2023 Code of Virginia › Title 37.2 - Behavioral Health and Developmental Services › Chapter 6 - Behavioral Health Authorities › § 37.2-608. Performance contract for mental health, developmental, and substance abuse services

A. The Department shall develop and initiate negotiation of the performance contracts through which it provides funds to behavioral health authorities to accomplish the purposes set forth in this chapter. The Department may, notwithstanding any provision of law to the contrary, disburse state and federal funds appropriated to it for mental health, developmental, and substance abuse services directly to the behavioral health authority. Six months prior to the beginning of each fiscal year, the Department shall make available to the public the standard performance contract form that it intends to use as the performance contract for that fiscal year and solicit public comments for a period of 60 days.
B. Any behavioral health authority may apply for the assistance provided in this chapter by submitting annually to the Department its proposed performance contract for the next fiscal year together with the approval of its board of directors and the approval by formal vote of the governing body of the city or county that established it. The behavioral health authority shall make its proposed performance contract available for public review and solicit public comments for a period of 30 days prior to submitting its proposed contract for the approval of its board of directors. To avoid disruptions in service continuity and allow sufficient time to complete public review and comment about the contract and negotiation and approval of the contract, the Department may provide up to six semi-monthly payments of state-controlled funds to the behavioral health authority. If the governing body of the city or county does not approve the proposed performance contract by September 30 of each year, the performance contract shall be deemed approved.
C. (Effective until July 1, 2024) The performance contract shall (i) delineate the responsibilities of the Department and the behavioral health authority; (ii) specify conditions that must be met for the receipt of state-controlled funds; (iii) identify the groups of individuals to be served with state-controlled funds; (iv) contain specific outcome measures for individuals receiving services, provider performance measures, satisfaction measures for individuals receiving services, and participation and involvement measures for individuals receiving services and their family members; (v) contain mechanisms that have been identified or developed jointly by the Department and the behavioral health authority and that will be employed collaboratively by the behavioral health authority and the state hospital to manage the utilization of state hospital beds; (vi) establish an enforcement mechanism, should the behavioral health authority fail to be in substantial compliance with its performance contract, including notice and appeal processes and provisions for remediation, withholding or reducing funds, methods of repayment of funds, and the Department's exercise of the provisions of subsection E; and (vii) include reporting requirements and information about revenues, costs, services, and individuals receiving services displayed in a consistent, comparable format determined by the Department.
The Department may provide for performance monitoring to determine whether behavioral health authorities are in substantial compliance with their performance contracts.
C. (Effective July 1, 2024; effective until July 1, 2025) The performance contract shall:
1. Delineate the responsibilities of the Department and the behavioral health authority;
2. Specify conditions that must be met for the receipt of state-controlled funds;
3. Identify the groups of individuals to be served with state-controlled funds;
4. Contain specific outcome measures for individuals receiving services, provider performance measures, satisfaction measures for individuals receiving services, and participation and involvement measures for individuals receiving services and their family members;
5. Contain mechanisms that have been identified or developed jointly by the Department and the behavioral health authority and that will be employed collaboratively by the behavioral health authority and the state hospital to manage the utilization of state hospital beds;
6. Contain provisions that enable the Department to enforce the performance contract in the event that the behavioral health authority fails to substantially comply with the requirements of its performance contract, which shall include:
a. Provisions to ensure that the executive director and chairman of the behavioral health authority are notified when the behavioral health authority fails to substantially comply with the requirements of its performance contract;
b. A remediation process to allow the behavioral health authority, after failing to substantially comply with its performance contract, to come into substantial compliance with its performance contract;
c. Provisions for withholding or reducing funds, repayment of funds, or termination of all or part of a performance contract in accordance with the provisions of subsection E in the event that the behavioral health authority fails to come into substantial compliance with the provisions of its performance contract despite utilization of the remediation process described in subdivision b; and
d. Provisions for appeal of an enforcement action undertaken by the Department; and
7. Include requirements for the behavioral health authority to report specific information about (i) its revenues, costs, and services; (ii) individuals served; and (iii) any other information deemed necessary by the Department, which shall be displayed in a consistent, comparable format developed by the Department.
C. (Effective July 1, 2025) The performance contract shall:
1. Delineate the responsibilities of the Department and the behavioral health authority;
2. Specify conditions that must be met for the receipt of state-controlled funds;
3. Identify the groups of individuals to be served with state-controlled funds;
4. Set forth specific goals and objectives related to the delivery of services to individuals with mental illness, developmental disabilities or substance use disorders that are consistent with the purposes set forth in § 37.2-601;
5. Contain specific relevant, and measurable performance measures to assess the experiences and outcomes of individuals receiving services through behavioral health authorities;
6. Contain relevant benchmarks and monitoring activities for each performance measure;
7. Contain mechanisms that have been identified or developed jointly by the Department and the behavioral health authority and that will be employed collaboratively by the behavioral health authority and the state hospital to manage the utilization of state hospital beds;
8. Contain provisions that enable the Department to enforce the performance contract in the event that the behavioral health authority fails to substantially comply with the requirements of its performance contract, which shall include:
a. Provisions to ensure that the executive director and chairman of the behavioral health authority are notified when the behavioral health authority fails to substantially comply with the requirements of its performance contract;
b. A remediation process to allow the behavioral health authority, after failing to substantially comply with its performance contract, to come into substantial compliance with its performance contract;
c. Provisions for withholding or reducing funds, repayment of funds, or termination of all or part of a performance contract in accordance with the provisions of subsection E in the event that the behavioral health authority fails to come into substantial compliance with the provisions of its performance contract despite utilization of the remediation process described in subdivision b; and
d. Provisions for appeal of an enforcement action undertaken by the Department; and
9. Include requirements for the behavioral health authority to report specific information about (i) its revenues, costs, and services provided; (ii) individuals served; and (iii) any other information deemed necessary by the Department, which shall be displayed in a consistent, comparable format developed by the Department.
D. The Department shall develop and implement a process for regular, ongoing monitoring of the performance of behavioral health authorities to ensure compliance with the requirements of performance contracts entered into pursuant to this section.
E. If a behavioral health authority fails to substantially comply with the requirements of its performance contract, the Department shall utilize the remediation process described in the performance contract to allow the behavioral health authority to come into substantial compliance. The Department shall notify the Board and the chairman of the behavioral health authority upon initiation of the remediation process and provide to the Board and chairman regular updates regarding the behavioral health authority's progress toward coming into substantial compliance.
If a behavioral health authority fails to come into substantial compliance after utilization of the remediation process, the Department shall, after affording the behavioral health authority an adequate opportunity to use the appeal process described in the performance contract, terminate all or a portion of the performance contract.
F. Upon terminating all or a portion of a performance contract pursuant to subsection E, the Department may, using the state-controlled resources associated with that performance contract and after consulting with the governing body of the city or county that established the behavioral health authority that was a party to the performance contract, negotiate a performance contract with a community services board, another behavioral health authority, or a private nonprofit or for-profit organization or organizations to obtain services that were the subject of the terminated performance contract.
1998, c. 680, § 37.1-248.1; 2005, cc. 75, 716; 2012, cc. 476, 507; 2023, cc. 484, 754, 790.