Public Comments for 02/08/2021 Health, Welfare and Institutions
SB1102 - Personal care aides; DMAS shall establish an orientation program for certain aides.
SB1102 will enhance the provision of Medicaid consumer-directed supports. The Virginia Association of Centers for Independent Living supports this legislation.
The Arc of Northern Virginia strongly supports SB1102. We have worked regularly with families who wait years for a Medicaid Waiver. When one is finally granted, they're shocked with all of the work they must take on to hire, fire, and train care attendants who have incredibly high turnover rates. SB1102 would provide some training to those attendants directly from DMAS. We believe this would decrease the burden on people with disabilities and families and increase the morale of Personal Support Attendants who would get some formal training and assistance taking on a challenging job.
SB1121 - Birth certificates; an amendment of a certificate shall be evaluated by the State Registrar.
SB1147 - Nurse Loan Repayment Program; certified nurse aide.
Available to answer questions that the committee may have
SB1154 - Behavioral Health and Developmental Services, Commissioner of; reports to designated protection.
SB1176 - Barrier crimes; amends current requirements for DBHDS to provide, etc.
SB1178 - Genetic counseling; repeals conscience clause.
Dear members of the Committee, I am writing to you on behalf of NARAL Pro-Choice Virginia in opposition of this bill. No patient should have to wonder whether their medical professional will provide them with complete, accurate and unbiased information. Genetic counseling is no different. A counselor's first duty should be to his or her patients. Part of the responsibility of being a genetic counselor is to put the counselor’s own feelings and beliefs aside and give the patient the information they need to in a timely, unbiased manner to help the patient come to their own decision about the health issues they face. The “conscience clause” enables genetic counselors to discriminate against, and even harm, clients with total impunity. The so-called “conscience clause” in place is a blanket license to discriminate. The law’s current language sets a dangerous precedent for other professions and businesses in Virginia where practitioners/owners want to impose their religious beliefs (or deeply held moral beliefs which are undefined) on their patients or clients and refuse to provide services to people who do not believe the same things that they do. The current statute is so extreme that it shields a genetic counselor from accountability even if the counselor takes purposeful action based only on his or her personal beliefs that result in actual physical harm or death to the patient. Removing the clause does not prevent a genetic counselor from practicing their religion, it just makes it so they have to follow medical ethics/genetic counselor ethics, that every person in the medical field SHOULD be bound to follow. At the end of the day, every patient deserves accurate, timely and unbiased medical information. Thank you for your consideration. Please feel free to reach out if you have any questions, Galina Varchena, Esq. Policy Director, NARAL Pro-Choice Virginia firstname.lastname@example.org.
SB1187 - Physical therapy; extends time allowed for a therapist to evaluate and treat patients.
SB1189 - Occupational therapists; licensure.
SB1205 - Career fatigue and wellness in certain health care providers; programs to address, civil immunity.
SB1220 - State facilities; admission of certain aliens.
Chairman Willett and members of the Health, Welfare and Institutions Committee, Good morning, I am an attorney with the Capital Area Immigrants’ Rights (CAIR) Coalition. I am writing today to ask for your support on SB 1220. I provide legal representation at no cost to clients, primarily for residents of Virginia who are detained in immigration detention centers across the state. Each year, the U.S. government detains nearly 400,000 immigrants, including over 600 Virginia residents. Of those residents, more than 700 children were impacted by ICE detaining their parents. We serve over 1,200 people a year detained in Virginia. Of those people detained, over 1,200 children were also impacted by their parent's detention. Our clients are diverse in their backgrounds, with some having resided in the United States as legal permanent residents for years and others having arrived to seek refuge from violence and persecution in their home countries. They are members of our community. They are mothers, fathers, husbands, wives, brothers and sisters, often of U.S. citizens. In relying on CAIR Coalition for legal services, they are also generally of limited economic means and often fill jobs at the front line of our economy as essential workers. Several suffer or have suffered from serious mental illness, often in connection with past trauma they have endured in the places they fled. Providing these individuals with the proper mental health care enables them to get back on their feet, continue supporting their families and, where needed, apply to adjust their status. Weaponizing the state facilities where they seek refuge, on the other hand, worsens their prospects and those of Virginia’s communities as a whole. Immigration court proceedings are civil, not criminal, in nature. However, with the use of jails as ICE detention facilities and the prospects of deportation resulting in prolonged family separation, persecution, or even death, the stakes are equally high. Information sharing between healthcare providers and immigration enforcement breaks community trust in government and goes against ethical principles in public health including patient consent, confidentiality, and non-maleficence, as empirical research has demonstrated. Immigrant detention has also been shown to worsen mental health, with one study broadly reviewing the scientific literature on the issue finding detention duration to be died to worsening symptoms in illnesses such as anxiety, depression, and post-traumatic stress. At CAIR Coalition, we have directly witnessed cases of individuals detained by ICE after being hospitalized, facing the threat of deportation to countries where the mentally ill face violence and lack treatment options. We have also witnessed the desperation and impacts on well-being that many of our clients face while detained. We have also spoken with their families, many of them U.S. Citizens, who are left hurting without individuals who often had been mustering the strength to be the prime income provider in spite of their mental health struggles. Particularly during the economic distress and "mental health pandemic" caused by COVID-19, access to mental health treatment must be encouraged regardless of national origin. For all of the foregoing reasons, I respectfully support SB1220. Alice N. Barrett, Staff Attorney CAIR Coalition Phone: (202) 381-9004 email@example.com
SB 1220 -- The disAbility Law Center of Virginia supports this legislation. The reporting requirements in current law act as a dangerous disincentive, deterring people from seeking necessary mental health treatment. We thank Senator Favola and the committee. SB 1304 -- The disAbility Law Center of Virginia supports efforts to improve discharge planning for the state hospitals. We would be willing to bring our substantial experience in discharge representation to this work group.
