With state revenues softening, the story state Sen. Siobhan Dunnavant, R-Henrico shared from her shift at a Richmond area E.R. was an early signal of tough budget talk to come.
In that emergency room, Dunnavant, whose day job is as a physician, spotted someone under a temporary detention order, because of a mental health crisis, and discovered that the person had been there for 24 hours because there was no bed available.
That’s not the way things are supposed to be. People subject to a temporary detention order, which is magistrate’s finding that a person needs immediate hospitalization, are supposed to be in a hospital bed within eight hours. If no private bed is available, state law says they have to go to a state hospital.
But on average, 96% of state hospital beds were taken last fiscal year; as many as seven state hospitals are at 100% of capacity, or more, acting commissioner of the Department of Behavioral Health and Developmental Services Mira Signer told the Senate Finance Committee Tuesday – prompting Dunnavant’s story about that what she saw that weekend at the E.R.
“This is a crisis,” Dunnvant said. “People on TDOs are not getting what they need.”
Signer’s report on hospital capacity and Dunnvant’s story came after Secretary of Finance Aubrey Layne told the senate committee what he’d shared Monday with the House Appropriations Committee.
First, that the state’s two main sources of funds – individual income taxes and sales taxes – have been growing at about 3.5% a year, amounting to about $600 million a year. Those two taxes account for about 80% of state revenue.
Second, that the two biggest bills the state faces – K-12 education and health (mainly Medicaid)—have been growing at about a 5% to 7% a year pace. They account for about three quarters of state spending. Those growth rates mean another $800 million to $1 billion a year in state spending.
Third, said Layne, growth in revenue is likely to slow, as the economy slows.
“We have been in a situation where we’re coming off a recession, and revenue’s been growing and demands for state spending easing. Now, we’re in a different fiscal cycle,” said Senate Majority Leader Thomas K. Norment, Jr., R-James City, as he digested the one-two punch from Layne’s and Signer’s reports.
He said he’s worried that too many people in Richmond are looking at the $750 million surplus of tax and fee collections over state spending during the fiscal year ended June 30.
“We’re facing slowing revenue and big needs,” Norment said. Some, he said, like matching the federal payment for basic Medicaid or paying for the state’s update of its Standards of Quality for schools, are mandated – there’s no room for cutting. Some, like overcrowding at state hospitals, are needs it simply isn’t right to ignore.
And it’s going to mean tensions over the next two year budget, which will be the General Assembly’s main task in the 2020 session, will be even higher than they’ve been in recent years, Norment said.
Shad Plank is the Daily Press blog that tracks Virginia politics. It takes its name from the traditional Shad Planking political get-together, though hopefully it is tastier than the roasted fish featured at that Sussex County event. To contact Dave Ress with tips or questions, call 757-247-4535 or email dress@dailypress.com.