The Virginia Association of Community Services Boards represents the 40 Community Services Boards in state and federal public policy matters, funding, legislation and regulation. The VACSB has a number of legislative priorities for the upcoming year to support individuals with behavioral health needs and concerns. Two of those priorities are connected to STEP Virginia and Medicaid expansion.
In 2017, the Department of Behavioral Health and Developmental Services introduced the STEP-VA program, which stands for System Transformation Excellence and Performance, to provide a uniform array of services with consistent quality measures offered at local community services boards across the state. The STEP-VA program incorporates a number of “steps” that are tied to best practices of service delivery in behavioral health.
The first “step” is Same-Day Access, which means that any individual can walk through the door at his or her local CSB/BHA and have an initial screening and full assessment that day. Same-Day Access is designed to help make connections and allow treatment to begin more quickly. Region Ten sees around 40 individuals per week for Same-Day Access; however, with four assessment clinicians, there is often not enough capacity to ensure that everyone receives a thorough assessment in a timely manner. The VACSB will be advocating for the staffing infrastructure to support Same-Day Access and other Step Virginia initiatives. Plus, there is proposed legislation to begin offering student loan repayment to help build out the CSB workforce over time.
The second step is a requirement for CSBs to conduct regular primary care screenings to track referral information and link health information back to a medical provider. This is grounded in the integrated health approach to services and involves brief medical screenings for individuals with a diagnosis of serious mental illness. These screenings are intended to foster wellness among individuals with behavioral health disorders.
The third step is providing outpatient services. Unlike Region Ten, many CSBs across the state are not able to provide outpatient services. STEP Virginia would require that these services be offered at all 40 CSBs in Virginia.
The fourth step is to build out a robust emergency services system that would defer individuals from hospitalization. Both the third and fourth steps are underfunded at this time, so there is legislative advocacy in place to request additional funds needed to meet the requirements of these steps.
Additional steps in the future will include peer support, psychiatric rehabilitation services, mental health services for military and service members, case management and care coordination. The Virginia Association of Community Services Boards will continue to advocate for funding so that these services can be built out and individuals ultimately will be able to receive consistent services across the state.
There is further advocacy from the Virginia Association of Community Services Boards to bring funding back to CSBs following the expansion of Medicaid. When Medicaid expansion began in 2019, it was funded through a general fund reduction to CSBs, with the idea that CSBs then would be able to enroll individuals in Medicaid and bill for those services. However, since the expansion began, Region Ten has enrolled 1,800 individuals to services, but only 400 are receiving services, as a result of the lengthy and tedious authorization process. Additional advocacy is therefore needed to help restore funding to CSBs so that we may continue to meet the behavioral health needs of those in our community.
For more information on STEP-VA, go to http://www.dbhds.virginia.gov/developmental-services/step-va.
To see the full list of the VACSB Legislative Priorities, go to https://vacsb.org/advocacy-public-policy/.