SB1221 - Loudoun County; operation of local health department.
SB1227 - Hormonal contraceptives; payment of medical assistance for 12-month supply.
This is just one example of why we need contraceptives for all people.... I am a single mother of two children. Both children are adopted through Alexandria Social Services. My kids are half-siblings and have 3 other full or half siblings. .ALL 5 children were removed from their birth family. If you didn't know, there are approximately 400,000 (FOUR HUNDRED THOUSAND!!) children in foster care, right now, wishing for a forever home. My take on all this is PREVENTION. We cannot house the kids we have in Foster care and unless you all are willing to adopt multiple children each, you should stay out of other peoples business and permit contraceptives for everyone, no matter what insurance they are on. The state should be the first to understand the cost of prevention vs the cost and challenges of a child in foster care.
My name is Nicole Liberatore and I live in Annandale, Virginia. I began taking hormonal birth control when I was a sophomore in high school. There have been times when I was unable to fill my prescription because of lack of transportation, being unable to make it to the pharmacy before it closed, or waiting multiple days until my prescription could be filled. I didn’t have a car when I attended George Mason University, which meant that I had to rely on public transportation to obtain my birth control once a month. At one point close to finals my sophomore year, I missed taking my pills with consistency and because of my hectic study schedule, was unable to get to a pharmacy. When my period arrived later that week, my cramps were so bad that I fainted during my Arabic language class. I had to miss the rest of my classes for the day and have a friend pick me up from campus. During my senior year, I studied abroad for a semester and went without birth control because I couldn’t get an advanced prescription filled. I now live within a mile of my pharmacy, own a car, and work a somewhat regular schedule when I can arrive to my pharmacy before it closes. I also have insurance through my employer and can get access to 12 months of birth control at a time thanks to a bill passed in 2017. I understand this privilege and recognize from past experiences that there are many in Virginia that do not have this accessibility. Virginians who are on Medicaid deserve the same access to birth control that the rest of us have. Pass SB1227 and make accessible contraceptives a reality for ALL Virginians.
Unfettered access to contraception prevents unplanned and/or unwanted pregnancy In the 1960s, as a young, married woman going into the Peace Corps for a 2 year term of service in Tanzania, East Africa, my forward thinking doctor wrote me a prescription for a 2 year supply of birth control pills and had me fill it before leaving the U.S. Had I become pregnant I would have been sent home. Pass the bill and the budget amendment for Medicaid recipients to improve effectiveness and reduce Covid risks, by reducing the number of trips to a pharmacy or standing around waiting for a prescription refill.
I fully support providing Medicaid insurees access to 12 months of birth control at a time. As a woman who has depended on birth control to both prevent pregnancy and alleviate symptoms from painful periods, I have been forced to receive one month supplies of birth control for years. I can personally attest to running out of my supply and having to quickly set up a doctor's appointment for a new prescription (which not everyone is able to take off work and do) and for missing days of taking my pill while waiting for a new prescription to be filled. I could have gotten pregnant during that time when I did not want to be pregnant. We need to empower women to control their own reproductive future, and this starts with preventing unplanned pregnancy. This bill will give women who need it most greater control of their future and should be passed.
My name is Taylor Bernstein, and I am a resident of Falls Church. I support this bill because I know how important it is to have reliable access to birth control, especially during the pandemic. I have been taking oral birth control since I was 18, but at the start of the COVID-19 pandemic, my prescription ran out. I was in between doctors, but had an appointment with a new OBGYN set for mid-March. Like so much else during this time, my appointment was cancelled because of safety. My prescription for birth control ran out and I was forced to go several months without it until I could find a new prescriber. During that time, I experience longer periods with more cramping, headaches, and mood swings than I normally did on birth control. I support this bill because I know that it would allow Virginians, particularly the most marginalized, to access oral contraceptives more easily and more reliably. No one should struggle to access basic healthcare because of their financial circumstances. I urge you to pass this bill. Thank you
Having a 12-month supply of birth control available for medicaid subscribers is important to me. Having to fill a prescription monthly can become a burden and in a time where lots of mother's are having to work more than one job to make ends meet, this could make a huge difference in avoiding unintended pregnancies. There is literally no downside to allowing this.
Hello. My name is Armani Anderson, and I am a third-year student at the University of Virginia. Thank you for allowing me to share my story in support of Senate Bill 1227 with you. I severed ties with my parents halfway through my first semester of college, leaving me to navigate the complicated world of healthcare completely on my own without insurance coverage, comprehensive information, or adequate support. My experience with birth control has and continues to be a struggle. Without having access to my family history, I experienced many initial health complications once on the pill. I had to find friends to drive me to the doctor and the pharmacy because I didn’t have reliable transportation. I also had to pay out-of-pocket for my birth control, which, as a college student, wasn’t easy. Faced with these financial and logistical barriers, I knew I needed healthcare that would help me pay for the medication I needed. After lots of time and energy, I was able to acquire Medicaid—but my prescription for hormonal birth control expired shortly after. Because of the complications I’ve experienced, I know that I need to work with a culturally competent medical professional to find the hormonal birth control that works best for me. COVID-19, however, has prevented me from being able to see a PCP. This underscores the fact that barriers to birth control access have already been exacerbated during the pandemic, and my insurance coverage shouldn’t compound those difficulties. Once I do have my appointment, I know that being able to receive a full year’s supply of birth control would make my life so much easier, allowing me to focus on my studies and achieve my goals. I shouldn’t be denied the same kind of healthcare access my peers have just because I use Medicaid. I shouldn’t have to schedule my own life around someone else’s schedule so I can get a ride every month to the pharmacy. I shouldn’t have to worry about missing a pill because I can’t get my next pack in time. I shouldn’t have to worry about how I’ll get my birth control when I’m hunkered down studying during finals or being forced to choose my class schedule based on a pharmacy’s hours of operation. Instead, I would have everything I need to care for my health all at once – just like everyone else. Virginia Medicaid recipients, like myself, are equally worthy and deserving of that same kind of healthcare access, no matter what insurance plan we may use. I know first-hand that reproductive freedom isn’t just about having the right to decide what happens to our bodies—it’s about being able to access equitable healthcare once those decisions are made. I am testifying because I understand the institutional barriers to healthcare and coverage that have harmed so many generations of women, including that of my own and those before me—I understand that being forced into a single option because it is the only thing someone can afford is not the same as having an autonomous choice. Bearing that in mind, I strongly urge you to please vote in support of Senate Bill 1227. Thank you for your time and thoughtful consideration.
