Fairfax-Falls Church Community Services Board

Behavioral Health Outpatient & Case Management Services

Behavioral Health Outpatient & Case Management Services includes outpatient programming, case management, and intensive outpatient programming, for people with mental illness, substance use disorders and/or co-occurring disorders. Individuals served may also have co-occurring developmental disabilities.

Outpatient and intensive outpatient programs include evidenced based practices (individual and group) for adults who are living with serious mental illness and/or substance dependence. Services help people make behavioral changes that promote recovery, develop problem-solving skills and coping strategies, and help participants develop a positive support network in the community. Intensive outpatient services are provided for individuals who would benefit from increased frequency of services. Depending on the individual's need. These intensive services are designed to help prevent the need for hospitalization or to help people transition from recent hospitalization or less intensive services. Programming focuses on helping individuals develop coping and life skills, and on supporting vocational, educational, or other goals that are part of the process of ongoing recovery.

Turning Point, a program for young adults (ages 16-25), provides rapid intervention after a first episode of psychosis and subsequent wraparound services.

Case management services are strength-based, person-centered services for adults who have serious and persistent mental illness and who may also have co-occurring substance use disorders. Services focus on interventions that support recovery and independence to improve quality of life, crisis prevention and management, psychiatric and medication management and referral to group and peer supports. The goal of case management services is to work in partnership with individuals to stabilize behavioral health crises and symptoms, facilitate a successful life in the community, help manage symptom reoccurrence, build resilience, and promote self-management, self-advocacy, and wellness.

Engagement, Assessment and Referral (EAR)

The Engagement, Assessment and Referral service area is the point of entry “front door” for the CSB, to triage individuals and help them get appropriate treatment that meets their behavioral health needs. The goal of EAR services is to ensure safety for individuals with mental health disorders, substance use disorders, developmental disabilities, and co-occurring disorders.

Services Provided:

• Initial assessment to determine the appropriate level of care.
• Referral to community resource if the individual needs a higher or lower level of care.
• Limited telehealth services.

Population Served:

• Individuals in need of services that have behavioral health disorders.

Setting:

• Walk-in same day service.

Webpage:

• Engagement, Assessment & Referral Services | Community Services Board (fairfaxcounty.gov)

Youth and Family Outpatient Services

Outpatient mental health services help youth cope with their stressors and manage their mental health. Treatment is tailored to address the individual needs of the youth and family. Services take place in an office or virtually and usually last 3-6 months. Youth may be referred to a psychiatrist for an evaluation. Outpatient substance use services are available for middle and high school-aged youth and their families. The goal is to reduce and then stop the youth’s use of alcohol and/or drugs. The Youth and Family outpatient services focus on helping individuals who have serious emotional and mental health issues and for those who have substance use or substance dependency issues.

ACRS - Developmental Disability Residential Programs (ACRS)

Assisted Community Residential Services (ACRS) provides comprehensive residential supports and services in group homes and independent living settings operated by the Fairfax-Falls Church Community Services Board (CSB). Individuals with an intellectual disability (ID), a developmental disability (DD) or a co-occurring mental illness diagnosis have access to residential services up to 24 hours per day. ACRS also contracts with residential, drop-in, in-home and respite providers within the county. Individuals with and without the Medicaid Waiver are supported.

Services Provided:

• Person centered residential supports.
• Promotes self-determined community living to the fullest of abilities.
• Support by Program Managers of each group home lead a team of trained Direct Support Professionals to provide quality supports and services.
• Nursing team provides integrated health care services led by a Behavioral Health Nurse Supervisor.

Population Served:

• Individuals with intellectual/developmental disabilities.
• Individuals with a co-occurring mental illness diagnosis.
• Families of individuals with intellectual/developmental disabilities.

Setting:

• 6 group homes and 1 supported living apartment.
• 37-bed assisted living facility: Mental health and complex medical needs.
• Developmental disability group home and apartments.
• Drop-in and in-home service.

Webpage:

• Assisted Community Residential Services | Community Services Board (fairfaxcounty.gov)

Intensive Community Treatment

Intensive Community Treatment consists of multiple programs (4):

 Assertive Community Treatment (ACT)

