Gov. Ralph Northam will name a new leader for Virginia’s behavioral health system, as the state prepares for crucial decisions to transform the way it delivers services to people with mental illness, addictions and other behavioral disabilities.

Northam will appoint Dr. Hughes Melton, now chief deputy health commissioner, to lead the Virginia Department of Behavioral Health and Developmental Services.

Melton, a nationally recognized family practitioner and addiction expert from Southwest Virginia, will replace Dr. Jack Barber, a psychiatrist and 30-year veteran who has served as acting behavioral health commissioner for three years.

 

Northam spokesman Brian Coy said the governor thanks Barber “for his dedication and leadership during his time as acting commissioner,” and looks forward to working with both men “to take the next step forward.”

“The governor believes Dr. Melton will build on the outstanding work underway at [the department] to transform Virginia’s mental health system to better serve families and communities in every corner of this commonwealth,” Coy said.

The decision to replace Barber dismayed Sen. Creigh Deeds, D-Bath, who is leading a bipartisan legislative effort to transform a mental health system that has weighed heavily on treatment at state-run institutions, with uneven delivery of community services at the local and regional levels.

“I’m disappointed that Jack wasn’t reappointed,” said Deeds, chairman of the Joint Subcommittee to Study Mental Health Services in the 21st Century. “I had confidence in him and the direction we were going in reforming the system.”

The Northam administration said Melton will carry that work forward, bringing administrative skills that will couple with policy expertise provided by Chief Deputy Commissioner Mira Signer, a former longtime mental health advocate.

“I think that’s a real powerful one-two punch,” Coy said. “This is how we believe we’re going to get the plan executed.”

Melton, who joined the Department of Health two years ago, is, like Northam, a former U.S. Army doctor who won a national award as “family practitioner of the year” in 2011 for his practice in Lebanon, the seat of Russell County. At the Health Department, “he led coordinated efforts to fight addiction across the commonwealth,” the governor’s office said.

With both a medical degree and MBA from the University of Virginia, he founded a family medical clinic, C-Health, that served 18,000 patients in four Southwest Virginia counties over 12 years and an addiction treatment center, HighPower, that served as a model for the state’s Addiction Recovery Treatment Services program under Medicaid. He also served for two years as chief medical officer for Mountain States Health’s Virginia hospitals.

“He brings some timely experience to the table,” Deeds acknowledged. “My main concern is not losing ground.”

That concern is shared by House Appropriations Chairman Chris Jones, R-Suffolk, who helped structure the Deeds panel .

“The timing makes me scratch my head, given the task ahead in transforming Virginia’s behavioral health system,” Jones said Tuesday.

Barber, who worked for 29 years at Western State Hospital, including 16 as its director, had helped Virginia policymakers develop a plan for improving community-based care called STEP-VA, or System Transformation Excellence and Performance in Virginia.

The plan’s goal is uniform availability of behavioral health services in communities across Virginia, including same-day access to treatment at community services boards and behavioral health authorities, and drop-off centers to evaluate people in psychiatric crises without overburdening the law enforcement officers who enforce emergency custody orders.

The changes are crucial to Deeds, whose 24-year-old son, Gus, attacked his father and killed himself in November 2013, less than 13 hours after being released from involuntary custody because the emergency services worker did not find a hospital bed to take him in time.

Subsequently, the General Assembly adopted legislation to lengthen the duration of emergency custody orders while guaranteeing a bed at state mental hospitals if private beds cannot be found in time. The result has been a surge in state hospital admissions under temporary detention orders that has pushed state institutions to near their limit.

Last year, Barber briefed legislators on a new proposal to realign Virginia’s public behavioral health system by working to reduce strain on state hospitals while building more capacity for treating people in their communities, and while shifting state funding to the community level to determine the best way to deliver effective care.

Coy said Melton’s job will be to work with legislators to carry out the plan.

“The design has been done,” he said. “It’s implementation time.”