CONTENTS OF THIS ISSUE
Fall 2017 Issue |
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Legislative Update
By James Pickral
PSV Lobbyist
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James Pickral |
PSV and its legislative affairs team actively supported or monitored several pieces of important mental health related legislation during the 2017 General Assembly session.
Certificate of Public Need (COPN)
Two COPN bills were directly related to psychiatric beds and services, SB 1141 (Sturtevant) and HB 1420 (Farrell):
- Repeals the requirement for a certificate of public need (COPN) for certain projects involving mental hospitals or psychiatric hospitals and intermediate care facilities established primarily for the medical, psychiatric, or psychological treatment and rehabilitation of individuals with substance abuse.
- The Senate bill would create a new permitting process for such projects, exempted from the COPN process, that requires the Commissioner of Health to issue a permit upon the agreement of the applicant to certain charity care conditions and quality of care standards.
HB 1420 passed the House with considerable support (86-Y, 8-N), the furthest a recent COPN reform bill has managed to reach in the legislative process; however, both bills died in the Senate Education and Health Committee, which also called for the issue to be studied in the COPN Workgroup and the Deeds Commission.
Other Legislation
Two other bills of interest dealt with denials of admission to hospitals providing psychiatric services and step therapy protocols, respectively.
HB 1777 (Stolle) passed both houses unanimously and was signed by the Governor. The bill:
- Requires the Board of Health to promulgate regulations that require hospitals that provide psychiatric services to require direct verbal communication between the on-call physician in the psychiatric unit and the referring physician prior to refusing admission of a medically stable patient.
- The bill also prohibits on-call physicians or other hospital staff from refusing a request for such direct verbal communication by a referring physician.
SB 1408 (DeSteph) was referred to study by the Senate Commerce and Labor Committee. The legislation calls for requiring health benefit plans that restrict the use of any prescription drug through the use of a step therapy protocol to have in place a clear, convenient, and expeditious process for a prescribing medical provider to request an override of such restrictions for a patient. The bill outlines specific instances in which an override would be mandatory.
Deeds Commission
The Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century continues to focus on reforming Virginia’s mental health system. The body is commonly referred to as the “Deeds Commission” after its Chairman, State Senator Creigh Deeds. The commission led the passage of three pieces of legislation in 2017. First, the list of services that Community Service Boards (CSBs) are required to provide was expanded with a delayed implementation schedule and funds appropriated to provide additional resources to the CSBs. Second, in response to the death of inmate Jamycheal Mitchell at the Hampton Roads Regional Jail, the Board of Corrections has been given clear responsibility for investigating suspicious jail deaths, accompanied by funding for another investigator. Jails must also promptly assess inmates who demonstrate mental illness. Lastly, the General Assembly appropriated an additional $5 million for permanent supportive housing, a vital component of long-term recovery from mental illness. The Deeds Commission recognizes that much work is yet to be done, including ensuring children receive the services they need.
2018 Outlook
COPN Reform
House Republican leadership told stakeholders that next session they would entertain individual COPN exception bills since necessary comprehensive reform has been elusive thus far. We will likely again pursue repeal of the COPN requirement for psychiatric beds and services.
Opioid Addiction
The opioid addiction crisis has reached epidemic levels. Virginia’s Health Commissioner declared a public health emergency and issued a Naloxone statewide standing order. The Board of Medicine has adopted related emergency regulations and several other health profession regulatory boards are in the process of adopting similar regulations. We expect additional action from policymakers next year.
Step Therapy Protocol
We are optimistic that Sen. DeSteph’s step therapy protocol bill will have the opportunity to be revived after the Senate Commerce and Labor Committee directed further study of the issue.
Budget
Next year, Governor McAuliffe will propose his final, outgoing budget as he enters the last year of his term. Governors often pack their last budgets with legacy “wish list” items. This is an opportunity for us to work with the Administration on mutual funding priorities.
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PSV 2017
FALL MEETING
October 27-28, 2017
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Virginia Beach, Virginia
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