Tales of kids in handcuffs brings call for statewide alternative for people in mental health crisis

Dave Ress-Contact Reporter |  December 19, 2017

Tales of kids taken for emergency mental care in handcuffs prompted a legislative panel to step up the pace of change in the way people in mental health crisis get to the hospital.

Paying for an alternative to a trip to the hospital in the back of a police car could cost $10.2 million if phased in statewide, but the panel decided to seek that instead of a more modest $1.7 million program meant to launch alternatives in two regions of the state.

The idea would be to hire firms that operate ambulances or other medical transportation, with staff specially trained to manage adults and children who are in the midst of a mental health crisis, said state Sen. Creigh Deeds, D-Warm Springs, the panel’s chairman.

The panel endorsed Gov. Terry McAuliffe’s proposals to boost spending on mental health programs, including $11.8 million to expand access to same-day mental health assessments at all the state’s Community Services Boards, $11.2 million to support outpatient clinics for medical care of people with serious mental illness, $6.9 million on discharge assistance planning to help some 80 to 90 state hospital patients who are ready to leave, and $4.8 million to fund community mental health services for former state hospital patients.

But the governor’s budget is structured in a way that would fund those services by tapping Affordable Care Act funds to expand Medicaid, said state Sen Emmett Hanger, R-Mount Solon, a panel member and co-chairman of the Senate Finance Committee.

The General Assembly might not go along, but several members, including Hanger himself, are looking at ways to expand access to Medicaid, he added.

McAuliffe has pushed for Medicaid expansion for four years, but what had been an overwhelmingly Republican House of Delegates has refused to go along. It rebuffed Hanger’s own efforts to find a compromise.

But after Tuesday’s Newport News recount, the House is now split 50-50, after the election of 16 Democratic challengers, campaigning largely on the need for expanded Medicaid.

Deeds, the panel chairman, said he strongly supports Medicaid expansion as a way to finance badly needed improvements to Virginia’s mental health system.

Hanger said he’s looking at approaches that might expand eligibility for Medicaid, now income-based, to focus on diagnoses.

Currently, Virginia covers adults with disabilities only if their household incomes are less than 80 percent of the federal poverty level, or $9,648. That is about two-thirds the average disability benefit Social Security pays.

Amy Woolard, an attorney with the Legal Aid Justice Center in Charlottesville, told the panel about two instances in which a 7-year-old and 10-year old in mental health emergencies were cuffed before police officers took them to the hospital.

“I don’t blame law enforcement … there’s no alternative,” she said.

“But the 7-year-old was in foster care and had just seen his father arrested and handcuffed,” she said.

She added that re-enacting his father’s experience made it that much harder for the 7-year-old to recover from the crisis.

State Sen. Janet Howell, D-Reston, said she’s been hearing complaints from sheriff’s departments, families of people with mental illnesses, providers of mental health treatment and courts that Virginia needs to find an alternative for getting people in a crisis to care.

Sheriffs complain about the cost and say deputies can be tied up for hours as mental health officials try to find a hospital bed — often one across the state that requires hours of driving. Families and therapists say the process is traumatic.

Daily Press