Ken Cuccinelli and Bob McDonnell unveil plan to reform Virginia's mental health system.
Proposals allow for more humane treatment of the mentally ill to
improve their quality of life.
FAIRFAX - State Senator Ken Cuccinelli, candidate for Attorney General, along with Bob McDonnell, Republican gubernatorial nominee and former Attorney General of Virginia, joined members of the press this morning on a conference call to announce their proposals to reform Virginia's mental health system.
Cuccinelli and McDonnell are both recognized leaders on the mental health issue. Both have championed legislation to make substantial reforms to the system in the past, but as they discussed this morning, there is still much that needs to be done. "As is so often the case, leadership is critical to success in mental health," said Cuccinelli.
Below is the announcement released by McDonnell for Governor, followed by the McDonnell/Cuccinelli Mental Health Policy Proposals:
McDonnell and Cuccinelli Unveil Plan to Improve Quality of Mental Health Care in Virginia
-Building on Successful Mental Health Records, Ticket Mates Unveil Plans to Expand Community Based Care, Better Involve Families and Communities, and Support Wounded Warriors-
RICHMOND - Bob McDonnell, Republican gubernatorial nominee and former Attorney General of Virginia, and State Senator Ken Cuccinelli, Republican candidate for Attorney General, today unveiled their plans to improve the quality of mental health care in the Commonwealth. McDonnell and Cuccinelli announced their proposals during a press conference call this morning.
The McDonnell-Cuccinelli plan includes the following highlights:
· Expand community based system of care
· Include families and communities in support system
· Support wounded warriors
· Improve children and adolescent services
· Update Virginia's mental health statutes to reflect changes in system
Speaking about the mental health proposals, McDonnell remarked, "Mental health care is a critically important issue that unfortunately often is overlooked. Working together across party lines we made great strides in recent years, but there is still much room for improvement. As Attorney General, and as a legislator, I made mental health reform a priority. This included working closely with Governor Kaine to include the names of all individuals ordered to undergo involuntary mental health treatment in the firearm background check database. I also patroned significant legislation to expand the community based system in the Commonwealth. As Governor I will continue to work in the same bipartisan fashion.
We must improve and expand community based mental health care. Every citizen should have access to basic services such as crisis intervention, counseling, and housing and employment supports. Behavioral health services should involve the family and community, as well as mental health consumers and their advocacy groups in mental health policy decisions. We must also put in place more services for vulnerable children, and that means working to expand community based treatment for children in every region of the state. It is essential that we work together to minimize the impact of mental illness, while maximizing the opportunity of every individual to participate to their fullest possible extent in the life of our Commonwealth."
Cuccinelli noted, "After more than a decade of working within the mental health system, I have a great appreciation for its many complexities and how it affects individuals, their families and the community. I have also come to believe that we in Virginia must help improve the current system for the benefit of the mentally ill and society at large. As a State Senator, I took the lead on sponsoring and supporting legislation year after year to reform the system. We made progress, and I look forward to continuing this work as Attorney General. I have a five-point plan that I will work across party lines to pass. It includes transferring mentally ill prisoners to mental hospitals to give them the treatment that they need, allow for step-down treatment which provides for patients in in-patient care to transfer over to out-patient care with oversight, require that TDO orders be issued between 24 and 72 hours, allow for more non-lawyer presentation and modernize the Virginia statutes regarding mental health to make them legally consistent with one another. I look forward to turning this plan into action as the next Attorney General."
Both Bob McDonnell and Ken Cuccinelli have strong records of working to improve mental health services and procedures in Virginia.
Bob McDonnell has a background in healthcare as a Medical Service Corps Officer in the U.S. Army, and as a manager with the American Hospital Supply Corporation. Bob has an extensive record of leading on mental health reform issues, including legislation to move to a more community based system (HB2596 2001; HB995 2002), and championing legislation to require a state and community consensus and planning team for any restructuring of the system of mental health services involving existing state mental health facilities.
