Authority: Title 37.1, Chapter 1, Articles 1, 2, and 10, Code of Virginia.

A. The Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services shall, at the beginning of each fiscal year, establish the current capacity for each facility within the system. When a facility becomes full, the Commissioner or his designee shall give notice of the fact to all sheriffs.

B. The Commissioner of Mental Health, Mental Retardation and Substance Abuse Services shall work in conjunction with community services boards to develop and implement a graduated plan for the discharge of eligible facility clients to the greatest extent possible, utilizing savings generated from statewide gains in system efficiencies.

C. Notwithstanding § 4-5.12 of this act and paragraph C of § 2.2-1156, Code of Virginia, the Department of Mental Health, Mental Retardation and Substance Abuse Services is hereby authorized to deposit the entire proceeds of the sales of surplus land at state-owned mental health and mental retardation facilities into a revolving trust fund. The trust fund may initially be used for expenses associated with restructuring such facilities. Remaining proceeds after such expenses shall be dedicated to continuing services for current patients as facility services are restructured. The trust fund will receive any savings resulting from facility restructuring. Thereafter, the fund will be used to enhance services to individuals with mental illness, mental retardation and substance abuse problems.

D.1. The Secretary of Health and Human Resources and the Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services shall report to the Governor annually on progress made in implementing the following goals of the Comprehensive Plan for the Restructuring of Virginia’s Mental Health Care Programs and Facilities, December 20, 2000.

a. Actively provide for consultation with and participation by affected local governments, citizens, community-based organizations, and other stakeholders, including organizations representing families of patients in any affected facility in the planning of any state facility restructuring efforts.

b. Provide inpatient acute psychiatric services in local community hospitals instead of state mental health facilities, to the extent possible.

c. Allocate resources through the Mental Health, Mental Retardation and Substance Abuse Services Trust Fund to expand and strengthen community-based crisis stabilization and longer-term services required to divert acute psychiatric inpatient admissions to state mental health facilities.

d. Establish a new Medicaid-reimbursed gero-psychiatric residential service for individuals now served in state mental facilities whose care and treatment could be managed in less restrictive community-based residential settings

e. Implement individualized plans of care to permanently discharge long-term patients in state mental health facilities who are clinically ready for discharge.

f. Assure consumer and family protections throughout any state facility restructuring process.

g. Implement comprehensive provisions, including transition benefits, for state employees who may be adversely affected by any facility restructuring.

2. The Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services is authorized to sell, subject to approval by the Governor, on behalf of the Commonwealth, a portion of real property now occupied by Eastern State Hospital in James City County, provided that the proceeds of such sale shall be used, in accordance with Title 37.1, Chapter 17, Code of Virginia, to construct a new psychiatric inpatient facility to be located on the grounds currently occupied by Eastern State Hospital. This facility shall serve populations currently served by Eastern State Hospital. The Commissioner shall report to the Governor, the Chairmen of the House Appropriations and Senate Finance Committees and the Chairman of the Joint Behavioral Healthcare Commission by November 1, 2002 on the status of plans to sell the property and the process for constructing the new facility.

3. The Secretary of Health and Human Resources and the Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services shall report to the Governor quarterly on the progress of community planning efforts underway in implement the goals of the Comprehensive Plan for the Restructuring of Virginia’s Mental Health Care Programs and Facilities.

4. The Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services is authorized to continue plans to develop sufficient community services infrastructure for individuals who are ready for discharge from Southern Virginia Mental Health Institute in Danville or who could be served appropriately in the community. In developing community services such as residential, rehabilitation, assertive community treatment, intensive outpatient and other supportive services, the Commissioner shall involve representatives of the jurisdictions surrounding and encompassing the Institute, including local government officials, consumers, family members of consumers, advocates, facility employees, community services boards, public and private services providers, local health department staff, local social services staff, sheriffs’ office staff, and other interested citizens. In addition, the Commissioner shall involve members of the House of Delegates and the Senate of Virginia elected to serve the jurisdictions surrounding and encompassing the Institute. The Commissioner shall report to the Governor, the Chairmen of the House Appropriations and Senate Finance Committees and the Chairman of the Joint Behavioral Healthcare Commission by November 1, 2002 on the development of these community services in Southside Virginia.

