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Request for Virginia Budget/Policy Priorities

Written by Bruce Cruser

Bruce Cruser has been Executive Director of Mental Health Virginia since 2016, bringing a background in social work and community corrections, and many years of leadership experience in local and state government.

August 13, 2023

The Honorable John Littel, Secretary of Health and Human Resources

Commonwealth of Virginia

Dear Secretary Littel,

As you are preparing the Governor’s draft budget for the next fiscal year, we encourage you to address the following:

1. Expand the DCJS behavioral health discharge planning grants so that all local and regional jails have access. It is vital that upon release the person in recovery from a serious mental illness or addiction has immediate access to the medications, CSB programming and community resources essential to their recovery. These programs have shown great results where they are in place currently with stakeholder support. Expansion will do much to prevent recidivism and overdose deaths. 

2. (Related to #1) Ensure that Medicaid coverage is either continuous during incarceration for those sentenced to a local or regional jail, or in place prior to an inmate’s release. I understand efforts are underway now to address this through 1115 waivers and other approaches. 

3. Through legislation or budget language, improve current systemic policies that result in the incarceration rather than treatment of someone in a mental health crisis accused of assaulting hospital staff or a law enforcement officer. There will be exceptions, but in many cases the “assault” is not intentional but rather the manifestation of a person in crisis, and often the injuries to others are not serious, while the person in crisis is moved from a treatment facility to the trauma of incarceration.. At least two people in crisis have died in the past few months in similar circumstances.  (see Preventing Another Death in Custody)

Although this is a serious challenge, a work group of representatives from the hospitals, law enforcement, the CSBs, Peer Recovery Specialists, advocates and a few others may be able to agree on a starting point to improve current practice and save lives.  

Thank you for your openness to these suggestions. 


Bruce N. Cruser, MSW, Executive Director

Mental Health America of Virginia

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