Supporting individuals by promoting recovery, self-determination, and wellness in all aspects of life

A life of possibilities for all Virginians

Focus First on Individuals Receiving Services

Our decisions and actions consider first the best interests of individuals who receive services and their families. We respect the potential and capacity of each individual who receives services. We value and support the healing and recovery process.

Accountability and Oversight

We take seriously our responsibility to provide oversight and accountability throughout Virginia’s public behavioral health and developmental system to ensure individuals receive timely access to quality, consistent services.

Responsiveness to External and Internal Customers

We seek input and involvement from our customers. We share ideas and remain open to different opinions. We listen to and respect what our customers say and respond promptly to their requests.

Partnership and Collaboration

We create opportunities for partnerships, encourage teamwork, and support each other to succeed. We accept shared ownership and seek win-win (mutually acceptable) solutions. We communicate openly and clearly. We are willing to take risks as we look for creative solutions and new ways of solving problems. We make decisions and resolve problems at the level closest to the issue.

Professionalism, Integrity, and Trust

We recognize and celebrate individual and team successes. We use valid data that reflect best practices and positive results and outcomes. We take responsibility for ourselves, for our actions, and for how these actions affect others. We develop a supportive learning environment and work continuously to improve the quality of the services we provide. We keep our word and deliver what we promise. We incorporate our values into everyday decisions.

Stewardship

We protect the assets and interests of the entire services system. We value and take care of staff. We use the Commonwealth’s resources in the most effective and efficient manner.

The Department of Behavioral Health and Developmental Services (DBHDS) provides funding to the 39 community services boards and one behavioral health authority (referred to as CSBs), which serve as the single point of entry for public behavioral health and developmental services in Virginia. Although part of the DBHDS system of care, CSBs are established by the 133 local governments in Virginia and may serve single or multiple jurisdictions. CSBs are key operational partners in Virginia’s public behavioral health and developmental services system and their relationship with DBHDS is based on the community services performance contract, provisions of Title 37.2 of the Code of Virginia, State Board policies and regulations, and other applicable state or federal statutes and regulations. Services provided by all CSBs are licensed by DBHDS.

DBHDS is working with CSBs and other community service providers to:

• Implement recovery and resiliency principles and recovery support services across Virginia;


• Expand access to and availability of evidence-based and best practice behavioral health care, including same-day access, integrated behavioral and physical health approaches, trauma-informed services for all individuals and families, comprehensive and integrated children’s programs, community-based services appropriate to support individuals being discharged from state hospitals such as Programs  of Assertive Community Treatment and Permanent Supportive Housing, additional drop-off centers to provide an alternative to incarceration for individuals with serious mental illness, additional mental health inpatient treatment purchased in community hospitals, and expansion of psychiatry services;


• Provide flexible and individualized developmental services and supports that keep families intact and reduce the need for costly out-of-home placements, including enhanced case management/care coordination, crisis services for adults and children and adolescents  with developmental disabilities, and expanded opportunities for integrated housing and competitive employment, and assist in increasing and improving capacity in the community;


• Implement STEP-VA: System Transformation Excellence Performance; an initiative to ensure the availability of core services to be available in every region of the Commonwealth, including a comprehensive crisis system.


• Improve service provider transparency and accountability through the community services performance contract with CSBs and finance and program reviews of CSBs, DBHDS licensing of services and human rights protections, risk management and quality improvement processes, and monitoring provider performance and outcomes.

The 40 CSBs maintain their own information technology (IT) systems or these systems are maintained by their local governments. However, they do rely on DBHDS central office for core reporting applications such as the Community Automated Reporting System (CARS) to provide semi-annual reporting on performance contract financial metrics, the Community Consumer Submission (CCS3) application to report demographic, clinical, and services data monthly on the more than 216,000 individuals who receive services from CSBs, and the new Waiver Management System (WaMS) for Medicaid Developmental Disability waiver enrollments, service authorizations, and determinations regarding retaining slots. 

