I am the executive director of the Hampton-Newport News Community Services Board (H-NNCSB), and it is our CSB that was directly impacted when this bill stripped us of our responsibility. In 1993, the General Assembly decided that it was in the best interest of the citizens of Virginia that private mental health providers not be granted the authority to determine if a person needs psychiatric hospitalization while also being the entity that treats them and directs their services. This is because it gives an entity with financial interest the ability to make decisions about a person’s care. This represents a conflict that could place a person’s freedom at risk. At that time, CSBs were designated as the sole entity responsible for pre-screening people to determine the need for psychiatric treatment.
The Code of Virginia specifically states that pre-screeners “determine the least restrictive treatment available for the person being evaluated; be able to provide an independent examination of the person; have no financial interest in the admission, treatment, or denial of admission of the person being evaluated; and have no investment interest in the facility detaining or admitting the person.” What you are being asked to do is in direct conflict to this law. These clinicians are responsible for screening the person, deciding the best course of treatment, and providing that treatment— in direct conflict with existing law. To be clear, we are in no way opposed to the psychiatric emergency department (psych ED) being present in our community; we want our citizens to have every opportunity to receive the care they need. We are concerned that the law would be changed to permit this private entity to do the very thing that required the law to be put into place in the first place.
The code of Virginia states that the CSB is the “single point of entry into the publicly funded behavioral healthcare system,” yet we are often not involved in the care of the people coming to this private entity for treatment. In fact, we were told directly that their goal is that people who come through their psych ED get connected to one of their outpatient services such as partial hospitalization. Consider that the reimbursement rate for partial hospitalization is $500 per person per day, a rate that significantly increased in January of 2024, just before this pilot was put into place. I am not implying that financial gain is the intent of Riverside but pointing out that this represents financial interest— in direct conflict with the current law.
There is no data we can access that is supportive of making this a permanent program. In fact, the data we have been able to see show that Riverside's psych ED issues temporary detention orders in 80% of the screenings it provides, compared to 43% issued by our CSB. While we don’t know the reason for this disparity, it warrants further evaluation to determine if this is a result of circumventing the law that has been in place to protect our citizens.
I urge you to take a look at the various articles out there that show what happens when psychiatric facilities are allowed to fully direct the care of their patients. Please also consider the fiscal impact statement that shows that from a DBHDS perspective, this is not something that can be replicated throughout the state, so it is hard to understand why this exception is being made for this single entity.
I am the executive director of the Hampton-Newport News Community Services Board (H-NNCSB), and it is our CSB that was directly impacted when this bill stripped us of our responsibility. In 1993, the General Assembly decided that it was in the best interest of the citizens of Virginia that private mental health providers not be granted the authority to determine if a person needs psychiatric hospitalization while also being the entity that treats them and directs their services. This is because it gives an entity with financial interest the ability to make decisions about a person’s care. This represents a conflict that could place a person’s freedom at risk. At that time, CSBs were designated as the sole entity responsible for pre-screening people to determine the need for psychiatric treatment. The Code of Virginia specifically states that pre-screeners “determine the least restrictive treatment available for the person being evaluated; be able to provide an independent examination of the person; have no financial interest in the admission, treatment, or denial of admission of the person being evaluated; and have no investment interest in the facility detaining or admitting the person.” What you are being asked to do is in direct conflict to this law. These clinicians are responsible for screening the person, deciding the best course of treatment, and providing that treatment— in direct conflict with existing law. To be clear, we are in no way opposed to the psychiatric emergency department (psych ED) being present in our community; we want our citizens to have every opportunity to receive the care they need. We are concerned that the law would be changed to permit this private entity to do the very thing that required the law to be put into place in the first place. The code of Virginia states that the CSB is the “single point of entry into the publicly funded behavioral healthcare system,” yet we are often not involved in the care of the people coming to this private entity for treatment. In fact, we were told directly that their goal is that people who come through their psych ED get connected to one of their outpatient services such as partial hospitalization. Consider that the reimbursement rate for partial hospitalization is $500 per person per day, a rate that significantly increased in January of 2024, just before this pilot was put into place. I am not implying that financial gain is the intent of Riverside but pointing out that this represents financial interest— in direct conflict with the current law. There is no data we can access that is supportive of making this a permanent program. In fact, the data we have been able to see show that Riverside's psych ED issues temporary detention orders in 80% of the screenings it provides, compared to 43% issued by our CSB. While we don’t know the reason for this disparity, it warrants further evaluation to determine if this is a result of circumventing the law that has been in place to protect our citizens. I urge you to take a look at the various articles out there that show what happens when psychiatric facilities are allowed to fully direct the care of their patients. Please also consider the fiscal impact statement that shows that from a DBHDS perspective, this is not something that can be replicated throughout the state, so it is hard to understand why this exception is being made for this single entity.