DBHDS: COVID-19 Surveillance and Testing at State Facilities, Item 317 D (August 1, 2022)

Summary

An August 1, 2022 memo from Nelson Smith, Commissioner of the Department of Behavioral Health and Developmental Services (DBHDS), to the chairs of the Senate Finance and Appropriations and House Appropriations Committees regarding Item D of the 2022 Appropriations Act and COVID-19 surveillance and testing at state facilities. It states that Item D provides $2,142,601 in FY 2022 and $4,282,202 in FY 2023 for surveillance and testing costs. The memo says that in facilities that have experienced outbreaks, testing has occurred as frequently as twice per week. It also states that a memorandum of agreement with the Virginia Department of Health for the federal ELC Enhancing Detection Expansion grant was signed in October 2021.

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                           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


                                                 August 1, 2022

        To:    The Honorable Janet D. Howell, Chair
               Senate Finance and Appropriations Committee

               The Honorable Barry D. Knight, Chair
               House Appropriations Committee

        From: Nelson Smith, Commissioner
              Department of Behavioral Health and Developmental Services

        RE: Item 317 D of the 2022 Appropriations Act regarding COVID-19 surveillance and testing at
        state facilities
        Background
        Item 317 D of the 2022 Appropriations Act provides $2,142,601 in FY 2022 and $4,282,202 in
        FY 2023 for surveillance and testing costs for the patients and staff to manage 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 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 Department of Behavioral Health and
        Developmental Services (DBHDS) facilities based on plans coordinated with the Virginia
        Department of Health (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

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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-positive
individual.


Current Status of Testing and Expenditures
During the past year, there have been times during COVID-19 outbreaks that led local health
departments to recommend halting admissions to individual facilities experiencing these
outbreaks for 14 to 28 days, depending on the type of individuals that the facility serves. Where
these plans 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 temporary limits or closures to 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
when quarantine and isolation units needed to be activated and maintained. Currently, however,
there are no state facilities that are closed to admissions due to COVID-19.
The outbreak of the Omicron variant of COVID-19 increased the number of COVID-positive
staff and patients in state facilities that 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. These two factors led
to decreasing numbers of tests utilized for each month during the third and fourth quarters.
There were slight increases in the number of positive patient and staff COVID-19 tests during
portions of the past quarter, likely due to the BA.5 variant, but it does not appear this led to the
need for significantly increased testing.
The number of COVID-19 tests administered at DBHDS facilities during the first quarter of FY
2022 was 8,131; although, these were not funded from 317D due to most facilities having stocks
of testing materials on hand. During the second quarter, this increased to 14,823 tests
administered. During the third quarter, the number of tests utilized increased to a total of 18,961.
During the fourth quarter, there were 1,142 tests administered. There was $189,218.17 utilized
from the 317 D Appropriations during the second quarter, $42,915.31 during the third quarter
and $40,128.19 during the fourth quarter of FY 2022.
Quarter        Tests           317D Funds Utilized
1st            8,131           0
2nd            14,823          $189,218.17
3rd            18,961          $42,915.31
4th            1,142           $40,128.19


Current Status of 317 D Appropriations



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The federal ELC Enhancing Detection Expansion grant was awarded in August 2021 to the
Virginia Department of Health (VDH). 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. These funds will
continue to be distributed on a monthly basis to DBHDS as the grant is distributed on a
reimbursement basis.




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