The Virginia Department of Behavioral Health and Developmental Services seeks to implement a Grants Management system utilizing the Dulles Technology contract for the purposes of facilitating the application, review, approval, and distribution of grant payments to Virginia CSBs, Non-CSB providers, and BHAs and report on the grant application and funds distribution processes. The Department currently uses traditional processes to collect, review, approve and report on the application and funds distribution processes. Incorporating automation into the grant application and review process will enable CSBs and Non-CSBs to seamlessly apply for and receive approval for grants, submit invoices and report on expenditures. It will enable the DBHDS team to collect, track, monitor, and report on key funding metrics at both the state and federal levels and service any public records requests. Additionally, once implemented, this Grants Management solution can also be modified to create, manage and track additional grant types and future solicitation rounds. DBHDS will use the Dulles Technology Partners Grants Management System state contract. 

Eliminating as much double entry as possible between CSB systems and DBHDS systems improves efficiency and reduces errors in the information that appear in multiple records. However, because WaMS is also an authorization system designed to be accessed by providers, case managers, and authorization staff, case managers (and CSBs with direct services) will have to work in two systems (WaMS and local electronic health record systems). The effort to create a method for data exchanges between WaMS and CSB electronic health record systems (EHRs) is compounded by the diverse nature of the different business functions across CSBs, and the cost of the data exchange may not be offset by productivity gains by the users. 

While most CSBs have in-house IT staff, some CSBs do not. This poses challenges to those CSBs, particularly regarding data quality and using data for management purposes. The added data reporting requirements associated with the DOJ Settlement Agreement are imposing significant workload burdens on CSB IT systems as well as service staff. 

Statewide service and financial data are not readily available to CSBs, in part due to the absence of a statewide data sharing environment accessible to CSBs. The DBHDS IT approach to solving this problem is two-fold. First, the DBHDS OneSource Data Warehouse has the capability of acting as a reporting and analytics platform for the CSBs. Second, web service-based data exchanges have been developed to automate the sharing of data between CSB and DBHDS systems, most notably in the Infants and Toddlers Online Tracking System (ITOTS). DBHDS IT intends to extend this approach by coordinating CSB use of OneSource with the DBHDS Quality Management division, and by adding additional data exchanges to connect the CSB system to other DBHDS central office applications. 

The Waiver Management System (WaMS) including the Department of Justice Settle Agreement enhancements and the Medicaid Enterprise System (MES) project provides updates and enhancements. A mandated major update to DMAS’ system is currently underway which requires significant changes to the DBHDS WaMS system. This is being accomplished by implementing the WaMS DOJ/MES update which includes adding modules to the WaMS System for better waiver management. 

The Early Intervention Part C Data System, TRAC-IT, is replacing the Infant and Toddler Online Tracking System (ITOTS). The existing Part C early intervention data system, ITOTS, was developed and implemented in 2001 primarily to meet annual federal reporting requirements related to child data. The system provides data on who is getting services and includes the number of children by the local system, race/ethnicity, gender, age, and the reason for eligibility. ITOTS allows for the collection of data on the services planned on each child’s initial IFSP. However, ITOTS does not collect the data or generate the reports that are needed to allow for ongoing monitoring at the state and local levels. ITOTS is also incomplete in terms of data and reporting needed for fiscal monitoring and for program improvement planning.

Crisis Call Center (STEP VA) Create a statewide call center data platform that can be used both by CSB staff (potentially a subcontracted private provider), private and state hospital staff, as well as Central Office staff. This is to assure the collection of caller information from those in crisis (demographics) along with dispatch and monitoring functionality (GPS enabled), linking to other services, maintaining a real-time bed registry, and text and chat function. 

Incorporating the Individual and Family Support Program (IFSP) into the WaMS application will help enable the families and individuals who are on Virginia’s DD waiver waitlist to apply for funds to cover the cost of a variety of items that will help that individual who is living in a community setting. The need is for a secure and stable website that is robust and able to send, receive and process up to 20,000 DD waiver waitlist client applications for funding assistance.  

