Connections Health Solutions strongly supports the proposed 1115 Serious Mental Illness Waiver  Amendment Application submitted by Virginia Department of Medical Assistance Services (DMAS).  We appreciated that it specifically references the Prince William County Crisis Facility and Programs.

Thank you to the many DMAS staff who have contributed to the effort to get the draft application prepared and ready for comment so quickly; in order to implement Governor Youngkin’s Right Help Right Now initiative and meet the many needs for effective and timely access to crisis services for both youth and adults, it will be critical to minimize the barriers to service.

We look forward to working with DMAS to ensure Medicaid support for its community-based crisis stabilization program.  Our planned Woodbridge Crisis Response Center is on track to open in 2025.  It will accept all individuals 24/7/365 experiencing a behavioral health crisis becoming the first center to fulfill the Right Help Right Now initiative.  It will offer walk-in behavioral health urgent care and extended stabilization units for youth and adults; regardless of ability to pay. 

The goals of the Demonstration as listed in Section III are appropriate and the Crisis Now model of care has proven effective in achieving the goals of reducing both utilization and length of stay in ERs, reducing preventable readmissions, and adding to the continuum of community crisis care as well as reducing wait times for law enforcement.

We thank DMAS officials for including accreditation through The Joint Commission as well as the other quality measures described will help to assure that the services provided are of the highest standard. 

Required in our contract with the Prince William Community Services Board, we will collaborate to improve the Care Coordination and facilitate the transition to other levels of community-based care.  We look forward to the dynamic involvement of the MCOs in this effort as well.

Short term stabilization beds are essential to the “No Wrong Door,” mission accepting 100% of individuals; particularly from law enforcement in the smoothest possible manner.  Additionally, without Medicaid’s involvement, this center would cost Commonwealth and county taxpayers 100% more to fund the system and result in more costly fragment care by multiple providers. This approach ensures Medicaid’s participation in Virginia’s crisis system given Crisis Stabilization programs are intended to prevent the need for institutional care as this waiver application assures. 

For the record, the Social Security Amendment of 1972 (P.L. 92-603) provides an IMD exception for children under the age of 21.  We urge Virginia to incorporate and expand upon Medicaid coverage of inpatient psychiatric services for individuals under the age of 21 into its program. Section 4930 of the State Medicaid Manual describes the criteria states must take into consideration when determining IMD status.

We appreciate DMAS for advancing these critical reforms and moving quickly with this vital waiver, and we look forward to collaborating and partnering on efforts to ensure that youth and adults experiencing behavioral health crises in our county receive the care and support they deserve. 

Thank you again.