Because I would want it I support the Medicaid 12 Month Bill knowing that I want coverage lasting a full year when -I- sign up on the exchange. I don’t have this need, but if I did I would want to have it for a year. I support others having it.
I am the mother of a teenager that in a few short years will be off in the world. Preventive reproductive health services should not be something that a young woman has to stress about. I do not want to see my daughter face the same struggles I did as a young woman with no insurance, unable to get screened to keep myself safe. I was limited in the types of contraceptives I could afford and healthcare providers I could see. We need to remove barriers and have reproductive health services with minimal out of pocket costs.
When I was 24 when I made the decision to have an abortion. As a mother, I knew that this was the right decision for me and my family. My son has a developmental disability and lives with low-functioning autism. I was 19 years old when my son was born; he is the light of my life and I worship the ground that he walks on. While I love my son tremendously, having a child who is developmentally disabled, especially at such a young age, has been an overwhelming emotional and financial struggle. I do my absolute best to be the parent my son deserves and needs, but it takes everything I have and more. As a mother, I knew I could not continue to give my son what he needs if I were to have another child. Access to birth control at the time I had my abortion was not easy. While the medication itself was accessible, I also had to worry about transportation from appointments, the cost of the appointment itself, and furthermore paying for birth control once I had access to it. Due to these obstacles, I fell behind on my birth control and found myself pregnant. No woman desires to have an abortion in her lifetime. If I had had better access to birth control medication through insurance coverage of that medication, it would have been one less obstacle preventing me from needing an abortion in the first place. While political parties differ on whether or not they believe women deserve the right to an abortion, we all can agree that we would like a world in which women do not need one in the first place. Expanding birth control access to low-income women helps to prevent scenarios in which these women find themselves making the choice to abort at all. This is common-sense legislation that would benefit all women (and their families).
My name is Abbie Henrickson, and I live in Sterling, Virginia. I am writing to urge you to support Senate Bill 1227 (12-Month Supply of Hormonal Contraceptives for Medicaid Insurees). At the present time, women in Virginia who get their contraceptives through Medicaid are not eligible for a 12-month supply. Women not on Medicaid are eligible to receive a 12-month supply. This is just wrong. Women in the Medicaid program are in potentially unstable situations that may make it difficult for them to stay in touch with their doctors to keep their prescriptions up to date and are forced to cover any additional expenses that they incur (such as transportation and childcare). I currently volunteer with the New River Abortion Access Fund. (I previously volunteered with the Blue Ridge Abortion Fund for many years.) As an intake volunteer, I speak directly with women who are in need of financial assistance to help pay for their procedures. Not having access to contraceptives is a common reason that they are in need of our assistance. Providing a 12-month supply of hormonal contraceptives significantly reduces both unwanted pregnancies and abortions. It is deplorable that women of extremely limited means are not able to take advantage of a healthcare benefit that women who are not Medicaid insurees have access to. To my mind it truly makes no sense that the state inflicts this burden upon them. I urge you to support Senate Bill 1227. Thank you for your consideration of this important matter.
SB1235 - Health, Department of; certain communication prohibited.
SB 1235 was tabled this morning 2/11/2021. Del Orrock asked if it could be discussed and voted on when Senator Peake was in the room. I speak as a collective voice for parents in Virginia because like myself, I had to sign a consent form after my 14 yr old had a medical procedure without my knowledge or consent, but for her to have reparative surgery to be performed, I had to sign a consent form. To add insult to injury, I was responsible for the cost of the follow-up care in the amount of $27,000. A story you have heard before. Please pass this bill out of committee and ask yourself, please, as a parent or grandparent why would you not want to know or consent to having a stranger talk to your child or grandchild? The committee members are comprised of parents and grandparents and deserve a right to know and to give consent to anyone talking to your child or grandchild on healthcare, sex, education and upbringing - not strangers. You love your children more than strangers and certainly have their best interest at heart not a stranger. Please pass this bill on.
