Mental Health Check: In Virginia, New Funding Approach Sought by Professor-Led Expert Panel

With ‘Unprecedented Surge’ in Hospital Admissions, Group Says Immediate Action Required
Richard Bonnie

With a decades-long track record as an expert health policy adviser, UVA Law professor Richard Bonnie is overseeing an effort to recommend comprehensive changes to Virginia’s mental health care system.

November 29, 2017

University of Virginia School of Law professor Richard Bonnie released a preliminary report on Monday urging Virginia’s state legislators to prioritize community mental health services in 2018.

The recommendations were part of a two-day presentation to a General Assembly joint subcommittee tasked with comprehensive mental health reform in the state. The effort follows the 2007 Virginia Tech shootings and, more recently, the 2013 suicide of Virginia Sen. Creigh Deeds’ son, Gus.

Bonnie, who has a decades-long track record as an expert health policy adviser, is coordinating a set of expert advisory panels for the General Assembly’s mental health study and chairs the panel providing input on health system structure and financing.

If adopted, the funding move would be more than just a short-term fix. It would signal a commitment to revising the state’s current budgeting approach, which Bonnie’s group says relies too heavily on crisis care in state hospital settings and doesn’t align incentives for investing in community services.

“Establishing accessible community services statewide will enable the Commonwealth to substantially reduce its investment in maintaining and operating state hospitals for crisis mental health admissions,” the report says.

The preliminary report notes an “unprecedented surge in admissions” to state hospitals and an increasing number of patients waiting to be released back to “suitable community placements.” If hospital utilization is not brought down, the report says, the state faces the prospect of inefficient investment in older state facilities that ought to be closed or downsized.

The report stresses that legislators should act immediately to address the current pressures while they continue to implement a long-term plan for enhancing community services that the General Assembly embraced in the 2017 session.

For the next budget cycle, “[a]n urgently needed short-term infusion of resources is necessary to stabilize the current situation and to put in place the conditions required to permanently reverse the unsafe and unsustainable trajectory of state hospital admissions.”

The report goes on to outline where the subcommittee believes initial resources should be allocated.

The subcommittee was charged in 2014 with investigating systemic reform. Deeds asked Bonnie to convene and oversee the advisory panels, which include Bonnie’s structure and financing group and three others. The expert advisers include several UVA Law alumni with expertise in health and public safety. The panels report to the subcommittee's work groups.

Law students are supporting the research and coordination efforts. The efforts are also being assisted by UVA's Frank Batten School of Leadership and Public Policy, and the School of Medicine, with funding from the General Assembly and the Department of Behavioral Health and Developmental Services.

A final report of recommendations was originally scheduled for completion in December 2017, but the General Assembly granted a two-year extension last year in order for allow the joint subcommittee to develop a detailed and comprehensive plan. 

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