Sep. 17--West Virginia is working on a $30 million three-year plan to start improving behavioral health services and supports by adding more care coordinators, residential slots and group homes, among other needs, a Department of Health and Human Resources official said.

"This will improve our behavioral health system tremendously," Vickie Jones, acting commissioner of the Bureau for Behavioral Health and Health Facilities, told lawmakers Wednesday.

The department agreed to a list of items in a July 2 court order relating to a 1981 consent decree that West Virginia would provide appropriate behavioral health services in the least restrictive stetting, Jones told the Legislative Oversight Commission on Health and Human Resources Accountability.

Agreed remedies over the next three years will include:

--Building five to seven group homes and five to seven day treatment centers.

--Adding 143 new residential slots in community supportive housing.

--Hiring 35 additional care coordinators or case managers to a current number of about 90.

--Funding a 10-bed unit at Highland Hospital to detain patients for up to 72 hours for evaluation to determine if they need inpatient commitment or if they can be treated in a less restrictive environment.

--Developing a policy to help patients using prescription drugs so as to improve consistency with medication when patients are discharged from hospitals to community settings.

--Increasing pay for direct care workers at inpatient hospitals to help with recruitment and retention.

--Providing $1.5 million in state funds to raise the Medicaid reimbursement rates for certain services.

"We're defining what the needs are for the population we currently serve," Jones said.

Total state and federal spending, including a Medicaid match, were estimated to be about $30 million, Jones said.

"We expect to see a savings," Jones said, as a result of not having to divert as many patients.

The funding would be sustainable, Jones later added.

"Once we put something into place, such as operational funding for (a) group home, that will continue forever," Jones said after the meeting.

During the meeting, Senate Minority Leader Don Caruth, R-Mercer, asked if West Virginia has enough facilities.

West Virginia has 240 inpatient beds at its two psychiatric hospitals -- Mildred Mitchell-Bateman Hospital in Huntington and William R. Sharpe Jr. Hospital in Weston, Jones said. Of those, the census is about 110 percent to 125 percent, Jones said, adding that patients are then diverted to the private sector.

"We are currently looking at options," Jones said.

Jones told lawmakers that the state has been working on unresolved issues with traumatic brain injuries, case management and forensic care.

Forensic care involves court-ordered patients, including those found not guilty by reason of mental illness or incompetence.

West Virginia has about 145 forensic patients today, up from 16 in 1996, Jones said, adding that the increase is not due to more patients but because of longer stays.

"We don't turn over our forensic beds," Jones said.

That means that while 220 to 230 beds are needed for civil commitments, only 140 are available, she said.

"That will continue to eat away at the civil commitment space," Jones said.

Hospital stays for court-ordered, forensic patients average about 233 days, while civil commitment stays are closer to 30 days, Bateman CEO Mary Beth Carlisle said earlier this summer.

Diverting patients can be more expensive, officials say.

West Virginia pays about $500 per day per patient cared for at Bateman, but the cost increases to $700 to $1,200 when patients are diverted to other facilities, Carlisle said.

Meanwhile, Delegate Margaret Anne Staggers, D-Fayette, an emergency physician and paramedic, asked how patients would be treated at the 72-hour detention center to protect them and keep them from walking out.

Jones said they would not be forcibly medicated.

"We will never take away a person's rights," Jones said.

House Health and Human Resources Committee Chairman Don Perdue, D-Wayne, noted at the end of the meeting how much time has passed since the 1981 consent decree and that he hopes things are better 28 years from now.

"This has been a long road," Perdue said.

He added that staff members at Bateman and Sharpe have kept the state informed about issues at the hospitals.

"They need to be complimented for not only informing us but for staying at their jobs," Perdue said.

Contact writer Michelle Saxton at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 304-348-4843.

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