An advisory group convened to implement legislation enacted in 2019 directing the Board of Corrections to establish standards for medical, dental, pharmaceutical, and behavioral health care has developed in concept a recommended set of behavioral health standards to be considered by the Board. VACo reported on the establishment of the advisory group, which was convened by the Department of Behavioral Health and Developmental Services (DBHDS), in an earlier edition of County Connections. VACo and VML worked with other interested parties to include language in the 2019 legislation directing the establishment of the workgroup, which is tasked with developing cost estimates for the proposed standards as well.
The advisory group used as a starting point for discussion a list of recommended standards for mental health care that was developed by an earlier workgroup. These standards largely drew from national accrediting bodies’ requirements and incorporated some elements which jails are already required to provide (such as mental health screening of all inmates upon intake), as well as some proposals that will likely require additional resources for some jails. Two proposed standards addressing substance use disorder were added in order to comply with the 2019 legislation, which encompassed both mental health and substance use disorder under the category of “behavioral health.”
Key elements in the draft list recommended by the advisory group include:
- A general requirement for inmates to have access to mental health care
- A requirement for jails to have written policies and procedures regarding mental health care services
- Requirements for appropriate communication between jail administration and mental health professionals regarding inmate mental health needs
- Requirements for mental health-related training for correctional officers
- Requirements for the timely administration of medications
- Requirements for screening of all inmates upon intake and assessment of those inmates who screen positive for potential mental health concerns
- Requirements for monitoring of inmates held in restrictive housing
- Requirements for discharge planning
- Required elements of jails’ suicide prevention programs
- Requirements for identification and treatment of substance use disorders
- Requirements for the management of intoxication, withdrawal, and overdoses
Each proposed standard includes a set of proposed compliance indicators. DBHDS staff are preparing a final draft of the standards and compliance indicators based on the discussion at the advisory group’s meetings, which will be circulated for final revisions by the advisory group before submission to the Board of Corrections for consideration.
DBHDS is also preparing a survey of sheriffs and regional jail administrators to determine what resources they expect to require in order to meet the proposed standards; the survey results will be used to develop cost estimates. The Department of Criminal Justice Services has been tasked separately with developing cost estimates, based on its experience administering pilot projects to enhance mental health services in several jails, and providing those estimates to the money committees chairs by June 30, 2020. VACo has consistently maintained that the state needs to improve its assistance to localities for jail operations, particularly as the majority of current mental health care spending in jails is supported by local funds.
DBHDS next will turn to the development of recommended standards for inmate medical care. VACo will continue to participate in the second phase of the advisory group and will provide updates to members.
VACo Contact: Katie Boyle