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Joint Commission on Health Care Receives Briefings on Health Care Workforce and Hiram Davis Medical Center Closure

The Joint Commission on Health Care met on September 18 and received a briefing on the results of Commission staff’s study of the state’s health care workforce programs and a presentation from Department of Behavioral Health and Developmental Services Commissioner Nelson Smith about the Department’s plans to address significant capital needs at Hiram Davis Medical Center, which provides acute medical care, skilled nursing, long-term care, and outpatient services and serves patients with dementia, developmental disabilities, and mental health needs.

Commission members directed a study of the state’s workforce programs in fall 2023.  The study directed staff to develop a framework to measure the performance of health workforce programs, to include obtaining relevant data to measure program outcomes, and consider policy options to improve program performance.  Staff found that the state supports 34 programs, with most state funding concentrated in 24 recruitment programs, and that programs are typically focused on shortages in a specific profession rather than on broader criteria such as practice settings.  While limited reviews are generally conducted to ensure that program requirements are met, only a small number of programs incorporate monitoring for long-term outcomes and data collection overall is limited.  Staff presented two policy options for Commission consideration: (1) requesting state agencies to review existing program eligibility, screening criteria, and service requirements, and identify opportunities to align programs with the state’s workforce needs, and (2) requiring the Virginia Health Workforce Development Authority, in collaboration with Virginia Works, to develop a plan for improved data collection and reporting on health care workforce programs.

Staff’s presentation is available at this link; the full report is not yet posted online but should be available soon at this link.  Public comments are due by close of business on Friday, October 4, and may be submitted by email to jchcpubliccomments@jchc.virginia.gov or via mail to the Joint Commission on Health Care at 411 E. Franklin Street, Suite 505, Richmond, VA 23219.

Commissioner Smith briefed members on plans under development at the Department of Behavioral Health and Developmental Services (DBHDS) to address capital needs at Hiram W. Davis Medical Center.  The facility has not undergone any substantial renovations in 50 years, and the HVAC system, electrical system, and elevators are at the end of their useful lives; the facility has also struggled to resolve plumbing issues, including the presence of Legionella bacteria.  Commissioner Smith provided an overview of the Department’s plan for closure of the facility, including potential placement options for patients, some of whom are permanent residents of the hospital.  Provisions in state Code dictate the composition of a state and community consensus and planning team that is required when any restructuring of the state’s mental health system involves an existing state hospital, as well as stipulating the components of a transition plan.  State law also requires that any plan be submitted to the Joint Commission on Health Care and the Governor at least nine months prior to any proposed state hospital closure.  The Department’s initial proposed timeline would envision this plan being submitted in March 2026, with closure planned for December 2027.

Commission members also discussed the work of the Virginia Task Force on Primary Care, which is an initiative of the Virginia Center for Health Innovation and is working to improve payment models and infrastructure to support primary care – a key concern in light of Task Force data showing a declining number of primary care physicians in Virginia in the last several years.  The Task Force has implemented several pilot projects on improving clinician well-being and integrating behavioral health care into primary care, among others, and is working on several initiatives for 2025, including legislative proposals to raise Medicaid payments to primary care providers to parity with Medicare rates, expand the integrated behavioral health pilot, and increase research and evaluation on primary care.

VACo Contact:  Katie Boyle

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