                                 CODE OF VIRGINIA

COMPREHENSIVE CRISIS SYSTEM; MARCUS ALERT SYSTEM; POWERS AND DUTIES OF THE
DEPARTMENT RELATED TO COMPREHENSIVE MENTAL HEALTH, SUBSTANCE ABUSE, AND
DEVELOPMENTAL DISABILITY CRISIS SERVICES (§ 37.2-311.1)

A. As used in this section and &#xA7;&#xA7; 37.2-311.2 through 37.2-311.6,
unless the context requires a different meaning:
			&#8220;Community care team&#8221; means a team of mental health service
providers, and may include registered peer recovery specialists and
law-enforcement officers as a team, with the mental health service providers
leading such team, to help stabilize individuals in crisis situations. Law
enforcement may provide backup support as needed to a community care team in
accordance with the protocols and best practices developed pursuant to &#xA7;
9.1-193. In addition to serving as a co-response unit, community care teams may,
at the discretion of the employing locality, engage in community mental health
awareness and services.
			&#8220;Comprehensive crisis system&#8221; means the continuum of care
established by the Department of Behavioral Health and Developmental Services
pursuant to this section.
			&#8220;Crisis call center&#8221; means a call center that provides crisis
intervention that meets NSPL standards for risk assessment and engagement and
the requirements of &#xA7; 37.2-311.2.
			&#8220;Crisis stabilization center&#8221; means a facility providing
short-term (under 24 hours) observation and crisis stabilization services to all
referrals in a home-like, nonhospital environment.
			&#8220;Fund&#8221; means the Crisis Call Center Fund established under &#xA7;
37.2-311.4.
			&#8220;Historically economically disadvantaged community&#8221; means the
same as that term is defined in &#xA7; 56-576.
			&#8220;Mental health awareness response and community understanding services
alert system&#8221; or &#8220;Marcus alert system&#8221; means a set of
protocols to (i) initiate a behavioral health response to a behavioral health
crisis, including for individuals experiencing a behavioral health crisis
secondary to mental illness, substance abuse, developmental disabilities, or any
combination thereof; (ii) divert such individuals to the behavioral health or
developmental services system whenever feasible; and (iii) facilitate a
specialized response in accordance with &#xA7; 9.1-193 when diversion is not
feasible.
			&#8220;Mobile crisis response&#8221; means the provision of professional,
same-day intervention for children or adults who are experiencing crises and
whose behaviors are consistent with mental illness or substance abuse, or both,
including individuals experiencing a behavioral health crisis that is secondary
to mental illness, substance abuse, developmental or intellectual disability,
brain injury, or any combination thereof. &#8220;Mobile crisis response&#8221;
may be provided by a community care team or a mobile crisis team, and a locality
may establish either or both types of teams to best meet its needs.
			&#8220;Mobile crisis team&#8221; means a team of one or more qualified or
licensed mental health professionals and may include a registered peer recovery
specialist or a family support partner. A law-enforcement officer shall not be a
member of a mobile crisis team, but law enforcement may provide backup support
as needed to a mobile crisis team in accordance with the protocols and best
practices developed pursuant to &#xA7; 9.1-193.
			&#8220;NSPL&#8221; or &#8220;National Suicide Prevention Lifeline&#8221;
means the national suicide prevention and mental health crisis hotline
established by the federal government in accordance with 42 U.S.C. &#xA7;
290bb&#x2014;36c to provide a national network of crisis centers linked by a
toll-free number to route callers in suicidal crisis or emotional distress to
the closest certified local crisis center.
			&#8220;NSPL Administrator&#8221; means the entity designated by the federal
government to administer the NSPL.
			&#8220;Registered peer recovery specialist&#8221; means the same as such term
is defined in &#xA7; 54.1-3500.
			&#8220;SAMHSA&#8221; or &#8220;Substance Abuse and Mental Health Services
Administration&#8221; means the agency within the U.S. Department of Health and
Human Services that leads federal behavioral health efforts.

B. The Department shall have the following duties and responsibilities for the
provision of crisis services and support for individuals with mental illness,
substance abuse, developmental or intellectual disabilities, or brain injury who
are experiencing a crisis related to mental health, substance abuse, or
behavioral support needs:

   1. The Department shall develop a comprehensive crisis system, with such funds
   as may be appropriated for such purpose, based on national best practice
   models and composed of a crisis call center, community care and mobile crisis
   teams, crisis stabilization centers, and the Marcus alert system. In addition
   to all requirements under this section, the crisis call center shall meet the
   requirements of &#xA7; 37.2-311.2.

