Community Services Boards and the Behavioral Authority (CSBs and the BHA)
39 CSBs and the BHA in Virginia provide programs and services that
- Insure the growth and development of infants who are or at risk of development disabilities, birth to age three, as well as supporting their families.
- Enable children and youth with mental illness, intellectual disability and substance use disorders to remain in their homes, schools and communities.
- Respond to psychiatric emergencies, 24 hours a day.
- Promote resiliency in youth and communities through prevention and education activities.
- Meet the residential, outpatient, employment, and day support service needs of individuals with severe mental illness.
- Offer opportunities for occupational and residential independence for individuals with intellectual disability.
- Effectively treat individuals with substance use disorders.
- Support the efforts of schools, Departments of Social Services, law enforcement agencies and courts in a coordinated manner.
- Prevent further incidence of mental illness, intellectual disability, substance use disorders.
- Support the care of older adults with intellectual disability, mental illnesses or substance use disorders and their families.
- Assist families in caring for members with mental illness, intellectual disability, and substance use disorders.
CSBs and the BHA are established by local governments pursuant to the Code of Virginia beginning in 1968.
The Virginia Code requires that every city or county establish or, with other cities or counties, establish a CSB. CSBs and the BHA are responsible for assuring, with resources, the delivery of community-based mental health, developmental, and substance abuse services to individuals with mental health or substance use disorders, intellectual disability, or co-occurring disorders.
- Emergency services and case management are Code-mandated services;
- All services are funded by the Department of Behavioral Health and Developmental Services (DBHDS), the Department of Medical Assistance Services (DMAS), and other human services agencies.
- CSB/BHA services are licensed by DBHDS, subject to the DBHDS Human Rights Regulations and to state and local Human Rights Committees. DBHDS, under the oversight of DMAS, has specific roles in the operation of the Medicaid ID Waiver. All CSBs and the BHA have provider agreements with DMAS for Clinical, Rehabilitation, and ID Waiver services.
- Services are delivered through a network of CSBs and the BHA, private providers, and other public providers, licensed by DBHDS. Many of these providers also have provider agreements with DMAS.
- CSBs and the BHA have agreements with local human services agencies, sheriffs and courts.
CSBs and the BHA have Appointed Board Members.
- Approximately 530 board members are appointed by local governing bodies to serve on CSBs or the BHA. They are local officials, responsible for the services in their localities and directly represent the community.
- The duties and accountabilities of Board members are prescribed in the Code of Virginia as well as the responsibilities and accountability requirements for CSB/BHAs. The Code requires that one-third of the Board members of each CSB or the BHA are individuals receiving services or family members of individuals receiving services.
- One city in Virginia fulfilled the requirement to establish a CSB by creating a city department of behavioral healthcare services with a policy-advisory CSB.
- CSB and the BHA employ over 12,000 full-time equivalent staff statewide. Each individual is a public employee, many are on call 24/7, and accountable to their Boards and localities for their actions and decisions.
CSBs and the BHA have Performance Contracts with DBHDS.
- Performance contracts specify the services to be provided by the CSB or BHA and the costs of those services, include all revenues used to support the services, list state and federal statutory and regulatory requirements applicable to the CSB or BHA, and contain outcome and performance measures for the CSB or BHA.
- Each CSB or the BHA submits its performance contract to the city councils or boards of supervisors that established it for review and approval.
- As part of the Code requirement for comprehensive planning, DBHDS, CSBs and the BHA and state facilities engage in planning and data activities that produce the DBHDS Comprehensive Plan.
- Such planning translates to provisions in the Performance Contract for services for children and adults, many of whom are eligible for Medicaid and Medicaid Intellectual Disability Waiver services.
CSBs and the BHA - Single Points of Entry
- Virginia’s public policy decision-makers, both elected and appointed, have affirmed and, through the years, strengthened the role of CSBs and the BHA as the single points of entry into publicly funded mental health, developmental, and substance abuse services for individuals with mental illness, intellectual disability, substance use disorders, or co-occurring disorders.
- CSB/BHA oversight and accountability at the local and state levels put in place by the Virginia General Assembly and implemented by DBHDS, DMAS, and local governing bodies, provide the confidence in CSBs and the BHA to be the single points of entry and case management entities.
- As state leaders have determined criteria for individuals being placed on the Urgent Care Wait list for the ID Waiver by CSBs and the BHA, DBHDS and DMAS have approved individuals placed on the list based on the criteria.
- When funding allows for additional ID Waiver slots, local CSBs and the BHA have an objective process in place, to determine who on the Urgent Care Wait list has the most critical need for a slot. In place also are procedures that support individual choice and transfer options should an individual receiving services choose to move to a different locality.