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

February 13, 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 Amendment Items
3. Mental Health Insurance Issues
4. Mental Health Issues
5. Substance Use Disorder Measures
6. Legislation for Mental Health Professionals
7. Miscellaneous Mental Health and Substance Use Disorder Bills
8. Contacting Your Legislators

1. INTRODUCTION

This coming week will be the last week for Committees to consider legislation during the 2005 session. The final week of the General Assembly will focus on bills on the floor of the House and Senate and on the budget.

If you care about a bill that is listed as being in a Committee, now is the time to make your voice heard. If the bill is in the House, let your Delegate and the members of the Committee know your feelings; if the bill is in the Senate, do the same with your own Senator and members of the Committee.

This also is the last week that speaking your opinions on the budget will have much impact. We will recap the major budget items in this issue and, if any of them is important to you, you will want to speak now on those items, too.

2. BUDGET AMENDMENT ITEMS

Last week, we told you what the House and Senate each planned for additional mental health funding in their budgets. We have included those proposals again below.

The differences in the budgets will be worked out in a committee of conference. While that committee will not be appointed until later this week, we have no reason to believe it will change from last year. The conferees last year were: Dels. Callahan, Putney, Hamilton, Cox and Joannou; and Sens. Chichester, Wampler, Stosch and Colgan.

To make your opinions known on budget issues, first you will want to contact your own Senator and Delegate. To find out who represents you in the Virginia House of Delegates and Virginia Senate, check out the final article in this newsletter. If your Senator or Delegate is not a conferee, you should indicate that you know they do not sit on the Committee that works out the budget, but that you hope they will let the conferees know that this funding is important to people who live in their districts. Then, contact the members of the conference committee listed above.

When you call or e-mail about the budget, refer to the amendments by their item number.

House Budget Amendments

Item 326 #5h: exempts antidepressant and antianxiety medications used for the treatment of mental illness from the Medicaid Preferred Drug List program.

Item 334 #1h: adds $2.9 million from the general fund in the second year for four additional community crisis stabilization units to provide acute and intensive services. Crisis stabilization services have proven effective in assisting consumers in crisis and providing needed stabilization and treatment, averting more costly hospital placements. This amendment earmarks a total of $4,870,000 for crisis stabilization services, accounting for funds included in the introduced budget for this purpose. Language is added specifying the areas of the state where the units will be established -- Northern Virginia, the Shenandoah Valley, the Roanoke Valley, Southside Virginia, the Upper Peninsula of Hampton Roads, and South Hampton Roads.

Item 362 #1h: adds language directing the Department of Social Services, as well as the Secretaries of Health and Human Resources, Education, and Public Safety to assist in ensuring that Virginia's Information and Referral (I&R) System operates as a single source or information clearinghouse on services available for families or those working with children and families. With more extensive information on services, this clearinghouse would be a timesaving and vital link to information on services for youth and families, community members, professionals, and policymakers.

Senate Budget Amendments:

Item 326 #7s: exempts antidepressant and antianxiety medications used for the treatment of mental illness from the Medicaid Preferred Drug List program.

Item 334 #5s: provides an additional $2.2 million from the general fund the second year to establish six crisis stabilization programs in areas of the Commonwealth experiencing severe shortages of available inpatient treatment beds. The introduced budget included $1.1 million for two locations. Crisis stabilization services have proven effective in assisting individuals in crisis, providing needed stabilization and treatment, and averting more costly hospital placements.

Item 334 #8s: provides $500,000 the first year and $1.0 million the second year from the general fund to continue providing substance abuse treatment services for 800 consumers, including adolescents and pregnant women with substance abuse disorders.

Item 334 #12s: adds $1.0 million from the general fund the second year to implement nationally-tested and evidence-based models of effective community treatment through two demonstration projects that will serve children with serious emotional disturbances and other related conditions. Each pilot project will serve approximately 150 to 200 children, children whose needs are currently unmet by existing programs.

Some advocates believe that the one crucial missing piece in budget funding is for next year's funding for the aftercare pharmacy, the state pharmacy that provides prescription medications to consumers after they have been discharged from state facilities. The pharmacy has a significant budget shortfall that was plugged for the current year but not for next year. Many advocates also are voicing this need despite the fact that neither house adopted a budget amendment to address it.