Dear Mr. Chairman and Members of the House Health, Welfare, and Institutions Committee: On behalf of Virginia’s sexual and domestic violence victim advocacy community, the Action Alliance is asking you to oppose SB 1235 (Peake). Many of our 65 sexual and domestic violence agencies (SDVAs) statewide, including the Virginia Sexual & Domestic Violence Action Alliance, are contracted partners (primarily as grant recipients) with the Virginia Department of Health. Part of our work includes making sure that minor victims of child abuse, sexual assault, dating violence, and harassment have access to information on accessing services if they are victimized, on preventing violence in their peer groups, and on supporting healthy relationships and norms. This bill, with amendments, as written, would have a chilling effect on minor access to reporting violence, seeking justice and healing, and to efforts to promote long-term health and wellbeing. The CDC reports that 1 in 4 women and 1 in 10 men have experienced sexual violence, dating violence, or stalking and that of those numbers, almost 70% of women and 54% of men who were victimized first experienced this violence between the ages of 11 and 24. Given the magnitude of sexual and dating violence among youth, the public health science calls on us to treat this as we would any other epidemic. Our programs, who contract with VDH to support information sharing on preventing sexual violence and dating violence, offers us an inoculation, a means by which young people can access critical conversations and education that serve to prevent issues like relationship violence, unintended pregnancy, and adverse childhood experiences before they can ever occur. This is essential and any policy seeking to make it less accessible to youth is one that also disregards public health and safety. Thanks for your time and attention to issues impacting the lives of survivors of abuse and the advocates who serve them. I'm always happy to talk more about this and our programming to prevent sexual and domestic violence in Virginia, --- Jonathan Yglesias Policy Director Virginia Sexual & Domestic Violence Action Alliance 1118 W. Main Street Richmond, VA 23220 Office: (804) 377.0335 Find us on Twitter and Facebook to join the conversation. Statewide Hotline | Call: 800.838.8238 | Text: 804.793.9999 | Chat: www.vadata.org//chat/ LGBTQ Helpline | Call: 866.356.6998 | Text: 804.793.9999 | Chat: www.vadata.org//chat/
Dear Chair and Committee Members, I am writing in favor of SB 1235, a common sense bill which would require the consent of parents to be involved with the healthcare, education, upbringing and religious freedom, for their minor aged children. SB would protect children in Virginia from the harm which came to my 14 year old daughter after she obtained a surgical procedure without my knowledge or consent. As a result of my absence, my daughter suffered physical and emotional damage caused by the physician, which required follow-up surgery. However, she could not have the follow-up reparative surgery and hospitalization unless I signed a consent form. To add insult to injury, I was responsible for the follow-up medical costs, amounting to over $27,000. SB 1235 would stop what happened to my family from happening to other families in Virginia when speaking to strangers, concerning their healthcare, education, religious freedom and certainly all medical and surgical procedures. This bill would continue to ensure a parent's constitutional right to care for their minor aged daughter as they see fit. Besides, who knows their children better than the parent. While not ever child is from a loving family, this bill protects those children in a volatile situation. Please don't punish parents who love their children, parents and grandparents just like yourself. I am sure you would want your children to know and give consent for any healthcare, education and other situations as named in this bill, for your grandchildren. Most importantly, parents not strangers, kidnappers, or sexual predators have the right to be involved with their children. I urge you not only for your constituents, but for your own families and all Virginia parents, to put their arms around their children and say "we love you, we can work this out together". Please pass SB 1235 out of committee. Thank you for your time, Eileen Roberts, President Parents for Life "Serving as a collective voice for all parents". February 6, 2021
SB1237 - Emergency and quarantine orders, certain; additional procedural requirements.
SB1302 - Crisis Call Center Fund; created, consistency with federal guidelines.
RE: SB 1302, Crisis Call Center Fund Dear Chair Sickles and Members of the Health, Welfare and Institutions Committee: I am writing on behalf of Inseparable, a growing coalition of people from across the country who share a common goal to fundamentally improve mental healthcare policy to heal ourselves, our loved ones, and our communities. This year, as the recovery from the COVID pandemic begins, America cannot afford to let mental health care fall further behind. Because of the dramatic increase in mental health crises, it has never been more important to invest in mental health and addiction care policy and services. We applaud Senator McPike for introducing SB1302. The success of the new mental health emergency hotline (988) is dependent on a timely and well-resourced nationwide rollout. Key to this is securing expanded and sustainable funds for not only crisis centers, but also for the mental health workforce that will deal with expected increase in demand and provide follow-on services. Like other mental health advocacy groups in the state and nationally, we are concerned that the current $0.12 fee in the bill is not sufficient to cover vital costs. We ask you to please urgently revisit the financial costs that will be generated by the establishment of the hotline and revise the fee amount on the bill. While we appreciate that there are plans to make increases in the future, Virginians are suffering today and need adequate support now. Sincerely, Krithika Harish Inseparable.us
February 11, 2021 Delegate Mark D. Sickles, Chair HWI Committee Virginia General Assembly RE: SB 1302, Crisis Call Center Fund Dear Chair Sickles and Members of the Health, Welfare and Institutions Committee: NAMI Virginia is part of NAMI, the National Alliance on Mental Illness. Our mission is to promote recovery and improve the quality of life of Virginians with mental illness through support, education and advocacy. We would like to express our gratitude to Senator McPike for introducing SB 1302, the Crisis Call Center Fund, and to the Committee for hearing this bill today. NAMI supports the vision outlined in the bill, but we believe the bill should be strengthened by small changes, which we believe are critical to meeting the needs of Virginians with serious mental illness. NAMI’s members frequently come to us in need of help and support after enduring life-shattering circumstances. Too often, those circumstances include law enforcement. I’d like to share two brief examples to highlight the pain of inadequate investment in a mental health crisis service system. Recently, a Virginia man reached out to NAMI, distraught. His sibling had been saying things that didn’t make sense and was increasingly paranoid and lashing out, sensing threats where none existed. After an altercation with his partner, who called 911, police came and arrested the man, who was experiencing psychosis and had a family history of serious mental illness. With his family’s advocacy, this man was eventually given a mental health examination. The man and his family were traumatized by the police intervention and the daunting and stigmatizing challenges of navigating the criminal justice system. If they had been able to call 988 and receive a mobile crisis team response instead of police, there would have been no arrest, no criminal record and legal fees, and far less trauma for this Virginia family. Instead, the family’s sole focus could have been on helping this man get the care that he needed – not navigating the criminal justice