CHARLESTON, W.Va. -- The state will spend millions of dollars on new group homes, day treatment programs, jobs at psychiatric hospitals and other items associated with mental health care under an agreement reached Thursday.

The state Department of Health and Human Resources, which oversees mental health care in West Virginia, has agreed to remedies with petitioning attorneys in a case that dates back to the early 1980s.

The agreement was accepted Thursday by Kanawha Circuit Judge Duke Bloom, although he has qualms about what he called lack of detail in the order.

"What concerns me in the order is the lack of specificity,'' Bloom said to the two teams of lawyers. "How am I going to keep you guys on track?''

To that end, Bloom ordered the conversion of the Office of the Ombudsman for Behavioral Health, which reports to the state Department of Health and Human Resources, into a court monitor position.

The office was originally designed as a court monitor, and became an ombudsman position after the state had made progress in fixing problems with mental health care.

The overarching case goes back to the early 1980s, and has been periodically reviewed by the court since then.

Bloom wants the court monitor to report back regularly to him on progress in carrying out the remedies agreed to by the state.

One of the major remedies agreed to is a three-year, $15.3 million commitment from the DHHR to build seven new group homes and seven new day treatment centers for people discharged from inpatient psychiatric treatment.

CHARLESTON, W.Va. -- The state will spend millions of dollars on new group homes, day treatment programs, jobs at psychiatric hospitals and other items associated with mental health care under an agreement reached Thursday.

The state Department of Health and Human Resources, which oversees mental health care in West Virginia, has agreed to remedies with petitioning attorneys in a case that dates back to the early 1980s.

The agreement was accepted Thursday by Kanawha Circuit Judge Duke Bloom, although he has qualms about what he called lack of detail in the order.

"What concerns me in the order is the lack of specificity,'' Bloom said to the two teams of lawyers. "How am I going to keep you guys on track?''

To that end, Bloom ordered the conversion of the Office of the Ombudsman for Behavioral Health, which reports to the state Department of Health and Human Resources, into a court monitor position.

The office was originally designed as a court monitor, and became an ombudsman position after the state had made progress in fixing problems with mental health care.

The overarching case goes back to the early 1980s, and has been periodically reviewed by the court since then.

Bloom wants the court monitor to report back regularly to him on progress in carrying out the remedies agreed to by the state.

One of the major remedies agreed to is a three-year, $15.3 million commitment from the DHHR to build seven new group homes and seven new day treatment centers for people discharged from inpatient psychiatric treatment.

The agreement also calls for the health agency to devote at least $1.5 million in state funds to increase Medicaid reimbursement rates for some mental health services.

It also agreed to increase pay for workers at the state's two psychiatric hospitals in Huntington and Weston and end the use there of mandatory overtime and temporary staff in most cases.

Some of those remedies are due to start this month, but petitioning attorney Dan Hedges said the situation is bad enough that it may be some time before improvement can be seen.

"The situation is deteriorating badly,'' he said. "It's probably going to get worse before it gets better.''

The current phase of the case centers on the hospitals in Huntington and Weston. A report by the ombudsman last summer on overcrowding at the Mildred Mitchell-Bateman Hospital in Huntington drew new attention to a problem that state officials say has been getting worse for years.

The petitioning attorneys argued in April hearings that the hospitals are packed with people who can't get access to community-based psychiatric care like group homes or outpatient day programs.

Even though the state and the petitioning attorneys have reached agreement on some issues, there are lingering disputes over some aspects of care. Those include the coverage available to Medicaid recipients in the state's specialized Mountain Health Choices plan and payment for professionals who use telemedicine to treat patients.

Bloom wants a hearing on the latter issue early next week.