VMHE NEWS - Virginians for Mental Health Equity Newsletter
Published as a service to mental health and substance abuse consumers, family members and professionals

February 6, 2005

Published as a service to mental health and substance abuse consumers, family members and professionals

Virginians for Mental Health Equity is a coalition of the major mental health and substance abuse professional and consumer organizations. It is dedicated to improving access to mental health and substance abuse treatment in the private and public sector, with a focus on insurance coverage, but an interest in many other issues.

During sessions of the Virginia General Assembly, VMHE publishes this newsletter on a weekly basis to inform advocates about pending legislation as it moves forward. Our intent is to allow advocates to make their voices heard to public policymakers as they deliberate issues that affect the lives of consumers with mental illness and substance use disorders, and professionals who work to provide care for them. It is distributed by e-mail only.

For more information on any of the bills listed here, or on the General Assembly, please look on the Internet at legis.state.va.us.

To subscribe to this newsletter, go to http://www.macbur.com/global/links.php. This also is the webpage to access if you would like to discontinue receiving this newsletter.

Please feel free to pass along this issue to others who share your interest in mental health and substance use disorder issues.

And, we invite your comments. Please contact Leslie Herdegen at LHerdegen@macbur.com or call 804-649-1053.

CONTENTS

1. Introduction
2. Budget Proposals Adopted by House and Senate
3. Mental Health Insurance Issues
4. Mental Health Issues
5. Children's Mental Health Issues
6. Substance Use Disorder Measures
7. Legislation for Mental Health Professionals
8. Miscellaneous Mental Health and Substance Use Disorder Bills
9. Contacting Your Legislators

1. INTRODUCTION

On Tuesday, we will know which House bills survived the House and which Senate bills survived the Senate. As this is written, the both bodies are taking action on their final bills before crossover, the date by which each house must have acted on its own legislation. So, if the bills you care about have passed the house in which they were introduced, you should not address your views to the legislators on the other side.

As bills cross over to the other house, they retain their original designation and number and have the same patron. Those bill numbers you memorized still will be useful.

Committees will act on bills that have crossed over within the next two weeks, so if you have an opinion on a bill, you will want it now.

The final weeks of the session also will focus on the state budget and funding for public mental health services. Read on to find out what the House and Senate have proposed for this portion of the budget for the next year.

2. BUDGET PROPOSALS ADOPTED BY HOUSE AND SENATE

The House Appropriations and Senate Finance Committees reported out their respective budgets today. You will see by the amendments below that the two houses had very different ideas of funding for mental health and substance abuse services in Virginia for the rest of this year and for the coming year.

Over the next weeks, the differences between the House and Senate amendments will be worked out by the leadership of both of those Committees. Next week's issue will give you some specific pointers about how to influence the outcome of mental health and substance abuse funding in the final budget.

In the meantime, below are the funding increases proposed by the House and the Senate.

House budget amendments:

Add $2.9 million to create four additional crisis stabilization programs for people at risk of hospitalization due to an impending mental health crisis. These programs are to provide needed stabilization services with the intent of avoiding more costly hospitalization and it is hoped that they will alleviate some of the bed shortage problems being experienced in the Commonwealth. The introduced budget provided funding for two such programs. The House specified that these programs are to be in the following regions: Northern Virginia, Shenandoah Valley, Roanoke Valley, Southside Virginia, Upper Peninsula of Hampton Roads and South Hampton Roads.

The House added language to the budget related to the Medicaid Preferred Drug List program exempting antidepressant and antianxiety drugs from the restrictions imposed by the program. It also added language to ensure that at least half of the members of the Committee appointed to oversee development of the program are professionals who provide services to Medicaid recipients in the Medicaid fee-for-service program.

Senate budget amendments:

Add $2.2 million to the funds in the introduced budget to create a total of six crisis stabilization programs in areas of the Commonwealth experiencing severe shortages of available inpatient treatment beds. The Senate amendment did not specify which areas are to receive funding for these programs.

