City of Alexandria, Virginia
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MEMORANDUM
DATE: JUNE 20, 2023
TO: THE HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
THROUGH: JAMES F. PARAJON, CITY MANAGER /s/
FROM: KATE GARVEY, DIRECTOR, DEPARTMENT OF COMMUNITY AND
HUMAN SERVICES
DOCKET TITLE:
TITLE
Release of Bed Finder Contingency Funds.
BODY
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ISSUE: Release of Bed Finder Contingency Funding.
RECOMMENDATION: That City Council release Contingency Funds in the amount of $79,250 to the Department of Community and Human Services (DCHS) to fund one (1) FTE/Bed Finder Position.
BACKGROUND: The purpose of this memorandum is to request funding in the amount of $79,250 to support the creation of one (1) FTE/Bed Finder position within the Center for Adult Services. On Tuesday, April 25, 2023, during the Add/Delete Work Session for the FY 2024 budget, the City Council directed staff to fund this Bed Finder position out of the existing INOVA Alexandria Hospital Non-Departmental General Fund contingency. The City Council then adopted the FY 2024 budget on Wednesday, May 3, 2023.
EXPLANATION FOR REQUEST: A critical shortage of inpatient psychiatric beds
significantly delays admissions for individuals experiencing a behavioral health crisis. Bed
finding is a very time-consuming process and absorbs vital hours from licensed Emergency
Services staff who otherwise would be engaging in clinical duties. Emergency Services staff
are seeking beds in addition to their scheduled clinical duties. As beds are secured on a first
come, first served basis, this puts Alexandria at a disadvantage for securing the limited supply
for the City’s residents.
The timing of this new resource in Alexandria is critical. Some new beds will be coming online in other jurisdictions in the Region in the near future, including five in Arlington in early 2024 and seven in Prince William. Both are dependent on adequate staffing. The impact of the 20 additional beds in Inova Mount Vernon has reduced the number of Alexandrians boarding in the Emergency Room. A full-time employee whose responsibility is to secure beds for Alexandria residents in need will put the City in the best position to access these new bed opportunities. Although staff anticipates dedicated staff to improve Alexandria’s access to this level of care, the need will continue to exceed the demand in the Northern Virginia region.
In addition to placing individuals in crisis in the appropriate environment as quickly as possible and as close to the City as possible, this position is expected to help reduce the impact the situation currently has on local law enforcement officers in the Alexandria Police Department and the Alexandria Sherriff’s Office who are required to maintain custody of individuals under Emergency Custody Orders (ECOs).
EXPLANATION OF USE OF FUNDS: This funding will support one (1) position that would facilitate expedited placements of individuals experiencing a behavioral health crisis and accelerate treatment for patients awaiting these placements. Overall, this position will improve and enhance the efficiency and effectiveness of the current bed-searching process with the intention of clearing emergency room use. This would free licensed staff in the Emergency Services to focus on clinical duties, as they are currently designated to lead the bed finding process.
The position will be one (1) FTE, Community Services Specialist II/ GS 15, in the Division of Crisis and Emergency Services within the Center for Adult Services. The position’s primary duty will be to perform bed-finding during the pre/post-commitment hearings for clients needing inpatient psychiatric placement and to provide follow up and administrative support. The position will report to the Emergency Services Team Leader and coordinate with Emergency Services and Alexandria Co-responding program (ACORP) staff to assist with the client’s care coordination and admissions to inpatient treatment facilities, including crisis stabilization units.
IMPACT OF NOT RECEIVING APPROVAL: Bed finding responsibilities are currently carried out by Emergency Services staff. The bed finding process consumes time from clinical care and puts Alexandria at a disadvantage to secure beds that are available on a first-come, first served basis. Without this position the clinical staff will continue to perform bed-finding work instead of clinical evaluations and assessments for Alexandrians in crisis. Alexandrians will continue to experience significant delays in accessing appropriate care. Multiple stakeholders, including law enforcement, Inova Emergency Department, and the Emergency Services workforce, will continue to be severely impacted by the current challenges of inpatient placement.
ALTERNATIVE FUNDING SOURCES: There are no alternative sources. The City Council approved the funding on May 3, 2023.
STAFF:
Kendel Taylor, Interim Deputy City Manager
Phil Caldwell, Center Director for Adult Services, DCHS