At its final meeting of the year, the Behavioral Health Commission adopted a series of recommendations for legislative and budget action in the upcoming legislative session, while also receiving a series of reports requested during the 2024 session as part of the Commission’s monitoring and oversight role.
Several adopted recommendations stemmed from studies conducted by Commission staff this year, including a review of the state’s Permanent Supportive Housing program and a study of ways to minimize assaults on law enforcement officers and avoidable arrests of individuals in crisis. Several recommendations also revisit proposals from 2024 that were not adopted by the legislature, or reflect work to be conducted by related entities.
Key recommendations adopted by the Commission include:
- Directing the Department of Medical Assistance Services (DMAS) to develop a housing benefit for individuals with serious mental illness. Staff found that tenant supports and one-time housing costs have consumed a growing proportion of permanent supportive housing funding; covering these expenses through Medicaid would free up General Fund dollars for rental assistance.
- Directing the Department of Behavioral Health and Developmental Services to require screening of patients for permanent supportive housing when discharged from state hospitals. Staff found that only a small percentage of state hospital patients are discharged directly to permanent supportive housing, despite these patients being considered the highest priority for these placements.
- Providing funding for co-response programs for the 13 remaining CSBs with localities required to implement Marcus Alert protocols by 2028.
- Providing funding to private hospitals that agree to increase the percentage of involuntary admissions they accept; this proposal is intended to reduce lengthy wait times for individuals under Temporary Detention Orders, which can increase the risk of assaults on law enforcement officers and hospital staff.
- Clarifying that law enforcement officers have discretion as to whether to arrest someone under an Emergency Custody Order, Temporary Detention Order, or involuntary admission, and requiring additional training for law enforcement on these provisions of law.
- Providing funding to restore the School-Based Mental Health Integration program; this funding was directed to projects with a broader scope in FY 2025.
- Supporting legislation to establish the Autism Advisory Council as a permanent commission and requesting that it undertake reviews of several issues, including the establishment of a continuum of care for individuals with neurocognitive or neurodevelopmental disabilities.
- Directing additional resources to the Virginia Health Workforce Development Authority to enhance its capacity to address behavioral health workforce needs, and directing the Virginia Health Workforce Development Authority to establish an incentive program for supervisors of clinical internships.
- The Commission also approved its work plan for 2025; as previously reported, this plan includes a review of the implementation of the Marcus Alert initiative, a study of behavioral health services in local and regional jails, and a study of local contributions to Community Services Boards, in addition to the previously-assigned study of the state’s civil commitment statutes and the crisis services system.
The Commission received a series of updates, as requested in Appropriation Act language, on improvements to the state’s crisis services system; progress toward implementing the Certified Community Behavioral Health Clinic model in Virginia; a needs assessment for full implementation of STEP-VA, as well as updated performance measures for STEP-VA; revisions to CSB performance contracts; CSBs’ performance in improving their clients’ mental health; and the degree to which CSBs are billing Medicaid for covered services.
The Commission also received a presentation from the Department of Education on its effort to support school-based mental health services, including lessons from its pilot programs and its plans to provide technical assistance to school divisions, support provision of care through telehealth, and expand staffing.
VACo Contact: Katie Boyle