Reforming Virginia’s Behavioral Health System
System Transformation Excellence and Performance (STEP-VA)
The System Transformation Excellence and Performance of Virginia (STEP‑VA) initiative aims to strengthen Virginia’s public mental health system by establishing a consistent set of core services across all 40 Community Services Boards (CSBs). Built on the Certified Community Behavioral Health Clinic (CCBHC) model, a national best-practices model for behavioral health services, STEP‑VA provides a roadmap for delivering comprehensive, high‑quality, community‑based services for individuals facing mental health and substance use challenges.
CSBs serve as the primary point of entry into the system and are the main providers for individuals with Serious Mental Illness (SMI), Substance Use Disorder (SUD), and Serious Emotional Disturbance (SED). Established in the Code of Virginia in 2018, STEP‑VA set the foundation for a more accessible, consistent, and accountable system of behavioral health care. Since then, the initiative has progressed through phased implementation and now includes full implementation of all nine STEPs

The nine core services in STEP-Virginia
Same Day Access (SDA) – creates a way for Virginians to receive an initial triage and risk assessment the same day they contact their local CSB to request services, followed by an initial clinical assessment and treatment scheduled based on the individual’s level of clinical need. Full implementation of this initiative was achieved in July 2020.
Primary Care Screening – collects key data to identify individuals’ health risks and coordinate with medical care providers. Full implementation of this initiative was achieved in July 2021.
Outpatient Services – considered the core of behavioral health services, this includes both mental health and substance use therapy for adults and children, as well as psychiatry services. Full implementation of this initiative was achieved in July 2022.
Crisis Services – builds out a comprehensive crisis system situated to provide the right service at the right time to individuals nearing crisis, experiencing crisis, or stabilizing after a crisis. Full implementation of this initiative was achieved in July 2022.
Peer and Family Services – incorporates certified professionals with lived experience into the full array of behavioral health services. Full implementation of this initiative was achieved in July 2023.
Service Members, Veterans, and their Families (SMVF) – requires that all clinical staff of CSBs have SMVF training, in addition to identifying Virginians with a connection to military service, at entry to public mental health services, and offers referrals to appropriate services and resources. Full implementation of this initiative was achieved in July 2023.
Psychiatric Rehabilitation– services that build or rebuild the skills and supports necessary for individuals to lead a successful life in the community. Full implementation of this initiative was achieved in July 2024.
Targeted Case Management (TCM) – a comprehensive service that coordinates and links individuals with key resources and care planning. Full implementation of this initiative was achieved in July 2024.
Care Coordination – person-centered, holistic care planning that connects resources and services across the continuum of care for all individuals served by the CSBs. Full implementation of this initiative was achieved in July 2024.
Anticipated Outcomes
The implementation of STEP-VA services will improve access, increase quality, build consistency and strengthen accountability across Virginia’s public behavioral health system. Also, STEP-VA services are intended to foster wellness among individuals with behavioral health disorders in everyday life to prevent crises before they arise. Additional outcomes would include fewer admissions to state and private hospitals, decreased emergency room visits, and reduced involvement of individuals with behavioral health disorders in the criminal justice system.
Technical Assistance Requests
Requests for technical assistance related to STEP-VA can be sent to STEP-VA@dbhds.virginia.gov
STEP-VA Office Hours for CSB staff are held each Tuesday from 1:00pm-1:30pm (with the exception of holidays or extenuating circumstances). Please contact the STEP-VA email address above to request the meeting link.
Data Specific requests for technical assistance can be coordinated by requesting at https://forms.office.com/g/7rgNwLrn8A
