RD418 - Report On Item 282.C of the 2008 Appropriation Act - November 1, 2008


Executive Summary:
Item 282.C the 2008 Appropriation Act requires the Secretary of Health and Human Resources (HHR), in consultation with the Executive Secretary of the Supreme Court of Virginia (OES), to develop a reporting system to collect information on emergency custody orders (ECOs), temporary detention orders (FDOs), and mental health commitment hearings by fiscal year. The data shall include, but not be limited to, the number of ECOs, TDOs, and commitment hearings that occur each year by locality, and the estimated cost, duration, location, and disposition of each proceeding. The information collected shall comply with all relevant state and federal health privacy laws and shall not include any personal identifiable information. The data collected shall be reported to the Governor, the Chairmen of the Senate Finance and House Appropriations Committees, and the Supreme Court by November 1, 2008, and each year thereafter.

This report describes the activities of the Department of Mental Health, Mental Retardation and Substance Abuse Services (Department) on behalf of the Secretary of Health and Human Resources and with the Office of the Executive Secretary in response to this budget item. Since the language in Item 282.C requires reporting by fiscal year, and since the amendments to Chapter 8 of Title 37.2 of the Code of Virginia that substantially revised statutory provisions related to the involuntary civil admission process only took effect on July 1, 2008, Fiscal Year (FY) 2009, only limited information is available to include in this first report. However, the Department is working closely with community services boards and the behavioral health authority (CSBs) and the OES to produce more data on this subject in time for consideration during the 2009 session of the General Assembly.

As the Department noted in its Report on the Allocation of Funds in Item 316.KK of the 2008 Appropriation Act, there is a dearth of usable data about the civil commitment process, and this lack of systemic data continues to make it very difficult to project fiscal impacts for implementing statutory changes in the involuntary commitment process.(*l) Along with this lack of usable data, another complication in gathering data about the involuntary civil commitment process is the high degree of variability with which it is implemented or administered across the state. For example, while the concept of an emergency custody order may appear to be fairly clear and uncomplicated, the manner in which statutory provisions for ECOs are implemented varies considerably across Virginia. In some localities, few if any ECOs are issued by magistrates; instead, law enforcement officials take individuals into custody, as authorized by the statute, but there is no paper order issued by a magistrate. While there is no authoritative information about the prevalence of this practice, most individuals familiar with the process indicate there could be thousands of ECOs executed by law enforcement officials each year. It would be virtually impossible to obtain information about the estimated cost, duration, location, or disposition of those paperless ECOs. Similarly, the manner in which temporary detention orders are issued and executed varies greatly, particularly regarding duration and location, and the availability of documentation about those TDOs also varies widely across the state. Finally, the location and scheduling of commitment hearings varies considerably across the state. In the absence of current systemic data, this report includes some anecdotal information about the experience of affected stakeholders to date as they have implemented the statutory changes and preliminary data demonstrating first quarter outcomes regarding ECOs, TDOs, commitment hearings, and MOTs. The report also contains a discussion of how more consistent statewide data will be gathered for the FY 2009 report.
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(*1) Report on the Allocation of Funds in Item 3I6.KK of the 2008 Appropriation Act, September 1, 2008, page 4.