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Mental Health Study Commission Kicks off 2019 Work

The Joint Subcommittee Studying Mental Health Services in the Commonwealth in the 21st Century met to review the results of legislation and budget initiatives introduced during the 2019 General Assembly session as a result of the Joint Subcommittee’s work. The Joint Subcommittee also received briefings on ongoing projects and discussed issues for consideration as part of the Joint Subcommittee’s 2019 work plan.

Jeff Lunardi, Director of the new Health and Human Resources Unit at the Joint Legislative Audit and Review Commission (JLARC), provided an update on two projects underway. At the request of the Joint Subcommittee, the new JLARC unit has undertaken a study of the current funding structure for Community Services Boards (CSBs), potential alternative models that could be used to allocate funds (whether drawn from other states’ systems or other state-local arrangements within Virginia), and the potential effects of changes to the funding structure. Following the briefing, members discussed the possibility of developing a funding model that would take into account localities’ ability to contribute to their CSBs; the K-12 funding formula was cited as a possible example, although members also acknowledged the shortcomings of this approach. JLARC is also reviewing the implementation of STEP-VA to determine how successfully the first mandated services have been implemented, and to advise as to whether planning and resources will be in place to implement the remaining required services in time to meet the statutory deadline of July 1, 2021. Senator Creigh Deeds, who chairs the Joint Subcommittee, expressed his willingness to revisit that deadline if it appears that more time will be needed to prepare.

Deputy Secretary of Finance Joe Flores and Department of General Services Director Joe Damico briefed the Joint Subcommittee on the Governor’s proposed budget amendments regarding the replacement of Central State Hospital. The introduced budget had included funding for detailed planning for the project, but the General Assembly replaced the funding with a directive to the Department of Behavioral Health and Developmental Services (DBHDS) to develop a proposal for replacement of the hospital. Discussions continued after adjournment of the regular session, and the Governor’s amendments provide for bond funding for detailed design, construction, and the purchase of furniture, fixtures, and equipment for a new hospital; the revised proposal is expected to shorten the construction time and provide for fewer beds for acute care and non-violent forensic patients (with an option to add beds later if needed).

DBHDS Commissioner Dr. Hughes Melton briefed members on the Department’s major behavioral health initiatives, including STEP-VA implementation, realignment of the behavioral health system to emphasize prevention services, and monitoring of the impact of Medicaid expansion on CSBs. As part of legislation that was passed during the session, DBHDS staff will lead a workgroup to develop standards for care, including behavioral health care, in local and regional jails, as well as to estimate costs for implementing the new standards (an effort in which VACo will participate). DBHDS also continues work to address census pressures at the state hospitals.

The Joint Subcommittee discussed several potential areas of study for the remainder of 2019, including children’s mental health, mandatory outpatient treatment, and permanent supportive housing, as well as continued discussion about the overall structure of the state’s behavioral health system.

VACo Contact: Katie Boyle

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