A House of Delegates committee forwarded bills seeking to address strains on the state’s psychiatric hospitals to the floor Tuesday.
Virginia’s state psychiatric hospitals regularly fill 95% or more of their beds, according to a 2023 study by the Joint Legislative Audit & Review Commission.
Half of the patients are typically admitted involuntarily. A temporary detention order issued by a judge or magistrate allows law enforcement to commit a person involuntarily to a facility; state hospitals are required by law to accept them if no other placement can be found.
Del. Sam Rasoul (D–Roanoke City) also had his bill on delaying admission to state hospitals sent to the House floor. The bill would allow hospitals to delay the admission of patients until it determines whether they have potentially life-threatening medical needs. Rasoul said this was in line with a January 2023 opinion from Attorney General Jason Miyares, which said law enforcement had to maintain custody of people under TDOs until a facility admits them.
“Since then, 452 drop-offs have happened without the proper clearance,” Rasoul told the committee. In Fiscal Year 2023, there were 927 drop-offs, according to JLARC.
Del. Patrick Hope (D–Alexandria) sponsored a separate bill that would authorize the commissioner of Behavioral Health and Developmental Services to discharge patients. Some patients remain at state hospitals for more than 30 days after they’ve been deemed clinically ready to be discharged. Concerns over lack of housing, services or support in their home communities have been cited as potential reasons for the delays.
Hope also sponsored a bill that would require the Office of the State Inspector General to develop a plan by Nov. 1 to investigate complaints of abuse or neglect at state psychiatric hospitals in a timely manner.
According to the JLARC study, high occupancy rates at the hospitals put patients and staff at risk; the industry standard for a safe operating level is 85%. In March 2023, Irvo Otieno died as Henrico County Sheriff’s deputies pinned him to the ground as he was being admitted to a state hospital.
Last year, Youngkin said he’d seek legislation in Otieno’s honor that would allow relatives to be near patients in behavioral health emergencies. The bill, sponsored by Del. Rodney Willett (D–Henrico), is currently before the House’s Courts committee.
Politicians across the political spectrum have cited behavioral health as an area of potential cooperation this session.
The budget for FY 2024 includes $250 million for Gov. Glenn Youngkin’s behavioral health plan, dubbed “Right Help, Right Now.”
Youngkin’s proposed two-year budget (for FY 2025 and 2026) hiked funding for those initiatives — which include more money for provider reimbursement rates and comprehensive crisis services — to $328 million a year. It would also add $500 million over two years for programs like emergency-room alternatives and opioid addiction services.
$1.4 billion would come from state, federal and opioid settlement funds.
The committee also referred a bill from Del. Michael Jones (D–Richmond) that would add beds to Central State Hospital to House Appropriations.
“We are definitely in the posture here with this of micromanaging this department. And that was the reason for my opposition to the measure,” said Del. Bobby Orrock (R–Caroline), while discussing open beds at mental health facilities in Virginia. “I understand we're just in [a] shortage statewide. And there was no demonstrable evidence that I heard that shows that it's a greater need in Central Virginia.”
Central State Hospital, where Otieno was killed, was above 100% capacity between July 2021 and October 2023, according to the JLARC report. The current hospital has 277 beds, but will move to a new Petersburg facility with 252 beds. Adding a wing to accommodate the beds sought by Jones would cost $85 million, according to a fiscal impact statement.
