Thank you for allowing us the opportunity to send recommendations to the Town Hall pertaining to the Virginia Crisis Continuum. Please see the following recommendations for your review and consideration.

1. The section on Mobile Crisis states, "all employees" are required to complete training. Recommended that this be changed to all employees providing services are required to complete training.

2. The section on service delivery and outcomes states, services may not be provided to more than one individual at a time, even when a team of employees are present. Situations may arise where there is a crisis involving more than one child and there is not a team present. Recommend that it be added that crisis involving more than one child may receive services without a team present. 

3. The section on REACH referrals and response time states, that employees must be physically present for all psychiatric pre-screenings to determine if REACH services can sufficiently mitigate the immediate crisis or prevent hospitalization, ensure that REACH services are fully activated, and provide initial crisis stabilization efforts through the pre-screening process. Recommend expanding language to employees must conduct pre-screenings in person or via telehealth.

4. The section on Mobile Crisis response states, if an ECO or TDO is issued, REACH employees will make all efforts to stay with the individual until an appropriate bed is located or the individual is stabilized in the emergency room setting. However, it may not be feasible for a REACH employee to remain with the individual for the length of time indicated and it limits the assistance we can provide to others during that wait time. Recommend adding that a REACH employee must remain with the individual until the REACH service disposition has been determined.

5. The section on service overview and program description states, that REACH is unable to accept individuals into the CTH who have met the criteria for TDO by an emergency service pre-screener. Recommend changing the wording to REACH is unable to accept individuals under at TDO unless lifted into the CTH.

6. The section on type of admission-step down prevention admission states, that REACH employees will attend TDO hearings, however, if the individual has been admitted to the program, then the TDO has already been lifted. Recommend removing this statement.

7. The section on REACH responsibilities (required prior to admission) states that a signed stabilization service plan is to be signed prior to admission, however, the stabilization plan  is signed after admission. Recommend changing to the stabilization plan is signed after admission.