The CONNECT project is licensing reengineered. Under the terms of the federal Department of Justice settlement agreement, the Department of Behavioral Health and Developmental Services (DBHDS) must collect and report data relating to compliance with the agreement. DBHDS issued a Request for Proposal to purchase and customize a licensing system for the storage, aggregation, and reporting of this data. The DBHDS Division of Licensing obtained approval to procure and customize a Commercial-off-the-Shelf (COTS) Licensure product to support the newly re-engineered DBHDS Licensing process, required by the federal DOJ settlement agreement. This is aimed at providing consumer services in the least restrictive environment and ensuring framework growth for the future.

Operating CSBs and the BHA maintain their own human resources management and development systems, while administrative policy boards are part of their local government systems. Many CSBs, especially those not part of local governments, face continuing challenges in attracting and retaining well-qualified staff due to a lack of resources for adequate compensation. Additionally, some rural CSBs face special challenges in attracting staff to their areas. CSB recruitment and retention issues were substantially impacted by the pandemic. Vacancy rates for positions across CSBs have been so significant that some programs have been shuttered.

Staffing

Operating CSBs and the BHA maintain their own buildings. Ownership and leasing arrangements vary for the group homes funded through DBHDS and constructed for individuals with intellectual disabilities. DBHDS has also worked with CSBs to build transitional homes for individuals being discharged from state hospitals.

DBHDS Executive Progress Reports. See Department of Behavioral Health and Developmental Services (720); Mental Health Treatment Centers (792); Intellectual Disabilities Training Centers (793); and Virginia Center for Behavioral Rehabilitation (794).

Several factors will have a significant effect on community services providers over the next four years.

• Workforce:  An inability to recruit and retain staff is the single greatest threat to CSB operations at this time. While many health care settings have suffered loss of staff during the pandemic, behavioral health and developmental disability services have been particularly hard hit. Many local CSBs have had extreme challenges finding enough staff to operate their programs.


• Inadequate behavioral health service capacity: Although mental health is a crucial component of individual and community wellness, access to needed community behavioral health services varies significantly across the state. Service availability is limited by notable gaps in important basic services such as crisis, emergency, acute inpatient, outpatient, case management, and psychiatry services and recovery-focused housing and employment supports. In particular, the prevention and early intervention system are underdeveloped and very few targeted investments in recent years went to early intervention. Even with funds provided by the General Assembly during the last several sessions to complete initial funding of all STEP-VA services, continued investments in innovative, evidence-based mental health and substance use disorder services programs, particularly trauma-informed crisis management and interventions focused on prevention and early intervention, are needed to address capacity issues.


• Inadequate developmental service capacity: To meet the requirements of the Commonwealth’s settlement agreement with the U.S. Department of Justice (DOJ), a major expansion of new or enhanced waiver slots, work and housing supports, and crisis services are required to support individuals who are living in the community and those who are transitioning from training centers to the community.  As of August 2022, there were 13,903 individuals on the Medicaid developmental disability waiver waiting list.


• Continuing Opioid Epidemic: Virginia’s Chief Medical Examiner recently reported preliminary numbers for 2021 that showed 15% more overdose deaths in 2021 than in 2020; this is on top of a 63% increase in overdose deaths from 2019 to 2020. By 2022, fentanyl contributed to 77% of all overdose deaths.

Community service boards (CSBs) are funded with general and federal funds. Federal funds are derived from block grants (Substance Abuse Prevention and Treatment and Community Mental Health Services), other grants for substance abuse and mental health services, and Early Intervention grant funds for infants and toddlers with developmental delay.

CSBs also receive funds from other sources such as local funds, Medicaid, other fees, and other revenues.  These funds are not appropriated to CSBs and, therefore, are not included in these tables. 

Revenue collections are from various federal grant funds including the Substance Abuse Prevention and Treatment (SAPT) and the Community Mental Health Services (CMHS) block grants funded by the Substance Abuse and Mental Health Administration (SAMHSA); Part C Early Intervention grant funds for infants and toddlers with developmental delays; and other grants for SA and MH services. Additionally, the department was awarded funds from the American Rescue Plan Act (ARPA). These funds were appropriated by the General Assembly for specific purposes as one-time funds only. 

