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Session Newsletter (Feb. 14, 2014)

February 14, 2014 by Creigh Deeds

Crossover and Medicaid Expansion

This past week the General Assembly saw the crossover and lots of chest thumping. Both sides, Republicans in the House of Delegates and Democrats in the Senate, claimed to be the source of all things moderate and reasonable. The proof, however, is in the pudding, and people can make their own judgments. The big hang up at this point remains from the opening day of session: Medicaid expansion.

Paying for Medicaid Expansion

As explained in this space before, Medicaid expansion is an optional part of the Affordable Care Act. Payment for expansion, however, is not optional. Funding comes from federal taxes. People are already paying increases in taxes on insurance premiums and in other areas. Virginia taxpayers will continue to pay those taxes whether or not we expand Medicaid; however, if we don’t expand in Virginia, our taxpayer dollars will be spent to provide coverage to residents in other states. Virginia loses in excess of $5 million in federal funding every day that we don’t expand Medicaid.

Last week Senator John Watkins, a Republican from Powhatan, revealed a new approach to Medicaid expansion. His proposal, which would need to be approved by the federal government, would allow us to put our own brand on expansion and provide coverage to an estimated 285,000 people. The plan, Marketplace Virginia, requires recipients of the new coverage to pay a premium, just as they would if they had private insurance. The proposal also includes language we inserted into the budget last year that says if federal funding ever dips below 90 percent of the cost of expansion, Virginia will be allowed to withdraw. As explained before, under existing law, the federal government will pay 100 percent of the cost of expansion for three years, reduced to 90 percent in the sixth year of expansion. The premiums will be collected to apply against the state’s share of the cost.

Members of the House of Delegates argue that reforms to Medicaid must occur before expansion. Two of the primary concerns, however, are already written into the law. We already establish a minimum 90 percent funding level, and we require the payment of premiums. Requiring some form of financial responsibility on the part of the insured is a significant reform. What’s more is the unbelievable pressure that the cost of providing for the uninsured puts on our health care system. That pressure has shut down hospitals in Virginia and in other parts of rural America. Expansion of Medicaid will provide the necessary funding to keep rural hospitals open.

Impact of Medicaid Expansion on Treatment of Mental Illness

And, important to me, expansion of Medicaid requires equity between the treatment of mental illness and other illnesses. This will pump over $200 million a year into Virginia’s treatment for mental illness. Without question, this will raise the level of mental health care higher than we have ever had in Virginia. Expanding insurance coverage, passage of the omnibus mental health bill, and a comprehensive review of our system has the potential to bring much needed transformations in the delivery of mental health care in Virginia and put the Commonwealth in a leadership position among the fifty states in the treatment of those who suffer mental illness.

As Virginians we should not expect to be any less than leaders.

I continue to be overwhelmed by the kindness and the support I receive from constituents, people around Virginia, and people all over the country on a daily basis. It remains my distinct honor to represent you in the Senate of Virginia. If I can be of service, do not hesitate to contact me at PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.

Session Newsletter (Feb 7, 2014)

February 8, 2014 by Creigh Deeds

The 2014 session rolls on, and we are nearing crossover. Crossover is the time when the Senate must complete work on bills introduced in the Senate, and the House must complete work on bills introduced in the House. It’s called the crossover because after it occurs, the bills cross over to the other house for consideration.

Virginia Budget Issues

Transportation

As usual, the budget is the major piece of work to be completed in this session of the General Assembly. In past years, transportation has been the topic at the top of the agenda. With the passage of the comprehensive transportation package last year, there are more arguments over spending priorities and how to balance the budget. With that said, the transportation plan last year has not raised nearly as much money as anticipated because last year’s numbers were built on the presumption that the price of gas would continue to rise. The good news for consumers is that the price of gas, though high, has remained fairly stable.

Expansion of Medicaid

Not surprisingly, the big issue this year with respect to the budget is the expansion of Medicaid. As outlined in this space a few weeks ago, I think expansion would be a good deal for Virginia. It would provide health care, including mental health service, to between 200,000 and 400,000 currently uninsured Virginians; and it would create a significant number of new jobs in Virginia. The federal government has committed to funding 100 percent of the cost of Medicaid expansion for the first three years and at least 90 percent in subsequent years. To me, it’s a no brainer: it is the right thing to do, and it makes good economic sense. A proposal to create a Virginia Marketplace to provide coverage for these individuals has been advanced in the Senate. The General Assembly is far from reaching a consensus on this issue, which risks tying up the budgetary process for a considerable period of time.

Contentious Legislative Proposals

A number of controversial topics have been debated this session that generated a lot of phone calls and emails. Among the most contentious measures are:

Sunday Hunting

This year a bill was fashioned by Senator Phillip Puckett and others to allow Sunday hunting on private property by the owner of the property or those to whom he gave permission. I have long resisted voting for Sunday hunting because I think there are things to do outside on a Sunday other than hunt. In Bath County, where I live, hunting remains a popular activity. In the fall, Sunday is the only day that you can participate in other outdoor recreation, like trail riding or hiking, without coming across hunters in the woods.

