Virginia Gov. Terry McAuliffe's plan expands access to mental health services

Sept. 09--The expansion of treatment for those with a serious mental illness took top billing in Gov. Terry McAuliffe's 10-point plan, "A Healthy Virginia," announced Monday.

The Governor's Access Plan, GAP, promises to provide medical and behavioral health care to about 20,000 uninsured Virginians with severe mental illnesses. The development of "health homes" for current Medicaid enrollees with a severe mental illness or substance abuse disorder is aimed at an additional 13,000. The programs are slated to launch in January and July 2015 respectively.

While not offering the comprehensive services that a full expansion of Medicaid would effect, as allowed by the Affordable Care Act, health advocates lauded the plans.

Chuck Hall, executive director of the Hampton-Newport News Community Services Board, hailed the announcement as indicative of the state turning a corner in mental health care. "It's the beginning of the state focusing more clearly on those with serious mental illnesses, designing a package of services and assigning responsibility," he said. "It brings more clarity for the future of behavioral health. It's long overdue."

McAuliffe cited the emergency regulations section of the Virginia Code in setting out his mental health plans, which require cooperation from the Centers for Medicare & Medicaid Services, CMS, in issuing waivers and providing matching funds. The community services boards have been talking with Cindi Jones, director of the Department of Medical Assistance Services (DMAS) "for years" regarding such integrated programs, said Hall.

The 1115 waiver allows for a different way to provide services, he explained, citing the bundling of services in health homes and integrated care models. In recent reports, the state has held up both TACT, a crisis intervention training program, and PACE (Program of All-Inclusive Care for the Elderly), as successful programs tailored to specific populations; both are examples of the creativity that waivers allow, said Hall.

In response to the governor's plan, Debra Ferguson, state commissioner of the Department of Behavioral Health and Developmental Services, said that thousands of Virginians with serious mental illness "will finally be able to receive affordable, quality, coordinated health care with better outcomes."

David Coe, president of Colonial Behavioral Health, the agency that provides mental health services to residents of Williamsburg, Poquoson, and York and James City counties, said that McAuliffe's proposals would speed up implementation of services. "It's a two-year process to change Medicaid regulations, with public comment periods, hearings and interim final rules. It's very laborious and time-consuming. This speeds it up because of the urgency."

Coe particularly lauded the "health homes" model, noting that people with a serious mental illness have a life expectancy 25 years less than others. "By bringing together primary care and mental health care -- as has been tried in various pilot plans, but not truly statewide -- it will enhance outcomes," he said.

Salasky can be reached by phone at 757-247-4784.

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