The Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century met on May 7 to review progress in improving the state’s mental health system and to plan its course for the year ahead. Secretary of Health and Human Resources Dr. Daniel Carey and Commissioner of Behavioral Health and Developmental Services Dr. Hughes Melton discussed the Governor’s priorities for behavioral health and substance abuse services and reaffirmed the Administration’s commitment to implementing STEP-VA (a plan for provision of a standard menu of services in each Community Services Board) and the plan for financial realignment of the public system toward community-based care and away from reliance on state hospitals. Commissioner Melton expressed his interest in working with the Joint Subcommittee on the issue of local contributions to Community Services Boards (CSBs) as well as state resources for STEP-VA and state hospital capital projects, and encouraged members to continue to look at both public and private providers of behavioral health as part of the overall system of care, as most behavioral health care is provided outside of the public system (CSBs and state hospitals).
The Joint Subcommittee will again be divided into two work groups. The Criminal Justice work group plans to investigate ways to increase Crisis Intervention Team training for first responders and methods of diverting individuals with mental illness away from the criminal justice system, as well as improvements to discharge planning for individuals being released from correctional facilities. This workgroup is also charged with developing realistic goals for the provision of permanent supportive housing.
The System Structure and Finance work group, which held its first meeting the same day, will continue to review the implementation of STEP-VA and financial realignment, and will examine the relationship between localities and the state with respect to how CSBs are structured and funded, as well as ways to enhance accountability for CSBs through their performance contracts with the state. Members also expressed interest in resolving the issue of whether CSBs should be tasked with providing behavioral health services in jails, which was the subject of legislation during the 2018 General Assembly and is currently under review by the Joint Commission on Health Care. During the work group’s meeting, there was further discussion of the subset of CSBs that received a waiver from the local match requirement. Members expressed particular interest in how the state could work with localities to establish a baseline level of local support for all CSBs without discouraging localities from supplementing state support with additional local funds.
As the legislative mandate for the Joint Subcommittee is scheduled to expire in December 2019, members began discussions about creating a permanent “home” for legislative oversight of behavioral health issues, whether by making the Joint Subcommittee permanent in some manner or folding its work into the mission of the existing Joint Commission on Health Care. The Joint Subcommittee’s next meeting is scheduled for June 5.
VACo Contact: Katie Boyle