system. In another instance, a person with bipolar disorder became manic and confused and tried to leave the state. When the family called for help, police arrested their child and held him in jail. Desperate, the family spent heartbreaking hours and significant resources trying to obtain not only legal help, but mental health treatment for their beloved child. Despite their resources, they were unable to navigate an incomprehensible system that criminalizes people with serious mental illness. There are countless families in Virginia whose lives have been turned upside down because of the lack of a sufficient behavioral health crisis system in Virginia. While we appreciate that there are plans to gradually improve this, the slow pace of investment does not do justice to the lives of Virginians who are suffering today and who deserve an investment of more than $0.12 a month. We respectfully request that you reconsider the level of E-911 fee for the Crisis Call Center Fund, clarify that it can be used to support mobile crisis teams, and further clarify that the annual report should include not only recommendations on crisis system needs, but also a recommendation on fee levels needed in the future to support the level of mobile response needed for the complex and acute mental health needs in our communities throughout Virginia. Respectfully, Kathy Harkey, MAPP, BSP, BSMDS Executive Director
Although I am supportive of the National 9-8-8 Crisis Line, I am very concerned about linking the 9-1-1 and 9-8-8 funding. By linking the two, the National VDOT 9-1-1 Coordinator and FCC have ruled that Virginia would be considered as diverting 9-1-1 funds. Additionally, the 9-1-1 Public Safety Answering Points (PSAP) are not adequately funded. Currently the 9-1-1 Wireless Distribution, offsets an average of 12% of a PSAP's operating costs, and this is before the increases from moving to Next Generation Technology. I urge you to de-couple this Bill from 9-1-1. There will be significant value if 9-8-8 has a separate funding stream and separate visibility on carriers bills. Additionally, line 289 and 290 of the Senate Substitute Bill assigns in-house building repeaters as the number 2 priority. Although again while this important, it is restrictive and not the number 2 priority for 911 PSAPs. This should be removed, or at a minimum changed to "investments to improve location accuracy". I would like to speak, but I am receiving a message that requests to speak are closed. I have also reached out to Senator McPike, but have not been successful in getting a return call. I know others have submitted written comments on the Bill as well.
Delegate Mark D. Sickles, Chair Health, Welfare and Institutions Committee RE: SB 1302, Crisis Call Center Fund Dear Chair Sickles and Members of the Health, Welfare and Institutions Committee: NAMI Virginia is part of NAMI, the National Alliance on Mental Illness. Our mission is to promote recovery and improve the quality of life of Virginians with mental illness through support, education and advocacy. We would like to express our gratitude to Senator McPike for introducing SB 1302, the Crisis Call Center Fund, and to the Committee for hearing this bill today. NAMI supports the vision outlined in the bill, but we believe the bill should be strengthened by small changes, which we believe are critical to meeting the needs of Virginians with serious mental illness. NAMI’s members frequently come to us in need of help and support after enduring life-shattering circumstances. Too often, those circumstances include law enforcement. I’d like to share two brief examples to highlight the pain of inadequate investment in a mental health crisis service system. Recently, a Virginia man reached out to NAMI, distraught. His sibling had been saying things that didn’t make sense and was increasingly paranoid and lashing out, sensing threats where none existed. After an altercation with his partner, who called 911, police came and arrested the man, who was experiencing psychosis and had a family history of serious mental illness. With his family’s advocacy, this man was eventually given a mental health examination. The man and his family were traumatized by the police intervention and the daunting and stigmatizing challenges of navigating the criminal justice system. If they had been able to call 988 and receive a mobile crisis team response instead of police, there would have been no arrest, no criminal record and legal fees, and far less trauma for this Virginia family. Instead, the family’s sole focus could have been on helping this man get the care that he needed–not navigating the criminal justice system. In another instance, a person with bipolar disorder became manic and confused and tried to leave the state. When the family called for help, police arrested their child and held him in jail. Desperate, the family spent heartbreaking hours and significant resources trying to obtain not only legal help, but mental health treatment for their beloved child. Despite their resources, they were unable to navigate an incomprehensible system that criminalizes people with serious mental illness. There are countless families in Virginia whose lives have been turned upside down because of the lack of a sufficient behavioral health crisis system in Virginia. While we appreciate that there are plans to gradually improve this, the slow pace of investment does not do justice to the lives of Virginians who are suffering today and who deserve an investment of more than $0.12 a month. We respectfully request that you reconsider the level of E-911 fees for the Crisis Call Center Fund, clarify that it can be used to support mobile crisis teams, and further clarify that the annual report should include not only recommendations on crisis system needs, but also a recommendation on fee levels needed in the future to support the level of mobile response needed for the complex, acute mental health needs in our Virginia communities. Respectfully yours, Kathy Harkey, MAPP, BSP, BSMDS Executive Director
I am the Director of Tazewell County PSAP. My understanding of Bill SB1302 is to provide a 9-8-8 Crisis Call Center and establish a staff administered by the Department of Behavioral Health and Development Services providing a Hotline Center for the purposes of participating in the National Suicide Prevention Lifeline and to provide consistency with federal guidelines. I'm in support of the 9-8-8 Crisis Line but opposed to this Bill for the following reasons: 1) Separate Bill introduced for the 9-8-8 line; Separating it out of Public Safety Answering Point funds. It should be separate and distinct from the current 9-1-1 legislation 2) The 9-1-1 PSAP Community consistently faces financial challenges and is conducting a cost study to determine the current adequacy of our current 9-1-1 surges to ease the costly increases to the NextGen voice and ever changing data technologies. Technology and costs for NG-911 are increasing our operating costs by leaps and bounds and a increase to what we receive from the wireless E-911 and the prepaid E-911 should be for providing our current expected services to maintain the quality of life for every citizen in State and locally. 3) E911 is in the middle of a huge migration now to Next Generation 9-1-1, which is mandated. PSAP's cannot just not migrate because of lack of funding. This Bill would limit the amount of funding PSAP's would be allotted, when we need these funds more now than ever. Technology is great and the 9-1-1 community is constantly growing and changing and the future is here we need to increase PSAP's funding and not share with another Department. 3) 9-1-1 funds (taxes) are collected to be used for 9-1-1 services / needs. Using these funds for other projects / needs for other Departments could lead a continued problem for the PSAP Community, it could lead to having funds continually diverted to non-9-1-1 needs or projects. I appreciate you time, consideration and efforts on this project, but please consider re-evaluating this SB1302 and designating a separate Bill for the needed funding to the 9-8-8 Crisis Call Center. Thank you.