Boating on Non-Navigable Streams

Senator Dave Marsden introduced a bill this year granting anyone the right to float on a stream with a drainage area of at least seven square miles. The bill was framed somewhat innocuously but would have allowed, from my perspective, floating on just about every stream in Virginia. Because I was concerned that this approach would have negatively affected some people’s property rights and would have provoked confrontation, I voted no.

Death Penalty

Currently there is a bill pending from Senator Bill Carrico that would mandate execution by electrocution, a method that is optional under current law, if the chemicals for lethal injection are not available. Starting in 1994 Virginia joined the trend of performing executions by lethal injection. Today, some of the drugs that have been used to make the cocktail for the lethal injection are in short supply. I understand why Senator Carrico introduced the bill. However, there are only four states that currently allow the use of the electric chair. I am inclined not to support this legislation. I think we need to make sure that our statutes are constitutional, and I am concerned that this bill will actually weaken our death penalty statute.

Ethics Reform

The high profile case involving former Governor Bob McDonnell generated a great deal of interest and legislation pertaining to our ethics laws. The bill moving through the Senate would create the Virginia Conflict of Interest and Ethics Advisory Council, expand reporting requirements to include gifts to children, require semi-annual reporting of lobbyists and elected officials, and cap tangible gifts to legislators at $250, among other provisions. The bill is pending on the Senate floor as we debate amendments. While the bill does not go as far as some would like, the provisions are an improvement over current law.

Mental Health Policy Reform

A large portion of my work continues to be in the area of attempting to reform our mental health laws. Two of my proposals, Senate Bills 260 and 263, and legislation sponsored by others have been merged into one bill. The omnibus bill will require subjects be held up to 24 hours under an emergency custody order, create a database of available psychiatric beds, and ensure people in need of hospitalization cannot be “streeted” by establishing state hospitals as providers of last resort. That bill is currently on the floor of the Senate, and I expect to move it to the House by next week. The resolution creating a joint subcommittee to study mental health services passed the Senate and is pending in the House Committee on Rules.

The response to my legislative work on mental health has been overwhelming. People from throughout Virginia and the United States have shared their stories and reached out to me for help. Getting in touch with your elected officials and voicing your concerns is critical to effecting change. The Governor’s Task Force of Mental Health Services and Crisis Response will continue to meet throughout the year. You can submit public comment here.

It continues to be my distinct honor to serve you in the General Assembly. This will continue to be a busy session for me, and I look forward to your input throughout the process. Concerns, questions, or requests should be directed to my office at: PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.

Session Newsletter (Jan. 25, 2014)

January 27, 2014 by Creigh Deeds

The 2014 session of the General Assembly is streaking by and will soon be a memory. This year’s session is memorable for several reasons. First, it is the first year of a new governorship, which always brings a certain level of excitement, together with a period of uncertainty as new people get accustomed to new jobs. Second, the legislature convenes with the idea of addressing problems and balancing the budget for all the people of Virginia. While each session resembles the previous one, new legislators and a new administration guarantee a new twist.

For the past several years, I have been forced to deal with the state’s system of mental health on behalf of my son. In November a lot of issues related to that system were thrust in my face. I am determined to take the experience I have and use what I’ve learned to try and prevent future tragedies. To that end, I’ve introduced several pieces of legislation.

First, I introduced legislation requiring the Department of Behavioral Health and Developmental Services (DBHDS) to review the qualifications of workers charged with evaluating people in crisis. Current regulations require the person performing the evaluation to have a Master’s degree or its equivalent or be a registered nurse with a certain amount of experience in the psychiatric field. However, based on my experience, it is not clear that every person charged with doing evaluations has the necessary skills and qualifications; I have asked the Department simply to review the regulations and make a report to the General Assembly. Before wholesale changes are made to current law, we need to take into account that which is currently on the books and review whether it works.

Second, I’ve called for increasing the amount of time a person may be held under an emergency custody order (ECO). Current law allows a person to be held for four hours with, under certain circumstances, one two hour extension. That time frame is the shortest in the nation. Most states hold people between 24 and 72 hours before a determination is made that they should be held pursuant to a temporary detention order. While that legislation has drawn a lot of fire, specifically from the Virginia Sheriffs’ Association and the ACLU, it makes sense to me to bring Virginia in line with the rest of the country. There should not be an incident of one who is in need of stabilization services being released, or “streeted.”

Just as important as extending the time period is to eliminate the requirement that the duration of the ECO be extended by a magistrate. Particularly in rural areas, merely having to seek an extension is a waste of precious time.

Coincident with my legislation, others have introduced bills to require that a state facility be a provider of last resort. That legislation essentially would require that a bed be available when one is deemed necessary.

The third bill I sponsored calls for the establishment of a digital registry of available, public and private, psychiatric beds. The Department has been working on a registry for about three years; however it is not a mandate in the law. In this internet driven information age, it makes no sense for precious hours to be wasted on the phone looking for a bed when live time information could be readily accessible.