 The following statistics provide a snapshot of CSB operations:

Anticipated Changes to Customer Base

Virginia's population is increasing, becoming more culturally diverse, and growing older.  The customer base for community mental health, developmental, and substance use disorder services is expected to change to reflect these demographic trends.  Proportionately greater numbers of individuals seeking community services will have:

• significant or complex needs or will experience serious medical conditions or behavioral challenges requiring specialized services and supports;


• co-occurring combinations of mental illness, substance use disorders, or intellectual or other developmental disability; or


• Involvement with the criminal justice system.

Increasing numbers will be veterans experiencing behavioral health issues or individuals with older caregivers who will require community developmental services to enable them to continue to reside in their homes or other community settings.

Community mental health, developmental, and substance use disorder services provided by or through CSBs include:

• Emergency services;


• Acute psychiatric and substance use disorder inpatient services, including medical detoxification;


• Outpatient services, including counseling and psychotherapy, medication services, intensive outpatient substance use disorder services, intensive in-home services, assertive community treatment, medication-assisted treatment, and behavior management;


• Case management services;


• Day support services, including day treatment or partial hospitalization, ambulatory crisis stabilization, rehabilitation, and habilitation; Employment services, including individual supported, group supported, and sheltered employment;


• Housing and residential services, including highly intensive - residential treatment centers, residential detoxification, and intermediate care facilities for individuals with intellectual disability; residential crisis stabilization; intensive - group homes, primary care, intermediate rehabilitation, and long-term habilitation; supervised - supervised apartments, domiciliary care, emergency shelter or respite, and sponsored placements; and supportive - supported living arrangements, permanent supportive housing and housing subsidies;


• Prevention services; and


• Ancillary services, including motivational treatment, consumer monitoring, assessment and evaluation, and early intervention services.

Most, but not all CSBs provide Medicaid waiver services, Part C services, and peer support specialist services.

The Individual and Family Support Program (IFSP) provides funds to eligible individuals with developmental disabilities on waiver waiting lists and their families to purchase a wide array of supports, services, and other assistance that enable individuals to continue to live at home.

In addition, in 2017, the General Assembly required that the CSBs implement System Transformation, Excellence and Performance (STEP-VA) services:

• Same Day Access,


• Primary Care Screening and Monitoring


• Outpatient Behavioral Health


• Behavioral Health Crisis Services


• Psychiatric Rehabilitation


• Peer/Family Support Services


• Veterans Behavioral Health


• Care Coordination


• Targeted Case Management (Adults and Children)

Important measures of performance of community behavioral health and developmental services involve the intensity of case management services and the retention of individuals in substance use disorder services.

• Active engagement of individuals in case management services allow case managers to observe and assess individuals’ needs and preferences; ascertain if supports and services are being implemented appropriately; and determine if supports and services remain appropriate or should be changed.

• Intensity of engagement by adults with serious mental illness in mental health case management services is measured by the percentage of individuals who received at least four hours of services within 90 days of admission.

• The provision of in-home developmental case management services to specific groups receiving face-to-face visits under the settlement agreement with the U.S. Department of Justice reflects the degree to which individuals are actively engaged.

• One of the principles of effective treatment of substance use disorders is that an individual's involvement in ongoing treatment significantly reduces or stops drug use and that the best outcomes occur with longer durations of treatment. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment. Retention in services is measured by the percentage of individuals admitted to substance use disorder services during the past year who remain engaged for at least six months.