Assertive Community Treatment services aim to provide a single, fixed point of responsibility for treatment, rehabilitation, and support needs for clients with serious mental illness (SMI) whose needs have not been consistently met by more traditional service delivery approaches.  Typically, individuals served by ACT are adults who have a serious and persistent psychiatric disorder such as schizophrenia, schizoaffective disorder, and bipolar disorder who experience significant impairments in independent daily functioning in the community.  Individuals served by ACT often have a history of frequent use of psychiatric hospitals and emergency rooms, involvement with the criminal justice system, sustained alcohol/substance use, prolonged periods of medical care neglect, and lack of engagement in traditional outpatient services.  ACT services are for individuals who need intensive levels of support and clinical services in their natural environment to support or enhance functioning in the community. ACT services are delivered in community settings such as hospitals, jails, homeless shelters, individuals’ homes, libraries, fast food restaurants, places of employment, or any setting in the community where individuals prefer to receive services.  The overall goal of this service is to lower incidents of hospitalization, incarceration, and homelessness for those served while promoting safe, stable, and independent community living.  ACT is a multidisciplinary team that includes a peer specialist, vocational specialist, co-occurring specialist, psychiatric nurse, psychiatric prescribers, mental health clinicians, supervisors, and a dedicated administrative assistant.  The team adheres to the Assertive Community Treatment care model, an evidence-based practice endorsed and promoted by SAMHSA.  The program operates 7 days a week, 365 days a year. ACT is located in the Gartlan Center in Alexandria and will be expanding to the Heritage Building in Annandale.

Intensive Case Management (ICM)

Intensive Case Management services are offered to individuals with acute, complex psychiatric and/or co-occurring substance use issues who require outpatient services provided in their natural environment.  ICM services include ongoing assessment of needs, intensive case management, crisis intervention, and linking with needed benefits, housing support, employment support, medication services, medical care, and mental health skill building services. The Teams adhere to person-centered and strengths-based approaches for engagement, goal development, treatment planning, and delivering direct services in community or office settings.  Individuals served by ICM Teams have severe psychiatric symptoms and impairments that are not effectively remedied through traditional outpatient behavioral health treatment or, because of reasons related to their mental health or substance use disorder, resist, or avoid needed services to remain stable in the community.  ICM Teams primarily serve adults with serious mental illness and co-occurring substance use disorders, typically with Axis I diagnoses such as schizophrenia, schizoaffective disorder, bipolar disorder, and major depression. A recent history of psychiatric hospitalization and/or incarceration without successful community stabilization is typical of newly admitted individuals.  Individuals served by ICM Teams often experience functional impairments on an intermitting basis without intensive community support that result in individuals not being able to perform practical daily living tasks required for basic adult functioning.  ICM teams deliver services Monday through Friday during daytime hours.  An ICM team is traditionally made up of a supervisor, psychiatric nurse, psychiatric prescriber, senior clinician, and behavioral health specialists. ICM services are offered from 3 locations: Reston- covering north county, Annandale covering mid county and Springfield and South County covering primarily the Rt one corridor of Alexandria.

Projects for Assistance in Transition from Homelessness (PATH)

The PATH team aims to work with individuals who meet the program’s priority population definition, as mandated by SAMHSA.  Individuals must meet the following program enrollment criteria to receive priority access to PATH services:

• Individual is determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder, AND
• Individual is experiencing homelessness or is at risk of homelessness.

The PATH team covers all of Fairfax County and strives to assist homeless, mentally ill individuals with securing basic needs such as shelter/housing, food, clothing, identification, entitlements, and medical care while attempting to engage and link them into mainstream mental health services.  PATH operates a Homeless Drop-In Group at the Gartlan Center in the southern region of Fairfax County on Tuesdays from 12:00 P.M. – 4:00 P.M. and Fridays from 8:00 A.M. – 12:00 P.M.  The program delivers all services Monday Through Friday during daytime hours.

Discharge Planning Services

Discharge planning services are provided to individuals in state psychiatric hospitals to link individuals to community-based services that enhance successful community-based recovery. Discharge planners are primarily Senior Clinicians (licensed staff) who work closely with individuals in state hospitals in Virginia. The goal is overcoming any barrier to discharge (barriers can be the lack of entitlements, need for guardianship, unable to stabilize symptoms etc). The discharge planner makes a full comprehensive plan for community integration often applying for assisted living or nursing homes to help individuals lead a life that maximizes their recovery. Discharge planners often work with the court system to help prepare individuals who are Not Guilty by Reason of Insanity (NGRI) for their conditional graduated release into the community. Discharge planners are located in each geographic area of the county.

Intensive Community Treatment Services Provided:

• Case management.
• Wraparound services (help with housing and other basic needs).
• Mental health supports.
• Medication management.
• Crisis intervention.

Population Served:

• Individuals who have serious mental illness and/or co-occurring substance use disorders, many of whom are homeless.

Setting:

• Community settings.

Webpage:

• Intensive Community Treatment Services | Community Services Board (fairfaxcounty.gov)

Supportive Community Residential Services - Residential Intensive Care (RIC)

Residential Intensive Care provides daily direct supervision of individuals who are living in scattered site community based residential serviced homes.  These scattered site homes are controlled and operated by the CSB.  The individual shares a home with up to three other residents.  Based upon the individual’s assessment, treatment planning is developed to support them in gaining independent living skills, such as, but not limited to, food preparation and storage, housekeeping, medication administration, budgeting, supportive counseling, symptom management and case management. 

