Virginia still looking for ways to improve access to mental health care

July 16, 2018 | By Luanne Rife

Virginia is using contracts with local mental health agencies to set a standard of care, but availability and variety of services vary widely across communities.

“How do we fix the variation? It still depends on where your ZIP code is,” asked Del. Scott Garrett, R-Lynchburg, during a meeting of a legislative work group studying reforms to the structure and funding of mental health services.

In essence it is the same question the group has been asking since its formation in 2014, said Sen. Creigh Deeds, whose family tragedy set the process in motion.

The work group met Monday at Catawba Hospital to hear from the Department of Behavioral Health and Developmental Services on its efforts to provide oversight of the 40 community services boards that provide local services.

The state contracts with the CSBs to provide emergency services, case management and hospital pre-screening and discharge planning. By next July, all will need to also offer primary care screening and same-day access.

The work group heard that nine boards do not receive local support, despite a law mandating a 10 percent local match; that the number of people served per caseworker can vary from fewer than 20 in Loudoun County to nearly 200 in Dickenson County; and that services vary from 40 types offered in Fairfax to just 18 at the Rockbridge Area CSB, which in 2013 failed to find a hospital placement for Gus Deeds, who hours later attacked his father and killed himself.

Deputy Commissioner Daniel Herr said, “The core thing we are working toward is that it doesn’t matter where you live, how poor or wealthy your community, you’ll have same-day access to services.”

Deeds said the General Assembly made two huge strides this year in improving access to mental health services by expanding Medicaid and by providing the first round of funding for STEP Virginia, the department’s plan to reform behavioral health.

“It’s really an elephant. A few chunks have been taken out of it but we are nowhere near done,” Deeds said.

The work group will meet in August to look at how other states structure and fund mental health services.