Veterans Affairs lawmakers find common ground on mental health reform

This is an initiative that exceeds the more than $316 million increase in behavioral health spending that Youngkin proposed in last December’s draft budget. The new ideas are specifically focused on ensuring that people who are ready to leave crowded state hospitals actually do so.

The bill would make into law Yonkin’s promise, made before Irvo Otieno died last year at Central State Hospital, that no one would have to be involuntarily admitted to a hospital while their family was denied visitation. Includes writing measures.

Youngkin said of the “bills that are moving,” “some of which directly reflect some of our work, and some of which are good ideas from the General Assembly.”

He further added: “When I look at the budget submission, I think we are moving in the right direction. We will continue to truly leverage each other’s good ideas and efforts.”

The House and Senate passed their own versions of the state’s two-year budget. Negotiators from both chambers aim to reach a compromise before Congress is scheduled to adjourn on March 9.

Rep. Patrick Hope, an Arlington Democrat who has sponsored several important bills, echoed Youngkin’s opinion that there is broad, essentially unanimous support for addressing the state’s behavioral health crisis. agree.

“I really focused on a particular list of barriers,” Hope said, referring to the list of patients waiting to be discharged from state hospitals, where hospitals and community mental health agencies are trying to arrange the services they need to live in their home communities. I’d like to guess,” he said.

The state Department of Behavioral Health and Developmental Services has been working hard over the past two years to address this challenge.

The list peaked at 245 people in 2019, but now ranges around 160 people. The length of stay for people on the list has also decreased, with the median length of stay for those on the list now being 77 days, compared to 161 days a decade ago.

But Hope, like other lawmakers and the governor, says there’s still a lot of work to be done in the behavioral health system.

“We can’t just keep pulling people out of the river. We have to start working upstream to keep them from flowing in,” he said.

This year, bills passing the House and Senate (House Bill 314 and Senate Bill 179) would set strict deadlines for implementing discharge plans from state hospitals.

So is the Ensuring Insurance Companies Cover Crisis Services Act (House Bill 601). This includes mobile crisis response teams, a key element of Youngkin’s Right Help Right Now reform of the behavioral health system.

In the wake of Irbo Otieno’s death, the House, Senate, and the Governor have pledged that people in mental health crisis cannot be denied access to their families if a decision is made to send them to treatment against their will. tied.

Senate Bill 546 passed the Senate 40-0 and will be sent to the House with 22-0 approval by the Judicial Courts Committee. The House version (House Bill 1242) passed the House unanimously.

Senate Bill 176 and House Bill 888, which aim to direct individuals with neurocognitive and neurodevelopmental disorders (such as autism spectrum syndromes) to facilities that can better support them than state psychiatric hospitals, have been passed in the House and Senate. The bill has passed and is currently under deliberation in each house. In front of other bodies.

When people with dementia or intellectual disabilities end up in state psychiatric hospitals, they stay there much longer than other patients because there are limits to what hospitals can do to change their condition. there is a possibility. But if there are safe and relatively independent places for them to live, directing them there would alleviate overcrowding in state hospitals.

A bill is also moving that would direct the state inspector general to investigate all complaints alleging abuse, neglect or inadequate care at state hospitals. Senate Bill 178 passed the same committee 40-0 and is now being sent to the House with a 22-0 vote from the House Health and Human Services Committee. The House version (House Bill 313) passed its committee unanimously.

In December, the Joint Legislative Audit and Review Committee reported that the state Office of Inspector General reviewed only 117 of 663 human rights complaints and sent the rest back to the Department of Behavioral Health and Developmental Services, the agency that runs the state hospitals.

While these bills are making their way through the Legislature, intensive lobbying from private hospitals and sheriff’s departments is ensuring that patients have potentially life-threatening medical needs that require immediate treatment by state hospitals. A measure that would allow state psychiatric hospitals to delay admissions (House Bill 808) failed. Not available.

The bill’s sponsor, Rep. Sam RaSoul (D-Roanoke), on the last day the bill could have been considered, said he was aware of concerns about the bill and moved it to the House of Representatives. was removed from the agenda.

He said the measure is aimed at ensuring that federal law and the opinion of the state attorney general’s office are enforced. The law and the ruling say people who need urgent treatment cannot simply be sent to a psychiatric hospital.

He later said there were concerns about delaying the bill because of opposition from hospitals and sheriffs.

JLARC reported that law enforcement officers left 1,432 people in state hospitals without admission in the 2022-2023 fiscal year.

Between Miyares’ January 2023 opinion and early December, more than 450 people were left stranded on the doorsteps of state hospitals.

One state hospital official told JLARC that while none of these patients died, “they were in very critical situations.” The patient he brought to the hospital 15 minutes after arriving was in a near-death condition. I feel lucky that the outcome was not catastrophic. ”

Mr. Rasoul said: “He’s on track to hit 900 this year. That’s why we needed this bill.”

On the funding side, the Senate Finance Committee, which focuses on health and human services spending, has signaled it will follow Youngkin’s budget proposal fairly closely, but also to help hire staff for the state’s 40 community service boards. It is also asking for an annual increase of $7.5 million. Retain staff. Community mental health agencies in Virginia have a huge number of job openings.

It also proposes a $3.3 million annual increase for the state’s STEP-Virginia effort to ensure all community service boards provide nine essential services. $2.5 million annually to staff crisis stabilization units (places where people in mental health crises can stay for emergency short-term treatment); Increases existing funding by $1 million annually to help people with mental illness and developmental disabilities pay rent.

Difficulties finding housing are a big reason why patients in state hospitals often have to stay there even when they’re ready to be discharged.

The House committee also asked for funding to direct the Department of Behavioral Health to identify alternative ways to care for the children and youth currently served by the state’s Commonwealth Children and Youth Center Hospital in Staunton. There is.

“I think it’s clear that everyone wants to do something,” said Rep. Bobby Orlock (R-Spotsylvania), the ranking member of the House of Representatives and the ranking member of the Health and Human Services Committee. said.