This is one of those columns where I probably need to put our disclaimer right up front. So here it is:
The statements and opinions expressed in the Advocate are those of the authors and do not necessarily reflect the views of the members or the VJJA Board of Directors.
Allow me to add that the following article also does not necessarily reflect the views of the Virginia Department of Juvenile Justice by whom I am employed … for the moment.
That being said, on December 17, Governor Kaine released his proposed budget for FY10. It includes cuts that would end state-operated inpatient psychiatric treatment for children and adolescents in Virginia. The plan involves closing all public child and adolescent inpatient psychiatric beds (the Commonwealth Center for Children and Adolescents and 16 adolescent beds at Southwest Virginia Mental Health Institute) and allocating $2 million for private hospital beds.
The Commonwealth Center for Children and Adolescents (CCCA) is located here in our jurisdiction. I can practically hit the place with a rock from my Staunton office, but not quite. CCCA serves children and adolescents from around the Commonwealth, and the folks who work there are extremely good at what they do. In FY08, the Center had 605 admissions, served 559 kids, for a total of 12,114 bed days. The Center’s annual budget is $8.3 million.
The arguments supporting closure of the Commonwealth Center are:
- The Commonwealth of Virginia is in a major financial bind and cuts need to be made in the state’s budget.
- Those children being served by the Commonwealth Center (and SWVMHI) would be better served in facilities closer to their homes.
- It will be more cost-efficient to serve children needing inpatient psychiatric treatment through a public/private partnership.
OK. I get it. But could we take a closer look at those numbers?
After closing the Commonwealth Center and re-investing the $2 million to purchase treatment in private hospitals, the state hopes to realize a net yearly savings somewhere in the neighborhood of $6.3 million. That’s CCCA’s budget of $8.3 million minus the $2 million the state will use to purchase private bed space.
Using the FY08 figure of 12,114 total bed days occupied at the Commonwealth Center, we come up with a per diem cost of $685 for a child to receive inpatient care and treatment at CCCA. I don’t know if any of you have placed your kid in a private psychiatric hospital lately, but I have. And the bill was on the high side of $1,500 per day. (Thank God and the Commonwealth for Value Options!). But let’s say for the sake of argument that Governor Kaine could negotiate with private hospitals to get that per diem cost down to 1,000 bucks. At $1,000 per day, those 559 kids who spent 12,114 days at the Commonwealth Center in FY08 would have cost Virginia taxpayers $12,114,000 in private hospitals. If my math is correct, that would have been 32% MORE than the Commonwealth Center’s budget and over 6 TIMES the 2 mil Governor Kaine wants to allocate for private bed space in FY10.
Those 559 children and adolescents in question would have cost Virginia $12.1 million in FY08 IF private hospitals had had room for those kids, and IF (an even bigger if) the private facilities had agreed to accept those children. So let’s take a survey. How many of you out there have ever tried to get a probationer/parolee/ detainee/foster child/student into a private psychiatric hospital? Go ahead, raise your hand. How did that work out for ya? Were you successful? Why not? No bed space? No insurance? The family lived too far away? The kid had delinquent charges? The child was too dangerous? The child was just too dayumned mean? All of the above? I rest my case.
To think that the private providers of inpatient psychiatric treatment for children and adolescents are going to accept all or even many of the kids treated at the Commonwealth Center and SWVMHI is unrealistic if not delusional thinking. They never have, and they never will; because they don’t have to.
As you ponder this dilemma, consider whether or not we in Virginia would ever think of closing all of the state-operated ADULT psychiatric hospitals in the Commonwealth. Not likely; especially when you consider that during their 2008 Session the Virginia Legislature appropriated $110 million to build a brand new Western State Hospital. That would be a new adult psychiatric hospital, ironically to be built within spitting distance of the Commonwealth Center.
The results of closing the Commonwealth Center and eliminating the adolescent beds at SWVMHI will not be good. Many children will not get the services they need; a LOT of them. What will become of these kids? If you have worked in the field of Juvenile Justice for any length of time, you know the answer to that question. These kids will be criminalized; charged with delinquent offenses and placed in secure detention for the protection of themselves and others. As good as they are, detention center employees across Virginia are not equipped to deal with an influx of actively psychotic kids.
No one argues that the Commonwealth of Virginia needs to cut spending, which means the elimination of programs and positions to stay afloat in these difficult times. But do we have to do it by depriving mentally ill kids of their only safety net? It just doesn’t seem like Virginia’s style.
Cartoon published with permission of the Staunton News Leader.
(Gary Conway is the Director of the 25th District Court Service Unit with offices in Staunton, Waynesboro, Lexington, Covington and Botetourt.)
