A New Lease on Life

What is A New Lease on Life?

A New Lease on Life was a successful $2 million special initiative to provide uninsured Virginians with treatment for basic mental health services, and to provide primary medical care and prescriptions medicines to uninsured Virginians with serious mental illness. It combined the expertise and talents of local health safety net organizations (free clinics, community health centers) and local community services boards to address serious unmet needs through two innovative approaches. The results of their combined efforts can serve as models for other areas of the state, and improve the overall health and well being for many uninsured Virginians who suffer from mental illness.

Who led this initiative?

A New Lease on Life was a collaboration among the Office of the Attorney General of Virginia, the Virginia Health Care Foundation, the Virginia Community Healthcare Association (VACHA), the Virginia Association of Free and Charitable Clinics (VAFCC) and the Virginia Association of Community Services Boards (VACSB).

In February 2009, then Attorney General Bob McDonnell awarded a $1 million challenge grant to VHCF and its partners in order to provide greatly needed care and treatment to Virginians with mental illness. The money for A New Lease on Life derived from settlement funds that Virginia received as part of a multi-state case.

Why was this initiative needed?

Since the decision was made 10 years ago that community services boards (CSBs) should only use their state funds to treat the seriously mentally ill, uninsured Virginians suffering from basic mental illnesses such as depression or anxiety often have nowhere to go.  A growing number have found their way to their local health safety net providers (free clinics, community health centers, and similar providers).

Depression, anxiety, and other mental health conditions have been among the top diagnoses for many patients of Virginia’s free clinics (after diabetes and hypertension).  Likewise, psychosis has been the most frequent diagnosis for uninsured patients admitted to local hospitals with potentially avoidable conditions.

At the same time, while Virginia’s seriously mentally ill can obtain treatment for their mental illnesses from the CSBs, many have no source of basic medical care because they are uninsured.  As a result, various chronic conditions such as diabetes and hypertension, frequent side-effects of psychotropic medications, go untreated. One solution to this problem is a partnership where a local health safety net provider offers primary medical care and related prescription medicines to CSB patients, who are capable of being compliant with doctor’s orders.

How was A New Lease on Life implemented?

The entire $2 million underwrote nine three-year grants throughout the state.  All supported salaries for mental health professionals who are treating depression, anxiety and other basic mental health conditions in Virginia’s free clinics and community health centers.

Each of these initiatives demonstrated collaboration between a health safety net provider and a local CSB, ensures access to needed prescription medications, and expands or establishes the following:

  • Basic mental health services and access to necessary prescription medicines in a health safety net setting for uninsured patients of the health safety net organization and uninsured clients referred by the local CSB; and/or
  • Primary medical care and access to necessary prescription medicines in a health safety net setting for uninsured CSB clients with serious mental illness, who are able to follow a provider’s recommended treatment.

How, specifically, were A New Lease on Life grant funds used?

Organizations providing basic mental health services used grant funds to hire mental health professionals (Licensed Clinical Social Workers, Psychiatric Nurse Practitioners, etc.) to treat uninsured patients suffering from depression, anxiety, and other similar illnesses.  Most of these conditions are biological and can be treated with medication and some disease-management skills that combine teaching about symptom control and problem-solving with supportive listening. Some funds were also used to pay for psychiatric consultations related to appropriate medications.

Those interested in providing medical care to seriously mentally ill clients from local CSBs used the funds to hire necessary medical staff (e.g. Physician, Nurse Practitioner, Physician’s Assistants), and underwrite some related costs, including prescription medications.

Which local initiatives received grant funding through A New Lease on Life?

  • Alexandria Community Services Board and Arlington County Behavioral Health Division and Neighborhood Health
  • Greater Prince William Community Health Center and Prince William County Community Services Board
  • Henrico Mental Health & Developmental Services and CrossOver Ministries Free Clinic
  • Northern Neck Free Health Clinic and Middle Peninsula-Northern Neck Community Services Board
  • Richmond Behavioral Health Authority; Chesterfield Community Services Board; Goochland-Powhatan Community Services Board; The Daily Planet and Goochland Free Clinic and Family Services
  • Colonial Behavioral Health; Lackey Clinic and Olde Towne Medical and Dental Center
  • Danville-Pittsylvania Community Services; Piedmont Access to Health Services and Free Clinic of Danville
  • Eastern Shore Community Services Board and Eastern Shore Rural Health System
  • Rockbridge Area Community Services; Alleghany Highlands Community Services Board; Rockbridge Area Free Clinic and Alleghany Highlands Free Clinic