Column by David Cox
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God forbid, next winter I slip on the ice, bang my head, and sustain major injury. Our rescue squad right away gets me to Stonewall Jackson Hospital which provides immediate initial care. But the damage is too great for SJH to handle. They transfer me ASAP to the University of Virginia Hospital where an ICU bed awaits me, and brain surgeons prepare to work their miracles. Thank goodness, I can take advantage of the continuum of health care in our area.
God forbid, next winter a neighborhood child encounters teenaged angst in a big way. Parents try their best, get counseling and other help at hand in our community. But a crisis erupts that is more than anyone here, including professionals, can handle. The young person needs the equivalent of the UVA Hospital, one specializing in juvenile mental health. But it’s not there. The state closed the Commonwealth Center for Children and Adolescents in nearby Staunton over the summer. SJH or the jail may be the only alternatives, neither of which wants to, or can, handle the crisis.
There is genuine danger that the continuum of health care in our state will soon be limited. CCCA is reportedly on the budgetary chopping block. It shouldn’t be. Shutting down an outstanding facility that treats youth in crisis with rare expertise is as foolishly shortsighted as closing the Natural Bridge Juvenile Learning Center.
But it may happen. Unless we in our community, and across Virginia, insist otherwise.
There are two big reasons why we should.
First, CCCA works. Statistically, it’s a small place, just 48 beds; but they are so well used that twice as many people are treated, per bed, as any other mental health facility in the Commonwealth—over four times more than, say, Western State, which itself does a darn good job. That means that, one after another, these young people are treated quickly and then released so they can return to their home communities for further assistance. It’s like a good ICU—effective for treating a crisis for a limited time, and essential for healing.
Moreover, it does the job. A friend wrote, “After a bad experience at a private hospital, CCCA was a breath of fresh air. It saved his life.” As a nurse, she continues, “I am deeply aware of how important CCCA is to the emergency mental health needs of many children and families who are not able to be treated at private facilities (605 served last year, by one count).”
The second reason is: Other places don’t. Private psychiatric hospitals lack the expertise, the facilities, and/or the willingness to take on the most difficult juvenile mental-health patients. According to information from CCCA, “56 percent of kids were kids who were either denied admission to the private hospital at the front end due to behavioral issues OR were kids who were accepted by private hospitals initially and transferred to us due to inability of the private hospital to handle the child’s behavior. Many of these kids DID have insurance that was active but the private sector would not serve them.”
There’s a third reason. If the state closes CCCA, the burden will increasingly shift to localities. Local jurisdictions—Lexington, BV, Rockbridge—will be expected to shoulder the burden of providing care, and, after the pittance proposed in the budget is used up, pay for it. The current cost is around $8 million, but only about $2 million is proposed for state funding. Needs such as those covered by that $8 million don’t decrease by 75 percent because some government says so.
Of course, we here cannot provide the intensity of care now which is precisely why we use CCCA (and do so with close attention from our Rockbridge Area Community Services folk). I serve on the RACS board and cannot say enough good about how well our staff uses limited resources, including CCCA. But no one has extra funds to pay for where we would need to send them—if we could find such places in the first place.
It would be like doing brain surgery at SJH and paying for it with property taxes.
Money is not the most important reason to keep CCCA open. Still, the conservative columnist David Brooks reported in The New York Times last week that seven tax dollars are spent on serving the elderly for every one dollar supporting young people. Yet we all know where our country’s future lies.
In one of his more boneheaded moves, Gov. Kaine last year proposed closing CCCA. Sen. Emmett Hanger and others rallied to keep it open.
The same forces are rallying again. They need all the help they can get. Last week Lexington’s City Council unanimously voted support for retaining CCCA.
The main reason is simple. When our kids need it, they really need it. And nothing else on the horizon will do.