Settlement Agreement Provision
III.C.6.a.i – iii
The Commonwealth shall develop a statewide crisis system for individuals with intellectual and developmental disabilities. The crisis system shall:
i. Provide timely and accessible support to individuals with intellectual and developmental disabilities who are experiencing crises, including crises due to behavioral or psychiatric issues, and to their families;
ii. Provide services focused on crisis prevention and proactive planning to avoid potential crises; and
iii. Provide in-home and community-based crisis services that are directed at resolving crises and preventing the removal of the individual from his or her current placement whenever practicable.
About Crisis System
The Commonwealth of Virginia embarked on a mission to transform the existing crisis system. The vision of this crisis system transformation is to develop a community-based, trauma-informed, recovery-oriented crisis system that will respond to a crisis where it is occurring rather than relying on the local emergency department or law enforcement as the primary way to access crisis care. This is an all-inclusive system no matter the disability or age of the person with the goal of supporting the individual and their natural support system to meet their needs by linking to the appropriate level of care to stabilize the crisis and prevent further crisis cycles. This transformation of the crisis system would align the Commonwealth’s statewide crisis system with national best practice standards around crisis services. The Commonwealth established the Crisis Office in June of 2021 and further expanded to a Division of Crisis Services on 7/1/2022.
The REACH program (Regional Education Assessment Crisis Services Habilitation) is a part of this crisis system and was established as a statewide crisis system of care that serves individuals diagnosed with a developmental disability (DD). This system is designed to meet the crisis support needs of individuals who have a developmental disability and are experiencing crisis events that put them at risk for homelessness, incarceration, hospitalization, and/or danger to themselves or others. REACH programs offer an additional layer of support to Emergency Services, the state hospital system, and caregivers who work the most closely with individuals with a developmental disability (DD). The REACH program offers mobile crisis response, community crisis stabilization both residential and non-residential, prevention services, and community training. For individuals who avail themselves of REACH services, staff create Crisis Education and Prevention Plans (CEPP) and provide training on this plan to the individual and caregiver. The CEPP is an individualized, client-specific written document that provides a concise, clear, and realistic set of supportive interventions to prevent or de-escalate a crisis and assist an individual who may be experiencing a behavioral loss of control.
To foster proactive and preventative referrals to the REACH program, DBHDS initiated the Crisis Risk Assessment Tool (CAT) in FY21Q1. This tool and associated training are currently being utilized throughout CSBs/BHA in the Commonwealth.
This page also provides information on behavior support planning, which is included under the overarching crisis provisions and compliance indicators in the Settlement Agreement.
Authorizing Authority
Budget Bill – H.B. 1500 (Chapter 806), 2013 Sess. (Va. 2013), Item 315.Y
Delegation
Processes, Protocols and Standards
Guidelines, Charters, Plans
Instruments and Tools
- Crisis Education and Prevention Plan
- Crisis Stabilization Admission Checklist
- Prevention and Stepdown Admission Checklist
- REACH Program Data Collection Tool
- Crisis Risk Assessment Tool (CAT)
- Behavior Support Plan Adherence Review Instrument (BSPARI)
Training Materials
For more information about the Crisis System, visit: https://dbhds.virginia.gov/developmental-services/Crisis-services
For more information about behavioral services and behavior support planning under the DD waivers, visit: https://dbhds.virginia.gov/developmental-services/behavioral-services/