5. In accordance with the Comprehensive Plan for the Restructuring of Virginia’s Mental Health Care Programs and Facilities, the Secretary of Health and Human Resources, the Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services, and the Director of the Department of Medical Assistance Services shall examine the practices in other states regarding psychiatric care and service innovation for the geriatric population and develop recommendations for new payment systems and Medicaid waivers, if necessary, for services that respond to the needs of this population. The Secretary, Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services, and the Director of the Department of Medical Assistance Services shall report their findings and recommendations to the Governor, the Chairmen of the House Appropriations and Senate Finance Committees and the Chairman of the Joint Behavioral Healthcare Commission by November 1, 2002.

6. The Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services is authorized to establish a community planning team to study and develop alternatives for the future provision of services to individuals served by Piedmont Geriatric Hospital in Burkeville. This team shall consist of Department staff and representatives of the jurisdictions surrounding and encompassing the Hospital, including local government officials, consumers, advocates, facility employees, community services boards, public and private services providers, local health department staff, local social services staff, sheriffs’ office staff, and other interested citizens. In addition, the team shall include members of the Piedmont Foundation and members of the House of Delegates and Senate of Virginia elected to serve the jurisdictions surrounding and encompassing Piedmont Geriatric Hospital. The community planning team shall advise the Commissioner on (i) the types, amounts, and locations of new and expanded community gero-psychiatric services required to successfully address the needs of geriatric citizens in need of mental health services; (ii) the development of a detailed implementation plan designed to build community gero-psychiatric services infrastructure; (iii) the creation of new and enhanced community services prior to any recommended changes to the size or mission of Piedmont Geriatric Hospital; (iv) the transition of Piedmont Geriatric Hospital patients to appropriate community services; and (v) resolution of issues relating to any proposed transition process. By September 1, 2002, the community team shall submit a plan to the Commissioner who shall report to the Governor, the Chairmen of the House Appropriations and Senate Finance Committees and the Chairman of the Joint Commission on Behavioral Healthcare on or before November 1, 2002.

E. Out of this appropriation shall be provided $250,000 the first year and $250,000 the second year from the general fund for the Consumer Support and Family Involvement Pilot Project.

F. Out of this appropriation, $2,570,847 the first year and $2,570,847 the second year shall be provided from the general fund for a public-private partnership pilot to secure short-term inpatient psychiatric services through competitive contracts with community-based hospitals or other private health care providers, for purposes of serving individuals closer to their homes. Pursuant to individual agreements with the Department, community services boards will reduce their utilization at a selected state facility or facilities for short-term (30 days or less) acute hospitalization by a specified number of beds, and will contract by competitive bidding with community-based hospitals for short-term psychiatric inpatient services. Any savings resulting from the reduced utilization of short-term acute facility beds will be made available under agreement with the Department, to permit the community services boards to contract for additional short-term psychiatric inpatient services. Specific bed utilization targets and competitive contract performance expectations will be included in the performance contracts of these community services boards.

G. Out of this appropriation, $130,986 the first year and $130,986 the second year shall be provided from the general fund to establish 2.0 positions to enforce compliance by each state mental health and mental retardation facility with the provisions and requirements outlined in the facility directors’ performance agreements with the Department. In addition to providing increased oversight of these performance agreements, these positions will monitor implementation of all settlement agreements with the United States Department of Justice.

H. The agency shall transfer $171,523 the first year and $178,508 the second year from nongeneral funds to the Secretary of Health and Human Resources to support the activities of the Office of Inspector General.

I. The Department of Mental Health, Mental Retardation, and Substance Abuse Services and the Department of Medical Assistance Services, in cooperation with the Office of Comprehensive Services, Community Services Boards, and Court Service Units, shall develop an integrated policy and plan, including the necessary legislation and budget amendments, to provide and improve access by children to mental health and mental retardation services. The plan shall identify the services needed by children, the cost and source of funding for the services, the strengths and weaknesses of the current service delivery system and administrative structure, and recommendations for improvement.

J. The Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) and the Department of Medical Assistance Services (DMAS), in cooperation with the Community Services Boards, shall select the specific substance abuse services that shall be available statewide to children and adults.