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Commonwealth's Counties

Behavioral Health Commission Plots Course for 2023 and Beyond

The Behavioral Health Commission held a strategic planning session on April 28 to discuss the Commission’s role in improving the behavioral health system, the goals that the Commission should prioritize, which strategies would best advance those goals, and how the Commission should select specific initiatives to pursue. Members of the twelve-legislator Commission, which is chaired by Senator Creigh Deeds, held a wide-ranging discussion of the role of the Commission and the key issues members envision as priorities for the Commission’s short-term and long-term work.

Members were in agreement that the Commission should prioritize tracking behavioral health initiatives being undertaken by the various entities involved in this arena. Staff pointed out that there are benefits to the high level of interest in improving the behavioral health system and the large number of legislative and executive branch entities involved, but noted that the current structure could also result in duplication of efforts, and suggested that the Commission could monitor initiatives across the system in a holistic manner. Members also emphasized the importance of monitoring the implementation of previously-approved initiatives in order to evaluate these initiatives and projects. For example, members expressed interest in the effects of recent investments in the state hospital workforce and whether these appropriations have had the desired effect of stabilizing staffing and increasing hospital capacity. Several members characterized the Commission as a repository of institutional knowledge, particularly in light of the periodic turnover of Administrations and the election of new legislators over time.

Staff provided a set of potential goals for the state’s behavioral health system to support the Commission’s statutory mission of “studying and making recommendations for the improvement of behavioral health services and the behavioral health service system in the Commonwealth to encourage the adoption of policies to increase the quality and availability of and ensure access to the full continuum of high-quality, effective, and efficient behavioral health services for all persons in the Commonwealth.” These proposed goals included a complete continuum of care; timely access to services statewide; cost-efficient care for everyone; effective and efficient services; and lower inappropriate criminal justice involvement. Discussion of the strategies that would support these goals featured extensive conversation about the role of the state hospital and how the state hospital system could be “right-sized” relative to investments in community-based care.

Members discussed using a structured process for directing staff work, possibly through an executive committee structure, as is used with other legislative commissions. Topics for potential further work included the behavioral health workforce; permanent supportive housing; and the state-local funding partnership for Community Services Boards. Several specific items have been referred to the Commission, including a 2022 Appropriation Act directive on maximizing school-based mental health services; legislation that would have created a process for expedited diversion to court-ordered treatment for defendants charged with certain misdemeanors; a bill that would have increased the minimum age for consent of a minor to admission to a mental health facility for inpatient treatment from 14 to 16; and legislation that would have applied the same procedures currently in place for an unrestorably incompetent defendant charged with aggravated murder to an unrestorably incompetent defendant charged with an act of violence.

Staff will be presenting a draft workplan at the Commission’s next meeting on May 16, at which time the Commission will further discuss a draft strategic plan, which will be finalized later in the summer.

VACo Contact: Katie Boyle

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