Governor Announces Agenda to Strengthen Virginia’s Mental Health System and Combat Opioid Epidemic
~Proposes comprehensive analysis of behavioral health system~
RICHMOND – Governor Terry McAuliffe today announced that his amendments to the FY-2016-18 budget will include significant investment in mental health and substance abuse treatment. The Governor also announced that he will submit legislation in the upcoming General Assembly session to further enhance Virginia’s approach to behavioral health and combatting opioids.
“It is time to bring our behavioral health system into the 21st century,” Governor McAuliffe said, speaking at today’s announcement. “For too long we have made reforms only in response to crises, but we need a better plan to improve the things that are working and change the things that are not. The budget I will propose will make investments to modernize our behavioral health system and align our approach with best practices.
“These issues have a serious impact on our Commonwealth’s economy, on the safety of our communities and on families in every corner of Virginia. Taxpayers have a right to expect that we will do everything to ensure that Virginians who seek treatment for mental illness or substance abuse get the access and care they need to be healthy, productive members of society.”
Governor McAuliffe’s budget proposal includes $31.7 million in new funds to expand and improve treatment for mental health and substance abuse disorder services in state facilities, community services boards, and in local and regional jails.
The new funds will pay for increased same-day access to assessment at community services boards; increased medication-assisted treatment access for people with opioid addictions; reduction of the bed census at state mental health hospitals; an evaluation of the structure of the behavioral system through the Department of Behavioral Health and Developmental Services and Virginia’s 40 CSBs; and an expansion of this year’s pilot project to improve mental health treatment in jails by funding grants to help jails identify a mental health assessment program.
Governor McAuliffe’s budget proposal will allow 25 of Virginia’s 40 community services boards to initiate same-day screening and assessment services.
“We know that same-day access to evaluations at our CSBs has proven results in getting more people to treatment more quickly,” said Lt. Gov. Ralph Northam. “Our CSBs are the primary provider of mental health and substance abuse treatment in many communities, and this additional funding will help ensure that access and services are the same no matter where in the state a person lives.”
The budget also includes additional money for medication-assisted treatment for people with an opioid addiction, because the assistance of medication can help many people in recovery from addiction.
“There are so many Virginia families looking for hope, for a lifeline, and for help in fighting their own battle against substance abuse. To any family or any Virginian out there struggling with addiction, help is on the way,” said Attorney General Mark Herring. “These measures are a big step forward in reorienting our response to substance abuse and mental health towards a more effective and common sense approach. We're not where we want to be yet, but I know that Governor McAuliffe, Lieutenant Governor Northam and our partners in the legislature are going to stay in the fight.”
The Governor’s proposed budget includes $4.5 million to conduct a comprehensive evaluation and gap-analysis of Virginia’s behavioral health system as provided through DBHDS and the CSBs.
“Our state and local employees at the Department of Behavioral Health and Developmental Services and CSBs do good work and care deeply about the populations they serve. It is time we built a system that is more cohesive and can better support their work,” said Secretary of Health and Human Resources Dr. Bill Hazel. “This evaluation will allow us to dive deeply into how we reshape our system for the next generation.”
The governor’s budget and legislative proposals include a provision clarifying the Board of Corrections’ authority to investigate deaths in jails. The budget also includes funding for a grant that jails can use to strengthen and standardize their screening assessments at intake to help identify mental health issues.
“Our public safety agencies increasingly encounter mental health and substance abuse issues,” Secretary of Public Safety and Homeland Security Brian Moran said. “Improving our jails’ ability to assess mental health at intake is an important step as we work toward providing treatment to those in need.”
In addition to the budget package, Governor McAuliffe will propose legislation focused on strengthening treatment for opioid addiction and clarifying the responsibility to investigate jail deaths.
Legislation on Opioids and the Board of Corrections proposed by Gov. McAuliffe:
- Authorize certain entities and individuals to lawfully possess clean syringes as part of a comprehensive harm reduction strategy
- Limit opioid prescriptions written in emergency departments to 3 days
- Create a state registry for certified peer recovery specialists and qualified mental health professionals
- Allow community organizations to distribute Naloxone as part of trainings
- Allow Child Protective Services to respond to all reports of substance exposed infants
- Expand eligibility for participation in Drug Treatment Courts to include those convicted of violent crimes
- Mandate e-prescribing for all opioids
- Clarify that the Board of Corrections has the authority to investigate when someone dies in jail, and specify the expertise needed on the BOC to accomplish this.
Explanation of Governor McAuliffe’s Mental Health and Opioids Budget Package:
Community Mental Health
- This budget takes the first step in moving towards a comprehensive state system of standard community treatment options by funding the implementation of “same day access” to screening and assessment services at 25 of our 40 Community Services Boards, with the remaining CSBs to come on board in the next biennium.
- $8.2 million (GF) is provided through the Department of Behavioral Health and Developmental Services and the Department of Medical Assistance Services for implementation by funding additional intake and evaluation staff at CSBs to ensure that every person who walks through the door is screened the same day.
- To address the increasing census at state mental health hospitals that are at or near capacity, we have included $7.4 million in funds for discharge planning, private bed purchase, and other community supports that will aid in discharging and diverting individuals into community settings.
- $2.5 million for discharge assistance planning
- $1.0 million for community detox and sobriety services
- $3.0 million for child/adult/geriatric private bed purchase
- $880,000 for a multi-disciplinary team in the community to work with nursing homes
- To assure the safety of staff and those being served at our facilities, we have included $2.1 to hire an additional 24 full-time security and direct care employees and purchase necessary pharmaceuticals.
- In November, in response to a growing number of fatal overdoses in our commonwealth, the state health commissioner declared the opioid addiction crisis to be a Public Health Emergency. To address this crisis, this budget includes a total of $5.3 million (GF) to increase access to opioid addiction treatment and aid in preventing fatal overdoses:
- $5.0 million is appropriated to provide medication assisted treatment and supports to over 700 people struggling with opioid addictions;
- $200,000 is provided to purchase over 9,000 overdose reversal kits and 6,600 doses of naloxone that can be used in cases of accidental overdose to block the life-threatening effects;
- $78,000 is provided to fund a position in the Department of Behavioral Health and Developmental services to oversee the opioid addiction treatment programs funded in this budget.
Comprehensive Evaluation of Virginia’s Behavioral Health System
- We also commit to strengthening our system of behavioral health services. To begin this transformation, we have included $4.5 million (GF) for a statewide assessment, gap analysis and high-level design of the service delivery system that will incorporate the voices of the CSBs, the correctional system, and those in the General Assembly who have been working on the future state of our community-based system.
- This evaluation will also look at the Department of Behavioral Health and Developmental Services as a whole, and identify resource gaps and areas where structural changes may result in improved outcomes for those served by our state facilities and CSBs.
Mental Health in Jails
- $4.2 million is appropriated to the Department of Criminal Justice Services for funding and positions to support mental health screening and assessment in local and regional jails to build on previously funded efforts to address the population of individuals with mental illness in jails.
- $4.0 million for grants for which criteria would be developed in collaboration with the Department of Behavioral Health and Developmental Services.
- Two positions and $200,000 in correlating administrative funds for administering the grant program.