Amid State Hospital Closures, a Federal Funding Plan to Shore Up Mental Health Staffing
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Virginia Gov. Ralph Northam proposed a $485 million spending package to increase high turnover and vacancies at state-run behavioral hospitals, which have struggled during the pandemic.
Virginia Gov. Ralph Northam hopes to spend $485 million in federal and state coronavirus relief money to shore up the state’s behavioral health resources, including investments to alleviate staff shortages and overcrowding that closed five of eight state-run mental health hospitals earlier this month.
“The pandemic has led to increases in depression, anxiety, substance use disorders, and other mental health issues in Virginia and across the country, which has added to the strain on our behavioral health system and the valued people who work within it,” Northam, a Democrat, said in a statement. “This funding package is a down payment that will significantly increase support for our state hospitals, community-based providers, and substance abuse prevention and treatment programs so they can best help those who rely on their services.”
The announcement came weeks after Alison Land, head of the state’s Department of Behavioral Health and Developmental Services, ordered five of the state’s eight adult hospitals to reduce patient capacity and halt new admissions. (One has since reopened at limited capacity.) Land said the action was necessary to protect staff amid high turnover rates and continuously rising admissions.
“The challenges faced by the state hospitals are now an immediate crisis for two reasons,” Land wrote in a July 9 letter to the department’s partners and providers, which was made public on Facebook by the Virginia Association of Chiefs & Police & Foundation. “First, the level of dangerousness is unprecedented, and second, recent admissions are occurring in an environment that is no longer adequately staffed.”
“Without doubt,” she continued, “the pandemic drove many workers to positions that pose less risk to their personal health and wellbeing and shattered an already fragile staffing milieu.”
In the first nine days of July, Land said, the department received reports of 63 serious injuries to patients and staff, or an average of about 4.5 incidents per day. At that time, roughly a third of staff positions were vacant, with 108 new resignations in the preceding two weeks. Those departures came as admissions skyrocketed, thanks largely to a 2014 law that requires state hospitals to admit patients after eight hours if private hospitals can’t, or won’t, find a bed for them.
Since that policy took effect, the number of patients admitted via temporary detention order—a procedure that includes a mandated mental health evaluation—has gone from 3.7 to 18 per day, a 392% increase, Land said.
Northam’s announcement came after Virginia lawmakers spent several weeks discussing how to best allocate funds to shore up state hospital resources. The governor’s proposal includes roughly $200 million for staffing needs at those facilities—$154 million for raises over two years and $45 million to “continue staff bonuses”—along with $150 million for community-based crisis services and support programs for families and children.
The package also includes money for infrastructure repairs at state-run health facilities, “including water treatment, ventilation and sewer systems,” the governor’s office said.
The money is a mix of state and federal funding, including a portion of Virginia’s $4.3 billion share of the American Rescue Plan Act. Lawmakers will consider the proposal next week in a special legislative session convened specifically to decide how to allocate that federal funding.
“These measures outline a significant step towards ensuring state hospitals remain operational for the immediate and foreseeable future,” state Del. Mark Sickles, a Democrat and chair of the House Health, Welfare and Institutions Committee, said in a statement. “We have to take action now to address these critical issues.”
Kate Elizabeth Queram is a senior reporter for Route Fifty and is based in Washington, D.C.
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