Community services boards (CSBs) are established by the 133 local governments in Virginia under Chapters 5 or 6 of Title 37.2 of the Code of Virginia and may serve single or multiple jurisdictions. Chapter 5 of Title 37.2 authorizes the establishment and operation of CSBs by local governments to provide community behavioral health and developmental services and authorizes DBHDS to fund CSBs. Chapter 6 of Title 37.2 authorizes the establishment and operation of a behavioral health authority (BHA) by a specified city or county to provide community behavioral health and developmental services and authorizes DBHDS to fund a BHA. CSBs provide services directly and through contracts with private providers, which are vital partners in delivering behavioral health and developmental services. As the single point of entry into publicly funded behavioral health and developmental services, CSBs provide access to state facility services through preadmission screening, case management and coordination of services and supports, and discharge planning for individuals leaving state facilities. This goal transforms and strengthens community behavioral health and developmental services by incorporating core principles of recovery and resilience for individuals with mental illnesses or substance use disorders and self-­ determination for individuals with developmental disabilities.

This objective supports the statewide implementation of behavioral health initiatives that promote recovery support services and increase use of peers in direct service roles. It also facilitates the realization of a more person-­focused and needs-­based system of developmental services and supports that build on the individuals’ strengths, preferences, and goals.

• Implement a Recovery Oriented System of Care (ROSC) in which services and supports are provided in the most integrated settings, not separated from the communities in which individuals live and in the least restrictive manner, by a fully integrated and trained workforce, including peers and other providers.

• Increase the statewide availability of a consistent array of community behavioral health services that promote recovery and resilience, self­ determination, and community participation.

• Expand family supports and other initiatives that allow individuals receiving developmental services and supports to have control over how their service dollars are spent.

• Train and support public and private behavioral health providers aimed at increasing their use of peer support specialists and promoting effective collaborations with independent peer programs.

• Develop and expand a wide range of recovery­ oriented peer services and peer provided recovery supports delivered through CSBs and peer­operated programs.

• Increase the basic knowledge and competency of public and private behavioral health services providers in the use of recovery evidence­based and best practices, including psychiatric advance directives.

• Expand opportunities for individuals and their families to participate as partners in all aspects of service planning, delivery, and evaluation.

• Engage in and collaborate with community stakeholders (social services, schools, medical community, corrections, and employers) in developing and supporting recovery-­focused communities.

• Train and support behavioral health services providers in the integration of recovery values, principles, concepts, and language into services policies, processes, and structures.

• Support community ­based prevention planning coalitions at the local level to implement strategies that reduce exposure to risk and enhance protective factors.

This goal envisions statewide availability of a consistent array of individualized, person-­centered, and family-focused behavioral health and developmental services and supports that enable individuals to participate as fully as possible in all aspects of community life. No matter where they may live in Virginia, people will have access to quality, consistent behavioral health and developmental services that exemplify clinical and management best and promising practices. Services and supports are centered on the individual’s unique needs and strengths and provided as close to the individual’s home and natural supports as possible. This includes supports that incorporate the needs of the whole individual, from medical care to housing and employment.

Individuals experiencing substance use disorders often enter recovery and live productive, self directed lives in their communities. This objective supports easy access to and expansion of community substance use disorder services that promote recovery and support individuals to attain their highest achievable level of health and wellness. Regardless of where they live in Virginia, people should have timely access to a consistent array of quality substance use disorder prevention and early intervention services that prevent or reduce the need for more intensive interventions.

• Develop and implement same day access for assessment and treatment planning for outpatient substance use disorder services in each CSB.

• Increase the array of substance use disorder services in all communities to a consistent and need-based level, including medication assisted treatment, intensive outpatient services, case management, medically managed withdrawal (detoxification) beds, and residential treatment for pregnant women and women with dependent children and services for special populations such as individuals with co-occurring behavioral health issues, older adults, and individuals involved with the criminal justice system.

• Develop community treatment and support services tailored to divert young (juvenile and young adult) nonviolent offenders from incarceration and provide treatment to those who are released back to the community.

• Expand access to and availability of specialized services and supports for individuals with substance use disorders such as peer support, vocational rehabilitation counseling, safe and sober housing, medical services, and transportation.

• Enhance the core competencies of persons delivering substance use disorder services including case managers, clinicians, and clinical supervisors. Evidence-based and best practices will be used by service providers wherever applicable and appropriate.

