Mental Health Study Continues Work; Standards for Care in Jails Contemplated

November 21, 2018

A possible new funding formula for Community Services Boards (CSBs) and standards for the provision of mental health care in local and regional jails are two major issues under discussion by the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century, which met earlier this month to continue developing recommendations in advance of the upcoming General Assembly Session.

The Joint Subcommittee’s System Structure and Financing Workgroup has recommended that the Joint Subcommittee request that the Joint Legislative Audit and Review Commission (JLARC) undertake a detailed study of the current method of allocating state funds to CSBs, with an eye toward developing an alternative method of distributing funding. An advisory panel to the workgroup has recommended that such a study determine the best method to incorporate factors such as demographics, Medicaid usage, and local ability to contribute funds, and suggested that the legislature might consider whether a potential new funding formula should be applied only to new funding, rather than disrupting the provision of services by reallocating existing allocations. The workgroup is also reviewing potential changes to the relationship between the Department of Behavioral Health and Developmental Services (DBHDS) and the local CSBs, to determine whether regional DBHDS offices might provide better oversight of CSB operations. Meanwhile, DBHDS is also examining whether grouping CSBs into regional structures would enhance their ability to provide the full array of services contemplated in the STEP-Virginia plan by the statutory deadlines; some services are already delivered on a regional basis in some areas. In addition, DBHDS is contemplating modifications to the performance contracts between the Department and the CSBs, to include developing outcome measures and exploring other state-supervised, locally-administered service delivery, such as the relationship between the state Board of Education and local school divisions, as a potential model for enhancing the Department’s oversight authority.

The Criminal Justice Diversion Workgroup is continuing its discussion on the provision of mental health services within local and regional jails. Members expressed support for requiring the Board of Corrections to develop standards for the provision of these services, and are continuing discussions about whether service provision should be the responsibility of the CSBs. The Joint Commission on Health Care, which met later the same week, has also recommended pursuing legislation to require the Board of Corrections to adopt health care standards. VACo submitted written comments to the Joint Commission on Health Care reminding members that localities are currently funding the majority of health care services in jails and advocating for greater support from the state to meet these needs, and made similar public comments to the Criminal Justice Diversion Workgroup. Regardless of whether CSBs are ultimately mandated to provide services within jails, workgroup members are interested in improving the “handoff” between the CSB and jail staff when a current CSB client is incarcerated, and between the jail staff and the CSB when an inmate is preparing to be released into the community.

The Joint Subcommittee will meet in early December to finalize its recommendations for the 2019 Session.

VACo Contact: Katie Boyle

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