In 2019, the General Assembly required the Board of Corrections (now the State Board of Local and Regional Jails) to establish minimum standards for behavioral health care in local and regional jails. A stakeholder group met during summer 2019 and recommended a set of standards to the Board, which made some revisions to the workgroup’s recommendations and is in the process of promulgating the standards through the state’s regulatory process. One of the major points of discussion in the stakeholder workgroup was how promptly a mental health assessment should be required for individuals who appear to have a mental illness based on their initial screening at intake. The group wrestled with balancing the need for a swift response to individuals who are at risk of further deterioration against the limited resources of many jails, particularly jails in rural areas in which there is a shortage of behavioral health care providers. Ultimately the stakeholder group settled on a requirement that individuals whose initial screening indicated the possible presence of a mental illness receive a preliminary assessment by a nurse or qualified mental health professional within 14 days, with more rapid intervention required for individuals who are in acute distress or at risk for suicide.
HB 1874 (Coyner) as introduced would require the mental health assessment to be conducted within 72 hours of the initial screening, a standard that would likely be very challenging for smaller and rural jails to meet, particularly in the context of compliance with the overall set of standards. A preliminary estimate of compliance costs done by the Department of Behavioral Health and Developmental Services in the context of the 2019 workgroup indicated that jails would need approximately $42.6 million to meet the new standards (with the 14-day assessment requirement). After hearing concerns from VACo, VML, and the Virginia Association of Regional Jails, Delegate Carrie Coyner amended the bill to codify a requirement that individuals experiencing acute distress or at risk of suicide would receive immediate interventions and ongoing monitoring to ensure safety, and that a behavioral health assessment would generally be completed within 72 hours. The bill also directs the Board of Local and Regional Jails to review the screening and assessment process to identify barriers to an across-the-board requirement for an assessment within 72 hours of screening and develop recommendations to address those barriers. The amended bill was heard in subcommittee on January 19 and reported by the full House Health, Welfare, and Institutions Committee on January 21.
VACo believes the amended bill ensures that individuals in serious distress receive the care they need while recognizing the need for the state to assist local and regional jails in implementing best practices and improving the timeliness with which assessments are conducted. VACo appreciates Delegate Coyner’s work on the bill and willingness to consider local concerns.
VACo Contact: Katie Boyle