From: The Honorable Paul Tonko
Sent By:
Bill: H.R. 4349
Date: 2/18/2016

Dear Colleague,

When an individual is in the midst of a psychiatric or substance abuse crisis, gaining access to effective treatment in a timely fashion can be a life or death matter. In the majority of states, there is currently no standardized system for locating a treatment bed in a crisis situation, leading to overcrowded emergency rooms and creating additional barriers to care for patients. Often, overburdened healthcare workers will simply call each area hospital, one by one, to find an appropriate placement. At its best, this system is inefficient and time-consuming and at its worst can lead to tragic results.

In the highly publicized case of Gus Deeds, son of Virginia State Senator Creigh Deeds, hospital workers were unable to locate an appropriate treatment facility for Gus before his 6 hour emergency psychiatric hold order expired, despite the fact that there were treatment beds available in a nearby county. Gus was sent home without treatment and, the next morning, stabbed his father 13 times and completed suicide.

While many states, including Virginia, have taken steps in recent years to develop real-time bed registries, these systems can be costly to set up and can require capital investment and buy-in from a number of community stakeholders to function as intended. In addition, many of the registries that have been established only contain information about acute care beds and lack information on community and residential resources that could help individuals transition to more appropriate levels of care and free up space in emergency settings.

The Coordinating Crisis Care Act would provide grant funding to states to establish real-time bed registries to assist individuals experiencing a psychiatric or substance abuse crisis. The registries supported by this legislation would include real-time information from psychiatric hospitals, crisis stabilization centers, and residential community resources regarding available beds, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in psychiatric or substance abuse crisis. This grant program is authorized at a level of $15 million annually through FY2020.

While simply creating a bed registry is not a magic bullet for our mental health system, it has proven to be a vital tool in the toolbox that helps patients obtain access to care in a timely fashion. I hope you will join me in supporting this important legislation.


Paul D. Tonko

Member of Congress