1. VIRGINIA RESIDENTIAL PSYCHIATRIC TREATMENT ASSOCIATION (“VRPTA”) Presentation to the House Health, Welfare and Institutions Committee July 30, 2007 Jim Council, Executive DirectorKevin Burgess, Chairman

2. VRTPA VRPTA formed in Spring 2007 to represent the educational, regulatory and legislative interests of residential psychiatric treatment facilities throughout the Commonwealth. Its members provide the following mental health services: residential treatment for children ages 13 through 17 in a safe and secure environment that will prepare these young people for a return to a home, a less restrictive environment, or to independent living; acute psychiatric and substance abuse services for children, adolescents and adults; specialized care for young people with disabilities, injuries, lifelong illness, or other medical conditions; home-based services that offer intensive behavioral health intervention for children, adolescents, adults and families; case management services to youth who are transitioning to or from intensive services; and, treatment of behavioral and emotional disorders, adolescent sexual offending, drug and alcohol abuse, and other issues that compromise productive daily functioning.

3. VRTPA VRPTA Member organizations Subject to licensure and oversight of the Department of Mental Health, Mental Retardation and Substance Abuse Services as well as compliance with regulations issued by the State Boards of Education, Juvenile Justice, DMHMRSAS and Social Services through the Office of Interdepartmental Regulation Employ over 800 clinical, professional, and administrative staff (employees and contractors) Maintain facilities aggregating over 810 beds throughout the Commonwealth Formed a partnership with The Jason Foundation, Inc, a national non-profit organization dedicated to the prevention of youth suicide, under which members voluntarily support the goals of JFI through the contribution of physical facilities, staff time and assistance, and telecommunications support.

4. VRTPA Suicide ranks as the THIRD leading cause of death for ages 15-24 and FOURTH for ages 10-14. Each week in our nation, we lose approximately 100+ young people to suicide More teenagers and young adults have died of suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease COMBINED. It’s a “Silent Epidemic” JFI is a nationally recognized provider of educational curriculums and training programs for students, educators/youth workers, coaches and parents. JFI’s programs build an awareness of the national health problem of youth suicide, educate participants in recognition of “warning signs or signs of concern”, and provide information on identifying at-risk behavior and elevated risk groups, and direct participants to local resources to deal with possible suicidal ideation. JFI: Receives substantial funding from corporate America Has a strong alliance with the National Football Coaches Association Has Tennessee football coach Phillip Fulmer as its national spokesperson and Va. Tech’s Frank Beamer as one of its state and regional ambassadors Was responsible for legislation in Tennessee making suicide risk identification training part of teachers’ periodic recertification curriculum

5. Residential Treatment Providers Role in the Virginia Mental Health System Who do we treat? Treatment Components OutcomesFinancingFuture

6. Who do we treat? Children ages 9-22 and their families Primary Psychiatric Diagnosis 60% State custody Victims of neglect, abuse, trauma. Multiple treatment failures in outpatient, hospitals, foster care. Mentally Retarded with an IQ of 35 or higher Behavior history putting self and others at risk including sexual offenders, violent history

7. Treatment Components Clinical interventions including: –Psychiatrists –Psychologists (testing) –Licensed Clinical Specialists –Nurses –Mental Health Specialists –Behavioral Planning –Dieticians

8. Treatment Components Educational Interventions –Certified Teachers –Special Education Specialists –Emotionally Disturbed Specialists –Teachers Aids –SOL Directed –Longer school year

9. Outcomes Decrease in psychiatric symptoms Increase in patient behavioral stability 70-80% discharges to lower level of care (home, foster care, group homes, independent living) Improvement in education levels Decreased adjudication of mentally ill children

10. Financing 80% of revenue from State Medicaid Program Decreased dependence on locality funding helps increase funding to preventative and post discharge services (community based) Work in tandem with Community Service Boards to provide cost effective treatment options.

11. Residential Treatment in Mental Health Continuum  Acute Care  Residential Treatment Center  Group Home  Therapeutic Foster Care  Home Based Services  Intensive Outpatient Program  Outpatient Therapy

12. Future Collaboration with Commonwealth and local agencies in development of effective care models Decreased need for “out of Commonwealth” placements Decreased Length of Stay in out of home placement related to lack of step down availability Assist legislators and regulatory agencies in establishment of mental health system that is both easy to access as well as effective in clinical outcomes