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Focus on Fairfax
March 9, 2014

Dear Friends and Neighbors, 


Yesterday afternoon the 2014 "regular" session of the General Assembly adjourned sine die - which is the Latin term for final adjournment (or more literally, adjourning without a future date being designated). But this year our work is far from over. Without an adopted budget, we will return to Richmond for a special session on March 24th.


First, some successes. I was pleased that my HB1072 to prevent a retailer from scanning your driver's license and then using the personal information for marketing purposes was passed unanimously. My HB767 to enhance Virginia's efforts to fight human trafficking by allowing law enforcement to seize assets associated with trafficking was rolled into another bill that also passed. While the final ethics bill enacted by the General Assembly did not go nearly far enough in my opinion, my HB271 to increase the reporting frequency of gifts was incorporated into the final omnibus bill. In all, eight out of my 13 bills are now on their way to the Governor for signature. I was also glad to help our senators by serving as the House floor manager for some of their legislation, including Senator Marsden's bill to phase out the inhumane practice of fox penning and Senator Petersen's bill to give people more options if a pet store has sold them a diseased animal.


The General Assembly made considerable progress on fixing our mental health system. The need for reform gained attention when the son of Senator Creigh Deeds was ordered into care for a mental health crisis but was then released when no psychiatric bed could be found within the statutory time limit (one of the shortest in the nation). This practice, known as "streeting," ended in the stabbing of Senator Deeds and the tragic death of his son. Several important changes have been made in response. First, the General Assembly has mandated the creation of a real-time psychiatric bed registry (HB1232) so that care coordinators know exactly which local hospitals have space. The amount of time that a person can be held on an emergency custody order has also been increased from six hours to eight hours (HB478) to give care givers more time to coordinate. Most importantly, the General Assembly passed HB293 to create a "bed of last resort" where a state hospital must accept a patient if no other option is available. An additional $5 million was included in the budget to make this possible. Finally, an oversight commission has been established to monitor implementation and to make recommendations for future improvements. One of the key issues that will be reviewed by the commission is whether money that would otherwise be spent on expanding jails should instead be used to enlarge community mental health facilities and programs. Nearly a quarter of local jail inmates have mental health issues, with about half of those being considered serious.  Click here for a report to the Virginia Joint Commission on Health Care.


The Budget and Medicaid


One of the things I am most proud of as a member of the Virginia General Assembly is that we do find common ground and pass balanced budgets in accordance with our constitution. But that does not mean we don't have hard fought battles, and that is what is happening with the issue of whether to accept federal funding to expand Medicaid. Regardless of whether you support or oppose the other provisions of the Affordable Care Act (ACA), the issue here is whether to accept funds to provide health coverage to approximately 400,000 uninsured Virginians who fall into the gap between eligibility for traditional Medicaid and subsidies under the federal health care exchange. These are individuals who typically go without preventive health care and then use emergency services that are absorbed into insurance premiums. The federal government will pay for 100% of the cost for the first three years and then cover no less than 90% of the cost thereafter. By not accepting this funding, we leave about $5 million per day on the table that could be used to cover the cost of health care for Virginans.


Some have argued that we should pass a budget without addressing Medicaid and that these are two separate issues. From my perspective, they are very much intertwined. The proposed House budget, which does not include Medicaid expansion, includes millions of dollars for free clinics and hospital care for the indigent and uninsured that is made necessary only because of the unwillingness to accept the expanded Medicaid funding. For a bit of background, the ACA cut funding for these programs with the idea that these individuals would be served through expanded Medicaid. By not taking the funding, we are then forced to use Virginia's general fund to make up the difference. This means that money is diverted from core services such as education, public safety, etc. There have also been arguments that we shouldn't accept the funding because the federal government has a huge debt. I certainly share the concern about the national debt. However, the ACA increased taxes to cover the cost of Medicaid expansion. As a result, Virginia taxpayers actually get hit twice by not expanding -- once because our tax dollars are going to Washington and not coming back, and then again because our tax dollars are supporting services that would otherwise be covered under Medicaid.


The Senate has come up with a bi-partisan compromise that I hope will serve as the basis for moving forward on this important issue.


Thank you to everyone who emailed, wrote letters, or came to visit me in Richmond during this session. I am blessed to represent such an active community. Please do not hesitate to contact me if you have any questions. I am also happy to meet with interested organizations and community associations.


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David Bulova
Delegate, 37th Virginia House District

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