House Committee on Health, Welfare, and Institutions, The American Foundation for Suicide Prevention (AFSP), the nation's largest organization dedicated to saving lives and restoring hope to those impacted by suicide, appreciates your consideration and thanks Senator McPike for championing the 988 policy and for introducing legislation to support crisis services for callers in need. When 988, the national mental health and suicide prevention crisis hotline number designated by the U.S. Congress, is made nationally available in July 2022 it is crucial that Virginia's local crisis call centers and state crisis capacity is effectively equipped to respond to individuals calling for help. AFSP applauds Senator McPike's effort to increase funding for Virginia's crisis response services, but we acknowledge the body of concerns regarding implementation of SB1302. Implementing service fees on wireless, wireline, and VoIP bills to support 988 would be invaluable. Providing stable funding for 988 centers just as we do for 911 centers is essential for ensuring that calls to 988 are answered quickly and effectively. But, input from professional organizations and policy experts regarding the proposed expanding of Virginia's 911 fee to support 988 has raised notable concerns. We hope that the fees collected to support 988 will not constitute diversion from the dedicated purpose of 911 fees or create jurisdictional challenges between 988 call centers and 911 PSAPs. Collaboration between 911 and 988 as parallel, but independent, response lines will be important, and the points raised by 911 stakeholders should be heeded. Fees collected in support of 988 should receive appropriate guardrails to prevent diversion, similar to 911. AFSP supports regular assessment and oversight of the collection and use of 988 fees to ensure that callers are responded to quickly, that robust services are provided, that at-risk communities are provided specialized services, that data can be used effectively, and that 988 can coordinate effectively with the continuum or crisis and emergency response. AFSP further reciprocates the support of mental health and suicide prevention experts for increased investment in 988 crisis services. Just as 911 PSAPs need robust, dedicated funding to ensure our calls are answered and responded to effectively, so too do 988 crisis call centers need to be prepared to respond to the demand for crisis services. We hope that 988 fees will be in parity with 911 fees, to ensure these parallel systems are both resourced sufficiently so any Virginian, regardless of their crisis or emergency, receives effective responses. We recognize and appreciate the perspectives of numerous stakeholders on the historic implementation of 988. And we applaud Senator McPike's efforts to bring Virginia's crisis response system into the 21st century. AFSP believes that the provision of robust 988 service fees can fortify Virginia's local crisis capacity before July 2022. We encourage the Committee to consider the concerns regarding the diversion of 911 fees and the administrative and funding needs of local crisis call centers responding to individuals in need. Thank you.
Senate Bill 1302 proposes and increase in Wireless 9-1-1 surcharge to fund the National 9-8-8 Mental Health Crisis Line here in Virginia. This puts an increase for Next Generation 9-1-1 Sustainable Funding at risk. Please consider this: (1) Propose a separate bill be introduced to fund the 9-8-8 line. It can still utilize Wireless Surcharge. However it should be separate and distinct from the current 9-1-1 legislation. (2) If it continues under this Bill, then increase the surcharge to also address cost increases related to Next Generation 9-1-1 and the emerging technologies in voice and data. Additionally, there is an addition in Item D to make “Inhouse repeaters” the 9-1-1 grant funds second highest priority. This would be devastating to smaller PSAP’s. I would like to propose this be removed or modified to “improvements in location identification accuracy”.
My understanding of the bill is the following - 1. Creates a Crisis Call Center Fund (for 9-8-8), 2. Increases the wireless E-911 surcharge from .75 to .94 and increases the prepaid wireless E-911 charge from .50 to .63; some of the additional revenue to the Crisis Call Center and some to PSAP’s (9-1-1 Centers), 3. Expectations with the Marcus Alert System. ---- Some of the revenue attributed to the increase in the tax-rate would be distributed to the Crisis Call Center Fund (to establish and administer the call center) and the remainder of the additional revenue would be distributed to 9-1-1 Centers. Under the bill, .12 of the total monthly wireless 9-1-1 surcharge of .94 would be allocated for the Crisis Call Center Fund and .08 of the total surcharges on prepaid wireless devices (.63) would be allocated to the Crisis Call Center Fund. While this increase in the 9-1-1 taxes should result in additional revenue for 9-1-1 Centers, there are other considerations/concerns: 1. If approved, funds collected for 9-1-1 (and expected to be used for 9-1-1 services in the state) would be used for non-9-1-1 purposes (9-8-8 and the Crisis Call Center Fund). This is against the principle of why the 9-1-1 tax was created and a bigger-issue is the state most likely would be added to the FCC list of states that divert 9-1-1 fees for non-9-1-1 costs (from the NET911 Act from 2008). States on this list are subjects to consequences, such as withholding federal funding and how impacts to participating in aspects of FirstNet. Overall, is not a list a state wants to be on. 2. Our state in in the middle of a major 9-1-1 ecosystem transition (Next Generation 911), with costs incurred and expected to be incurred higher than what 9-1-1 Centers have previously experienced. The expectation would be to assure the necessary funds are provided to 9-1-1 Center’s before any consideration to use 9-1-1 funds collected elsewhere. 3. 9-1-1 funds (taxes) are collected to be used for 9-1-1 services/needs; using these funds for other projects/needs overall could lead to a slippery--slope in our state where these funds continue to be used (diverted) for non 9-1-1 needs/projects. The ESVA 9-1-1 Commission overall supports legislative changes to properly respond to individuals with mental health incidents or during a mental health crisis, however overall does not support the use of taxes/fees collected for 9-1-1 in our state not being used directly to support 9-1-1 services throughout our state, as is included in SB1302.