The last bill I introduced relating to mental health calls for a comprehensive study of our mental health care delivery system. We need to look not only on how we provide services in the area of crisis intervention, but how we deal with mental health issues long term. What kind of care should we be providing to people who are mentally ill? The study resolution has been rewritten to include issues related to the re-institutionalization of the mentally ill in our jails and prison system. The issues are absolutely related, and I hope we can move this matter forward.

While it is difficult for me even to talk to friends right now, I made a decision to speak publicly about my circumstances in order to prevent future tragedies. And I chose what I consider to be the biggest megaphone. By taking to the airwaves, I hope that I can effect as much change as possible and in some way help the millions of families across the country who are struggling and looking for help.

I look forward to hearing from you as we move through the session. I appreciate the opportunity to continue to serve you in the Senate of Virginia. Concerns, questions, or requests should be directed to my office at: PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.

Session Newsletter (Jan. 17, 2014)

January 17, 2014 by Creigh Deeds

The 2014 Session is well underway. This year, like every year, we have challenges to conquer to meet the needs of the Commonwealth’s 8.3 million residents. Before we get to those challenges, we have to go through the ceremony that is required every four years.

Last week, Governor McDonnell gave his farewell address highlighting his achievements over the past four years: over 170,000 new jobs in Virginia, brought on largely by the national economic recovery, success in increasing the number of children adopted out of foster care, and last year’s monumental transportation plan. He also apologized for his role in the gift scandal that plagued his last year in office. The matter is currently under continuing federal investigation. There are many who will suggest that all politicians receive such largesse, so Governor McDonnell’s culpability is insignificant; however, I take exception to that. Sure, there are a fair amount of free dinners and even vacations that people involved in politics accept. But the magnitude of the gifts accepted by the McDonnell family, and the fact that they weren’t reported, is unprecedented and leaves a stain on the McDonnell administration.

On Saturday, amidst a steady rain, Governor Terry McAuliffe, Lieutenant Governor Ralph Northam, and Attorney General Mark Herring were inaugurated. Whether it was a sign from above or not, the rain lifted and the sun came out at about the same time Governor McAuliffe began his address. The following Monday, the Governor outlined his priorities in an address before the Joint Assembly of the House of Delegates and the Senate of Virginia. Primary among his priorities is Medicaid expansion.

Medicaid is insurance provided by the federal government since the 1960s. The program is regulated and funded to a large degree by state governments, which historically have been able to determine to whom it is provided. Under a provision of the Affordable Care Act, the role of Medicaid would be expanded by increasing eligibility. The federal government has committed to funding 100 percent of the cost of Medicaid expansion for the first three years and 90 percent of expansion cost the following three years. Virginia has already adopted regulations requiring us to pull out of expansion if at any time federal funding of the cost of expansion falls below the 90 percent threshold. Expansion in Virginia makes good sense. We will provide coverage to an additional two to four hundred thousand Virginians. The health care of those Virginians is presently being subsidized by those who pay private insurance. Because they can’t afford preventative care, their health care needs are met primarily in emergency rooms. When hospitals aren’t paid for emergency room care, the costs are written off and insurance rates must go up to cover those costs. As many as 30 thousand veterans are among the Virginians who can benefit from expansion. It is inexcusable that these people who have given so much to this country return home to poverty.

It also makes good business sense for us to expand Medicaid. As noted above, the uninsured currently drive up the cost of insurance and thus health care. We simply have to find a way to control the cost of health care. In addition, Virginia will receive about $2.1 billion in federal funding per year for the next three years if we support expansion. The investment of federal dollars will continue and injects over $5 million a day into Virginia’s economy. As a result, Medicaid expansion is expected to create about 30,000 jobs, primarily in the health care field, over the next six years.

We lost a rural hospital in southwest Virginia this past year. These critical federal dollars, which all Virginians will pay in the form of taxes whether we expand Medicaid or not, could, save rural hospitals all over Virginia. Medicaid expansion is the right thing to do.

Much attention has been paid to my focus this session on mental health. In fact, that issue is important to me and will take a significant amount of time. However, I am working on other legislation, including:

A bill to extend the statute of limitations to one year past the 18th birthday of a victim of a misdemeanor involving sexual misconduct.
A bill to consolidate the law enforcement divisions of the Department of Game and Inland Fisheries and the Virginia Marine Resources Commission.
Several bills to revise the Standards of Learning tests for elementary age children.
A bill that would include conservation officers who work in our State Parks as members of the Virginia Law Officers Retirement System.
An effort to create a state park in either Highland County or Rockingham County.
A bill to reform the Board of the Department of Alcoholic Beverage Control.

On a personal note, thanks to all for your prayers and support during a tough time. Your kind expressions have been overwhelming.

This will be a busy session for me. I look forward to hearing from you as we move through the session. I appreciate the opportunity to continue to serve you in the Senate of Virginia. Concerns, questions, or requests should be directed to my office at: PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.