Committee, briefed members on the behavioral health-related items in the budget revisions that were enacted earlier this month.  Major spending items included $58 million for crisis receiving centers and crisis stabilization units; $30 million for permanent supportive housing; $18 million in additional compensation for Community Services Board (CSB) staff; $10 million for mobile crisis teams; $7.5 million to expand school-based mental health pilot programs; and $5.1 million to support overtime costs or additional funding for off-duty law enforcement officers maintaining custody or transporting individuals under temporary detention orders, among other provisions.  Members involved in budget negotiations explained that several items introduced by Commission members (including a series of language amendments implementing recommendations from the Joint Legislative Audit and Review Commission’s December 2022 study of CSBs) enjoyed broad support but were not included due to the short timeframe for implementing legislative changes prior to the consideration of a new biennium budget.

DBHDS Commissioner Nelson Smith shared the agency’s public dashboard, which tracks progress toward the goals contained in the agency’s strategic plan.  Goals include improving workforce recruitment and retention; increasing prevention, early intervention, and youth behavioral health services; and establishing a secure statewide data exchange for behavioral health and disability data.  The Department’s dashboard may be found at this link.

DBHDS staffers Nina Marino and Bern’Nadette Knight provided an update on the implementation of school-based mental health services pilot projects that received funding in the 2022 Appropriation Act (as discussed above, an additional $7.5 million was included in the budget revisions approved last week).  Programs in Lunenburg County, Hanover County, Mecklenburg County, and the cities of Bristol, Hopewell, and Richmond received funding, which enabled partnerships with community-based providers (including CSBs) to provide services within the schools.  DBHDS staff reported successes in delivering technical assistance to school divisions and providing services, although the full appropriation was not spent due to an accelerated timeline in establishing pilots in the first year and shortages of licensed personnel to be hired by providers.  With the additional funding appropriated for FY 2024, the Department will be expanding the program to additional school divisions through an application process and will be expanding technical assistance to all school divisions.

The meeting slides are available at this link.  The Commission’s next meeting is scheduled for October 17.

VACo Contact:  Katie Boyle

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