It appears that the Senate adopted language similar to the House with regard to the Preferred Drug List program. Additionally, language in the Senate budget calls for reporting to the General Assembly on the program.

The Senate proposed $500,000 in the current year and $1 million next year for substance abuse funding to ensure retention of federal funds for substance abuse treatment programs.

The Senate proposed $1 million to implement nationally-tested, evidence-based models of effective community treatment for children and adolescents with behavioral health needs. Each pilot project is expected to serve 150-200 youth.

As we see the actual amendments, we may find others that were not spelled out clearly in the reports issued today, so stay tuned.

3. MENTAL HEALTH INSURANCE MEASURES

SB-702 introduced by Sen. Roscoe Reynolds (D-Martinsville) passed the Senate Finance Committee and the whole Senate. This bill proposes increasing the income level at which senior citizens and people with disabilities are eligible for Medicaid from the current 80% of poverty to 100%. Since this comes with a price tag, however, and the Senate Finance Committee was not certain it would be able to provide the funding, they added a clause that prevents the bill from becoming law unless funds are appropriated. The members of the Committee indicated that they might consider increasing the eligibility to some level other than 100% of poverty. It appears that this bill remains a work in progress. If the income level for eligibility were to be increased, however, it would increase the number of people who would be eligible for the health benefits provided by Medicaid.

Del. Phil Hamilton (R-Newport News) will be presenting his HB-1492 to the Senate Commerce and Labor Committee next since it passed the House. This bill would revise health savings accounts to make them more accessible to Virginians. It also would allow individuals with health savings accounts to purchase health care policies with a high deductible since the savings account would pay for the deductible. The funds in the health savings account would not be taxed as long as they were used to pay health care costs.

SB-742 introduced by Sen. Yvonne Miller (D-Norfolk) is designed to allow Virginia to determine whether applicants for publicly-funded health care benefits (i.e Medicaid and FAMIS, the children's health care plan) are employed full time. If they are employed full time and are applying for these benefits, at least some members of the household do not have health insurance coverage. There is an interest in determining whether there is a pattern of employers who do not offer coverage to full time employees. The bill has passed the Senate Education and Health Committee by a vote of 11 - 4 and is on the Senate floor. If it passes there, it probably will be referred to the House Commerce and Labor Committee.

HB-2864 introduced by Del. Kathy Byron (R-Lynchburg) to create a tax credit for individuals for health insurance premiums and health savings accounts contributions was tabled in the House Finance Committee. Therefore, this measure is dead for this session.

SB-1255 introduced by Sen. Benjamin Lambert (D-Richmond) to create a tax credit for employers who provide health care coverage for their employees appears to be stuck in the Senate Finance Committee. Without Committee action on this bill before Tuesday, it also will be dead for this session.

4. MENTAL HEALTH ISSUES

You will recall that HB-2037 to create a Civil Admissions Advisory Council to address concerns regarding temporary detention orders passed the House. As expected, it now is in the Senate General Laws Committee where we understand some consumer organizations may try to have amendments introduced to place more consumer and family member representation on the Council. This bill was introduced by Del. Phil Hamilton (R-Newport News).

The bill to establish a standard for determining whether a person is a danger to himself or others and, therefore, in need of involuntary hospitalization, passed the House Courts of Justice Committee by a vote of 18 - 2 and now is on the House floor. This bill is HB-2110 and it was introduced by Del. Michele McQuigg (R-Prince William County) at the request of judges in her area and apparently is designed to codify court decisions on this topic. Currently, there is no standard in the law for making this determination, although most judges have used the clear and convincing standard proposed in this measure. We have heard that some people have expressed some concerns that this will result in some people not being hospitalized when they need to be. But, involuntary hospitalization is a serious issue since it deprives a person of their constitutional right to liberty, and the courts have determined that a high standard should be in place before this action is taken.

Del. Charles Carrisco (R-Independence) saw his HB-2436 pass the House and go to the Senate where it will be considered in the Senate Rehabilitation and Social Services Committee. This measure would allow a prisoner who has been involuntarily hospitalized but no longer is a danger to himself or others to remain in the hospital voluntarily if the need for hospitalization is determined by a physician or clinical psychologist.

