RD100 - 2013 Annual Executive Summary of the Activity and Work of the State Board of Behavioral Health And Developmental Services - January 31, 2014

Executive Summary:
Dear Governor McAuliffe:

I am writing on behalf of the State Board of Behavioral Health and Developmental Services. The purpose of this letter is to communicate the board’s priorities for the behavioral health and developmental services system in the 2014-2016 budget, and to provide a copy of the Annual Executive Summary submitted to the Governor and the General Assembly in accordance with subsection 5 of § 37.2-203 of the Code of Virginia.

The summary describes the statutory basis for the Board’s work and provides information concerning the Board’s policy, regulatory, and committee work during the preceding 12 months as well as outlining the Board’s policy priorities for the coming year. The Board held its Biennial Planning Meeting in July to set priority topics for the biennium and a copy of the letter to then-Governor McDonnell conveying our comments on budget priorities is included in this report. We are hopeful that you will receive this information in a manner that is timely for your consideration of amendments to the budget bill.

The membership of the board includes individuals who have received services, family members of people with disabilities, a local elected official, a psychiatrist and citizens at large. We feel it is important to make the case that, of all the demands presented each year for state support, the needs of Virginians with mental health or substance use disorders or intellectual or developmental disabilities and their families are particularly important and deserving of increased resources.

At its biennial planning meeting in July, the board was pleased to receive a detailed update on the progress of the department’s strategic initiatives included in the Creating Opportunities Plan. The participation by the broad spectrum of stakeholders who worked with department staff over the course of the previous Administration gives weight and credibility to the importance of successfully implementing the strategies developed for each of the plan’s key initiatives. The board also received a detailed update on the implementation of the settlement agreement between Virginia and the U.S. Department of Justice. We look forward to seeing the continued implementation of the requirements in the agreement, and hope that any corresponding funding or policy requests by the department will be approved by you and the legislature during the 2014 Session of the General Assembly to ensure efforts stay on track to transition individuals from training centers to the community and to expand needed capacity in the community greatly for individuals on the waiver wait list.

We see that there is substantial overlap between the Board’s priorities and the work in progress by various groups, namely, the Governor’s Taskforce on Improving Mental Health Services and Crisis Response and the Mental Health Policy Transition Council. Some board members have served, or are currently serving, as members of these groups.

For the coming biennium, the board endorses as its own priorities the following areas. It should be noted that the priorities listed here were sent to the Governor in October. Adequate funding for the publicly funded mental health system in Virginia for outpatient assessment and treatment capacity remains a longstanding concern.

1. Providing for more adequate mental health outpatient assessment and treatment capacity so individuals receive services in a more timely manner;

2. Continuing implementation of the DOJ settlement agreement;

3. Renewing the ID and DD Waivers based on the outcomes of the DBHDS study of waiver structures and rates;

4. Providing ongoing funding for exceptional rates for qualifying community placements (higher congregate care rates in the Medicaid ID waiver for individuals with high needs coming out of state facilities or at imminent risk of institutionalization);

5. Expanding housing assistance to support individuals in more integrated settings in the community;

6. Adding Program for Assertive Community Treatment (PACT) teams; and

7. Expanding substance abuse services.

Further, across all services we support policies that are individual- and family- centered. Also, as services have increasingly been supported by Medicaid and other funds targeted to specific services, we feel it is important to express concern about the increasing lack of flexibility localities have to manage their core responsibilities to provide behavioral health and developmental services and supports that are not covered by these resources.

The board urges that these priorities remain in the forefront of all those issues before the legislature as we move into the new biennium. If there are helpful ways we might highlight the need for these services, we are eager to support such efforts.


Ananda K. Pandurangi, MD