Prioritizing Youth Mental Health during the 2024 Legislative Session
Posted: - By:Cat Atkinson
The 2024 Legislative Session started with significant energy being poured into the Commonwealth’s mental health continuum. We are grateful for Governor Youngkin’s commitment to investing $500 million into our mental health system and are encouraged by his focus on young people in the Right Help, Right Now, Youth Mental Health Strategy; legislators have been following suit by uplifting youth mental health priorities across mental health systems.
The Commonwealth has continued to reckon with the realities of the youth mental health crisis, attempting to find a clear solution to a multi-faceted issue. Crisis services attempt to treat the symptoms of an unhealed system impacting our young people. Young people continue to remind us that this mental health crisis is not new, nor was it caused solely by the COVID-19 pandemic. The U.S. Surgeon General’s 2021 Advisory on Protecting Youth Mental Health highlights that youth mental health symptoms and suicide rates have been increasing for at least a decade. Young advocates and data emphasize factors such as increased substance use, academic pressure, and structural injustices such as racism, gun violence, and income inequality, all as contributing to the current state of youth mental health.
The 2024 Legislative Session brings new investments in mental health prevention services via school-based mental health, crisis services, and workforce development, support and incentivization programs. The outlined budget items and amendments below are promising as we work toward improving accessibility for young people and families to receive the care they need and deserve, regardless of their identity, socioeconomic status, or locality.
School-Based Mental Health
School-based mental health (SBMH) services prioritize the mental health and well-being of students within a school setting by providing easy access to mental health services, promoting healing and destigmatization, and supporting lifelong health and wellness. SBMH programs are an opportunity to advance mental health equity, overcome the many known barriers young people face to receiving services, and be intentional about addressing the unique needs of young people within each unique local community.
Voices has been following the development and expansion of the SBMH Integration Pilot and prioritizing funding that continues to address the unique needs of each division and locality.
Item 295 #3s: FY25: $7.5 million, FY26: $7.5 million
Item 295 #10h: Language Only
Adds funding to the school-based mental health pilots to support the development of performance measures for participating schools and the pilot overall. This is a Behavioral Health Commission (BHC) recommendation.
Requires DMAS and DOE to revise their interagency agreement on the amount of administrative funding DOE will receive to help school divisions bill Medicaid for allowable services, including mental health services.
Directs VDOE, DBHDS, and DMAS to work collaboratively on a plan for creating a new program that will deliver flexible mental health funds to school divisions. This is a BHC recommendation.
Funding to local school divisions via competitive grants that serve communities with high incidences of community violence to contract for community-based mental health services for students from public or private community-based providers or to fund the hiring of additional specialized support staff to meet student needs.
Provides one-time funding to school divisions to maintain school-based mental health services established using one-time pandemic relief funding. This is a BHC recommendation.
Provides the state share of funding for four specialized support staff per 1,000 students in public schools. These specialized staff include school social workers, school psychologists, school nurses, and others. In conjunction with SB127 and HB386.
Provides the state share of funding for one school counselor for every 250 students in public schools, a decreased ratio from 1:325. In conjunction with SB127 and HB181.
Funding to support implementation and provision of mental health teletherapy for students in public schools, as developed through the model MOU that will be enacted between a school board and the tele-mental health provider. In conjunction with HB919.
Funding to support the development of age-appropriate mental health curricula for ages K-12 as a part of physical health education in public schools. In conjunction with HB603.
Funding to update the requirements of mental health awareness training for public school teachers to include how to address the needs of youth who are at a high risk of experiencing mental health challenges. In conjunction with HB224.
Youth Crisis Mental Health
Currently, there are only three Residential Crisis Stabilization Units (RCSUs) for youth across the state—St. Joseph’s Villa, Mt. Rogers and Western Tidewater. St. Joseph’s Villa is also building out the first 23-hour crisis receiving center (CRCs) specific to youth, scheduled to start operating in the spring of 2024. There are also budget amendments below supporting the development of an additional youth unit within the Prince William County CRC.
These efforts are positive and are also inadequate; 2024 budget investments will continue to build out components of the crisis services system, however, it is important to keep a focus on crisis infrastructure specific to children and youth services.
Funding from the Opioid Abatement Authority Fund to establish a recovery high school in Hampton Roads (Superintendent Region 2). In conjunction with HB696.
Provides language directing DBHDS to work with relevant local and state agencies to review and report on alternative placements for children and youth who otherwise would be placed at the Commonwealth Center for Children and Adolescents (CCCA). This is a JLARC recommendation to the BHC.
Funding provided to account for inflation costs for implementing and delivering services associated with STEP-VA.There is no explicit language in the budget guaranteeing that any of this funding will be used for young people.
Funding to support the build-out of a Crisis Receiving Center (CRC) in Prince William County. Item 296 #9s states that this CRC will serve youth only while Item 296 #16h states this CRC will serve adults and adolescents.
Funding is redirected from Item 296 #19h (Del. Rasoul) to fully staff existing crisis centers. There is no explicit language in the budget guaranteeing that any of this funding will be used for young people.
Establishes a program to provide funding to private psychiatric hospitals that agree to increase the percentage of involuntary inpatient admissions they accept and to demonstrate the need for funding to safely admit such patients. This is a JLARC recommendation to the BHC.
Item 288 #13s (Sen. Locke) | Item 288 #51h (Del. Askew) | DMAS | FY25: $2.7 million GF / $2.7 million NGF, FY26: $2.7 million GF / $2.7 million NGF
Increases Medicaid payments to Children’s Hospital of the King’s Daughters (CHKD) to stabilize the hospital so it is not subject to dramatic fluctuations in Medicaid Disproportionate Share Hospital (DSH) payments.
Item 288 #6s (Sen. Deeds) | DMAS | FY25: $11 million GF / $12.5 million NGF, FY26: $22.2 million GF / $25 million NGF)
Increase rates by 10% for Medicaid-funded, community-based mental and behavioral health services, which includes Comprehensive Crisis Services and much more.
Mental Health Workforce
Voices’ priority is to attract and retain a culturally diverse behavioral health workforce that is representative of our young people and well-supported by Virginia’s behavioral health system.
The Virginia Health Workforce Development Authority identified interventions that should be prioritized in recruiting and retaining our behavioral health workforce, including ensuring adequate Medicaid reimbursement rates, increased residency slots and funding for psychiatry, promotion of team-based or collaborative care, removal of excessive supervised training hours and expenses to supervision, and student loan forgiveness/repayment.
Governor Youngkin and state legislators are taking the workforce shortage seriously by investing in programs and facilities that shift our system to train, support, and pay our mental health workers the compensation they deserve.
Funding will be used to create a loan repayment program for people that have worked in the Commonwealth as mental health professionals for at least five years (bill amended to two years). In conjunction with HB37.
The funding for Item 132 #9s supports the costs of required supervision for graduates of Master of Social Work and Master of Counseling programs seeking licensure.
Item 132 #20h: Language Only
Item 132 #20h requests the addition of private, nonprofit institutions that offer the Master of Social Work degree with access to this Mental Health Pilot program to assist in growing the state’s pool of qualified mental health workers.
Edits language to specify that funding shall be allocated to public and private not-for-profit institutions of higher education participating in the statewide contract to improve the mental health workforce pilot.
