Virginia Gov. Proposes Plans to Protect ‘Human Rights’ for Mentally Ill, Move Patients from State Facilities to Community-Based Care

Virginia Gov. James Gilmore (R) is proposing a set of "human rights" rules that would protect "mentally ill, retarded and addicted people," regardless of whether they are treated in a state-run hospital, private facility or outpatient center, the Richmond Times-Dispatch reports. The rules would replace the three current sets of guidelines that differ for public and private programs. Patients in private hospitals would have the same right to "internal advocates" as patients in state facilities. Gilmore called the new guidelines "a step in the right direction," adding that the intention is to "give a greater voice to 'the family and the person under care.'" While mental health advocates "welcomed" the Gilmore proposal, they "voiced some concern" over its failure to "provide adequate medical care in the definition of abuse and neglect." In recent years, several mental institution patients have died "as the alleged result of inadequate mental care," Valerie Marsh, executive director of the National Alliance for the Mentally Ill-Virginia, said. Still, Marsh praised the state's efforts to simplify the "sometimes contradictory" sets of rules for mental health facilities, saying the regulations "are an immense improvement over what they were before" (Martz, Richmond Times-Dispatch, 12/1).

State Care Needs Review
As previously reported by the Kaiser Daily Health Policy Report, the Gilmore administration also has proposed that over the next six years, the state close at least two of its mental hospitals and reduce the number of psychiatric beds at other state facilities -- shifting the care of the mentally ill to private and community-based groups. In an editorial, the Norfolk Virginian-Pilot states that the governor's plan is "a necessary step in Virginia's evolution to more community-centered treatment of mental illness." While noting that the plan has not been outlined in detail, the editorial says the debate over the proposed rules should focus on "creating an effective system for allowing the mentally ill to function as safely and normally as possible." Adoption of the rules and "[g]etting serious about community-based mental health" might result in hospital closures, but the rules also require "a thorough assessment of needs and resources" to ensure that the two "match." Such action, notes the editorial, will need to "maximize federal dollars" in community-based care. The editorial concludes, "The important step will be for the Gilmore administration to produce numbers establishing that private hospitals and community programs exist in sufficient numbers to replace an antiquated system of state hospital care" (Norfolk Virginian-Pilot, 12/1).