RD337 - Virginia Department of Behavioral Health and Developmental Services and Virginia Department of Criminal Justice Services: Alternative Transportation Workgroup Final Report HB 1426 (Garrett)/SB 1221 (Barker) – October 1, 2017
State laws require a magistrate issuing an emergency custody order (ECO) or temporary detention order (TDO) to specify a law enforcement agency that will provide transportation of a person to the location for evaluation or temporary detention (Va. Code §§ 37.2-808 and 37.2-810). These laws also allow the magistrate to consider transportation other than by law enforcement if identified by the community services board (CSB) evaluator. The alternative transportation could be provided by a family member or friend of the individual, a representative of the CSB, or an alternative provider trained to safely provide transportation.
Currently, alternative transportation is offered in a variety of forms in Virginia. However, these alternative providers are underutilized as CSB evaluators and magistrates have no formal method of identifying the provider, verifying whether the alternative provider can safely transport patients, and determining whether the alternative provider is qualified. The lack of statewide standards for determining whether someone can safely transport a person deters the use of alternate transportation providers.
The Department of Behavioral Health and Developmental Services (DBHDS) explored the feasibility of using an alternative transportation provider in 2015. In conjunction with Mount Rogers CSB, DBHDS piloted a year-long program that provided transportation by an alternative provider for individuals under a TDO. Specific details about the Mount Rogers Pilot are addressed in this report; however, a significant finding of the program is that every individual transported by the alternative provider safely arrived at his/her destination without incident.
Encouraged by the preliminary findings of the pilot program, in 2017 the General Assembly passed House Bill 1426 (Delegate Garrett) and Senate Bill 1221 (Senator Barker) requiring the DBHDS Commissioner and the Director of the Department of Criminal Justice Services (DCJS) to develop a model for alternative transportation for individuals in emergency custody or temporary detention in Virginia. The bills further required the model be developed in conjunction with a variety of stakeholder groups and state agencies.
A workgroup consisting of those stakeholders and agencies, and chaired by staff from DBHDS and DCJS, held three meetings during May and July 2017. The workgroup discussed the topics required in the legislation, which included the model for alternative transportation, criteria for certifying providers, training for the providers, responsible state agency, possible costs, cost savings, and barriers to providing the service.
After discussing and reviewing several options, the workgroup agreed on a model that implements a regionally based transportation service within each of the five primary DBHDS regions (see Appendix D), with state oversight and certification of providers. The workgroup identified DBHDS as the most appropriate agency to oversee the process, to include issuing requests for proposals (RFP) for transportation in each region. Each RFP would be tailored to regional needs and specify standardized criteria for the vehicles, drivers, training, and operational procedures. Twenty-four-hour dispatch services must be provided by either the transportation provider or in agreement with an existing local or regional dispatch service. The workgroup also identified potential statutory changes that would be needed to implement the model and several cost models that should be considered by policy makers.
The workgroup recommended a request for information (RFI) be sent out by DBHDS to solicit information from potential providers on costs of services and how they would provide 24/7 dispatch. This RFI was issued on August 1, 2017 with a close date of September 1, 2017. As of September 1, three responses have been received. See Appendix E and F for RFI and responses) Finally, the workgroup discussed possible cost savings such as integration with existing Medicaid transportation providers, and barriers to implementing a model.
The results of these discussions and recommendations on an alternative transportation model are included in this report.