The idea for a Mental Health hotline using E911 funding is not ideal. As a 911 center, we will still be responsible for taking those mental health calls even though there would be a designated hotline for this. E911 is in the middle of huge migration to Next Generation 911, which is mandated. PSAPs can not just not migrate because of lack of funding. This bill would limit the amount of funding PSAPs would be allotted, when we need these funds more than ever. The transition to Next Generation 911 is a very expensive transition, and E911 will need every bit of funding it can get to make this successful.
In Support of 9-8-8 Crisis Line but opposed to this Bill for the following reasons: 1) Risk of Virginia being placed on the 9-1-1 Diversion List. It is my understanding 9-8-8- would be a diversion based on their review of language in the The New and Emerging 9-1-1 Technologies Act of 2008 (NET 911 Act). Repercussions include Virginia becoming ineligible for grant funding and ineligible to participate on National Committees. 2) The 9-1-1 Community consistently faces financial challenges and is conducting a cost study to determine the adequacy of the current 9-1-1 surcharge for funding increased costs related to the NextGen911 voice and data technologies. 3) Lastly, in line 289 and 290, the Bill proposes a change in priority to include a specific technology "in-building repeaters". I understand this is an important need, in our jurisdiction remote repeaters on public lands is as great a need as in-building repeaters. In either case, I would argue repeaters is not the second highest priority for 9-1-1 but rather training. At a minimum the language should be changed from 'in-house repeater" to 'location identification improvements'. Mu preference would be that prioritization remain with the 9-1-1 Services Board and the 9-1-1 Grant Committee. Thank you for your consideration.
While there is agreement that mental health services should be addressed by the state, including that funding within E-911 funding is diverting needed additional funds from PSAP's. Local E-911 agencies and PSAP's are under a financial crunch to upgrade to NG-911 over the next few years and are seeing technology and operating costs exceeding funds from the state and local approved taxing methods. When you consider the additional costs we now incur locally with additional mental health mandates, we are seeing local budgets stressed. E-911 is at its core a service as important for life saving measures as any other provided or mandated by the state and citizens. I would ask that you consider providing funding in full for PSAP's through the increase in E-911 fees and provide an additional fee for the mental health services.
Although supportive of a 9-8-8 Crisis Line, I am opposed to this Bill for the following reasons: 1) Risk of Virginia being placed an the 9-1-1 Diversion List. In discussions with Laurie Flaherty, VDOT National 9-1-1 Coordinator, the FCC lawyers, VDOT lawyers are advising 9-8-8- would be a diversion based on their review of language in the The New and Emerging 9-1-1 Technologies Act of 2008 (NET 911 Act). Repercussions include Virginia becoming ineligible for grant funding but more importantly becoming ineligible to participate on National Committees. 2) The 9-1-1 Community is already facing financial challenges and are conducting a cost study to determine the adequacy of the current 9-1-1 surcharge for funding increased costs related to the Next Generation voice and data technologies. 3) Finally, in line 289 and 290, the Bill proposes a change in priority to include a specific technology "in-building repeaters". Again although an important need, in our jurisdiction remote repeaters on public lands is as great a need as in-building repeaters. In either case, I would argue repeaters is not the second highest priority for 9-1-1. Currently training takes that coveted spot. I would that at a minimum the language be changed from 'in-house repeater" to 'location identification improvements". Although my preference would be that prioritization remain with the 9-1-1 Services Board and the 9-1-1 Grant Committee. Thank you for your consideration.
I am the Communications Manager for the Washington County PSAP. I think the funding for the Crisis call Center and the PSAP 911 portion should not be co mingled. The PASP Community 911 legislation and this National 988 Mental Health Crisis should be separate and distinct. We as PSAP's are constantly striving to improve the overall voice and data technologies that serve the areas we are in. At this time we are in the process of the Next Generation 911 migration and with this comes additional costs. We currently need all available funding that the wireless surcharges provide our centers and with the co mingling this would drastically reduce the funding for the PSAP and could be detrimental to those smaller PSAPs as well as others. While supporting the Crisis line is not the issue, it should have its own legislation thus not sharing the proposed funding. An additional increase should be designated for the Crisis Line funding, not taking the funding from the PSAP's.
SB1304 - Community services boards; discharge planning.
SB 1220 -- The disAbility Law Center of Virginia supports this legislation. The reporting requirements in current law act as a dangerous disincentive, deterring people from seeking necessary mental health treatment. We thank Senator Favola and the committee. SB 1304 -- The disAbility Law Center of Virginia supports efforts to improve discharge planning for the state hospitals. We would be willing to bring our substantial experience in discharge representation to this work group.
SB1307 - School-based health services; Bd. of MAS to amend state plan for services to provide for payment.
SB1316 - Child care providers; background checks, portability.
Available to answer questions that the committee may have
SB1320 - Licensed certified midwives; clarifies definition, licensure, etc.
SB1321 - Confirmatory adoption; expands the stepparent adoption provisions.
