Behavioral Health Redesign

Official DMAS website

Memo from DMAS about service shortages

Here is the first formal communication from DMAS related to Behavioral Health Enhancement (BHE).

VABA has been participating in regular meetings hosted by DBHDS and DMAS on the redesign of behavioral health services in Virginia.

Official Web site:

This is the presentation from the first meeting held October 2, 2018

This is the presentation from the second meeting held October 23, 2018

This is the presentation from the third meeting held November 27, 2018

This is the presentation from the fourth meeting held January 7, 2019

This is the presentation from a follow-up meeting held July 29, 2019

Here are some links provided by DMAS/DBHDS:   CMS IMD 1115 opportunity  |   DPB link to see budget requests    |   Farley Center Continuum and Stakeholder reports

More information will be shared on this post as it is available.

Please see this message from DMAS to BHR stakeholders on 12/23/19

Behavioral Health Redesign Stakeholders:

We are writing to share the news that the Behavioral Health Redesign Proposal was included in the Governor’s Budget proposal. It is an exciting day for all of us as we take this next step forward in the process of improving our behavioral health system for those we serve together. We appreciate all of your participation and feedback in the engagement process so far. By proposing to align STEP-VA funding with the Medicaid funding requests, the proposed behavioral health redesign services would, if approved and funded from the General Assembly,  1) build the necessary crisis infrastructure, 2) implement new service definitions and reimbursement rates that support evidence based service delivery and, 3) assist with alleviating the psychiatric bed crisis in Virginia. In addition,  the proposed budget adds another 14.7 percent rate increase for outpatient psychiatric services to the equivalent of 110 percent of Medicare rates.  

The Governor’s Budget proposal included additional funding for the implementation of STEP-VA, including Outpatient Services, Crisis Services to include the infrastructure for regional call lines/call centers for dispatch of mobile crisis, Peer and Family Support Services, and Military and Veterans’ Services. The Governor’s Budget also included proposals for funding workforce development to support Behavioral Health Redesign and the authority for DBHDS to promulgate emergency regulations related to the licensing of services impacted by the enhancement of Medicaid behavioral health services.

What services were included in the Governor’s Budget?

The Governor’s Budget proposes to include all of the services in the current phase of the Behavioral Health Redesign. This includes: 1. Assertive Community Treatment, 2. Multi-Systemic Therapy (MST), 3. Functional Family Therapy (FFT), 4. Partial Hospitalization Programs, 5. Intensive Outpatient Programs, and 6. Comprehensive Crisis Services (Mobile Crisis Intervention, Community-Based Crisis Stabilization, 23-hour Observation Beds, and Residential Crisis Stabilization Units).

How much funding was proposed in the Governor’s Budget over the biennium?

The DMAS budget included a total of $7,155,416 ($3,028,038 general fund and $4,127,378 non-general fund) for the first year (2020-2021) to implement ACT, MST, and FFT services beginning January 2021 and a total of $24,343,875 ($10,273,553 general fund and $14,070,322 non-general fund) to implement crisis, partial hospitalization, and intensive-outpatient services beginning July 2021.

Why was the proposed amount for these services different from what was requested in the original budget package that was posted to Department of Planning and Budget?

This amount looks different because there were refinements made to the request in regards to the timeline for when differences services would be implemented.

What are the timelines indicated for service implementation in the budget?

The budget language states that the new services would be phased in over the two years of the biennium. Assertive Community Treatment, Multi-Systemic Therapy, and Functional Family Therapy would be implemented with a January 2021 start date, and their costs reflect the fact that this would only be over 6 months of the 2020-2021 fiscal year. The other services (Partial Hospitalization Programs, Intensive Outpatient Programs and all of the Crisis Services) would begin implementation on July 1, 2021 and their costs reflect their activity in the system for the full second year.

What regulatory authority was provided to each agency?
The budget language allows DMAS to develop emergency regulations to support the new service models and to implement services in two distinct phases. This aligns with DBHDS’ efforts to implement provider/workforce development initiatives, workforce training and to build essential crisis services infrastructure. DBHDS was also give authority to promulgate emergency regulations that align with changes within DMAS behavioral health regulations.

How much funding was allocated for workforce training?

The DBHDS budget proposal included $1,025,000 in FY 2021 and $1,215,000 in FY 2022 for workforce development to support Behavioral Health Redesign. This proposal includes the completion of a workforce study, support to build infrastructure for ongoing training and implementation of evidence based services in the community, and trainings specific to Behavioral Health Redesign (including changes to licensing and billing, as well as trainings in the specific services).

The Governor’s budget proposal is available for reference: 

Thank you again for your engagement and partnership through our stakeholder workgroups. Questions regarding Behavioral Health Redesign may be directed to our joint-agency email box:

Thank you,

Behavioral Health Redesign team

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