House HWI Committee
June 18, 2007
On June 18 the House Health, Welfare, and Institutions
Committee held its first meeting of the 2007 interim with Delegate Phillip
Hamilton as chair. The Committee will explore issues concerning Virginia's
mental health laws in general and involuntary commitment laws in particular.
Allyson K. Tysinger, Assistant Attorney General, gave a brief overview
of the laws governing civil commitment in Virginia. Ms. Tysinger discussed
emergency custody orders, temporary detention orders, voluntary commitment,
and involuntary outpatient and inpatient commitment orders, and explained
the process involved and criteria which must be proven for each.
Outpatient Treatment of Persons with Mental Illness
Mr. James M.
Martinez discussed different types of mandatory outpatient treatment (MOT)
laws and MOT laws in other states, highlighting New York's Kendra's Law.
Mr. Martinez then discussed operation and policy issues related to MOT,
including the need for new services, increased administrative costs, issues
surrounding forced medication, and the need for additional training and
support of special justices, law enforcement and mental health professionals.
Mr. Martinez stated that Virginia's current transformation, with its focus
on building capacity was working, and creating more options, and more
person-centered, recovery-oriented care which would enhance voluntary
engagement in services and lead to better outcomes. Mr. Martinez provided
some examples of successful voluntary outpatient treatment systems in
Virginia including the Assertive Community Treatment (PACT) programs and
other crisis stabilization programs. In conclusion, Mr. Martinez stated
that policy decisions about MOT must be made in the context of its full
impact on the service delivery system in its entirety. Any expansion of
MOT should be coupled with expanded community services, and a sufficient
administrative infrastructure to support it.
to Mental Health Issues: Understanding CSB/BHA Roles and Practices
Mary Ann Bergeron, Virginia Association of Community Services Boards
Ms. Bergeron provided an overview of the activities and role of Community
Services Boards (CSBs) in mental health generally and the commitment process
specifically. Ms. Bergeron explained the responsibilities of CSBs as mandated
by the Code of Virginia, and described a number of factors, including
differences in geographical catchment areas; workforce constraints; treatment
resources within communities, including private hospitals; magistrate
and court practices; public safety resources; and CSB/BHA state and local
funding levels that result in varied local responses to these responsibilities.
Ms. Bergeron also
identified a number of economic challenges facing CSBs, and provided several
recommendations for the committee including a thorough review of the legal
intervention process for consistency; emphasizing the needs of the person
with the psychiatric condition; considering best alternatives to coercion;
promoting training of all parties; addressing the workforce in meaningful
ways; and promoting adequate flexible funding for service gaps.
& Related Information from the Investigation of April 16, 2007 Critical
Incident at VA Tech by the Office of the Inspector General
Stewart, III, Office of the Inspector General for Mental Health, Mental
Retardation and Substance Abuse Services
Mr. Stewart presented a summary overview of the finding of his investigation
of the incident at Virginia Tech to the committee, including recommendations,
and answered questions regarding these recommendations. In summary, the
Office of the Inspector General recommended that the number and capacity
of secure crisis stabilization programs be expanded, and that the commitment
process be changed to facilitate the collection and interpretation of
critical collateral information, and enable engagement of the individual
in such a way that his or her journey of recovery is supported and facilitated.
Mr. Stewart also recommended that specific changes be made to clarify
and improve the outpatient commitment process, the capacity of outpatient
treatment services be expanded, and the number of CSB case managers be
The next meeting
of the House Health, Welfare and Institutions Committee will be held at
the General Assembly Building in Richmond on July 30, at 1:00 p.m.
The Hon. Phillip
Greg O'Halloran, DLS Staff
of Legislative Services > Legislative
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