RD347 - Virginia Department of Behavioral Health and Developmental Services - Item 319.A.2. - Bed Capacity Study of Northern Virginia Mental Health Institute - November 20, 2012

Executive Summary:
The 2012 General Assembly, through Item 319.A.2. of the 2012 Appropriation Act, requested the Department of Behavioral Health and Developmental Services (DBHDS) conduct a study regarding Northern Virginia Mental Health Institute, as follows:

"The Commissioner of the Department of Behavioral Health and Developmental Services shall convene a workgroup to develop a long-term funding plan for inpatient bed capacity in the catchment area served by NVMHI. The report shall outline specific strategies and plans to meet the psychiatric inpatient and inpatient diversion needs of individuals with serious and persistent mental illness who are served by the publicly funded mental health system. The Commissioner shall also assess the cost and feasibility of creating an alternative to re-opening beds at NVMHI. The Commissioner shall report his findings no later than October 1, 2012 to the Chairmen of the Senate Finance and House Appropriations Committees as well as the Joint Commission on Health Care."

The language was accompanied by $600,000 in additional state general funds in FY13 for the operation of the Northern Virginia Mental Health Institute (NVMHI).

DBHDS formed a stakeholder workgroup made up of NVMHI and DBHDS staff and representatives from all area CSBs and private hospitals to conduct the review. The review led to the following main findings:

• The Northern Virginia area has fewer psychiatric hospital beds per capita (both public and private) than any region of Virginia.

• The CSBs in the Northern Virginia region make maximum feasible use of both public and private hospital beds in the area, yet frequently must seek care for persons in hospitals far away from their homes.

• The need for maintenance of bed capacity at NVMHI has been so great that CSBs in the area have used funds intended for community services to keep 123 NVMHI beds open over the past three years. This means of supporting state hospital beds is not sustainable.

• Many practical alternatives to divert persons from inpatient care or to maintain them in the community with lessened need for inpatient care were researched; however, the cost and time required to develop and implement them make it necessary to restore bed capacity at NVMHI and continue full capacity operation for at least the next two years.

It is recommended that:

1. NVMHI be restored to its original (pre-2010) operational capacity of 129 beds, requiring an annual increase in allocated state general funds of $1,400,000 per year, beginning on July 1, 2013.

2. The Region II CSBs redirect 100% of the state general funds that are granted to individual CSBs and the Region for local inpatient purchase of service (LIPOS) and other inpatient diversion services to the purposes for which they were originally granted in order to decrease pressure for use of NVMHI.

3. Expanded program capacity designed to reduce the reliance on inpatient hospitalization be implemented in Region II on a continuing basis as soon as funding can be made available for this purpose.