SB-714 introduced by Sen. John Edwards (D-Roanoke) passed the Senate Courts Committee and has been referred to the Senate Finance Committee since it may have a fiscal impact. This measure allows for hospitalization of a defendant in a criminal matter if the defendant is so seriously mentally ill as to be unable to care for himself. Under current law the standard is "imminently dangerous to himself or others."

Sen. Edwards' SB-725 was passed by indefinitely, or killed, in the Senate Finance Committee by a vote of 10 - 5. This measure would have established mental health courts of up to five jurisdictions in Virginia for nonviolent offenders with serious mental illnesses. We do understand that at least one jurisdiction has started a mental health court; it is the belief of many that no legislation is necessary to create these special courts that focus on treatment rather than punishment.

The two identical bills to designate the Department of Mental Health, Mental Retardation and Substance Abuse Services as the lead agency for suicide prevention activities across the lifespan now look very different.

SB-889 introduced by Sen. Bill Mims (R-Loudoun) passed the Senate as it was introduced. HB-2796 introduced by Del. Viola Baskerville (D-Richmond) was amended so that the Department of Health remains the lead agency for suicide prevention activities among young people and there is no designated agency for suicide prevention activities across the lifespan. The House Health, Welfare and Institutions Committee was not persuaded about the efficacy of generic, community-wide suicide prevention activities. The Senate bill now will go to the House Health, Welfare and Institutions Committee. The House bill remains on the House floor where it will be voted before the crossover deadline on Tuesday.

5. CHILDREN'S MENTAL HEALTH ISSUES

SJR-287 was not acted on in the Senate Rules Committee and, since the Committee has not scheduled any other meetings before the crossover deadline, we can presume this measure has failed this year. This resolution was introduced by Sen. Yvonne Miller (D-Norfolk) to create a legislative subcommittee to study the need for in-state residential treatment for troubled and at-risk youth now served in out-of-state placements.

HB-2245 introduced by Del. Rob Bell (R-Albemarle) has passed the House and is on its way to the Senate. This measure would require the Board of Juvenile Justice to develop regulations for the planning and provision of mental health and substance abuse treatment of youth who are returning to the community following confinement in a juvenile correctional center.

6. SUBSTANCE ABUSE MEASURES

The two bills to place a moratorium on new methadone clinics until the licensure standards can be revised to include a determination of the need for the clinic have passed the houses in which they were introduced and have crossed over. HB-1778 with Del. Terry Kilgore (R-Gate City) as the chief patron now is in the Senate Education and Health Committee; SB-753 introduced by Sen. William Wampler (R-Bristol) now is in the House where we expect it will be referred to the House Health, Welfare and Institutions Committee.

HB-2810 introduced by Del. John Cosgrove (R-Chesapeake) to create a drug treatment court in Chesapeake has passed the Senate Courts of Justice Committee and is on the Senate floor.

Sen. Yvonne Miller's (D-Norfolk) proposed Constitutional Amendment to authorize by law the restoration of voting and other civil rights to nonviolent offenders has passed the Senate Privileges and Elections Committee by a vote of 9 - 5 and is on the Senate floor. Currently, the only way rights can be restored to those convicted of felonies is by the Governor. This measure is important to the substance abuse advocacy community because addiction sometimes results in criminal behavior and convictions that, absent the addiction, would never have happened. Following recovery and completion of all debt to society, advocates believe that there should be a predictable process to have rights restored.

7. LEGISLATION FOR MENTAL HEALTH PROFESSIONALS

HB-1512 introduced by Del. John Cosgrove (R-Chesapeake) has passed the House and is in the Senate Finance Committee. This measure would allow health professionals to claim a tax credit of up to $500 for 25% of the usual fee for services provided to indigent people, regardless of where the services were provided. Currently, this tax credit is available only for services provided at free clinics.