McDonnell was Co-Chair of the Virginia Supreme Court Mental Health Task Force from 2007-2008, helping to create major reforms in the system. As Attorney General Bob issued a landmark opinion to end the terrible policy that forced some parents to surrender custody of their seriously mentally ill children to access state-funded services. He subsequently worked to improve the Comprehensive Services Act to better serve children in need of services. Responding to the challenges facing Virginia's mental health system over the past few years, particularly in the wake of the tragedy at Virginia Tech in April 2007, McDonnell worked with Governor Kaine to issue Executive Order Number 50 instructing all executive branch agencies to immediately begin including the names of individuals found dangerous and ordered to undergo involuntary mental health treatment in the database accessed before the sale of firearms by licensed gun dealers to ineligible individuals. During the 2008 General Assembly session, Attorney General McDonnell championed landmark legislation to ensure access to mental health information and modify standards for involuntary commitment of the mentally ill.
A member of the State Senate since 2002, Ken Cuccinelli is the recognized expert on mental health issues in the General Assembly and is a leader in reforming the system. As a private attorney, Ken Cuccinelli has served as a court appointed representative for the mentally ill and worked with mental health professionals and patients and their families for over a decade. Ken has also worked for many years with Fairfax County's TDO Taskforce to improve the delivery of services in Fairfax. In the State Senate, Cuccinelli has been working to reform Virginia's mental health system from the moment of his arrival in the Senate, with too many bills to mention since 2003 - long before others recognized the deficiencies in Virginia's mental health system. Among his accomplishments are reducing the requirements for admission to Virginia's mental health system, establishing the ability of school systems to share mental health information with our universities once their students go to college, and creating more humane transportation alternatives for patients while reducing the burden on law enforcement, among others.
Improving the quality of mental health care in the Commonwealth
The McDonnell/ Cuccinelli administration will be a strong advocate for Virginians with mental health needs and their families. When we invest in people and focus on outcomes, we can transform the system to provide services that families and individuals need to minimize the impact of disabilities and strengthen the abilities of individuals.
McDonnell and Cuccinelli are recognized leaders in this area for proposing many substantial reforms to the mental healthcare system. While we have made strides in recent years, there is room for much improvement. Our strengths lie in the state's evidenced based practices such as Assertive Community Treatment (ACT), which lead to lower hospitalizations and decreased criminal justice system issues. However, funding for transitioning to a community based system has been inconsistent and lack of housing for consumers is a serious issue for many individuals.
Bob McDonnell and Ken Cuccinelli will work in coordination to take a comprehensive approach to reforming the mental health system, and continue to build upon their past leadership in this area.
Approximately 200,000 people are served annually by the Commonwealth's Community Services Boards. Community based mental health care is critically important, and the McDonnell administration will support the expansion of community based programs. The Joint Legislative Audit and Review Commission has shown conclusively that community based programs are the most cost-effective options for most consumers. Every community should have access to basic services such as crisis intervention and stabilization, child and adolescent services, counseling for individuals and families, housing and employment supports, and many others.
Bob McDonnell and Ken Cuccinelli support the policy of the National Alliance on Mental Illness that any savings realized from the downsizing of state mental hospitals should be reinvested into the community to develop, expand, or strengthen the community-based system of care, as McDonnell's original reform bill in 2001 envisioned (HB2596).
We support an affordable consumer-centered behavioral health system offering accessible and effective treatment and prevention services delivered in community-based settings.
Family and Community Values
We believe that behavioral health services should involve the family and community support. While a delegate, Bob McDonnell sponsored sweeping legislation requiring a broad consensus among local government officials, consumers, family members, advocates, state facility employees, CSBs, service providers, local health departments, local social services staff, sheriffs' offices, and other interested citizens as a part of proposed restructuring of existing state mental health facilities. Our administration will continue to involve mental health consumers and their advocacy groups in mental health policy decisions. Ken has also worked for many years with Fairfax County's TDO Taskforce to improve the delivery of services in Fairfax.
Children and Adolescent Services
Children and adolescents with serious mental health needs are among Virginia's most vulnerable citizens. Virginia's Department of Behavioral Health and Developmental Services estimates that between 92,000 and 111,000 Virginia children and adolescents have a serious emotional disturbance. Only one in five of these children and adolescents received needed treatment.
Community based care is particularly important for children. We must work in coordination to expand community based treatment services to children in every region. By investing in proven community based services we can help identify child mental health problems early, treat them close to home and reduce symptoms. This will avoid costly inpatient and residential treatment, which can be as much as four times the cost of community-based services.
