The Behavioral Health Commission (BHC) directed staff to conduct ongoing monitoring and evaluation of the System Transformation Excellence and Performance (STEP-VA) initiative in 2023. Launched in 2017, STEP-VA was intended to expand access to high-quality, publicly funded, essential behavioral health services provided by the state’s Community Services Boards (CSBs).

BHC staff used a variety of research methods to evaluate the implementation and performance of STEP-VA, including data analysis, review of program documents and the research literature, interviews, and surveys. BHC staff analyzed data on CSB service utilization, funding, staffing, and performance measures, and reviewed CSB performance contracts, the Code of Virginia, and agency reports. Additionally, staff reviewed relevant documentation including legislative reports, federal guidance on Certified Community Behavioral Health Clinics (CCBHCs), and research literature on behavioral health service delivery models in other states. Interviews were conducted with staff from the Department of Behavioral Health and Developmental Services (DBHDS), CSBs, and other relevant stakeholders. A statewide survey of CSBs was used to gather information on service capacity, barriers to access and recourse needs. (See Appendix A for a detailed description of research methods.)