   2. By July 1, 2021, the Department, in collaboration with the Department of
   Criminal Justice Services and law-enforcement, mental health, behavioral
   health, developmental services, emergency management, brain injury, and racial
   equity stakeholders, shall develop a written plan for the development of a
   Marcus alert system. Such plan shall (i) inventory past and current crisis
   intervention teams established pursuant to Article 13 (&#xA7; 9.1-187 et seq.)
   of Chapter 1 of Title 9.1 throughout the Commonwealth that have received state
   funding; (ii) inventory the existence, status, and experiences of community
   services board mobile crisis teams and crisis stabilization units; (iii)
   identify any other existing cooperative relationships between community
   services boards and law-enforcement agencies; (iv) review the prevalence of
   crisis situations involving mental illness or substance abuse, or both,
   including individuals experiencing a behavioral health crisis that is
   secondary to mental illness, substance abuse, developmental or intellectual
   disability, brain injury, or any combination thereof; (v) identify state and
   local funding of emergency and crisis services; (vi) include protocols to
   divert calls from the 9-1-1 dispatch and response system to a crisis call
   center for risk assessment and engagement, including assessment for mobile
   crisis or community care team dispatch; (vii) include protocols for local
   law-enforcement agencies to enter into memorandums of agreement with mobile
   crisis response providers regarding requests for law-enforcement backup during
   a mobile crisis or community care team response; (viii) develop minimum
   standards, best practices, and a system for the review and approval of
   protocols for law-enforcement participation in the Marcus alert system set
   forth in &#xA7; 9.1-193; (ix) assign specific responsibilities, duties, and
   authorities among responsible state and local entities; and (x) assess the
   effectiveness of a locality&#8217;s or area&#8217;s plan for community
   involvement, including engaging with and providing services to historically
   economically disadvantaged communities, training, and therapeutic response
   alternatives.

C. 1. No later than December 1, 2021, the Department shall establish five Marcus
alert programs and community care or mobile crisis teams, one located in each of
the five Department regions.

   2. No later than July 1, 2023, the Department shall establish five additional
   Marcus alert system programs and community care or mobile crisis teams, one
   located in each of the five Department regions. Community services boards or
   behavioral health authorities that serve the largest populations in each
   region, excluding those community services boards or behavioral health
   authorities already selected under subdivision 1, shall be selected for
   programs under this subdivision.

   3. The Department shall establish additional Marcus alert systems and
   community care teams in geographical areas served by a community services
   board or behavioral health authority by July 1, 2024; July 1, 2025; and July
   1, 2026. No later than July 1, 2028, all community services board and
   behavioral health authority geographical areas shall have established a Marcus
   alert system that uses a community care or mobile crisis team.

   4. All community care teams and mobile crisis teams established under this
   section shall meet the standards set forth in &#xA7; 37.2-311.3.

D. The Department shall report annually by November 15 to the Governor and the
Chairmen of the House Committees for Courts of Justice and on Health and Human
Services, the Senate Committees for Courts of Justice and on Education and
Health, and the Behavioral Health Commission regarding the comprehensive crisis
system and the effectiveness of such system in meeting the goals set forth in
this section. The report shall include, for the previous calendar year, (i) a
description of approved local Marcus alert programs in the Commonwealth,
including the number of such programs operating in the Commonwealth, the number
of such programs added in the previous calendar year, and an analysis of how
such programs work to connect the Commonwealth&#8217;s comprehensive crisis
system and mobile crisis response programs; (ii) the number of calls received by
the crisis call center established pursuant to this section; (iii) the number of
mobile crisis responses undertaken by community care teams and mobile crisis
teams in the Commonwealth; (iv) the number of mobile crisis responses that
involved law-enforcement backup; (v) the number of crisis incidents and injuries
to any parties involved; (vi) an analysis of the overall operation of any local
protocols adopted or programs established pursuant to &#xA7; 9.1-193, including
any disparities in response and outcomes by race and ethnicity of individuals
experiencing a behavioral health crisis and recommendations for improvement of
the programs; (vii) a description of the overall function of the Marcus alert
program and the comprehensive crisis system, including a description of any
successes and any challenges encountered; and (viii) recommendations for
improvement of the Marcus alert system and approved local Marcus alert programs.
The report shall also include (a) a description of barriers to establishment of
a local Marcus alert program and community care or mobile crisis team to provide
mobile crisis response in each geographical area served by a community services
board or behavioral health authority in which such program and team has not been
established and (b) a plan for addressing such barriers in order to increase the
number of local Marcus alert programs and community care or mobile crisis teams.
The Department of Criminal Justice Services shall assist the Department in the
preparation of the report required by this subsection.

HISTORY: 2020, Sp. Sess. I, cc. 41, 42; 2021, Sp. Sess. I, c. 248; 2022, cc.
613, 619.