This past Sunday, February 16th, the Senate and House “money committees” released their budgets. While there are differences in the House and Senate budget proposals, the great news is that both chambers prioritized funding for mental health services. Here is what they did:

Ensuring Consistency in Access: STEP-VA

The House and Senate budgets mostly align and retain most of the Governor’s proposal for STEP-VA. Building off progress and investments in STEP-VA since 2017, the Governor’s proposal includes:

• Outpatient services: $9.4 million in FY21 & $6.9 million FY22
• Mobile crisis services: $6.2million FY22
• Military services: $4.3 million FY21 & $3.8 million FY22
• Family and peer support services: $2.8 million FY21 & $5.3 million FY22

Additionally, $5 million NGF in FY21 and $500,000 NGF in FY22 from the DBHDS Trust Fund to improve the crisis response system. The funding will support the development of and maintain a state-wide crisis hotline and startup fund for emergency dispatch.

DIFFERENCES IN HOUSE & SENATE

House retained the Governor’s budget to provide $1.7 million per year to support 12 additional positions at DBHDS to help with oversight and ensure accountability of STEP-VA.

The Senate however, reduced this funding by $1 million per year, leaving $700,000 to support five positions at DBHDS to support implementation of STEP-VA.

We ask that the final budget includes funding for all 12 positions at DBHDS to ensure that implementation of the largest behavioral health investment Virginia has ever taken, has the correct support to ensure its success.

 

Funding for the Enhancement of Behavioral Health Services

We are pleased that the House and Senate budgets mostly align and retain a majority of what is in the Governor’s budget proposal for “Enhancement of Medicaid Behavioral Health Services”.  This investment includes funding to build out the following services:

• Multi-Systemic Therapy, Functional Family Therapy, Assertive Community Treatment: $3.1 million GF & $4.1 million NGF FY21
• Comprehensive Crisis Services, Partial hospitalization, Intensive Outpatient: $10.3 million GF & $14.1 million NGF FY22

 DIFFERENCES IN HOUSE IN SENATE

A key feature of behavioral health enhancement is that all services are evidence-based. Evidence-based services are important because there is “scientific evidence” that said services are impactful and result in positive outcomes. One challenge to implementing evidence-based services, however, is that training is typically cost prohibitive and time intensive.

• The House retained the full amount requested by the Governor to support training related expenses and coordination of these evidence-based services.
• The Senate reduced funding and positions for training related activities by $896,562 in FY21 & $1,086,062 FY22.

We ask that the final budget includes full funding for training related activities specific to these evidence-based services.  

 

Improving Integration of Behavioral Health and Primary Care: Virginia Mental Health Access Program (VMAP)

We are pleased that both the House and Senate retained the governor’s proposed funding, $4.2 Million GF per year, to complete state-wide implementation of  the Virginia Mental Health Access Program.  VMAP is a pediatric-driven training, consultation and referral model designed to increase capacity of primary care physicians to treat mental health needs of children in their care.

 

Behavioral Health Workforce Development

We are over the moon, that after many, many years of advocating for efforts to address the critical shortage behavioral health providers in Virginia, the general assembly is finally prioritizing this need in two ways:

Behavioral Health Loan Repayment Program

This amendment establishes the Behavioral Health Loan Repayment Program to increase the number of behavioral health providers by way of an educational loan repayment incentive that coordinates with existing efforts to recruit and retain providers in the Commonwealth. This program would allow for behavioral health providers to receive a student loan repayment award for up to 25% of student loan debt in exchange for each year of service in underserved communities. Provides behavioral health providers the opportunity to pay off their student loan debt while providing four years of service to the Commonwealth.

• The Senate included $1.6 million GF to start this program, while the House did not include any funding for this effort.

We ask that the final budget includes the Senate proposal of $1,688,914 million GF to support the Behavioral Health Loan Repayment program.

Increase Mental Health Provider Rates

During the 2019 session, the General Assembly increased mental health provider rates to 100 percent of Medicare. Building off of this progress, we are pleased that both the House and Senate retained Governor Northam’s budget proposal that increases the psychiatric services rate by 14.7 percent. This action increases rates to the equivalent of 110 percent of the 2019 Medicare rates. This effort is critical because Medicaid reimbursement rates for mental health services has been historically low, contributing to providers refusing to accept Medicaid.

 

Behavioral Health & Schools 

Chesterfield Recovery High School 

A companion to HB928, this House amendment provides $250,000 in FY21 & 22 to Chesterfield County School Board to assist with establishing a recovery high school for high school students residing in Region 1 and who are in the early stages of recovery from substance use disorder or dependency. The recovery high school will be year-round and will provide social, emotional and academic support needed to reintegrate into a traditional high school setting. The Senate did not include funding for this effort.

Mental Health Awareness Training 

This Senate amendment supports SB619, and provides $75,000 per year to the Department of Education to provide mental health awareness training at all school divisions across Virginia. Each school board shall provide mental health awareness training or similar program to all teachers and relevant personnel at least once during their tenure. The House did not include any funding for this effort.

We ask that the final budget includes the Senate proposal of $75,000 GF per year to support mental health awareness training for teachers. 

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