Virginia needs a new way of transporting people in psychiatric crisis — especially children — other than in handcuffs by law enforcement, according to a legislative panel that is recommending up to $10.2 million in state funds to develop alternative transportation programs across the state.
The Joint Subcommittee to Study Mental Health Services in the 21st Century agreed on Tuesday to seek statewide funding for the alternative transportation project, rather than a more limited approach recommended by an advisory work group to test the concept in the Charlottesville region and six communities in Southwest Virginia at a cost of $1.7 million.
“We know what our goal is,” subcommittee Chairman R. Creigh Deeds, D-Bath, said. “I think it’s a reasonable approach to ask for the whole thing.”
Alternative transportation in psychiatric emergencies has been a major goal for law enforcement agencies, especially small sheriff’s departments in rural counties, as well as mental health advocates who have become increasingly alarmed by the use of handcuffs and other restraints in transporting young children in crisis.
“It’s a real crisis for transportation of children,” said John Oliver, chairman of the subcommittee’s advisory panel on crisis response and emergency services.
However, the legislative subcommittee also acknowledged the challenge of getting full funding for the project, which isn’t part of a budget package of more than $76 million proposed by Gov. Terry McAuliffe to pay for a wide array of initiatives to improve Virginia’s public mental health system and treatment of substance use disorders, especially opioid addiction.
Money for alternative transportation wasn’t the only budget request adopted by the subcommittee, which also is seeking about $5 million in the next two years for crisis intervention training and assessment centers in six rural areas that can’t afford the services necessary to identify people with mental illness to divert them from jails into treatment. The panel also wants $2.8 million to divert people with serious mental illness out of the criminal justice system at the court level in those jurisdictions.
Other requests include $1.1 million for a series of pilot programs in the Appalachian Mountain region to provide mental health services by remote telecommunications — or telemental health — and $4.5 million for the Virginia Housing Trust Fund, in addition to the $4.6 million sought by the governor for permanent supportive housing for people recovering from serious mental illnesses.
Sen. Emmett W. Hanger Jr., R-Augusta, co-chairman of the Senate Finance Committee, said the larger challenge will be paying for all of the mental health initiatives proposed by McAuliffe in a budget that assumes the General Assembly will approve expansion of Virginia’s Medicaid program.
“The governor made some assumptions (Monday) that we may or may not adopt in terms of revenue resources,” he told the subcommittee.
McAuliffe estimates budget savings of $421.7 million by expanding Medicaid with $3.2 billion in federal funds under the Affordable Care Act, but he also is counting on Virginia hospitals to agree to pay a provider assessment that would raise about $307 million to cover the state’s share of the costs, or no more than 10 percent.
Hanger, who has supported past attempts to expand health insurance coverage for uninsured Virginians under Medicaid, said the state would need the federal money to bolster community services in the mental health system and relieve mounting pressure on state hospitals that have almost reached full capacity.
At the same time, McAuliffe and legislative leaders also are looking for money to build a new cash reserve to guard against economic uncertainty and reverse a negative outlook on the state’s finances by one of the nation’s bond-rating agencies, Hanger said.
“With the pressure to set aside more reserve dollars, we’ll be hard-pressed to fund all of these things without accessing Affordable Care dollars,” he said in an interview.