• Support community­-based prevention planning coalitions at the local level to implement strategies that reduce exposure to risk and enhance protective factors.

Individuals experiencing mental illness often enter recovery and live productive, self ­directed lives in their communities. This objective supports easy access to and expansion of community mental health services that promote recovery and support individuals to attain their highest achievable levels of health and wellness. Regardless of where they live in Virginia, people should have timely access to a consistent array of quality mental health prevention and early intervention services that prevent or reduce the need for more intensive interventions. Individuals in crisis and those with severe or complex conditions should be able to access services easily at the appropriate level of intensity and in the least restrictive environment geared towards preventing or reducing the use of more intensive interventions such as hospitalization or involvement in the public safety system.

• Increase access to prevention and early intervention supports that are integrated with family, the community, and other human services supports.

• Develop and implement same day access for assessment and treatment planning for outpatient mental health services in each CSB.

• Increase the array of mental health treatment services for adults and children in all communities to a consistent and need-based level in all communities including case management and intensive case management, outpatient counseling, in­home supports, psychiatric services and medication management, psychosocial rehabilitation, peer support, and wrap­around services. Evidence-based treatment programs and best practices will be developed and implemented based on the needs of individual communities. This may include Programs of Assertive Community Treatment (PACT), Dialectical Behavioral Therapy (DBT), and Multi-systemic Therapy (MST). Appropriate treatment for special populations will be included such as individuals with co-occurring behavioral health issues, transition-age youth (ages 16-25), veterans, older adults, and individuals involved with the criminal justice system.

• Expand access to and availability of specialized services and supports for individuals with mental illness such as peer support, vocational rehabilitation counseling, safe and affordable housing, medical services, and transportation.

• Increase access to an adequate and more consistent array of emergency, crisis stabilization, psychiatric evaluations, CIT Assessment Centers for law enforcement, and local purchase of inpatient psychiatric hospital beds.

• Implement new service initiatives that include child psychiatry through face-­to-­face telepsychiatry and consultation to pediatric and primary care providers.

• Enhance the core competencies of persons delivering mental health services including case managers, clinicians, and clinical supervisors. Evidence-based and best practices will be used by service providers whenever applicable and appropriate.

• Expand the array and capacity of jail diversion services, including pre­and post­booking, pre­trial alternatives, and community treatment services that prevent or divert individuals from incarceration.

• Expand outpatient restoration services to assure that defendants receive appropriate active treatment to restore competence in jails and community settings and providing funds for outpatient restoration services.

• Expand jail ­based behavioral health services that reduce demand for secure forensic treatment and prevent re­hospitalization of inmates.

• Support local law enforcement interventions to prevent individuals who are in crisis from involvement in the criminal justice system by providing Crisis Intervention Team (CIT) training and promoting CIT program development and outcomes, and develop local action plans.

• Support the development of community alternatives, including transitional housing, to improve the flow ­through of Not Guilty by Reason of Insanity (NGRI) acquittees and decrease their need for prolonged hospitalization.

• Collaborate with community providers of aging services and community organizations to raise awareness of the behavioral health service needs of older adults and develop a comprehensive, community-based array of specialized services for older adults in Virginia.

• Provide specialized training to CSB clinicians on challenges confronting veterans and their families, including PTSD and the behavioral health effects of traumatic injuries.

• Implement a children’s behavioral health workforce development initiative to increase consistency in public and private providers’ knowledge and skills and support implementation of the comprehensive service array in a manner consistent with best practice standards.

• Expand CSB partnerships and cross­referral networks with free clinics, federally funded health centers, and other providers of primary health care services.

This objective supports expansion of community-based developmental services and supports that promote community integration and self-determination and enable individuals to attain their highest achievable levels of health and wellness. These services and supports:
• Are provided in the most integrated settings appropriate to the needs of individuals;
• Are consistent with the informed choices of these individuals; and
• Offer opportunities for individuals to engage in meaningful activities and to experience integration in all aspects of their lives (e.g., living arrangements, work and other day activities, access to community services and activities, and opportunities for relationships with members of the community beyond paid staff).

