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

February 20, 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

With only one week left in the 2005 Virginia General Assembly, most bills have been considered in the other house and either have failed or are moving along. A few committees still plan to meet on Monday to finish up their work. The floor sessions will be long as the House labors to complete work on Senate bills and vice versa.

The remainder of the week will be devoted to working out differences in the House and Senate versions of bills, including the budget bill. The budget conferees are to report out their agreement by Tuesday night, although in past years, this deadline has been pushed back one or more times.

There are rumors that the General Assembly may adjourn on Friday, a day earlier than their scheduled adjournment. There are no expectations that the session will be extended.

2. BUDGET AMENDMENT ITEMS

You still can make your voice heard on budget issues on Monday. If you haven't already done so, that is the day to contact your own Senator and Delegate as well as the conferees on the budget to let them know which of the disputed funding items is important to you.

Below are the items in question, as well as a list of the conferees and how to contact them:

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.

Del. Vince Callahan, Del_Callahan@house.state.va.us, 804-698-1034 Del. Lacey Putney, Del_Putney@house.state.va.us, 804-698-1019 Del. Phil Hamilton, Del_Hamilton@house.state.va.us, 804-698-1093 Del. Kirk Cox, Del_Cox@house.state.va.us, 804-698-1066 Del. Johnny Joannou, no email, 804-698-1079 Del Leo Wardrup, Del_Wardrup@house.state.va.us, 804-698-1083

Sen John Chichester, district28@sov.state.va.us, 804-698-7528 Sen. William Wampler, district40@sov.state.va.us, 804-698-7540 Sen. Walter Stosch, district12@sov.state.va.us, 804-698-7512 Sen. Charles Colgan, district29@sov.state.va.us, 804-698-7529 Sen. Edward Houck, district17@sov.state.va.us, 804-698-7517

3. MENTAL HEALTH INSURANCE ISSUES

HB-1492 introduced by Del. Phil Hamilton (R-Newport News) has passed the Senate and is on its way to the Governor. This measure makes changes in the laws related to Medical Savings Accounts to increase the utilization and efficacy of health savings accounts. It also authorizes insurers to offer high deductible insurance plans designed to work with the new Health Savings Accounts.

HB-1798 introduced by Del. Dave Albo (R-Springfield) and SB-1143 introduced by Sen. Emmett Hanger (R-Mt Solon) appear to have been amended so they are identical and now are moving through the process without much opposition. These measures were designed to prevent people who are in this country illegally from receiving Medicaid benefits. As introduced and initially amended, however, they would have required production of documents that many people with serious mental illnesses do not have and may have difficulty obtaining. As amended most recently, however, the measure allows the Medicaid applicant or enrollee to provide a social security number than can then be checked through the Social Security Administration and, when confirmed, will suffice as proof of legal presence. HB-1798 is on the Senate floor; SB-1143 is on the House floor.

The House Appropriations Committee tabled SB-742 that would have required collection of information on employers for applicants for the FAMIS children's health insurance program or Medicaid. This measure was introduced by Sen. Yvonne Miller (D-Norfolk) to determine if there are employers in the Commonwealth who demonstrate a pattern of not providing health insurance coverage for their employees.

4. MENTAL HEALTH ISSUES

Del. Phil Hamilton's (R-Newport News) HB-2037 to create an interagency civil admissions advisory council passed the Senate and next will be considered by the Governor. The purpose of this Council is to work out implementation problems surrounding emergency custody and temporary detention orders for people who are deemed a danger to themselves or others as a result of mental illness.

HB-2110 introduced by Del. Michele McQuigg (R-Prince William) passed the Senate Courts Committee and is on the Senate floor. This measure provides that the judge must apply the standard of "clear and convincing evidence" during an involuntary commitment hearing for persons with mental illness. Current law requires the judge to make specific findings before issuing an order for involuntary commitment, but does not set forth a standard of proof for the judge to apply when considering the evidence.

HB-2245 and SB-843 were introduced to require the Department of Juvenile Justice to develop regulations outlining how minors with mental illness or substance abuse problems will be reintegrated into the community when leaving custody of the Department. HB-2245 introduced by Del. Rob Bell (R-Albemarle) was changed in the Senate Education and Health Committee to include more specific requirements for these regulations. Del. Bell asked that the House reject those amendments, so the bill appears to be headed for a committee of conference to work out the differences in the House and Senate versions of the measure. The companion bill, SB-843 introduced by Sen. Creigh Deeds (R-Bath) remains in the House Courts Committee which is scheduled to meet Monday afternoon.

The Senate has passed HB-2436 introduced by Del. Charles Carrico (R-Independence). This measure applies only to the Marion Correctional Center and would allow a prisoner to remain in the hospital when there is no further need for involuntary hospitalization if the prisoner is capable of and consents to voluntary admission, and is determined to be in need of continued hospitalization by a licensed physician, psychiatrist, or clinical psychologist.

