In its 2011 report to the General Assembly, Item 304.M. “A Plan for Community-Based Children’s Behavioral Health Services in Virginia," the Department of Behavioral Health and Developmental Services (DBHDS) described the comprehensive service array needed to meet the needs of children with behavioral health problems. A survey of community services boards (CSBs) indicated that of all the services in the comprehensive service array, crisis response services, including mobile crisis and crisis stabilization services, were the least available services in Virginia. These services are in short supply at least in part because the expense of such service models that require highly trained clinicians available on a 24/7 basis to respond to crisis situations. Rural CSBs are particularly challenged in supporting these service models. For these reasons, a regional approach was proposed to allow the services to be shared among CSBs . Child psychiatry is an integral part of all crisis response services, and it was also one of the highest-rated needed services in the survey for the 304.M. Plan. DBHDS awarded funding through a request for proposals and application review process to each of the five regions. A map showing the primary DBHDS regional structure can be found in Appendix A. Each region has a lead CSB. The regional leads are:

• Region 1 - Horizon Behavioral Health
• Region 2 - Arlington County CSB
• Region 3 - Mount Rogers CSB
• Region 4 - Richmond Behavioral Health Authority
• Region 5 - Hampton-Newport News CSB

The regions have experienced the most growth in the number of children served through child psychiatry access from one or more of the following psychiatry services: face-to-face visits, telepsychiatry, and consultation with pediatricians and primary care physicians. As the general fund allocation has increased from $1.5 million in FY 2013 to $8.4 million in FY 2017, there has been significant growth in the number of children who received mobile crisis, and crisis stabilization services. Budget language allocates funding to regions based on the availability of services with a report on the use and impact of funding due annually.