DBHDS: Surveillance and Testing Costs at State Facilities, Item 326 E (May 1, 2022)

Summary

A letter dated May 1, 2022 from Nelson Smith, Commissioner of the Department of Behavioral Health & Developmental Services, to the chairs of the Senate Finance & Appropriations Committee and the House Appropriations Committee, on COVID-19 testing at state facilities under Item E of the 2021 Appropriations Act. It states that the item provides $2,142,601 in FY 2021 and $4,282,202 in FY 2022. It reports 18,961 tests utilized during the third quarter, with 9,609 administered in January, 5,574 in February and 3,778 in March, and $42,915.31 utilized from the 326.E Appropriations during that quarter. It states that total expenditures for this item for FY2022, through April 1, 2022 are $232,133.

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Full text

                            COMMONWEALTH of VIRGINIA
NELSON SMITH                                  DEPARTMENT OF                                            Telephone (804) 786-3921
COMMISSIONER                                                                                              Fax (804) 371-6638
                               BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES                             www.dbhds.virginia.gov
                                                    Post Office Box 1797
                                               Richmond, Virginia 23218-1797


                                                    May 1, 2022
        The Honorable Janet D. Howell, Chair, Senate Finance & Appropriations Committee
        The Honorable Barry Knight, Chair, House Appropriations Committee
        14th Floor, Pocahontas Building
        900 East Main Street
        Richmond, VA 23219

        Dear Senator Howell and Delegate Knight,

        Item 326 E of the 2021 Appropriations Act provides for $2,142,601 in FY 2021 and $4,282,202
        in FY 2022 for surveillance and testing costs for the patients and staff to manages COVID-19
        outbreaks at state facilities. The language states:

               Out of this appropriation, $2,142,601 the first year and $4,282,202 the second year from
               non-general funds is provided for the surveillance and testing costs of residents and staff
               in order to avoid and manage COVID-19 outbreaks at state facilities. The department
               shall coordinate with the Virginia Department of Health (VDH) and local health districts
               as appropriate to coordinate its testing and surveillance activities in order to access
               federal ELC Enhancing Detection Expansion grant funding provided to VDH through the
               Centers for Disease Control. The Department of Behavioral Health and Developmental
               Services (DBHDS) shall report quarterly to the Secretary of Finance and the Chairmen
               of the House Appropriations and Senate Finance and Appropriations Committees on the
               expense of these funds, including the number of tests administered.

        COVID-19 testing has been conducted at all DBHDS facilities based on plans coordinated with
        VDH since the onset of the pandemic in 2021. The testing protocols have varied depending on
        the rate of infections within each facility and the input of the local health departments serving the
        area where the facility is located. In facilities that have experienced outbreaks, this testing has
        occurred as frequently as twice per week for all individuals receiving services as well as all staff
        who might come into contact with a potentially COVID-19 positive individual.

        Current Status of Testing and Expenditures
        During the past year, there have been COVID-19 outbreaks at individual facilities that led the
        local health departments to recommend halting admissions for periods of time from 14 to 28
        days, depending on the type of individuals that the particular facility serves. Where these plans

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have been enacted, admissions have been restarted at facilities after the agreed-upon period of
quarantine has elapsed. During these periods of quarantine, testing has been conducted more
frequently and has, at times, been required of all patients as well as direct care staff. There were
periodic limits on or closures to state facility admissions in some of the state hospitals during the
latter part of the first quarter, during the second quarter and during the early part of the third
quarter due to needing to activate and maintain quarantine and isolation units. Currently,
however, there are no state facilities that are closed to admissions due to COVID-19.

The Omicron variant of COVID-19 increased the number of COVID-positive staff and patients
in state facilities which, in turn, increased the amount of and expenditures for testing during the
latter part of the second quarter of FY 2022 and the early part of the third quarter of FY 2022.
There were also enhanced numbers of tests required for unvaccinated staff during the early part
of the third quarter that were not required during the latter part. There were also decreases in the
number of staff and patient COVID infections as the quarter progressed. These two factors led
to decreasing numbers of tests utilized for each month during the third quarter.

There were 8,131 COVID-19 tests administered at DBHDS state facilities during the first quarter
of FY 2022, although these were not funded from 326.E as most facilities had stocks of testing
materials on hand. During the second quarter, this increased to 14,823 tests
administered. During the past (third) quarter, the number of tests utilized increased to a total of
18,961. Each month of the third quarter, however, fewer tests were utilized with 9,609 tests
being administered in January, 5,574 tests being administered in February and 3,778 tests being
administered in March. While there was still some availability of tests acquired from previous
quarters of FY 2022, there was $189,218.17 utilized from the 326.E Appropriations during the
second quarter and $42,915.31 during the third quarter of FY 2022.

Current Status of 326.E Appropriations
The federal ELC Enhancing Detection Expansion grant was awarded to VDH in August 2021.
To receive these federal funds from VDH, DBHDS needs to be a sub-recipient. DBHDS has
worked with VDH to establish a memorandum of agreement (MOA) to create the required
relationship and the structure to meet federal sub-recipient guidelines required by the grant. This
MOA was signed in October 2021. Distribution of funds will continue on a monthly basis to
DBHDS, as the grant is disbursed through reimbursement. Because the appropriation for
FY2021 was allocated retroactively, exact expenditures for this item are not available for
FY2021. The total expenditures for this item for FY2022, through April 1, 2022 are $232,133.

Sincerely,


Nelson Smith
Commissioner, Department of Behavioral Health & Developmental Services

CC:
The Honorable John Littel, Secretary of Health and Human Resources




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