On behalf of the Virginia adoption community - passing this bill is greatly needed. As an adoption practitioner 32+ years, past- president, long-time Fellow and Board of Trustee of the Academy of Adoption & Assisted Reproduction Attorneys & co-author of the VA CLE Adoption Book - we need this law passed to support the legal stability of children in VA. There are so many situations I encounter on a monthly and even weekly basis - a mom co-parenting with an opioid addicted daughter and a deceased biological father, two foster parents not married and not in a romantic relationship co-parenting a child in need of a forever home with both of those parents, a former ex-boyfriend who helped co-parent for ten or more years with the ex-girlfriend still wanting him to be a recognized parent and a deceased biological father. There are so many more examples where kids just need both de facto - that is, in fact, parents made their legal parents but cannot do so under current VA law that requires they be a married couple. That is not the current reality for many children today. We need to bring Va law in line with the current reality of today’s kids and how they are being co-parented in many non-traditional ways - especially with the opioid crisis. This law is very much needed to protect today’s children. Those of us in the trenches can see this most clearly. Thank you.
When two loving parents raise a child they take on a moral and legal responsibility, but unfortunately our current legal system doesn't recognize a second parent and grant them the legal rights they deserve after accepting responsibility of raising the child because they are not of a different sex/gender than the legal parent. This needs to cease for the child's protection and for our community. We need not only to accept everyone to respect them for the roles they fill and give them the legal support they may need! Dani Butler 5800 Up A Way Drive Fredericksburg, VA 22407
I am writing in support of SB1321, in favor of allowing confirmatory adoption in Virginia. I am not personally impacted by this bill, but many in my community are. Children need the security that legally recognized parents can provide, and their lives are made more difficult when barriers exist that keep their parents from advocating on their behalf. I know this all too well, because I know what these barriers have meant for my own children at a different time and place. My young children had very good relations with both me and my spouse prior to, during, and after our divorce. However, a new magistrate who claimed she was "ordained by God to save the children" separated me from my children for the stated reason that I had advocated for marriage equality. She did this by declaring that she would not respect or enforce our shared parenting agreement and threatening to hold me in contempt if I complained, resulting in my ex refusing joint custody/visitation thereafter. I did not see my children again until they were adults. Even though I was a legal parent with full parental rights, these rights were not observed or respected in matters of education, healthcare, mental health, or faith. Eventually I was locked out of all communication and could obtain no further information about my children. I have since reconnected with both of my children as adults. Both suffered extreme psychological abuse, mental anguish and emotional harm because of our loss of contact. I was unavailable to protect them. Precious educational opportunities were also squandered (a full scholarship to a prestigious private school, admission privileges to my prestigious undergraduate university and financial aid at universities where I taught) because of my being blocked from advocating for them. They even suffered needless financial losses because of my inability to manage their educational accounts at particularly critical times. Children need security, and they need their parents, whether they are straight, gay, purple, or polka-dotted. Please give Virginia families the tools they need to ensure continuity of parenting so that that their children do not suffer as mine did. Please support SB1321.
This Bill is about equal rights!!! Different-sex couples are not forced to marry for both parents to have legal rights and responsibilities over their children, and same-sex couples shouldn’t be either. This bill simply extends the legal rights and responsibilities of parenthood to unmarried same-sex couples as well. Thank you for your work and dedication to represent all people in equality.
SB1328 - State-Funded Kinship Guardianship Assistance program; created.
Only speak if needed. Legislative staff to the Commission on Youth.
Voices for Virginia’s children strongly supports this bill.
SB1333 - Pharmaceutical processors; permits processors to produce and distribute cannabis products.
SB1338 - Telemedicine services; remote patient monitoring services.
SB1356 - Hospitals, nursing homes, etc.; visits by clergy.
Available should questions about the bill arise - 804-495-6880
SB1362 - Employers; reporting outbreaks of COVID-19, effective clause.
SB1366 - Aging services; economic and social need.
SB1421 - Brain injury; clarifies definition.
the disAbility Law Center of Virginia supports SB 1421. We thank Senator Edwards for bringing this good bill.
SB1427 - Early Psychosis Intervention and Coordinated Specialty Care Program Advisory Board; established.
Coordinated Specialty Care (CSC) is a recovery-oriented, evidence-based treatment program that targets young people with first episode psychosis. The coordinated team approach includes case management, psychotherapy, medication management, family education and support, supported employment and education and peer supports based on the individual’s needs and preferences. There are eight such programs across Virginia, four of which are located in Northern Virginia. As CEO of PRS, Inc., one of the four organization’s operating a CSC program in Northern Virginia, I cannot emphasize enough the positive impact these programs have on young adults and their families. Combined, these eight programs are currently treating just over 230 young adults; however, it is estimated that about 1,700 young adults will experience their first episode of psychosis each year. The Advisory Board proposed in this legislation will work with the Department of Behavioral Health and Developmental Services (DBHDS) to establish fidelity standards for CSC programs and look for resources to enhance existing programs and expand services to underserved areas in the state.
Each year over 1700 young Virginians experience their first episode of psychosis. Many do not receive treatment. During the period in which they are not treated, known as the duration of untreated psychosis (DUP), symptoms worsen and functioning decreases. Coordinated Specialty Care is an evidence based treatment for first episode psychosis. It is proven effective in decreasing symptoms and increasing functioning with outcomes such as decreased hospitalization, improved work and school achievement and enhanced social networks. There are 8 teams in Virginia currently providing treatment to 233 individuals. This does not approach the need. Besides treatment, Coordinated Specialty Care conducts outreach and community education so that new cases of psychosis are identified and engaged in treatment. The Advisory Board in this legislation will work with DBHDS to expand and enhance this essential service. I support SB 1427.