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VA Hospital & Healthcare Association Letter to State Leaders Argues Acute Care Hospitals “not designed or intended to provide long-term care for patients with specialized needs”

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From the Virginia Hospital & Healthcare Association:

Please see the attached letter that has been sent to Virginia legislative and state leaders related to mental health treatment in the Commonwealth in light of the recent decision by the Virginia Department of Behavioral Health and Development Services to temporarily halt admissions at several state-run psychiatric hospitals due to staffing and capacity issues.

The intent of the letter is to provide data-informed context around this issue. As the letter notes, and as the data shows, private hospitals in Virginia continue to handle the vast majority of both voluntary and involuntary (including TDOs) psychiatric patient admissions in the Commonwealth. This is occurring at a time when overall demand for mental health and substance use services continue to rise – data shows that utilization of such hospital-based services increased last year during the height of the pandemic even as many other hospital-based service lines saw decreased utilization.

The data also shows that average length of stay for patients admitted for behavioral health care at Virginia hospitals is increasing. Some hospitals are also encountering situations where patients in crisis whose care would ideally occur in a state-run psychiatric hospital are getting waylaid in hospital emergency departments while awaiting an appropriate transfer and admission to state-run psych hospitals. This can cause complications and capacity challenges for hospitals which are also continuing to respond to the COVID-19 pandemic and dealing with staffing and other resources challenges of their own.

In recent years, Virginia’s hospitals have added hundreds of new mental health beds to accommodate patients in need of care, with plans for more new beds to come online in the coming years. Meanwhile, Virginia hospitals over the years have offered policy proposals to the state to meet patient needs in inpatient and outpatient settings, and even now are developing new options to help respond to the current challenges being experienced at state-run hospitals. Funding for staffing and other resources needs is necessary to effectively implement these strategies.

It is important to remember that just as each patient is unique (some of the most challenging patients may be experiencing an array of mental, behavioral, substance use, and/or medical co-morbidities), so are hospitals which have different in-house capabilities, licensed bed types, etc. Different patients may require different levels of care depending on their diagnosis and condition. There isn’t a one-size-fits all solution. The goal for every patient is to find the appropriate setting for care to get them the best treatment. Virginia’s hospitals continue to engage with our partners in state government to identify strategies to best serve patients in need in the Commonwealth.

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