The Future Holds Promise
I may be speaking too soon but I’m more than pleased with the results of this General Assembly
session. A small degree of bipartisanship helped our citizens get much needed improvements in the
state roadway system and we’re finally tackling the issues around healthcare reform. Medicaid
Expansion cleared the assembly as part of a packaged deal with the roads legislation and although the
Governor says there is no connection between the two and he remains opposed to expansion, the
general belief is it will be delayed by 6 months to a year, but will nonetheless happen. Significant
additional funding of 6 million dollars annually was also attained for the statewide Part C program which
provides special education services to infants and toddlers (birth to age 3) with developmental delays.
The lack of current funding was of the highest concern to our care system because of waiting lists, lack
of capacity and the awareness that adequate federal funding was contingent upon Virginia’s full
participation. Virginia answered the need. Our thanks to the advocacy groups that educated the
legislators about the science of this specialized form of care and who showed them data that proves for
every dollar spent , the state generates seven dollars in savings.
Medicaid Expansion and Part C were at the top of my list of “must haves” from this session, but the list
did not stop there. We also needed systemic funding for a wide array of other behavioral health
services. Funding for Discharge Assistance Plans was increased by 1.5 million dollars, double what was
expected and an additional 200 Waiver slots were added to ID (Intellectual Disability) services. Funding
for children’s crisis stabilization and psychiatric services was also increased. The list goes on and “thank
you-s” were sent out from our board to all our legislative representatives after this most successful
session.
With so much legislation passed, you might wonder how the system adapts to it in enough time to be
ready for the implementation phase. The short answer is “with great difficulty”. The Department of
Behavioral Health and Developmental Services (DBHDS) has already begun the thankless task of sorting
out such complexities as how to get the funding out to the providers, how to ensure that funding
provides the biggest returns to the state for the investment, how to ensure the outcomes are reported
in a timely fashion that satisfies state requirements, the requirements of the General Assembly and that
of the citizens of the Commonwealth. Much of this is done with modifications to the performance
contracts that are signed with each of the 40 CSBs and quite a bit of the implementation will require
grants that may be competitive. As one of the 40 CSBs, we sometimes compete with our sister CSBs for
scarce dollars. It would be great if the system were adequately funded so that this practice was less
frequent, but the reality is that despite this bumper crop of a year, behavioral health is not close to
adequately funding the need and demand for services that is out there. We all know it and each year
we must appropriately educate our legislators of this fact. We do it with data, personal stories and
advocacy. Mostly, we do it with dedication, fueled by data and a bedrock belief that our most vulnerable
citizens, those who suffer from disorders such as schizophrenia, late stage addictions and/or intellectual
disabilities are equal to those of us who are able to navigate life with few difficulties. The human being is
invaluable to us, no matter the past, present, or future difficulties he or she may face or endure. We also
believe in the recovery process and routinely are able to show legislators success stories of individuals
who were “written off” as “unsalvageable” who are gainfully employed, productive and living in the
community. Yes, we also note that this group also tends to pass away 20 to 25 years earlier than their
healthier counterparts, but having years like this where we have a modicum of additional funding to
intervene earlier in the disease and disorder spectrum means we have a tool that just may add quality
and years to their lives. I am not just being an optimist but a true realist when waxing on what the future
of healthcare can produce. Healthy individuals who feel safe in their communities are naturally creative,
productive and an asset to their environments. As we set a standard of this for the most vulnerable of
us, likewise we all reach a level that exceeds our expectations. A better life, a better community is our
vision at Region Ten and years like this are markers along the way to getting there.