Authority: Title 37.2, Chapters 5 and 6; Title 2.2, Chapter 53, Code of Virginia.

A. It is the intent of the General Assembly that community mental health, intellectual disability and substance abuse services are to be improved throughout the state. Funds provided in this Item shall not be used to supplant the funding effort provided by localities for services existing as of June 30, 1996.

B. Further, it is the intent of the General Assembly that funds appropriated for this Item may be used by Community Services Boards to purchase, develop, lease, or otherwise obtain, in accordance with §§ 37.2-504 and 37.2-605, Code of Virginia, real property necessary to the provision of residential services funded by this Item.

C. Out of the appropriation for this Item, funds are provided to Community Services Boards in an amount sufficient to reimburse the Virginia Housing Development Authority for principal and interest payments on residential projects for the mentally disabled financed by the Housing Authority.

D. The Department of Behavioral Health and Developmental Services shall make payments to the Community Services Boards from this Item in twenty-four equal semimonthly installments, except for necessary budget revisions or the operational phase-in of new programs.

E. Failure of a board to participate in Medicaid covered services and to meet all requirements for provider participation shall result in the termination of a like amount of state grant support.

F. Community Services Boards may establish a line of credit loan for up to three months' operating expenses to assure adequate cash flow.

G. Out of the appropriation for this Item, $216,500 the first year and $216,500 the second year from the general fund shall be provided to continue the Keeping Our Kids At Home program in the Roanoke Valley, to contract with community providers for short-term crisis hospitalization of children and adolescents.

H. Out of this appropriation $200,000 the first year and $200,000 the second year from the general fund shall be provided to Grafton School for the continued operation and expansion of the Virginia Autism Resource Center.

I.1. Out of this appropriation, $7,203,366 the first year and $7,203,366 the second year from the general fund shall be provided for Virginia's Part C Early Intervention System for infants and toddlers with disabilities.

2. By October 1 of each year, the department shall report to the Chairmen of the House Appropriations and Senate Finance Committees on the (a) total revenues used to support Part C services, (b) total expenses for all Part C services, (c) total number of infants, toddlers and families served using all Part C revenues, and (d) services provided to those infants, toddlers, and families.

3. Any additional funds received by local early intervention systems pursuant to the federal American Recovery and Reinvestment Act (ARRA) of 2009 for early intervention services through Part C of the Individuals with Disabilities Education Act (IDEA) of 2004 shall be used to supplement, not supplant federal, state and local funding at the level in effect upon the date of enactment of the ARRA.

J. Out of this appropriation, $500,000 the first year and $500,000 the second year from nongeneral funds shall be provided to the Richmond Behavioral Health Authority to continue a substance abuse treatment program that allows substance-abusing women to remain with their children during treatment.

K. Out of this appropriation $6,148,128 the first year and $6,148,128 the second year from the general fund shall be provided for mental health services for children and adolescents with serious emotional disturbances and related disorders, with priority placed on those children who, absent services, are at-risk for custody relinquishment, as determined by the Family and Assessment Planning Team of the locality. The Department of Behavioral Health and Developmental Services shall provide these funds to Community Services Boards through the annual Performance Contract. These funds shall be used exclusively for children and adolescents, not mandated for services under the Comprehensive Services Act for At-Risk Youth, who are identified and assessed through the Family and Assessment Planning Teams and approved by the Community Policy and Management Teams of the localities. The department shall provide these funds to the Community Services Boards based on an individualized plan of care methodology.

L. Out of this appropriation, the expenditure of $2,625,000 the first year and $2,625,000 the second year from the general fund shall be provided for programs of assertive community treatment (PACT).

M.  Out of this Item, $5,260,000 the first year and $5,260,000 the second year from the general fund shall be provided for 77 individualized mental health discharge assistance plans.

N.  Out of this Item, $2,800,000 the first year and $2,800,000 the second year from the general fund shall be provided for mental health inpatient treatment purchased in community hospitals.

O.  Out of this appropriation, $1,771,180 the first year and $1,771,180 the second year from the general fund shall be used to fund four demonstration projects using evidence-based “systems of care” models for children and adolescents with behavioral health needs.  The commissioner may allocate up to $100,000 of this appropriation in each year for an evaluation of the pilot projects.

P.  Out of this appropriation, no less than $12,447,917 the first year and $12,447,916 the second year from the general fund shall be provided to maintain and expand access to crisis intervention and stabilization units. Funds shall be used to expand existing crisis stabilization sites as well as establish additional units.

Q. Out of this appropriation, $2,880,000 the first year and $2,880,000 the second year from the general fund shall be provided to fund discharge assistance plans for civil patients and patients found not guilty by reason of insanity who have been identified as ready for discharge and who need specialized support not currently available through the Community Services Boards.

R. Out of this appropriation, $6,575,000 the first year and $6,575,000 the second year from the general fund shall be provided for community-based services for individuals served by Health Planning Regions I and II.  These funds shall be used for discharge assistance planning, inpatient mental health treatment, in-home residential support, crisis stabilization and other related mental health services intended to delay or deter placement in a state mental health facility.  When allocating funds in Health Planning Region II, consideration shall be given, to the extent feasible, to projects that are designed to provide specialized geriatric mental health services that allow individuals to be served in their home communities.

S. Out of this appropriation, $6,928,540 the first year and $6,928,540 the second year from the general fund shall be provided for community-based services for individuals otherwise served by Eastern State Hospital in Williamsburg. These funds shall be used for discharge assistance planning, inpatient mental health treatment, in-home residential support, crisis stabilization and other related mental health services intended to delay or deter placement in a state mental health facility.

