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Welcome to the VACPN Blog!


Article: Virginia Drops Out of Program to Improve Mental Health Services

Posted on January 10, 2017 at 7:19 PM Comments comments (1023)
Please click on the below link to access the article:

Article.pdf (PDF — 116 KB)

Information on Injectable Antipsychotics

Posted on December 28, 2015 at 5:48 PM Comments comments (188)
Please review the attachments for more information about injectable antipsychotics and the recent policy change from DMAS now making this covered as a medical benefits instead of a pharmacy benefit. 

If you plan to attend the Spring 2016 Conference, one of our VACPN members, Kirk Morton, will speak more on the subject.  We're very excited for him to share his knowledge with us!

VACSB- Legislative Update 2-5-15

Posted on March 4, 2015 at 11:59 AM Comments comments (408)
Good morning,
The VACSB Legislative Update, as of February 5, 2015, can be viewed by clicking HERE.
This document lists VACSB's positions on bills identified by the VACSB Clearinghouse Committee designated bill reviewers as well as our advocacy partners. 
The VACSB Clearinghouse Committee meets weekly during the General Assembly and the Legislative Update is published following these meetings.  The document will also be posted to the VACSB website each week.  
If you have questions or need additional information, please contact the VACSB office.
Thank you for your interest and support. 

Home Health, Hospice and CMH 10.30.14

Posted on March 4, 2015 at 9:45 AM Comments comments (261)
Through our contacts at LCVN, the Virginia Association for Home Care and Hospice asked me to do a conference call on the importance and benefits for home health / hospice nurses to engage in continuing education with respect to community psychiatric nursing.
So I attached a rough outline to start as far as talking points for the call.  If you all could take a look and let me know if you have anything to add.
Thanks, Lisa
Home Health, Hospice and Community Mental Health
Three Peas in a Pod
v  Need to be equipped.  We are all are on the front lines.  You have the potential to work with mental illness in a variety of ways.
Ø  Your patient themselves may be a current recipient of mental health services.
Ø  Your patient may be an untreated individual in need of mental health services.
Ø  Stress Threshold.  Given the stress that comes with the need for home health care or hospice, an individual’s coping mechanisms and resilience could potentially be overtaxed, contributing to either a first break or a relapse of a psychiatric illness.
Ø  There may be a family member / caregiver living with your patient who is being treated for mental illness or in need of mental health services.  The latter is more likely.  A great deal of stigma remains with mental illness, and frequently the family system can remain closed because of this.
v  Continuing Education Benefits
Ø  Contributes to the arsenal in your tool box in the work that you already do, in terms of building coping mechanisms and resilience.
Ø  Learn resources to link your patients and families / caregivers to when needed.
v  Continuing Education Resources
Ø  VACPN conferences with CNE (

LCVN Update

Posted on August 6, 2014 at 10:10 AM Comments comments (195)

Meeting Summary sJ47 Subcommittee

Posted on August 6, 2014 at 10:08 AM Comments comments (283)

The first meeting of the Joint Subcommittee Studying Mental Health Services in the Commonwealth in the 21 Century (SJ47 Subcommittee) was held in Richmond yesterday.



The Subcommittee was given a briefing on the mental health law changes by Allyson Tysinger (same as delivered at the regional trainings on mental health law changes). 


Commissioner Ferguson then provided a broad overview of the structure of the publicly funded mental health system followed by detailed information regarding funding in the system over the last decade, specific information on ECO/TDO dispositions from 01 January 2014 through 30 April 2014 (May and June data will be available in the next few weeks), and an outline of the Department’s goals in shoring up the mental health system. 


The last presentation was from the Treatment Advocacy Center (TAC) and focused mostly on how Virginia should amend its commitment criteria and related laws to allow for a “need for treatment” standard.  In general, that standard allows involuntary commitment to treatment based on inability to seek needed psychiatric and medical care, inability to make an informed medical decision and the person’s need for intervention to prevent further physical, psychiatric or emotional deterioration. 


