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    Document Summary
    - Report Published -

    Senate Document No. 19
    PUBLICATION YEAR 2007
    View PDF Version*

    Document Title
    Availability and Cost of Licensed Psychiatric Services in Virginia

    Author
    Joint Legislative Audit and Review Commission

    Enabling Authority
    SJR 185 (Regular Session, 2006)

    Executive Summary
    SJR 185 (2006) directed JLARC to “study the use and financing of licensed inpatient psychiatric facilities in the Commonwealth.” The statewide supply of psychiatric beds in Virginia appears to be adequate although a lack of data on the demand for beds hinders this assessment. Other indicators suggest that persons with behavior problems have difficulty accessing psychiatric beds. Use of psychiatric beds could be reduced by increasing the availability of community-based mental health services, but this is impeded by a statewide shortage of psychiatrists.

    In 2005, licensed hospitals reported substantial unreimbursed costs from providing psychiatric services in inpatient beds and emergency departments; the largest sources of unreimbursed costs were uninsured patients and under-reimbursement from commercial insurers. Furthermore, Medicaid does not pay licensed hospitals for all costs associated with psychiatric patients. Medicaid reimbursements for psychiatrists decreased by 16 to 24 percent between 2000 and 2006 when adjusted for inflation.

    Finally, some groups of persons previously served by State mental hospitals are now deemed inappropriate for admission, although statutorily required admission regulations have not been issued. Also, many persons with mental illness are in jails. Statutory clarification is also needed on the role of regional partnerships of community services boards in State hospital admission decisions.