T. Out of this appropriation, $3,375,000 the first year and $3,375,000 the second year from the general fund shall be used to increase the availability of targeted community-based services statewide.  Such services may include, but are not limited to, discharge assistance planning, inpatient mental health treatment, in-home residential support, jail-based hospital diversion projects, psychiatric evaluation and crisis counseling and expanded case management services.

U. Out of this appropriation, $1,900,000 the first year and $1,900,000 the second year from the general fund shall be used to provide mental health services to juveniles detained in local community detention centers. Funds shall be allocated to Community Services Boards for local and regional detention centers based upon Memoranda of Understanding between the detention superintendent and the executive director of the local community services board or behavioral health authority that will provide the services.  Memoranda shall specify the expected types of services, as well as estimated workloads.  The department shall review and approve each memorandum to ensure consistency and shall allocate funding based upon the projected levels of services to be provided.

V. Out of the amounts appropriated in Item 297, $4,125,438 the first year and $4,125,438 the second year from the general fund and $4,125,438 the first year and $4,125,438 the second year from nongeneral funds shall be provided for the Intellectual Disability Home and Community-Based Waiver Program. The funds shall be used to provide a total of 117 slots for individuals at Southeastern Virginia Training Center or Central Virginia Training Center who have been discharged or determined to be ready for discharge and have chosen to be served in the community.

W. Beginning July 1, 2007, the Commissioner of the Department of Behavioral Health and Developmental Services shall allocate $1,000,000 the first year and $1,000,000 the second year from the federal Community Mental Health Services Block Grant for two specialized geriatric mental health services pilot programs. One pilot shall be located in Health Planning Region II and one shall be located in Health Planning Region V. The pilots shall serve elderly populations with mental illness who are transitioning from state mental health geriatric units to the community or who are at risk of admission to state mental health geriatric units.

X. Beginning July 1, 2007, the Commissioner of the Department of Behavioral Health and Developmental Services shall allocate $750,000 the first year and $750,000 the second year from the federal Community Mental Health Services Block Grant for consumer-directed pilot programs offering specialized mental health services that promote wellness, recovery and improved self-management.

Y. The Commissioner of the Department of Behavioral Health and Developmental Services shall work with Community Services Boards to ensure that fund allocation decisions for regional restructuring projects in the second year consider the service needs of individuals who are expected to be discharged into each region upon the downsizing of affected facilities.

Z. Out of this appropriation, $2,400,000 the first year and $2,400,000 the second year from the general fund shall be used for treatment and support services for substance use disorders. Funded services shall focus on recovery models and the use of best practices.

AA. Out of this appropriation, $2,780,645 the first year and $2,780,645 the second year from the general fund shall be used to provide outpatient clinician services to children with mental health needs. Each Community Services Board shall receive funding as determined by the commissioner to increase the availability of specialized mental health services for children. The department shall require that each Community Services Board receiving these funds agree to cooperate with Court Service Units in their catchment areas to provide services to mandated and nonmandated children, in their communities, who have been brought before Juvenile and Domestic Relations Courts and for whom treatment services are needed to reduce the risk these children pose to themselves and their communities or who have been referred for services through family assessment and planning teams through the Comprehensive Services Act for At-Risk Youth and Families.

BB. Out of this appropriation, $100,000 the first year from the general fund shall be used for start-up funding for the establishment of community residential services to support the Intellectual Disability Home and Community-Based Waiver Program.  The Department of Behavioral Health and Developmental Services shall manage the distribution of these funds to Community Services Boards to support public and private sector implementation of service plans for individuals enrolled for those services under the expanded community waivers.

CC.1. Out of this appropriation, $17,701,997 the first year and $17,701,997 the second year from the general fund shall be used to provide emergency services, crisis stabilization services, case management, and inpatient and outpatient mental health services for individuals who are in need of emergency mental health services or who meet the criteria for mental health treatment set forth pursuant to House Bill 559 and Senate Bill 246, 2008 Session of the General Assembly. Funding provided in this item also shall be used to offset the fiscal impact of (i) establishing and providing mandatory outpatient treatment, pursuant to House Bill 499 and Senate Bill 246, 2008 Session of the General Assembly; and (ii) attendance at involuntary commitment hearings by community services board staff who have completed the prescreening report, pursuant to House Bill 560 and Senate Bill 246, 2008 Session of the General Assembly.

DD. The Department of Behavioral Health and Developmental Services, in cooperation with the Virginia Association of Community Services Boards (VACSB) and with input from the Senate Finance and House Appropriations Committees, shall maintain a reporting process to monitor implementation of (i) the new services funded in this item and (ii) changes to the civil commitment process included in Senate Bill 246, House Bill 499, House Bill 559 and House Bill 560 from the 2008 Session of the General Assembly. The department and VACSB shall identify specific data elements or performance measures that will be reported through this process. The commissioner shall submit a report on the implementation of these services, including CSB performance in the civil commitment process, no later than December 1, 2010, and each year thereafter.

EE. Out of this appropriation, $100,000 the first year and $100,000 the second year from the general fund shall be provided to Holiday House of Portsmouth, Inc.

FF.  The Department of Behavioral Health and Developmental Services, in cooperation with the Virginia Association of Community Services Boards (VACSB) and with input from the Department of Corrections and the Supreme Court shall examine the feasibility of expanding the use of community medical detoxification and opiate maintenance treatments to divert opioid dependent individuals from jails.  As part of its analysis, the department shall include efforts to maximize the utilization of existing benefits accessed through the Department of Medical Assistance Services.