I provided public comments on behalf of the VACSB which were centered on our willingness to assist the Subcommittee in any way it deems appropriate as well as on the spectrum of services, from least to most intensive, that helps keep individuals stable in the community.  VOICES, NAMI, VOCAL, two family members and a generally concerned citizen also provided public comment.



Both Delegate Bell and Senator Deeds questioned Commissioner Ferguson heavily on the details of the data on slide 17 of her presentation (link below) related to the number of incidences when a TDO was sought for an individual but was ultimately not obtained due to a lack of a willing facility.  The total number of cases for which that was true between January and April was 37.  Several had re-contact plans in place, which Senator Deeds pointed out was also the case for his son, equating it to leaving with nothing.


Of the 37 cases:


18 (49%) were medical admissions or were medically admitted until a psychiatric bed was located. 

4 (11%) individual left before a plan or follow-up was scheduled

2 (5%) another TDO was obtained and executed

2 (5%) individual provided with a crisis plan

2 (5%) individual left the ER against medical advice and could not be subsequently located

1 (3%) individual voluntarily admitted to a CSU

1 (3%) individual accepted voluntary outpatient treatment

1 (3%) left AMA and was subsequently located after being legally detained in jail

1 (3%) remained in a nursing facility, was reassessed and no longer met TDO criteria

1 (3%) individual subsequently admitted to a psychiatric hospital voluntarily


Commissioner Ferguson went on to say that the new laws would prevent these scenarios from happening in the future.  Commissioner Ferguson’s presentation was overall a positive one, focusing on access to a system of care that addresses an individual’s need before s/he enters into crisis.  Senator Deeds thanked Commissioner for her vision, specifically the principles outlined on slide 2 of her presentation.


Senator Deeds proposed several work groups, but is in the process of soliciting feedback from the Subcommittee members and solidifying the work group structure.  Senator Deeds suggested a work group devoted solely to children’s mental health issues, one devoted to emergency/crisis interventions, one devoted to examining the role of law enforcement, one to look at continuity of care (this would encompass looking at the current DBHDS and CSB structure) and one group to look at criminal justice involvement.  Delegate Bell suggested keeping the number of work groups to a minimum so that they can make sure the groups are coordinating well and getting a sense of the big picture.


Many of you have read the press coverage in this morning’s paper which quoted Delegate Bell as questioning whether CSBs should even exist.  He did make the statement as quoted, but it was followed by him saying that he hoped people listening found his statement alarming.  He was making a point about how the entire system should be examined and questioned and was not necessarily saying that CSBs should be done away with as a foregone conclusion.  The statement is indeed alarming, as he intended, but I do not believe that the Subcommittee will ultimately be interested in dismantling a system that works so well for so many people.  Keep in mind that this is a 4 year study and that this was just the first meeting.



The next meeting date for the Subcommittee has not yet been set but it is likely to be in late August or early September.  That meeting is envisioned as being mostly informational (presentations) and then some amount of time devoted to the work of the smaller work groups.  No indication was given as to how or when individuals/advocacy organizations/experts will be contacted to participate on these work groups.


Senator Deeds was elected as the Chair, Delegate Bell was elected as Vice Chair and as a reminder, the members of the Subcommittee are:


The Honorable Robert B. Bell                                     

The Honorable T. Scott Garrett, Member of House Appropriations Committee                                  

The Honorable Peter F. Farrell                                  

The Honorable Joseph R. Yost, Member, House Committee on Health, Welfare and Institutions                               

The Honorable Margaret B. Ransone, Member, House Committee on Health, Welfare and Institutions                                  

The Honorable Vivian E. Watts                                  

The Honorable Luke E. Torian, Member of House Appropriations Committee

The Honorable Janet D. Howell                                 

The Honorable Emmett W. Hanger Jr.                                    

The Honorable Linda T. Puller                                    

The Honorable R. Creigh Deeds                                

The Honorable George L. Barker


Presentations from yesterday’s meeting are linked below, and please feel free to contact me with any questions you may have.



July 1st mental Health Law Changes

Posted on July 15, 2014 at 11:55 AM Comments comments (433)

I wanted to send out the latest information provided by DBHDS (Please see email below).


