DBHDS: COVID-19 Surveillance and Testing at State Facilities, Item 317 D (October 20, 2022)

Summary

An October 20, 2022 memo from Nelson Smith, Commissioner of the Department of Behavioral Health & Developmental Services (DBHDS), to the chairs of the Senate Finance and House Appropriations Committees and Secretary of Finance Stephen E. Cummings, regarding Item D of the 2022 Appropriations Act and COVID-19 surveillance and testing at state facilities. It sets out the Item D language providing $2,142,601 in FY 2022 and $4,282,202 in FY 2023 and states that the department reports quarterly on these funds. It states that distribution of funds will continue on a monthly basis, as the grant is disbursed through reimbursement. It also states that exact expenditures for FY 2021 are not available because the appropriation for FY 2021 was allocated retroactively.

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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


                                                October 20, 2022

        To:    The Honorable Janet D. Howell, Chair, Senate Finance Committee
               The Honorable Barry D. Knight, Chair, House Appropriations Committee
               Secretary of Finance Stephen E. Cummings
        From: Nelson Smith, Commissioner of the Department of Behavioral Health & 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.

               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

                                                                                                           1
        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. 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-positive
individual.
Current Status of Testing and Expenditures
During the past 15 months, COVID-19 outbreaks at individual facilities have 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 have been
enacted, admissions have been restarted 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 and there have been no closures during the
fourth quarter of FY 2022 or the first quarter of FY 2023.
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. These two factors led to
decreasing numbers of tests utilized for each month during the third and fourth quarters. There
were some slight increases in the number of positive patient and staff COVID tests during
portions of the fourth quarter of FY 2022 and the first quarter of FY 2023, likely due to the BA.5
variant, but it does not appear that this led to the need for significantly increased testing. There
are also changes in the testing requirements for unvaccinated DBHDS employees and changes in
the testing protocols for employees potentially exposed to COVID-19 that have decreased the
demand for tests.
The number of COVID-19 tests administered at DBHDS state facilities during the first quarter of
FY 2022 was 8131 although these were not funded from 326E due to most facilities having
stocks of testing materials on hand. Since that time, the number of tests administered by
DBHDS facilities and the expenditures from the funds provided through 326E are outlined in
Table 1.


Table 1.
                                                                                                      2
         Quarter                   Tests                     326E Funds Utilized
         Quarter 1, FY2022         8,131                     0
         Quarter 2, FY2022         14,823                    $189,218
         Quarter 3, FY2022         18,961                    $42,915
         Quarter 4, FY2022         1,142                     $40,128
         Quarter 1, FY2023         1,622                     $107,454


Current Status of 317.D Appropriations
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. Distribution of funds
will continue on a monthly basis to DBHDS, as the grant is disbursed through reimbursement.
Because the appropriation for FY 2021 was allocated retroactively, exact expenditures for this
item are not available for FY 2021.


cc:    The Honorable John Littel, Secretary, Health & Human Resources




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