Hb-2796 was introduced by Del. Viola Baskerville (D-Richmond) and SB-889 was introduced by Sen. Bill Mims (R-Loudoun) to make the Department of Mental Health, Mental Retardation and Substance Abuse Services the lead agency for suicide prevention activities across the lifespan, with the Department of Health retaining authority for youth suicide prevention activities. The House declined to adopt this, and changed the bills to reflect only the Department of Health's responsibilities. The Senate amended the House bill to restore it to its original state. It appears that there will be a committee of conference on these measures, also, to work out the differences between the two versions.

5. SUBSTANCE USE DISORDER MEASURES

The two measures to require the Department of Mental Health, Mental Retardation and Substance Abuse Services to refine its regulations for opiate replacement therapy program licensure and place a moratorium on new licenses until the regulations are revised have passed both houses in the same form and are on their way to the Governor. These bills are HB-1778 introduced by Del. Terry Kilgore (R-Gate City) and SB-753 introduced by Sen. William Wampler (R-Bristol).

The Senate amended HB-2810 introduced by Del. John Cosgrove (R-Chesapeake) so that drug courts can be established in any locality. As introduced, the bill was designed to overcome existing law that prohibited the establishment of new drug courts unless they were specifically authorized by the General Assembly. As a result, Del. Cosgrove introduced this measure asking the General Assembly to authorize a drug court in Chesapeake. The Senate proposed and passed an amendment to eliminate the requirement for General Assembly approval of new drug courts. The bill now is on the House floor awaiting a vote adopting the Senate version of the measure.

SJR-259 introduced by Sen. Yvonne Miller (D-Norfolk) to create a constitutional amendment allowing the General Assembly to provide a statutory means for convicted felons to regain their civil rights, including the right to vote, was killed in the House Privileges and Elections Committee by a vote of 11 - 8. This measure has been important to substance abuse treatment advocates since some people in recovery from addiction have been convicted of felonies related to their addiction and, now that they are in recovery, they are no longer any threat to society and would like to regain their civil rights through an orderly process.

6. MENTAL HEALTH PROFESSIONAL ISSUES

The bills to conform Virginia's laws to the federal privacy laws in HIPAA all have passed the second house and are on their way to the Governor for approval. These bills are HB-2514 HB-2515 and HB-2516 introduced by Del. John O'Bannon (R-Henrico); SB-1109 and SB1110 introduced by Sen. Harry Blevins (R-Chesapeake); and SB-1064 introduced by Sen. Steve Martin (R-Chesterfield). Mental health professionals will want to note that HB-2514 and SB-1064 pertain specifically to mental health treatment records.

The Senate declined to pass HB-1512 introduced by Del. John Cosgrove (R-Chesapeake) that would have provided a tax credit for health professionals who provide services to indigent patients regardless of where those services are provided. Current law includes a tax credit for professionals who provide services in free clinics only.

HB-1556 introduced by Del. Bob Purkey (R-Virginia Beach) is on the Senate floor. As amended by the House, this bill now would require the Board of Medicine to provide its licensees with a full description of the protections from civil liability that may apply where health care services are provided without compensation to a patient of a clinic that is organized in whole or in part for the delivery of health care services without charge.

HB-1753 introduced by Del. Bill Janis (R-Goochland) was heard in a subcommittee of the Senate Courts Committee last week. This measure would remove the ability of a Medicaid provider to use the processes in the Administrative Process Act to resolve disputed payments when those payments are deemed to have been obtained fraudulently. The Attorney General's office testified that there are problems using the APA since the APA requires full disclosure of evidence, but when a federal grand jury is involved as in the case of fraud, some information is prohibited from being disclosed. The subcommittee was concerned about removing the protections of the APA from this situation, and indicated they believed the problems could be resolved with less sweeping legislative reform. While we understood the patron to indicate his intent to have the bill stricken during that subcommittee meeting, we now understand that he may be bringing a re-write of the bill to the Senate Courts Committee on Monday morning.

The Senate has passed HB-2503 introduced by Del. Jim Shuler (D-Blacksburg) to add marriage and family therapists to several Code sections that include other mental health professionals.

The House has passed SB-1106 introduced by Sen. Dick Saslaw (D-Springfield) to make changes to the Fair Businesses Practices Act governing the relationship between health professionals and health care plans.

7. MISCELLANEOUS MENTAL HEALTH MEASURE

Sen. Walter Stosch (R-Henrico) saw his SB-935 pass the House. This bill will extend the sunset provision on the Caregivers Grant Program to ensure that it remains in effect.

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.

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Next week will be the final issue of the NEWS for the 2005 General Assembly session. That issue will recap all the legislation introduced and considered by the legislature this year, and the outcome on it. It also will let you know what action was taken on budget amendments related to mental health and substance use disorders.

As a result, the NEWS may not be published on Monday, February 28, but will come out later in the week.