• Expand community-based developmental services and support pursuant to implementing and meeting the timelines filed with the oversight federal Judge as negotiated with the U.S. Department of Justice.

• Expand housing options for individuals with developmental disabilities who fall within the DOJ Settlement Agreement target population and related independent living supports options to achieve the goals set forth in the independent living plan.

• Create opportunities that emphasize integrated and supported employment for individuals with intellectual disability.

• Expand the adult developmental disability crisis program to provide as needed 24/7 support 24 hours per day and seven days per week to include two transitional houses.

• Expand crisis services to individuals under 18 years of age with intellectual or developmental disabilities with the addition of two child REACH homes, crisis respite services, and additional in-home supports.

• Develop community respite alternatives for children and youth in crisis with behavioral challenges.

• Enhance the core competencies of persons who provide case management services to promote consistency in the practice of case management across Virginia in the areas of housing, independent living, accessing the Building Independence waiver, and using the proposed planning calendar and service packages to facilitate critical conversations with individuals and their families or guardians or authorized representatives.

• Expand Part C early intervention services for infants and toddlers (ages 0­3) and their families to prevent or alleviate later developmental or learning problems.

• Assist individuals on the Medicaid DD waiver wait lists and their families to access resources, supports, services, and other assistance through the Individual and Family Support Program by completing the change to a model family supports program.

• Improve the quality and effectiveness of developmental services through strengthening the capacity and competency of the provider community.

• Support efforts with partners to provide information to the public, DD provider, and law enforcement about autism spectrum disorders, offer ongoing education and additional training, and expand access to early diagnosis and intervention resources.

Community Substance Abuse Services funds public community substance­use disorder treatment services provided by 39 community services boards and one behavioral health authority, hereafter referred to as CSBs, throughout Virginia. CSBs also offer prevention services that are aimed at substantially reducing the incidence of alcohol, tobacco, and other drug dependency and abuse. These services are integrated with other direct services and supports at the local level for individuals with special needs or those receiving services from multiple agencies, including adults and children or adolescents with co­occurring disorders such as mental illness and substance­ use disorders, and individuals who are hospitalized or involved in the criminal justice system.

Community substance­use disorder services support the statewide implementation of services that promote recovery and build on individuals' strengths, preferences, and goals.

• Emergency services;


• Acute substance-use disorder inpatient services, including community-based medical detoxification inpatient services;


• Outpatient services, including counseling and psychotherapy, intensive outpatient services, and medication-assisted treatment;


• Case management services;


• Day support services, including ambulatory crisis stabilization, rehabilitation, and day treatment or partial hospitalization;


• Residential services, including supportive (e.g., supported living arrangements and housing subsidies, supervised (e.g., supervised apartments, and emergency shelter or respite), intensive (e.g., primary care, intermediate rehabilitation, and long–term habilitation, and group homes), crisis stabilization, and highly intensive (e.g., detoxification) services;


• Prevention services; and


• Limited services, including motivational treatment, consumer monitoring, assessment and evaluation, and early intervention services.

This service area is funded with general and federal funds. The federal funds are from the Substance Abuse Prevention and Treatment (SAPT) Block Grant that is passed through to community programs. In 2020 Virginia was awarded nearly $52.6 million to fight the opioid epidemic and stimulant use, which will be invaluable as we fight the many impacts of COVID-19. CSBs also receive funds from other sources such as local funds, Medicaid, other fees, and other revenues which are not appropriated to CSBs and are not included in this table. 

Community Mental Health Services funds public community mental health services provided by 39 community services boards and one behavioral health authority, hereafter referred to as CSBs, throughout Virginia. CSBs also provide preadmission screening of all requests for involuntary inpatient treatment in state hospitals or other facilities. Each CSB provides discharge planning for all individuals who reside or will reside in cities or counties served by the CSB before they are discharged from state hospitals.

