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    Document Summary
    - Report Published -

    Senate Document No. 9
    PUBLICATION YEAR 2004

    Document Title
    Treatment Options for Offenders Who Have Mental Illness or Substance Abuse Disorders

    Author
    Joint Commission on Behavioral Health Care; Virginia State Crime Commission; Virginia Commission on Youth

    Enabling Authority
    SJR 440 (Regular Session, 2001)

    Executive Summary
    The initial study of "treatment options for offenders who have mental illness or substance abuse disorders" was requested in Senate Joint Resolution 440 during the 2001 General Assembly Session. SJR 440 (2001) directed the Joint Commission on Behavioral Health Care, the Virginia State Crime Commission and the Virginia Commission on Youth, to undertake the study. SJR 97 and HJR 142 (2002) subsequently continued "the study of certain mental health needs, training, and treatment issues" requiring a final report by the Joint Commission on Behavioral Health Care and the Virginia Commission on Youth prior to the 2004 Session of the General Assembly. This final report is being submitted on behalf of the Joint Commission on Health Care (JCHC) which assumed the responsibilities of the Joint Commission on Behavioral Health Care on July 1, 2003.

    The first report, "Report of the Committee of the Joint Commission on Behavioral Health Care, Virginia State Crime Commission and the Virginia Commission on Youth Studying Treatment Options for Offenders Who Have Mental Illness or Substance Abuse Disorders," Senate Document 25 (2002) was released in early 2002. The background information contained in SD 25 (2002) is not repeated in this report. The focus of this report is the work that was completed beginning July 1, 2003 when the Joint Commission on Health Care assumed responsibility for the work of the Joint Commission on Behavioral Health Care.

    To complete the study of treatment options for offenders, JCHC's Behavioral Health Care Subcommittee reestablished the Task Force Studying Treatment Options for Offenders with Mental Illness or Substance Abuse Disorders (or the Treatment Task Force) and two work groups - an adult offender workgroup and a juvenile offender workgroup. The reporting structure and membership of these groups is shown on the next page. The adult and juvenile offender workgroups met four times during the spring and summer of 2003 to formulate recommendations to present to the Treatment Task Force. The Task Force, in turn, made recommendations to the Behavioral Health Care Subcommittee. It should be noted that staff from the Commission on Youth and the Division of Legislative Services graciously continued to support the work of the offender work groups and the Treatment Task Force during this time period.

    Actions Taken by the Behavioral Health Care Subcommittee

    The Behavioral Health Care Subcommittee voted to take the following actions by letter of the Subcommittee Chairman.

    Reporting Structure for the Offender Treatment Study

    Joint Commission on Health Care:

    Delegate Harvey B. Morgan, Chairman
    Delegate Clifford L. Athey, Jr.
    Delegate Robert H. Brink
    Delegate L. Preston Bryant, Jr.
    Delegate Benjamin L. Cline
    Delegate Jeannemarie A. Devolites
    Delegate Franklin P. Hall
    Delegate Phillip A. Hamilton
    Delegate S. Chris Jones
    Delegate Kenneth R. Melvin
    Senator William T. Bolling, Vice-Chairman
    Senator R. Edward Houck
    Senator Benjamin J. Lambert, III
    Senator Stephen H. Martin
    Senator William C. Mims
    Senator Linda T. Puller
    Senator Nick Rerras
    Senator William C. Wampler, Jr.
    The Honorable Jane H. Woods (ex officio)

    Behavioral Health Care Subcommittee:

    Senator Stephen H. Martin, Chairman
    Senator R. Edward Houck
    Senator William C. Mims
    Senator Linda T. Puller
    Senator William C. Wampler, If.
    Delegate Robert H. Brink
    Delegate Jeannemarie A. Devolites
    Delegate Franklin P. Hall
    Delegate Harvey B. Morgan (ex-officio)
    Delegate Robert Tata
    Delegate Glenn M. Weatherholtz
    Gary L. Close, Commonwealth's Attorney for Culpeper County

    Task Force Studying Treatment Options for Offenders with Mental Illness or Substance Abuse Disorders:

    Senator Stephen H. Martin, Chairman
    Senator R. Edward Houck
    Senator Janet D. Howell
    Secretary Jane H. Woods
    Deputy Secretary Barry R. Green

    Adult Offender Workgroup
    Juvenile Offender Workgroup:

    Workgroups include representatives of human service and criminal/juvenile justice entities, provider associations, and consumer advocates.

