On January 23, 2024, Voices for Virginia’s Children and ChildSavers are joining together to host Healing for the Healers – an advocacy day to uplift policy for youth mental health and the healers who support them. We recognize healers as parents, caregivers, peers, school staff & administrators, licensed mental health professionals, community leaders, and beyond. Healing comes in many forms and can occur in many places – in the community, in families, in peer groups, in schools, and in medical settings. 

Below is a summary of the policy priorities we will be emphasizing on our shared advocacy day. Our overall hopes are to influence school-based mental health, workforce development, and crisis response services. Please note that this is not an exhaustive list of the policy changes that Voices is pursuing under mental and behavioral health or health equity. A key can be found at the bottom of this post to assist with defining terms and organizations.

Advocates can register to attend the 2024 Healing for the Healers by completing this form. Attendees will receive training (hybrid options, with dinner included for in-person), technical assistance, and assistance with parking and transportation to the General Assembly Building. With a max capacity of 30 attendees, we request that advocates only register if they are confident they can attend the in-person advocacy day on January 23 in Richmond, VA. Contact Kristin Lennox, kristin@vakids.org, for additional inquiries or to cancel registration.

School-Based Mental Health 

As the youth mental health crisis in Virginia persists, young people have been clear: they are demanding more mental health services in their schools. They want more than fifteen minutes of academic advising and are asking for more licensed professionals to address and support their mental and behavioral health needs during the school day and beyond. 

• Support Continued Funding of the Department of Behavioral Health and Developmental Services (DBHDS) School-Based Mental Health Integration Pilot Program: 

• • Recommended by the Behavioral Health Commission (BHC): Support $7.5 million in funding for FY25 and $7.5 million in FY26 to continue and expand the DBHDS School-Based Mental Health Services Pilot Program which has supported some school divisions to contract with community-based mental health agencies (CSBs) to provide mental health services within schools.  

• Review School-Based Mental Health Service Options and Workforce Requirements: 

• • Provide funding to the Department of Medical Assistance Services (DMAS) to complete a review of Multi-Tiered School Based Behavioral Health Services (see below) including (1) whether and how to redesign Therapeutic Day Treatment (TDT), and (2) how to appropriately fund the number of mental health providers needed to deliver the identified services.
•  

• Streamline Funding for School-Based Mental Health Services: Funding for school-based mental health is currently not efficient nor is it flexible in addressing the various needs of young people and the needs of the mental health workforce. 

• • BHC Recommendation: Direct the Department of Education (DOE) to collaborate with DBHDS and DMAS on a plan for creating a new program to provide flexible mental health funds to school divisions for having school-based mental health services. This plan will also include assisting the divisions with billing Medicaid, reimbursing community-based partners quickly, and assessing the success of each division’s programming.  
  • BHC Recommendation: Support one-time funding for current pilot school divisions to maintain school-based mental health services in FY25 until additional funding is found.  

• Support Funding for one full-time position at the DOE to provide Virginia School Divisions with technical assistance with billing Medicaid for school-based services.  

Workforce Development 

We cannot adequately address the youth mental health crisis without a diverse workforce, which includes sustainably training, paying, and retaining licensed mental health professionals. 

• Streamline Medicaid Reimbursement: This refers to the amount that Medicaid insurance companies (like Virginia Premier and Anthem Healthkeepers, etc.) pay providers for mental and behavioral health services that have already been delivered. 

• • Authorize reimbursements for care coordination services (also known as case management services) for community-based providers. 
  • Protect the 10% Medicaid reimbursement rate increase for community-based mental health services. 
  • Increase Medicaid reimbursement rates for community-based mental health services to reflect the true cost of care. 
  • Authorize DMAS to establish processes and procedures for an annual adjustment to reimbursement rates for Medicaid-funded mental health services to address inflation. 
  • Support DMAS rate study on mental health parity, to ensure reimbursement amounts for behavioral health services are the same across different treatment settings, i.e., schools vs pediatricians’ offices vs community services agencies. 

• Remove Barriers to Licensure for all Behavioral Health Professionals, such as Clinical Social Workers, Psychologists, Psychiatrists, Counselors, and Behavioral Analysts.  