Community mental health services are integrated with other direct services and supports at the local level for individuals with special needs or those receiving services from multiple agencies, including children or adolescents and their families, persons with co­occurring disorders such as mental illness and substance use (alcohol or other drug dependence or abuse) disorders, and adults or children who are hospitalized or involved in the criminal justice system.

Several consumer­-run, non­profit organizations provide a few direct services under separate contracts with the Department.

This service area also funds CSBs to support the implementation of conditional release orders, pursuant to § 19.2­182.7 of the Code of Virginia, for individuals who have been acquitted by reason of insanity.

Community mental health services support the statewide implementation of services that promote recovery and build on individuals' strengths, preferences, and goals.

• 
  Emergency services;


• 
  Acute psychiatric inpatient services;


• 
  Outpatient services, including counseling and psychotherapy, medication services, intensive in-home services, and assertive community treatment;


• 
  Case management services;


• 
  Day support services, including ambulatory crisis stabilization, rehabilitation, and day treatment or partial hospitalization;


• 
  Employment services, including individual supported, group supported, and sheltered employment;


• 
  Residential services, including supportive (e.g., supported living arrangement and housing subsidies, supervised (e.g., supervised apartments, domiciliary care, emergency shelter or respite, and sponsored placements), intensive (e.g., group homes), crisis stabilization, and highly intensive (e.g., residential treatment centers) services;


• 
  Prevention services;


• 
  Limited services, including consumer monitoring, assessment and evaluation, and early intervention services; and


• 
  Consumer-run services.

This service area is funded with general and federal funds. The federal funds are from the Community Mental Health Services (CMHS) Block Grant that is passed through to community programs. CSBs also receive funds from other sources such as local funds, Medicaid, other fees, and other revenues which are not appropriated to CSBs and are not included in this table.

Community Developmental Disability Services funds public developmental services provided by 39 community services boards and one behavioral health authority, hereafter referred to as CSBs, throughout Virginia. CSBs also provide preadmission screening of all requests for admission to training centers. Each CSB provides discharge planning for all individuals who reside or will reside in cities or counties served by the CSB before they are discharged from training centers.

Community developmental services are integrated with other direct services and supports at the local level for individuals with special needs, those receiving services from multiple agencies, and individuals with co­-occurring disorders such as an intellectual disability and a mental health disorder or an intellectual disability and a substance use (alcohol or other drug dependence or abuse) disorder.

This service area includes infant and toddler intervention (Part C) services, which are provided through contracts with local lead agencies (LLAs) across Virginia. LLA councils include representatives from a variety of agencies, including CSBs, serving infants and toddlers eligible for services under the Part C program.

Community developmental services support the statewide implementation of services that build on the strengths, preferences, and goals of individuals receiving services and promote inclusion and participation in all aspects of community life, including work, school, family, and other meaningful relationships.

• Emergency services;


• Outpatient services, including behavior management and medication services;


• Case management services;


• Day support services, including habilitation;


• Employment services, including individual supported, group supported, and sheltered employment;


• Residential services, including supportive (e.g., supported living arrangement and housing subsidies, supervised (e.g., supervised   apartments, domiciliary care, emergency shelter or respite, and sponsored placements), intensive (e.g., group homes), crisis stabilization, and highly intensive (e.g., community intermediate care facility (ICF) for individuals with intellectual disability) residential services;


• Prevention services;


• Individual Family Support Program (IFSP)


• Limited services, including consumer monitoring, assessment and evaluation, and early intervention services;


• Medicaid Intellectual disability waiver services; and


• Infant and toddler intervention (Part C) services.

This service area includes general and federal funds. The federal funds are from the Program for Infants and Toddlers with Disabilities (Early Intervention) grant passed through to community programs as well as funds from the DOJ trust fund. CSBs also receive funds from other sources such as local funds, Medicaid, other fees, and other revenues.  These funds are not appropriated to CSBs and are not included in the Appropriation Act and, therefore, are not included in the following table.