Services Provided:

• Person Centered Care
• Daily supports in mental health skill building; supportive counseling targeting independent living skills, medication management and symptom monitoring.
• Case Management linkage to employment/volunteer opportunities, financial and health benefits, and other community resources.

Population Served:

•  Adults (age 18 and above) who have daily living impairments in relationship to a diagnosis of serious mental illness (SMI) and or co-occurring illness.
• Current pattern of behavior or presentation that indicates the individual will not be successful in a lower level of care, in maintaining their community independence. 
• Demonstrate an ability to have stable behavioral health systems without 24/7 awake supervision.

Setting:

• A multidisciplinary team that is physically present at scheduled/various times during the awake hours.
• A designated staff member is on call for clients and responsive to phone calls after hours. 
• Supports are offered seven days a week with no overnight staffing.

Website:

• Supportive Community Residential Services | Community Services Board (fairfaxcounty.gov)

Support Coordination - Developmental Disability Services

Developmental Disability (DD) Support Coordination provides case management and monitoring services to individuals with a developmental disability diagnosis.

Services Provided:

• Assessment: Determines eligibility services and Medicaid DD Waiver benefits.
• Transition Services: Assists young adults transitioning from Fairfax County Public Schools to adult services.
• Monitoring: Links to community resources and funding and evaluates status on the statewide waitlist for DD Waiver.

Population Served:

• Individuals with a developmental disability.
• Families/guardians of individuals with a Developmental Disability.
• Individuals serviced may have co-occurring Substance Use Disorder (SUD) or Serious Mental Illness (SMI) diagnosis.

Setting:

• Residents of Fairfax County and the Cities of Fairfax and Falls Church.

Website:

• Support Coordination Services | Community Services Board (fairfaxcounty.gov)

Employment and Day Support Services

Employment and Day Support Services (EDS) provides comprehensive services through a network of contracted providers that support individuals with meaningful day activities as well as employment services. The CSB’s Employment and Day Support Services team provides multiple levels of supported employment and day support services for individuals with developmental disabilities (DDE), serious mental illness (SMI) and/or substance use disorders (SUD).

Services Provided:

• Day Support Services are day activities that may include enhancing personal activities of daily living, developing pre-vocational skills, medical care, behavioral interventions, socialization, communication, fine and gross motor skills, daily and community living skills that are provided at facility and community-based sites.
• Employment Services may include resume building, job application, interview skills which may lead to a job placement (which for some individuals may be in a group of facility-based setting), employment service coordination and supported education for individuals with disabilities or who are in recovery.
• Self-Directed Services help individuals with developmental disabilities develop important vocational and life skills through meaningful activities they choose.
• Psychosocial rehabilitation services provide life skills development support and services for individuals with mental illness or co-occurring illnesses or diagnoses during periods of transition.

Population Served:

• Individuals with intellectual disabilities/developmental disabilities.
• Individuals with serious mental illness and/or substance use disorders.

Setting:

• Residents of Fairfax County and the Cities of Fairfax and Falls Church.

Webpage:

• Employment & Day Services | Community Services Board (fairfaxcounty.gov)

Wellness, Health Promotion and Prevention (WHPP)

The Wellness, Health Promotion and Prevention team strengthens our community’s emotional health and ability to handle challenges related to mental health concerns and substance misuse through trainings, presentations, and public campaigns. We focus on providing mental health and substance misuse literacy to help the public identify, understand, and respond to the signs and symptoms of mental health concerns, illness, substance misuse, and suicide prevention.

Services Provided:

• Trainings.
• Presentations.
• Community resource events.

Population Served:

• Residents of Fairfax County and the Cities of Fairfax and Falls Church.

Settings:

• Online.
• CSB locations.
• In the Community.

Webpage:

• Wellness, Health Promotion & Prevention | Community Services Board (fairfaxcounty.gov)

The Virginia Department of Behavioral Health and Developmental Services (DBHDS) oversees public behavioral health services statewide and endorses a regional management approach for coordinated service delivery among Community Services Boards (CSBs) in Virginia. CSBs are the local behavioral health agencies that serve as the point of entry into publicly funded services for mental health, developmental disabilities, and substance use disorders.

DBHDS Region 2, for the provision of Behavioral Health Services and Developmental Services , consists of localities served by:

• City of Alexandria CSB
• Arlington County CSB
• Fairfax-Falls Church CSB
• Loudoun County CSB
• Prince William County CSB

The Northern Virginia Regional Projects Office (NVRPO) was created to manage and have oversight of regional initiatives that serve individuals of the five Northern Virginia CSBs and one state facility (the Northern Virginia Mental Health Institute). Since the Regional Projects Office is not a stand-alone entity, these projects, including the Regional Projects Office, are attached to one of the regional CSBs.

Each month the regional projects office holds a collaborative meeting. For the meeting schedule and to learn more visit NVRPO's Regional Utilization Group page.

Webpage:

• Northern Virginia Regional Projects Office | Community Services Board (fairfaxcounty.gov)