I have included a link to obtain the following forms:



Notice Of Alternative Facility Of Temporary Detention
[Form DC-4044]
Instructions Forthcoming

If you haven’t already seen it, the DBHDS website has some update information on it related to the ECO/TDO code changes as of this morning.


In particular, there is updated information on the “2014 Civil Commitment Law Changes” page:


The list of FAQs from the Code trainings has been updated as of 6/26/14:


There is also a comprehensive report regarding the TDO Exception data through April:

Instructions Forthcoming
Explanation of Emergency Custody Procedures
[Form DC-4050]
Instructions Forthcoming

DBHDS Site on Recent Civil Commitment Law Changes

Posted on July 15, 2014 at 11:44 AM Comments comments (173)

For your information, below is a link to the DBHDS website on the recent civil commitment law changes.  You will find on this site information on the 2014 legislation, materials and FAQs from the recent regional trainings, a link to the Supreme Court site on the new forms, updated regional protocols, and other helpful information.


Petition for rule making filed with the Board of Nursing

Posted on July 15, 2014 at 11:41 AM Comments comments (580)
Hi. This came across the cyber-waves last night. The link to the announcement is below. Click on “More details on this petition” and then on “transmittal sheet” to see the petition. Essentially it’s requesting that the BON consider clinical hours obtained in a paramedic curriculum to count for clinical hours in a nursing education program. The petition will be filed in the Register of Regulations on July 28, at which time a public comment period of 30 days will begin (until Aug 27th).

Here is the link to the petition.


Close the Coverage Gap Clips 6.24.14

Posted on July 15, 2014 at 11:30 AM Comments comments (297)

Close the Coverage Gap Clips
June 24, 2014

Virginia lawmakers finalize budget, averting a shutdown as GOP thwarts McAuliffe veto
The Virginia General Assembly completed work late Monday on a two-year, $96 billion state budget, averting a government shutdown and at least temporarily thwarting Gov. Terry McAuliffe's key priority of expanding health coverage under the Affordable Care Act.
(Laura Vozzella and Jenna Portnoy, The Washington Post)
House again blocks McAuliffe on Medicaid
Gov. Terry McAuliffe faces another roadblock erected by the House of Delegates in his quest to use federal funds to expand health coverage for uninsured Virginians. The question is: Will the governor run through it?
(Michael Martz, Richmond Times-Dispatch)
Va. House tosses out McAuliffe's Medicaid veto
The GOP-controlled Virginia House of Delegates tossed out a pair of Gov. Terry McAuliffe's line-item budget vetoes Monday while a new Republican majority took control of the state Senate. House Speaker William J. Howell ruled during a legislative veto session that two of McAuliffe's attempted vetoes were outside the scope of the governor's authority. Howell's ruling effectively dismissed the governor's vetoes without the General Assembly voting to override them.
(Alan Suderman, Associated Press)
Court likely to decide McAuliffe's Medicaid authority
The question of whether Gov. Terry McAuliffe has the authority to expand Medicaid on his own is likely to end up in court, leaders of both political parties said Monday after a McAuliffe veto on the issue was ruled out of order in the House of Delegates.
(Bill Sizemore, The Virginian-Pilot)
Our view: McAuliffe and Medicaid: Beware the precedent
The last royal governor of Virginia was the high-handed Lord Dunmore, one of whose chief political sins was his persistent refusal to consult with the elected House of Burgesses. This history lesson could be useful in contemplating the upcoming Independence Day holiday - or Gov. Terry McAuliffe's announcement last week that he intends to bypass a recalcitrant General Assembly and figure out a way to expand Medicaid through executive action alone.
(The Roanoke Times)
Stay within the law
Gov. Terry McAuliffe looks frustrated and sounds angry. He promised to expand Medicaid but found Republicans, particularly in the Virginia House, stridently opposed. He won election to strike deals but found good-faith negotiations hard to come by in Richmond. Losing a slim Democratic advantage in the Senate was the last straw.
(Daily Press)