The bills recommended by the Joint Commission on Health Care designed to bring Virginia's patient record laws into compliance with the federal HIPAA provisions all have passed the houses in which they were introduced and crossed over. The House bills now will be considered in the Senate Education and Health Committee and the Senate bills will be considered in the House Health, Welfare and Institutions Committee. These bills are HB-2514, HB2515 and HB-2516 introduced by Del. John O'Bannon (R-Henrico); SB-1109 and SB-1110 introduced by Sen. Harry Blevins (R-Chesapeake); and SB-1106 introduced by Sen. Steve Martin (R-Chesterfield). Professionals will want to note that SB-1106 and HB-2514 specifically address mental health and substance abuse records.

Sen. Dick Saslaw (D-Springfield) has his changes to the Fair Business Practices Act past the Senate and in the House Commerce and Labor Committee. This measure is SB-1106. The Fair Business Practices Act governs the relationship between health care providers and insurers/HMOs. The specific changes proposed by Sen. Saslaw relate to claims payment dispute mechanisms; notification of contract changes; and bundling and downcoding procedures.

Two very different bills related to Medicaid overpayments are moving through the process. HB-1753 introduced by Del. Bill Janis (R-Goochland) removes the ability of a provider alleged to have submitted a fraudulent claim from using the processes outlined in the Administrative Process Act to resolve the dispute. This bill has passed the House and now is in the Senate Courts of Justice Committee. SB-1247 introduced by Sen. Bill Bolling (D-Hanover) requires the Director of Medical Assistance Services to issue an informal fact-finding conference decision in appeals fert testimony, and services falling outside of the definition of employment for purposes of unemployment compensation.

Del. Bob Purkey (R-Virginia Beach) introduced HB-1556 to create immunity for physicians who render care without charge to indigent patieksburg) has passed the House Courts Committee and is on the House floor. This measure adds marriage and family therapists to the following Code sections that list other mental health professionals: privileged communications in civil actions, evaluation ofhe House floor.

8. MISCELLANEOUS MENTAL HEALTH MEASURES

Del. Bob Purkey (R-Virginia Beach) saw his B-1557 tabled in the House Appropriations Committee. This measure would have increased the amount of the grant available to a caregiver of a mentally or physically impaired relative under the Caregivers Grant Program.

The Senate passed SB-935 introduced by Sen. Walter Stosch (R-Henrico) to extend the Caregivers Grant Program until the year 2010. Without this legislation, the program would expire this year. bill then passed the Committee and is on the House floor.

9. MISCELLANEOUS MENTAL HEALTH MEASURES

Del. Bob Purkey (R-Virginia Beach) saw his B-1557 tabled in the House Appropriations Committee. This measure would have increased the amount of the grant avainia Senate. You can find out who represents you by calling your local voter registration office. You also can find it on the Internet at legis.state.va.us.

This website will give you the names, addresses, and phone numbers of your Senator and Delegate, aion, the program would expire this year. The measure now will be considered in the House where we expect it will be sent to the House Appropriations Committee.

10. CONTACTING YOUR LEGISLATORS

Every Virginian is represented by one member of the Virginia House of Delegates and one member of the Virginia Senate. You can find out who represents you by calling your local voter registration office. You also can find it on the Internet at legis.state.va.us.

This website will give you the names, addresses, and phone numbers of your Senator and Delegate, and you can send an e-mail to them through this webpage. Be sure to get the names of your representatives in the Virginia House of Delegates and the Virginia Senate - not your Congressional representatives.

When the General Assembly is in session, legislators spend much of each day in meetings. If you want to make your opinion known, you may not have a chance to speak directly with your Senator and Delegate, but you have several other options.

If you call, the legislative aide will be happy to discuss the issue with you and pass along your message to the legislator. Be sure to call the legislator's office in Richmond since that is where they can be reached most quickly during the session. You also can send an e-mail or call the constituent opinion line at (800) 889-0229 (outside Richmond)
or 698-1990 (Richmond area). Since things happen so quickly during the
session, we don't recommend sending snail mail - your letter might get there long after action has been taken.