Governor Kaine Announces Mental Health Budget and Legislative Initiatives

Press Release

Governor Kaine Announces Mental Health Budget and Legislative Initiatives
- Proposals will expand emergency services, provide more accountability -

Governor Timothy M. Kaine today announced budget and legislative proposals to improve the Commonwealth's mental health system by offering care to more people who need it and enhancing the quality of those services. The Governor stood with elected officials from both parties and mental health care advocates as he unveiled a proposal that includes nearly $42 million to hire new case managers, therapists and clinicians, improve and expand emergency services, and provide for more accountability in the system.

"The tragedy at Virginia Tech in April of this year has drawn attention to our mental health care system in an unprecedented way," Governor Kaine said. "Now is the time for us to work together to make the changes and to provide the funding and the accountability our mental health system needs."

Many of the Governor's recommendations are based on the report of the Virginia Tech Review Panel, released earlier this year. The Panel's report highlighted the need to strengthen the community services board system, recommending expansions for its emergency services capacity, as well as its case management capacity.

Over 90 percent of community services board case managers in Virginia have caseloads that exceed the nationally recommended caseload of 25 patients. The Governor has proposed funding to increase the number of case managers by 106 statewide, over the biennium.

In addition, the proposed budget increases the number of clinicians and therapists who are available on an outpatient basis, with funding to support 40 new clinicians recommended over the biennium. The Governor's budget also funds an additional 40 clinicians specializing in children's mental health at local community services boards statewide, to support those children who are not eligible for services through the Comprehensive Services Act.

To ensure that individuals who are subject to temporary detention orders are receiving attention in a timely and focused manner, the Governor has recommended funding to support emergency mental health services, including around-the-clock emergency psychiatric consultation, emergency clinicians, and crisis stabilization. In addition to this funding, the Governor announced legislative proposals to address how emergency detention orders are implemented.

The Governor's proposed legislation will:

* Allow an emergency custody order to be extended to 8 hours and matching emergency custody order criteria to commitment criteria (VT Panel recommendation IV-13)

* Require the independent evaluator and the treating physician of a temporary detention order patient to be available during hearing (VT Panel recommendation IV-20)

* Require community services board staff to participate in hearings (VT Panel recommendation IV-19)

* Change the criteria for emergency custody and temporary detention from the "imminent danger" terminology to: "substantial likelihood that in the near future he will (a) cause serious physical harm to himself or another person, as evidenced by recent behavior causing, attempting, or threatening such harm, or (b) suffer serious harm due to substantial deterioration of his capacity to protect himself from such harm or provide for his basic human needs" (VT Panel recommendation IV-15)

* Clarify the roles and responsibilities of the community services boards and the independent examiner throughout the detention process, the commitment hearing, and the subsequent disposition (VT Panel recommendation IV-17)

* Explicitly authorize the disclosure of information between providers in order to deliver, coordinate or monitor treatment, and between providers and the courts to monitor and report on service delivery and compliance with treatment (VT Panel recommendation V-22, 24)

"In addition to properly funding our mental health care system, we must also ensure an accountability structure that focuses on outcomes," Governor Kaine said. "Through the development of service standards across the community services boards, we will move toward a more uniform system of emergency response times, service admission criteria, staff credentialing and training requirements, and of mandatory activities, like attending temporary detention order hearings."

To further address accountability across the community services boards, the Governor's budget calls for additional staff to provide oversight for regional and local services, to enhance accountability and to improve quality management. These positions will monitor how service are delivered, measuring them against recommended standards.

The Governor has also recommended funding to expand a pilot program for jail diversion services and to expand training for law enforcement responding to crisis situations involving individuals with mental illness.

The Governor's budget includes:

* $14.6 million over the biennium to improve emergency mental health services, including around-the-clock emergency psychiatric consultation, emergency clinicians and crises stabilization. The increase will assist community services boards in providing legally mandated emergency services.

* $8.8 million to increase the number of case managers for mental health services provided through community services boards. A total of 106 additional case managers will be hired by the end of the biennium.

* $5.8 million to hire 40 clinicians specializing in children's mental health over the biennium. This funding will help serve children who are not eligible for services through the Comprehensive Services Act.

* $4.5 million to increase availability of outpatient clinicians and therapists at community services boards. These funds are necessary to address significant delays in accessing outpatient mental health services.

* $875,000 over the biennium to create four positions to expand monitoring and accountability of community services boards and to develop core standards and service improvement plans. The addition of these positions will allow for better oversight and monitoring of recent community-based service expansion.

* $6 million over the biennium to expand a pilot program for jail diversion services funded in the 2006-08 biennial budget. It is anticipated that these funds will provide diversion and wrap-around services and support for an estimated 300-500 people.

* $600,000 over the biennium to establish a training program for crisis intervention. The training will enable law enforcement to respond to crisis situations involving individuals with mental illness.

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