In 2017, lawmakers launched a four-year initiative called Step Virginia with nine steps to help improve the state’s community-based behavioral health system. A new report from JLARC released this week looks at how the implementation of the first two steps is going, and what can be improved.
It found that while all 40 community mental health centers across Virginia are providing some degree of same-day assessments, the hours the assessments are available vary from two to 40 hours each week.
“No one is tracking the information to tell us whether that’s enough,” said Jeff Lunardi, JLARC unit director. Lunardi says there needs to be more oversight and tracking of metrics to determine whether the new services are matching community needs.
Some centers also reported difficulty following up with patients within 10 days of that first assessment due to staffing and resource constraints. Others reported concerns about the second step taking away from other higher-priority STEP-VA services. Starting in July, all CSBs will be required to implement primary care screenings for all patients.
The report recommended using a portion of the program’s funding to pay for a dedicated senior-level staff person from the Virginia Department of Behavioral Health and Developmental Services (DBHDS) to help oversee that work.
“This [lack of a dedicated staff member] has resulted at times in ineffective communication,” Lunardi said during the report’s initial presentation to lawmakers Monday.
Senator Tommy Norment questioned why a senior staff member hadn’t been dedicated to the project. DBHDS Commissioner Hughes Melton stressed the need for more staff funding to effectively implement STEP-VA, citing a “mismatch of staffing to oversight.”
“There was and has always been a senior leader responsible for the development and implementation of Step Virginia,” Melton said. "Was it one FTE and was it all their job? No. It’s a multi-faceted project that requires different divisions of the agency to implement.”
The department says they’ve recently filled two key positions (Deputy Director for Community Services in the Division of Community Behavioral Health and a Director of the Office of Adult Community Behavioral Health began working at DBHDS in June 2019 and May 2019, respectively) to ensure stability and continuity in leadership. They also created a project manager position to support implementation in February 2019.