• • Support increased state funding for psychiatric residencies, specifically child psychiatry. 
  • Research done for the “Right Help, Right Now” priorities highlighted that 88 of Virginia’s 128 localities have no child psychiatrists.  
  • By recommendation of the Virginia Health Workforce Development Authority, loosening strict requirements on behavioral health residencies prior to licensure, such as educational degree requirements for supervisors, supervisor-to-student ratios, addressing the need for supervisors in community settings, and creating opportunities for paid residencies. 
  • Support DBHDS Budget Request to fund initiatives to expand the youth mental health workforce through analyzing the current unlicensed mental health workforce in Virginia to understand barriers to licensure and develop opportunities for post-graduate trainings or certificates to better serve youth. 
  • Support DBHDS Budget Request to increase the number of clinical training sites at state-operated agencies for medical residents, nurses, nurse practitioners, physician assistants, and other licensed mental health professionals. 

• Expand Behavioral Health Loan Repayment 

• • Increase funding for the Virginia Department of Health (VDH) Behavioral Health Loan Repayment Program. Specifically, refine criteria to direct clinical staff towards agencies and nonprofits treating high-risk children and youth, especially in underserved areas of Virginia. 

Crisis Response 

As Virginia prioritizes crisis response and stabilization services, we must ensure that young people and their unique needs are centered in the development of these new processes 

• Support Funding for Mobile Crisis Teams
• Support the Establishment of a Statewide Network of Community-Based Crisis Receiving Centers (CRCs) and Crisis Receiving and Stabilization Centers (CRSCs)
• Support funding of Comprehensive Psychiatric Emergency Programs (CPEP)

---

Key Terms and Organizations

• Behavioral Health Commission (BHC): The Behavioral Health Commission (BHC) was established in 2021 as a new standing commission of the Virginia General Assembly to study and make recommendations for the improvement of behavioral health services and the behavioral health service system in the Commonwealth. The Commission is composed of 12 state legislators charged with encouraging the adoption of policies that will provide Virginians with access to a full continuum of high-quality and efficient behavioral health services.  
• Department of Behavioral Health and Developmental Services (DBHDS): A state agency with the mission of “supporting individuals by promoting recovery, self-determination, and wellness in all aspects of life.” DBHDS hosts emergency information, the “Right Help. Right Now.” campaign, development disabilities services, and substance use disorder services. 
• Department of Medical Assistance Services (DMAS): The agency that administers Virginia’s Medicaid program with a mission of “improving the health and well-being of Virginians through access to high-quality health care coverage.” 
• Crisis Receiving Centers: From St. Joseph’s Villa, “The primary goal of the CRC is to divert inpatient hospitalization and reduce the community’s reliance on seeking behavioral healthcare in hospital emergency departments. Open 24/7 for walk-in for service, the CRC will provide rapid and comprehensive assessment, crisis intervention services, and linkages to resources that would allow individuals to be treated in their own community…. By accelerating access to high-quality treatment, the CRC will reduce youth hospitalizations and out-of-state placements, helping to keep families intact.” (Source: St. Joseph’s Villa, “Coming Soon: Central Virginia’s first emergency room alternative for youth experiencing mental health crisis”) 
• Crisis Stabilization Units: From DBHDS, “Crisis receiving and stabilization services offer the community a no-wrong-door access to mental health and substance use care; operating much like a hospital emergency department that accepts all walk-ins, ambulance, fire and police drop-offs. The need to say yes to mental health crisis referrals, including working with persons of varying ages (as allowed within the facility license) and clinical conditions (such as serious emotional disturbances, serious mental illness, intellectual and developmental disabilities), regardless of acuity, informs program staffing, physical space, structure and use of chairs or recliners in lieu of beds that offer far less capacity or flexibility within a given space.” 
• Comprehensive Psychiatric Emergency Programs: Comprehensive Psychiatric Emergency Services (CPEP) is a 24/7 hospital-based emergency psychiatric program to help patients in a mental health crisis. (Source: Virginia College of Emergency Physicians, “Dedicated spaces for emergency mental health patients coming online in Virginia”) 
• Mobile Crisis: The purpose of this service is to provide prompt crisis intervention with the goal of preventing psychiatric hospitalization, to prevent exacerbation of a condition, and to prevent injury to child or adolescent or others. (Learn more at DBHDS.) 
• Parity: the state of being equal, especially regarding pay. For example, the basic idea that mental health and addiction care are covered at the same level as care for other health conditions. 

_______________________________________________________________________

Register today to attend the 2024 Healing for the Healers by completing this form. Attendees will receive training (hybrid options, with dinner included for in-person), technical assistance, and assistance with parking and transportation to the General Assembly Building. With a max capacity of 30 attendees, we request that advocates only register if they are confident they can attend the in-person advocacy day on January 23 in Richmond, VA. Contact Kristin Lennox, kristin@vakids.org, for additional inquiries or to cancel registration.

---