2021 Mental Health General Assembly Outcomes

Here are some of the new initiatives which passed in this year’s General Assembly session to aid in mental health:

Improving School Based Mental Health Supports

Implement the “free care rule” to access Medicaid-funding to pay for school-based health and mental health services SB1307 | Senator Siobhan Dunnavant

This bill directs the Department of Medicaid Assistance Services (DMAS) to create a process to allow local school divisions to pull down Medicaid reimbursement for health and mental health services, even when a student does not have an Individualized Education Plan (IEP). This option, known as the “free care rule”, would bring more financial resources into local school divisions to support health and mental health services.

Access to services is a critical barrier to children receiving support, therefore, bringing more funding for services into schools helps to meet children where they are. Funds can be used flexibly for school support staff, contracts with private providers, and other expanded partnerships. This option has also been identified as a key step to expand school-based health centers. Local school divisions should look for more instruction from DMAS about billing procedures later this year. 

Increasing Student Support Staff 

Two budget measures were approved this year to bring additional support staff into schools. The Governor’s proposed budget included an additional $27 million to bring the school counselor to student ratio to 1:325. The House and Senate amended the budget to include an additional $49 million to hire 3 specialized support positions for every 1,000 students. Specialized student support positions include social workers, nurses, psychologists and applied behavior specialists. In the 20-21 school year at least 44 school divisions would need to hire additional personnel.

Supporting Young Children’s Social-Emotional Needs in Preschool & Child Care

The General Assembly directed the Department of Education to have the “green light” to move forward with implementing plans for Early Childhood Mental Health Consultation to meet the social-emotional needs of young children and to report back to the General Assembly about any additional funding needs or legislative changes.

Building a System of Crisis Response and Support

Implementing the MARCUS Alert System

Marcus-Davis Peters, a young, Black, biology teacher was shot by Richmond police in 2018 in the midst of a mental health crisis. Advocacy efforts led by his family led to the passing of The Marcus-Davis Peters Act. The Marcus-David Peters Act provides behavioral health responses to behavioral health emergencies to reduce negative outcomes involving use of force in law enforcement when an individual experiences a behavioral health crisis related to mental health, substance use, or developmental disability. The mental health awareness response and community understanding services (MARCUS) alert system directs DBHDS to develop a plan throughout the Commonwealth in collaboration with DCJS, law enforcement, and other stakeholders. 

$771,612 additional funds for FY 21-22 were provided for the administrative cost required to implement the Marcus Alert legislation. The funds will be used to maintain the crisis hotline, evaluate the current capacity of the crisis systems in localities, and lastly, to provide contractual funds for a public advertising campaign. 

Creating a Crisis Call Center & HotlineSB1302 | Senator Jeremy McPike

A key factor in creating the MARCUS Alert system to deescalate law enforcement responses to situations involving a mental health crisis is also to create systems that enable easy and effective notification and response to mental health crisis. A missing element of that system has been a hotline or crisis call center for professionals to use when encountering a child, youth or adult in mental health crisis.

Senator Jeremy McPike’s SB1302 builds on the MARCUS Alert legislation passed during the 2020 Special Session to create a more uniform crisis response system by creating a call center. The call center would link to the national suicide hotline. The bill adds a surcharge to cell phone bills of a few cents to help fund the call center.

Foster a More Diverse & Inclusive Mental Health Workforce

Increased Behavioral Health Loan Repayment Program (VDH) 

The final budget includes an additional $1.9 million for the Behavioral Health Loan Repayment Program that were unallocated in the 2020 budget. This loan repayment program can incentivize professionals to work in the mental health field, an incentive necessary to ensure the workforce is diverse and reflective of the population served and to address the service shortages across the state. Children and adults need to have diverse and representative professionals to address trauma, including racial and historical trauma.