3. MENTAL HEALTH INSURANCE ISSUES

Sometimes at crossover, bills that have been there all along jump out as creating concerns. Such is the case with two bills that, as amended, will make it much more difficult for people with serious mental illnesses to qualify for Medicaid. These bills are HB-1798 introduced by Del. Dave Albo (R-Springfield) and SB-1143 introduced by Sen. Emmett Hanger (R-Mt. Solon). As passed their respective houses, these bills are almost identical. They require an applicant for Medicaid to prove his legal residence in this country. They are designed to ensure that illegal aliens do not receive taxpayer-funded Medicaid coverage which, in the minds of some, would promote people coming to this country illegally. Unfortunately, many people who are citizens of this country do not have the documents necessary (i.e. birth certificate or passport) needed to prove they are citizens and, thus, legal residents of the United States. And, people with serious mental illnesses are even less likely to have those documents, and may well not remember the information required to obtain them. Thus, if these measures pass, it can be speculated that fewer people with serious mental illnesses will qualify for Medicaid to provide coverage for treatment of their mental illness and other health care. HB-1798 is in the Senate General Laws Committee; SB-1143 is in the House General Laws Committee.

The House Health, Welfare and Institutions Committee tabled SB-702 introduced by Sen. Roscoe Reynolds (D-Martinsville). This measure would have increased eligibility for Medicaid to incomes of less than 100% of the federal poverty level. Currently, 80% is the cut-off.

Sen. Yvonne Miller's (D-Norfolk) SB-742 passed the Senate and is in the House Health, Welfare and Institutions Committee. As redrafted by the Senate, this measure will gather statistical information on children enrolled in FAMIS, the children's health insurance program, to determine how many of them have a responsible family member who is employed. If employed, general information on the employers will be included in the statistical report so public policymakers can determine whether there is a concern about employers not making health care coverage available to employees.

The Senate Finance Committee took no action on SB-1255 introduced by Sen. Benjamin Lambert (D-Richmond). This bill would have created an income tax credit for employers who pay at least half of the premium for employees' health care coverage. This means the bill is dead for this session.

4. MENTAL HEALTH ISSUES

Del. Phil Hamilton (R-Newport News) saw his HB-2037 pass the Senate Education and Health Committee unanimously and move to the House floor. This measure would establish the Interagency Civil Admissions Advisory Council to study issues related to the provisions of Virginia law regarding the emergency custody, temporary detention, admission, and involuntary inpatient and outpatient treatment of persons with mental illness, to propose recommendations and provide advice addressing those issues, and to improve the coordination and effectiveness of the implementation of those recommendations.

HB-2110 to establish the standard required for a court to order involuntary commitment to a person believed to be a danger to himself or others passed the House and now is in the Senate Courts of Justice Committee. This measure was introduced by Del. Michelle McQuigg (R-Prince William) and specified that this involuntary hospitalization will require "clear and convincing" evidence.

HB-2245 was introduced by Del. Rob Bell (R-Albemarle) to require the Board of Juvenile Justice to develop regulations for the planning and provision of mental health, substance abuse or other therapeutic treatment services for persons returning to the community following commitment to a juvenile correctional center detention. An identical bill in the Senate, SB-843 introduced by Sen. Creigh Deeds (D-Warm Springs) passed the Senate and is in the House Courts Committee.

Del. Charles Carrico (R-Independence) saw his HB-2436 reported from the Senate Rehabilitation Committee to the floor of the Senate. This bill would allow a prisoner who has been involuntarily hospitalized to remain in the hospital when he no longer is a danger to himself or others if a need for hospitalization remains. We understand that, as drafted, it would apply only to prisoners at the Marion Correctional Center.

HB-2796 and SB-889 were introduced to specify that the Department of Mental Health, Mental Retardation and Substance Abuse Services is the lead agency for suicide prevention across the lifespan. The Senate bill passed the Senate as introduced and the House Health, Welfare and Institutions Committee. This is the Committee that substantially amended the House bill so that now it merely clarifies that the Department of Health should consult with behavioral health authorities on the youth suicide prevention program for the Commonwealth, as well as develop and carry out comprehensive youth suicide prevention strategies. This Committee now has amended the Senate bill so it looks the same as the House bill. It remains to be seen what the Senate Education and Health Committee does when it considers the House bill.

