Over the past several years, Virginia has been making concentrated and meaningful efforts to reform its strained public mental health system. In an effort to improve the system, the Department of Behavioral Health and Developmental Services (DBHDS) worked with the McAuliffe and Northam Administrations, the General Assembly, and stakeholders and drew from national best practices to design System Transformation Excellence and Performance (STEP-VA). STEP-VA focuses on improving access, quality, consistency, and accountability in public mental health services across Virginia. STEP-VA requires all community services boards (CSBs) to provide the same services, such as same day access, primary care screening, outpatient services for mental health and substance use disorders, targeted case management, crisis services, and other critical services. These essential services will be available consistently across all 40 CSBs. In addition to requiring a uniform set of services across all 40 CSBs, STEP-VA also requires consistent quality measures, and improved oversight in all Virginia communities, through investing in CSB and DBHDS infrastructure. STEP-VA services are intended to foster wellness among children and adults with behavioral health disorders and prevent crises before they arise. STEP-VA is also intended to provide critical support for individuals at risk of incarceration, those in crisis and those in need of stable housing. Statewide impact following full implementation is expected to be impressive: fewer admissions to state and private hospitals, decreased emergency room visits, and reduced involvement of individuals with behavioral health disorders in the criminal justice system.

In 2018, the General Assembly provided funding for all 40 CSBs to implement the first STEP-VA service, Same Day Access, which had been funded for 18 CSBs the prior year. The General Assembly also provided funding for Primary Care Screening, Outpatient Services (FY20), Detox Services (FY20), and Mobile Crisis Services (FY20).

Primary activities during SFY19 related to the implementation of Same Day Access (SDA) and Primary Care Screening, as well as planning for the implementation of Outpatient Services, Crisis Services, and other steps. This report details progress during SFY19 related to: disbursement of funds, planning and implementation for SDA and Primary Care Screening across all 40 CSBs, progress on statewide behavioral health needs assessment and founding of the State Transformation Advisory Council (STAC), as well as planning for Outpatient Services, Crisis Services and other steps. This report concludes with future directions and an overview of activities for SFY20.