Virginia Offers New Behavioral Health Services for Adults and Youth


Nicole Pasia


Virginia Medicaid members have access, starting December 1, 2021, to six new behavioral health services that strengthen crisis response, address a national emergency in children’s mental health care and provide new supports for individuals with developmental disabilities.

“These critical services will transform the way Virginians get care when they’re in crisis,” Governor Ralph Northam said. “When people can get the treatment they need, especially in their own communities, they are less likely to reach a crisis point, and less likely to need hospital care. Behavioral health, and how we can best provide treatment, has long been a challenge, in Virginia and around the nation– and the COVID-19 pandemic has intensified the struggle for everyday Virginians and for our hardworking behavioral health workforce. As a pediatrician, I’ve been particularly concerned that we address the rise in behavioral health needs among children. I’m proud of these steps that provide more options for our fellow Virginians and their families when they need help the most.”

The new services include two in-home therapy options for children in crisis. The services represent key steps in Virginia’s response to a national call to action following rising rates of mental health concerns and suicide among young people. The American Academy of Pediatrics last month declared a national emergency in children’s mental health.

“The need for enhanced crisis services has never been more prevalent than now, and Virginia is taking proactive measures that serve as a lasting legacy for Governor Northam and this administration,” said Secretary of Health and Human Resources Vanessa Walker Harris, MD. “These new behavioral health programs, along with the launch of new Marcus Alert teams, demonstrate our commitment to offering cost-effective innovations with proven measures of success.”

The Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS) are collaborating on a continuum of behavioral health enhancements through a multi-phase initiative known as Project BRAVO (Behavioral Health Redesign for Access, Value and Outcomes). The initiative has included support from hundreds of providers, advocates and other stakeholders. Medicaid began covering an initial set of three new services for its members on July 1, 2021. The six additional services qualify for Medicaid funding effective December 1, 2021.

“Research shows that 96% of individuals who receive a direct referral to crisis services do not require an emergency room visit,” said Karen Kimsey, DMAS Director. “We are committed to providing our Medicaid members with high quality, evidence-based care in their communities and in their homes, giving them the choices they deserve for stabilization and healing.”

December 1 will also see the establishment of Marcus Alert programs in five regions across Virginia: Orange, Madison, Culpeper, Fauquier, and Rappahannock counties; Prince William County; City of Bristol and Washington County; City of Richmond; and the City of Virginia Beach. Named for Marcus-Davis Peters, the Marcus Alert aims to provide evidence-based responses to behavioral health emergencies and reduce negative outcomes involving the use of force in law enforcement interactions when an individual is experiencing a crisis related to mental health, substance use, or developmental disability challenges.

The initiative focuses on effective diversions from 911 and law enforcement into community crisis care. DBHDS worked together with the Department of Criminal Justice Services to create a statewide implementation plan to provide the framework that each locality must use to write a more specific local plan. By July 1, 2026, all community services boards (CSBs) in Virginia will
have established Marcus Alert systems. Additionally, in July 2022, the new hotline for mental health emergencies, 9-8-8, will be available nationwide, allowing individuals in crisis to connect with suicide prevention and mental health crisis counselors.

“The Marcus Alert program helps us put into practice something we know to be true: A behavioral health emergency requires a behavioral health response,” said Alison Land, DBHDS Commissioner. “It is so important for people in crisis to get help as close to home as possible, and with as little intervention as possible, and through much hard work, we are building a system that offers that.”

The new services covered by Medicaid are:

Multisystemic Therapy: Intensive family and community-based treatment for youth ages 11-18 with significant disruptive behaviors and substance use disorders.
Functional Family Therapy: Short-term treatment for youth ages 11-18 with significant disruptive behaviors who have received referrals from juvenile justice, behavioral health, school or child welfare systems.
Mobile Crisis Response: 24/7 rapid response, assessment and early intervention for individuals experiencing a behavioral health crisis.
Community Stabilization: Short-term support for individuals who recently required crisis services or who need assistance to avoid escalation to more intensive treatment models.
23-Hour Crisis Stabilization: Up to 23 hours of crisis stabilization services in a community-based setting for individuals experiencing an acute behavioral health emergency.
Residential Crisis Stabilization Unit: Short-term, 24/7 residential evaluation and intervention for psychiatric and substance use crises. This new service enables some individuals to avoid inpatient admission and offers stepdown support for others who require hospitalization.

“The Virginia Association of Community-Based Providers (VACBP) and our members are grateful for the opportunity to participate in the development of Project BRAVO services,” said Mindy Carlin, VACBP Executive Director. “Our members provide more than 80% of all community-based Medicaid behavioral health services, and we appreciate the ability to share our expertise and insights. Implementation of these services represents an important step toward ensuring that Virginia’s behavioral health system can better meet the increasing needs of Medicaid members throughout Virginia.”

Virginia Medicaid members interested in learning more about these services should contact their managed care organization, behavioral health specialist or primary care provider.

This press release was provided by the Virginia Department of Medical Assistance Services.