2017 Session

Budget Bill - SB900 (Introduced)

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Secretary of Health and Human Resources

Item 284

Item 284

First Year - FY2017Second Year - FY2018
Administrative and Support Services (79900)$742,324
General Management and Direction (79901)FY2017 $742,324
FY2018 $742,360
Fund Sources:  
GeneralFY2017 $728,480FY2018 $728,516
Federal TrustFY2017 $13,844FY2018 $13,844

Authority: Title 2.2, Chapter 2; Article 6, and § 2.2-200, Code of Virginia.

A.1. The Secretary of Health and Human Resources, in collaboration with the Office of the Attorney General and the Secretary of Public Safety and Homeland Security, shall present a six-year forecast of the adult offender population presently incarcerated in the Department of Corrections and approaching release who meet the criteria set forth in Chapter 863 and Chapter 914 of the 2006 Acts of Assembly, and who may be eligible for evaluation as sexually violent predators (SVPs) for each fiscal year within the six-year forecasting period. As part of the forecast, the secretary shall report on: (i) the number of Commitment Review Committee (CRC) evaluations to be completed; (ii) the number of eligible inmates recommended by the CRC for civil commitment, conditional release, and full release; (iii) the number of civilly committed residents of the Virginia Center for Behavioral Rehabilitation who are eligible for annual review; and (iv) the number of individuals civilly committed to the Virginia Center for Behavioral Rehabilitation and granted conditional release from civil commitment in a state SVP facility. The secretary shall complete a summary report of current SVP cases and a forecast of SVP eligibility, civil commitments, and SVP conditional releases, including projected bed space requirements, to the Governor and Senate Finance and House Appropriations Committees by November 15 of each year.

2. As part of the forecast process, the Department of Corrections shall administer a STATIC-99 screening to all potential Sexually Violent Predators eligible for civil commitment pursuant to § 37.2-900 et seq., Code of Virginia, within six months of admission to the Department of Corrections. The results of such screenings shall be provided to the commissioner of the Department of Behavioral Health and Developmental Services (DBHDS) on a monthly basis and used for the SVP population forecast process.

3. The Office of the Attorney General shall also provide to the commissioner of DBHDS, on a monthly basis, the status of all SVP cases pending before their office for purposes of forecasting the SVP population.

B. The Secretary of Health and Human Resources, in consultation with the Secretary of Public Safety and the Secretary of Administration, shall convene a work group including, but not limited to, the Department of Medical Assistance Services, Department of Social Services, Department of Health, Department of Behavioral Health and Developmental Services, Department of Corrections, Department of Juvenile Justice, the Compensation Board, the Department of Human Resource Management and other relevant state agencies to examine the current costs of and protocols for purchasing high-cost medications for the populations served by these agencies. After conducting the review, the workgroup shall develop recommendations to improve the cost efficiency and effectiveness of purchasing high-cost medications in order to improve the care and treatment of individuals served by these agencies. The workgroup shall prepare a final report for consideration by the Governor and the Chairmen of the House Appropriations and Senate Finance Committees no later than October 15, 2016.

C. The Secretary shall develop a plan to address the data governance structure across all agencies in the Health and Human Resources Secretariat in order to streamline business processes, increase operational efficiency and effectiveness, and minimize duplication and overlap of current and future systems development. The plan shall consider how agencies can participate in such a structure while adhering to privacy provisions set forth in state and federal law and regulations. The Secretary shall report on the plan, including challenges impacting the plan, to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees by October 15, 2016.

D. The Secretary of Health and Human Resources shall report on transition planning for the Health and Human Resources Secretariat, including the achievement of performance metrics by agencies in the Secretariat, current and emerging challenges facing these agencies, the value of services provided by the agencies, and each agency's strategic plan and executive progress report, as well as cross-agency policy issues. The Secretary shall provide this report to the Chairmen of the House Appropriations and Senate Finance Committees, as well as the Chairmen and members of the Health and Human Resources Subcommittees of each respective committee by September 1, 2016 and semi-annually thereafter until a new Governor is elected and sworn into office.

E.1. Out of this appropriation, $4,500,000 the second year from the general fund shall be used for the Office of the Secretary of Health and Human Resources (OSHHR) to procure an independent contractor to expedite transformation of Virginia's community mental health system. Such contract shall be entered into in consultation with the Virginia Association of Community Services Boards (VACSB), the Virginia Department of Corrections, the Virginia Sheriffs Association, and the Virginia Association of Regional Jails. The goal of Virginia's community mental health system transformation is to ensure access, quality, consistency, and accountability across all forty Community Services Boards (CSBs) and Behavioral Health Authorities. The contract shall include a current state assessment, gap analysis, and high-level design of Same Day Access. The request for proposals shall be issued as soon as possible, but not later than 45 days after the enactment of this act, and include requirements for the following components: (1) Documented Vision of Transformation including expectations for partnerships with private providers; case management; care coordination; primary care and behavioral health integration; mobile crisis; and services for children, geriatrics, and veterans. The vision shall be based on the STEP-VA plan for system transformation, excellence, and performance in Virginia. (2) A Current State Analysis of all forty CSBs and Behavioral Health Authorities that includes an understanding of existing community resources; population needs including the behavioral health needs of incarcerated or otherwise criminal justice involved individuals; availability of private providers; transportation resources; governance; culture; challenges; and current processes, technology, and data and analytic capabilities. (3) A Gap Analysis indicating the difference between the Vision of Transformation and the Current State for each CSB. (4) High-Level Design to support implementation for Same Day Access including development of a clinical process flow, administrative process, and job design. (5) An analysis of the cost of such design compared to existing resources and funding streams.

2. The contract shall also include an assessment of the efficiency and effectiveness of the Department of Behavioral Health and Developmental Services' organizational structure. The assessment shall review the department's management of the services delivered by the agency or through the community services boards. The study shall include an evaluation of the adequacy of existing administrative resources and identify gaps in funding and staffing required to perform assigned statutory responsibilities, including the management of the community contracting division and operation of state mental health facilities and training centers, and recommendations for improved performance. The assessment shall also review and make recommendations as to the optimal agency service delivery structure including the creation of separate behavioral health and developmental disability agencies. In developing recommendations, the contractor shall incorporate the transformation of the service delivery system referenced in paragraph E.1 of this Item.

3. The Department of Behavioral Health and Developmental Services in partnership with the CSBs and VACSB shall provide necessary information in a timely manner as requested by the contractor. The contract shall require that the contractor submit a preliminary report within 90 days after signing the contract that includes its detailed project plan and progress to date. The contract shall also require that the assessment, design and analysis be completed by July 1, 2018, and a final report submitted by October 1, 2018, to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees.

4. In developing the report, the contractor shall examine and include information and recommendations provided by the Joint Subcommittee to Study Mental Health Services in the Twenty-first Century, established pursuant to SJ 47 (2014 General Assembly).

5. The Governor shall appoint a committee comprised of eleven members to include six gubernatorial appointees, three appointees of the Speaker of the House of Delegates, and two appointees of the President Pro Tem of the Senate to oversee progress on the specific actions funded in this Item as well as progress on transformation of the mental health system in Virginia and the evaluation of the department. Gubernatorial appointees shall include the Secretary of Health and Human Resources and the Secretary of Finance. The Contractor shall provide periodic progress reports to the committee at the call of the committee chair.