The McDonnell administration will also encourage innovative partnerships between local school divisions and mental health providers to reach troubled students before tragedy strikes. We will also work to streamline children's mental health services at the state level; presently families confront a confusing array of offices and funding streams that cross multiple secretariats.
MR Urgent Waiting List
Virginia's "urgent" waiting list, for MR Medicaid waiver slots, with more than 2,000 people on it, is too long. The Department of Behavioral Health and Developmental Services and the Department of Medical Assistance Services are working on a plan to reduce the waiting list. We will review the plan when completed to establish a strategy to reduce the current waiting list.
Wounded Warriors
The establishment of this program to aid with post traumatic stress disorder (PTSD) and traumatic brain injury (TBI) was a true bipartisan effort. The legislation authorized about a $4.5 million program for two years. Bob McDonnell and Ken Cuccinelli are concerned about our veterans returning from war with PTSD and TBI. We will keep faith with Virginia's wounded warriors and their families, by supporting the continuation of this program.
Updating Virginia's Mental Health Statutes to Reflect Changes in System
Since the early 1970's, Virginia's mental health system has evolved from an institutional-centered system to a community-based system of behavioral health care. As the state's institutions have shrunk, thousands of formerly institutionalized consumers are now served in their communities by our CSB system.
The McDonnell-Cuccinelli team will revisit the relevant code provisions, identify best practices, and adjust the system to incorporate what we have learned about community-based care delivery systems. Areas for specific attention include:
· Our jails now contain thousands of mentally ill inmates. Virginia should acknowledge this changed reality and adjust the "jail to hospital" transfer codes. We need to develop coherent programmatic jail-based content to serve this population. We can improve the prospects that mentally ill inmates will not reoffend once released.
· The current behavioral health continuum of care fails to recognize the need for something between in-patient and outpatient care - a so-called "step-down" option. We will restructure the treatment process to best serve the needs of patients, while creating an opportunity for patients to be moved from in-patient to outpatient care without having to start the entire judicial process over from the beginning for each patient.
· Require that Temporary Detention Order's be issued between 24 and 72 hours from detention to TDO hearing.
· Allow specially trained law students to represent willing petitioners with behavioral health issues.
Bob McDonnell's Record of Results
Bob McDonnell has a background in healthcare as a Medical Service Corps Officer in the U.S. Army, and as a manager with the American Hospital Supply Corporation. Bob has an extensive record of leading on mental health reform issues, including major reforms to move to a more community based system (HB2596 2001; HB995 2002), and championing legislation to require a state and community consensus and planning team for any restructuring of the system of mental health services involving existing state mental health facilities. McDonnell was Co-Chair of the Virginia Supreme Court Mental Health Task Force from 2007-2008, helping to create major reforms in the system.
As Attorney General Bob issued a landmark opinion to end the terrible policy that forced some parents to surrender custody of their seriously mentally ill children to access state-funded services. He subsequently worked to improve the Comprehensive Services Act to better serve children in need of services.
Responding to the challenges facing Virginia's mental health system over the past few years, particularly in the wake of the tragedy at Virginia Tech in April 2007, McDonnell worked with Governor Kaine to issue Executive Order Number 50 instructing all executive branch agencies to immediately begin including the names of individuals found dangerous and ordered to undergo involuntary mental health treatment in the database accessed before the sale of firearms by licensed gun dealers to ineligible individuals. During the 2008 General Assembly session, Attorney General McDonnell supported legislation to ensure access to mental health information and modify standards for involuntary commitment of the mentally ill.
A member of the State Senate since 2002, Ken Cuccinelli is the recognized expert on mental health issues in the General Assembly and is a leader in reforming the system. As a private attorney, Ken Cuccinelli has served as a court appointed representative for the mentally ill and worked with mental health professionals and patients and their families for over a decade. Ken has also worked for many years with Fairfax County's TDO Taskforce to improve the delivery of services in Fairfax.
In the State Senate, Cuccinelli has been working to reform Virginia's mental health system from the moment of his arrival in the Senate, with too many bills to mention since 2003 - long before others recognized the deficiencies in Virginia's mental health system. Among his accomplishments are reducing the requirements for admission to Virginia's mental health system, establishing the ability of school systems to share mental health information with our universities once their students go to college, and creating more humane transportation alternatives for patients while reducing the burden on law enforcement, among others.
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