SB-714 introduced by Sen. John Edwards (D-Roanoke) was left in the Senate Finance Committee without action on the deadline for the Senate to act on Senate bills. As a result, it is dead for this session. This bill dealt with the hospitalization of mentally ill defendants in criminal trials.

5. SUBSTANCE USE DISORDER MEASURES

The two bills calling for a moratorium on new licenses for methadone clinics until the licensure regulations can be amended are moving through the process. These bills are HB-1778 that passed the Senate Education and Health Committee and now is on the Senate floor; and SB-753 that now is in the House Health, Welfare and Institutions Committee. These measures were introduced by Sen. William Wampler
(R-Bristol) and Del. Terry Kilgore (R-Gate City).

Del. John Cosgrove (R-Chesapeake) saw his HB-2810 pass the House and get referred to the Senate Courts Committee. This measure calls for the creation of a drug court in Chesapeake. Readers will want to note that there was a mistaken report on this measure in last week's issue.

Sen. Yvonne Miller's (D-Norfolk) constitutional amendment regarding the restoration of voting rights to convicted felons passed the Senate and has been referred to the House Committee on Privileges and Elections. This amendment is supported by substance abuse treatment advocates who know that people with addictions sometimes are convicted of crimes related to their addiction. With recovery, the hope is that there would be a reasonable and orderly process to have rights restored. The House typically has killed this measure. We will watch as they act on this year's bill.

6. BILLS OF INTEREST TO MENTAL HEALTH PROFESSIONALS

HB-1512 introduced by Del. John Cosgrove (R-Chesapeake) passed the House and is under consideration in the Senate Finance Committee. This bill would provide an income tax credit to health care practitioners who provide free medical services to indigent persons who cannot pay for the services themselves. The amount of the credit would be equal to 25 percent of the fee the practitioner would charge for the service, not to exceed $500 annually for any practitioner. The credit would be available for taxable years beginning on or after January 1, 2006.

HB-1556 introduced by Del. Bob Purkey (R-Virginia Beach) passed the House and is in the Senate Courts Committee. As amended in the House, this bill now requires the Board of Medicine to provide its licensees with a full description of the immunity that may apply when they provide health care services to a patient of a free clinic.

More professionals are becoming concerned about HB-1753 introduced by Del. Bill Janis (R-Goochland). This measure exempts collection of overpayments by Medicaid from the protections of the Administrative Process Act when those overpayments resulted from fraud. We understand the Health Law section of the Bar Association now is taking a look at it and will be providing its interpretation soon. Meanwhile, the measure is in the Senate Courts Committee.

The Senate Courts Committee also will be considering Sen. Jim Shuler's
(D-Blacksburg) HB-2503 adding marriage and family therapists to a number of laws that include other mental health professionals.

SB-1106 amending the Fair Business Practices Act for health care plans has passed the Senate and is under consideration in the House Commerce and Labor Committee. This bill is SB-1106.

Sen. Bill Bolling (R-Hanover) saw his SB-1247 pass the House Health, Welfare and Institutions Committee and move to the House floor. This measure requires the Director of Medical Assistance Services to issue an informal fact-finding conference decision in appeals from agency determinations concerning provider reimbursement.

7. MISCSELLANEOUS MENTAL HEALTH AND SUBSTANCE ABUSE MEASURES

Del. Tim Hugo (R-Centerville) has asked that his HB-2613 be stricken from the docket in the Senate Education and Health Committee. This measure would have prohibited a variety of surveys of students in the public schools. Concerns of school divisions, as well as mental health advocates were raised, prompting him to conclude that the bill needs more work before it's ready to become law. Mental health advocates were concerned that a youth survey used by school divisions and localities to assess the risk of student drug use, mental health problems and other behaviors would be prohibited. This survey provides data for schools and localities to develop and offer prevention programs, many of which are funded with federal funds.

Sen. Walter Stosch (R-Henrico) saw his SB-935 pass the Senate and be referred to the House Health, Welfare and Institutions Committee. This measure would extend the Caregiver's Grant Program to the year 2010. Otherwise, the program would expire this year.

8. 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 http://www.macbur.com/global/links.php. 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.