Arlington officials are reacting favorably to Gov. Mark R. Warner’s proposal to allocate hundreds of millions of dollars to improve mental health services and facilities, but said more will be needed to end the shortage of psychiatric hospital beds in Northern Virginia.
Over the past year and a half Northern Virginia has lost 50 psychiatric beds, approximately 24 percent of the region’s private bed capacity. In addition, the movement of patients in and out of psychiatric beds is stymied by a paucity of community-based services, officials said.
“The lack of psychiatric beds is the most important health care gap Northern Virginia is facing right now,” said County Board member Barbara Favola. “Some people could be discharged from hospitals but we need more community-based programs to take them on.”
Under Warner’s plan, $116 million in state funds, and an additional $52 million in federal money, will be earmarked over the next two years to improve community services. An additional $290 million will be used to replace four aging state hospitals, none of which are located in Northern Virginia but do currently house some Northern Virginia residents.
The governor has yet to supply specifics of how the funds for community-based services will be distributed, though more details are expected to emerge when Warner releases his budget on Dec. 16.
County officials said they anticipated that a sizable sum would be designated to improve residential and social assistance programs, but will not know how the governor’s plan affects Arlington until details are announced.
“This is a wonderful step forward,” said Cindy Kemp, executive director of the Arlington County Community Services Board. “It will absolutely help. But much depends on how much we get and what we are able to buy.”
The shortage of psychiatric beds has been exacerbated by a recent slate of closing in the region’s hospitals.
In the past year, according to the Association of Community Services Boards, Inova Alexandria Hospital has eliminated 19 beds, Potomac Hospital 12 beds and Northern Virginia Community Hospital 20 beds. The potential closure of Dominion Hospital would result in a loss of an additional 100 psychiatric beds.
Since there are so few available beds in Northern Virginia, mental health patients must travel to Charlottesville or Richmond to seek help. Mental health workers are spending up to six hours trying to find beds for new patients, Kemp said.
Besides straining county resources, placing patients far away from family and friends can have a detrimental effect on their rehabilitation.
“For these patients to have a hope to stabilize and re-integrate into society, they need to have the support of their families,” Favola said. “It is impossible to have that if we take patients way out of the region.”
The burden for transporting individuals falls on the county’s police and sheriff’s departments. Deputies often have to spend more than five hours driving a patient down to a hospital, time when they otherwise would be patrolling the county’s streets.
According to Patrick Hope, chairman of the Arlington County Community Services Board, Arlington public safety officials transported individuals in need of hospitalization a total of 1,406 miles outside Northern Virginia in May 2005, compared to 106 miles in May 2004.
THE NORTHERN VIRGINIA Mental Health Institute (NVMHI), located in Falls Church, has 129 psychiatric beds, and operates at 99 percent capacity, said Lynn Delacy, the institute’s facilities director.
While 15 to 20 percent of NVMHI patients are ready for discharge to a community-based treatment program, there are not enough residential services available for them to leave the hospital, Delacy said.
“If they had access to 24/7 supervised care they could leave,” Delacy added. “But [Northern Virginia] lacks the funds for them.”
If these patients were discharged, that would free up beds so those who needed to be hospitalized would not have to travel down state.
County officials are beseeching the governor to allocate more money for intensive residential services, socialization assistance, employment aid, case management workers and counselors.
“We need more places for people to become stabilized and get on the road to recovery,” Hope said. “We need to help them with housing and getting a job so they can live normal and productive lives.”
In order to encourage hospitals to supply more psychiatric beds, the governor and General Assembly need to increase the Medicaid and state reimbursements they hand out to hospitals, officials said.
The average Medicaid reimbursement per psychiatric bed is $500 but the actual costs are close to $1,000, Hope said.
“If facilities are losing money, it is no wonder they don’t want to take more people,” Hope added.