The Client Services Committee of the Hammond Commission met in the Henrico County Training Center located at 7701 East Parham Road in Richmond on Thursday, July 8, 1999. Members present were: James W. Stewart, III, Executive Director of the Henrico Area Mental Health and Mental Retardation Services Board; The Honorable Thelma Drake, House of Delegates; The Reverend David Martin, Pastor of First Baptist Church in Norfolk; Anthony Vadella, President and CEO of Poplar Springs Hospital; Beverly Fleming, Chairman of the Shenandoah County Board of Supervisors; and Henry Altice, Blue Ridge Community Services Board. James Stewart, Chairman, called the meeting to order at 10:30 A.M., and introductions were made.

Also in attendance were: Julie Stanley, Executive Advisor to the Commissioner of the Department of Mental Health, Mental Retardation, and Substance Abuse Services and Administrator of the Hammond Commission; James Martinez, Director of the Department of Mental Health Services for the DMHMRSAS and liaison to the Committee; and Donna Bryant, Office of the Attorney General.

Ms Stanley gave a status report on the Commission. A Chairman for the Commission has not yet been named to replace Judge Catherine Hammond. The Executive Order for the Commission expires on August 27, and there has been no notice of its renewal at this time. Ms Stanley said that the Executive Committee could meet during mid-August to discuss the recommendations from the three committees and the full Commission could meet the last week in August, but that these meetings could occur later if the Executive Order is renewed.

The areas from the Work Plan for 1999 assigned to the Committee were discussed, and the following recommendations were formulated for each of the four areas.

SUBSTANCE ABUSE SERVICES

1. Expand adult and adolescent treatment services, including inpatient, residential, intensive day treatment, intensive and regular outpatient, and case management services by:

1. Providing Medicaid coverage for substance abuse and addiction services that are medically necessary for those individuals who are eligible for Medicaid; and
2. Providing funding for these services for those individuals who are not eligible for Medicaid.

1. Provide funding for local and regional jail therapeutic community programs for which federal grants are expiring.
2. The Commonwealth provide access for consumers to an adult and adolescent drug court in every judicial district in Virginia. Budget amendments for this purpose should be based on research conducted jointly by the Supreme Court and the DMHMRSAS.
3. Expand the capacity of detoxification and stabilization programs for adults and adolescents statewide to ensure access to these services for those individuals who need them.
4. Provide funding for the statewide implementation of the Healthy Communities / Healthy Youth Collaborative Prevention Initiative.
5. Require that any managed system of care developed by the Commonwealth for publicly funded services include substance abuse and addiction services.
6. Request that the Governor’s Council on Alcohol and Substance Abuse accept as a priority to ensure, through a collaborative effort involving the major providers of substance abuse services in Virginia, that gaps and duplication of services are eliminated and the best quality of care at the lowest cost for the taxpayer is available.

1. Provide funding for increased administrative capacity in order that each CSB can coordinate resources for a housing and residential support program, and develop a housing plan for MH, MR, and SA consumers in collaboration with other public and private agencies.
2. Provide sufficient reliable long-term state funding for rent subsidies for individuals with mental or addiction disabilities.
3. Target areas where housing is unavailable or inadequate and support the development of affordable housing for consumers by providing sufficient capital. Grants should be available to public and private providers for down payments and low interest mortgage loans.
4. Enable accessibility assistance grants to individuals for needed in-home modifications.
5. Provide additional funding for the service supports that are necessary for living in the community including:

1. MR Medicaid waiver;
2. Medicaid reimbursable residential and job supports for SMI;
3. Psychiatric services; and
4. Medicaid reimbursable PACT or comparable wrap-around service.

1. Establish a state council, involving the DMHMRSAS, VHDA, the Department of Housing and Community Development, and public and private entities to address housing issues.
2. Require that ACRs serving persons with mental disabilities be licensed by the DMHMRSAS to ensure appropriate care.
3. Allow the use of auxiliary grants in any residential facility licensed by the DMHMRSAS.
4. Provide additional resources for the DMHMRSAS to license ACRs and other residential facilities as required.

1. Involuntary commitment is necessary only as a last resort in crisis intervention. Wrap-around services such as PACT have been shown to be effective in managing crisis and should be available in every community.
2. Provide funding and encourage the development of a creative array of service alternatives for managing crisis through public and private providers.
3. Provide funding for the expansion of psychiatric services during the crisis phase and throughout treatment.
4. Collaborative training efforts should be undertaken among public and private providers, courts, law enforcement officers, attorneys and others involved in the involuntary commitment process.
5. The DMHMRSAS should collaborate with the VACSB, MHA of VA, and others to develop guidelines and standards for:

• Information and support provided to the consumers' families and significant others; and
• Consumer and family education, including psycho-education for the consumers regarding self-management of their condition.

1. Emergency service programs should be adequately staffed with experienced clinicians to provide quality appropriate services 24 hours a day.
2. Each CSB should evaluate its emergency services program on an ongoing random basis by soliciting consumer and family member comments in order to improve those services.
3. A system should be developed to require training and to monitor the practices of special justices, attorneys, and independent evaluators in the involuntary commitment process in order to ensure consistent high quality and appropriate practice across the Commonwealth.
4. No new mandatory outpatient treatment procedure should be implemented at this time.

1. The Secretaries of Education and Health and Human Resources should develop a statewide advisory committee, including public and private sector professionals and representatives of higher education, to address curriculum issues, pre-service and in-service education for professionals, research, recruitment, and other issues of mutual interest to the DMHMRSAS, CSBs, and the Commonwealth's universities and academic centers.
2. Explore and use information technology to expand continuing education efforts through distance learning and other strategies.

These recommendations will be forwarded to the Executive Committee for referral to the full Commission. The meeting was adjourned at 2:45 P.M.