    Letter to the Department of Mental Health, Mental Retardation and Substance Abuse Services (DMHMRSAS):

    Requests inclusion of "information about innovative practices among providers of mental health and substance abuse treatment services to offenders" in its web-based site for evidence-based, best and promising practices. In addition requests that DMHMRSAS report on its progress to the Subcommittee prior to the 2005 Session.

    Requests that DMHMRSAS consider the needs of offenders with mental health and/or substance abuse disorders in regional reinvestment plans and in restructuring.

    Requests that DMHMRSAS work with the Virginia Supreme Court to develop a system for reporting non-confidential data regarding the types of forensic evaluations that are reimbursed by the Court.

    Letter to the Virginia Supreme Court:

    Requests that the Virginia Supreme Court work with DMHMRSAS to develop a system for reporting non-confidential data regarding the types of forensic evaluations that are reimbursed by the Court.

    Letter to DMHMRSAS, the Department of Corrections (DOC) and the Virginia Association of Community Services Boards:

    Requests that the prototype for an interagency memorandum of agreement between DMHMRSAS, DOC, and a community services board continue to be developed and ultimately adopted. The purpose of the prototype is to assist in "facilitating the transition of offenders who have mental health and/or substance abuse services needs from the correctional setting to the community."

    Letter to DOC, the Department of Medical Assistance Services (DMAS) and the Department of Social Services:

    Requests a report on how implementation of improvements in the processing of offender applications is proceeding. In addition, requests that DMAS monitor any changes in federal regulation that would affect Medicaid coverage for offenders.

    Letter to the Secretary of Public Safety and the Secretary of Health and Human Resources:

    Requests that the Secretary of Public Safety and the Secretary of Health and Human Resources continue to collaborate on a plan to collect data and evaluate mental health and substance abuse treatment services for offenders.

    Letter to the Department of Health:

    Requests that suicide among offenders be considered and included in the Suicide Prevention Plan that is being developed.

    Letter to the Department of Juvenile Justice:

    Requests submission beginning in FY 2005, of annual reports on the results of the mental health screening that is being completed in secure detention facilities.

    Letter to the Item 329.G Workgroup:

    Requests that the workgroup consider the needs of juvenile offenders in planning for behavioral health care services for children and adolescents.

    Actions Taken by the Joint Commission on Health Care

    On November 12,2003, the Joint Commission on Health Care approved four budget amendments that were recommended by the Behavioral Health Care Subcommittee for Joint Commission action. Those budget amendments included:

    • Language to request the Department of Corrections include an evaluation and reporting component in any new mental health or substance abuse treatment initiative for offenders in DOC's custody.

    • Language to request the Department of Juvenile Justice include an evaluation and reporting component in any new mental health or substance abuse treatment initiative for offenders in DJJ's custody.

    • Language to indicate JCHC's support for the continuation of State funding of local initiatives to address the needs of adult and juvenile offenders with mental health and substance abuse disorders who come into contact with the criminal justice system.

    • Language to request that the Department of Mental Health, Mental Retardation and Substance Abuse Services, in cooperation with the Department of Criminal Justice Services, provide non-financial assistance in developing demonstration projects designed to divert individuals with mental illness (including co-occurring disorders) from jail or secure detention.

    In addition, JCHC approved a recommendation that a letter be sent by the Chairman to request that the Department of Juvenile Justice distribute a letter of legal advice from the Office of the Attorney General (GAG) to secure detention centers. The letter states that secure detention facilities may electronically transmit mental health screening information without relinquishing their status as exempt facilities under the Privacy Rule of the Health Insurance Portability and Accountability Act. The OAG letter further states that detention facilities that are subject to the Privacy Rule" may still disclose the information electronically to DJJ without an individual authorization because the disclosure ... is required by law and is to a health oversight agency performing a health oversight function."

    On January 13, 2004, two additional joint resolutions were approved for introduction by JCHC. The language in the two resolutions corresponds to budget amendments that were approved by JCHC for submission and seek to:

    • Encourage the Department of Corrections and the Department of Juvenile Justice to include an evaluation and reporting component to any new mental health or substance abuse treatment initiative undertaken for offenders in their custody; and
    • Encourage the Department of Mental Health, Mental Retardation and Substance Abuse Services to provide non-financial assistance in developing demonstration projects designed to divert individuals with mental illness (including co-occurring disorders) from jail or secure detention.

    The legislation that was introduced by JCHC is included at Appendix B.