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The Virginia COSIG Project and the Virginia Service Integration Program


In late 2002, SAMHSA presented a landmark report to the U.S. Congress on the status and treatment of co-occurring disorders in the nation which outlined the need for a coordinated, integrated response to the problem. Congress subsequently appropriated funding to develop the State Infrastructure Grant Program for the Treatment of Persons with Co-Occurring Substance Related and Mental Health Disorders, also known as “COSIG”. The COSIG grant program is designed to provide funding to the States to develop or enhance their infrastructure and capacity to provide “accessible, effective, comprehensive, integrated and evidence-based treatment services” to persons with co-occurring substance abuse and mental disorders.

In Virginia, DBHDS and the CSBs have long recognized the need to integrate and improve services to this segment of our consumer population. Several years ago, this need gave rise to the Virginia Association of Community Services Boards’ (VACSB’s) “Co-Occurring Workgroup,” which was established to create a partnership and forum between the VACSB Mental Health and Substance Abuse councils for dialogue and action. Within this context, in October 2004 DBHDS applied for and was awarded a five-year, $3.5 million award under the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) COSIG Program to enhance the screening, assessment and treatment of co-occurring mental illness and substance abuse (CODs) throughout Virginia’s public behavioral health system. Concurrent with the COSIG award, the Commonwealth was also selected to participate in SAMHSA’s second Policy Academy on CODs. Participation in the Policy Academy enabled state-level representatives from DBHDS, the Department of Medical Assistance Services (DMAS) and the VACSB to work with national-level experts to develop a State Action Plan for COD service integration.

Virginia’s COSIG Project began in May 2005 at a pilot group of 11 CSBs, and in 2006 was expanded to all CSBs and state mental health hospitals. The overall goal of the project is to enhance the state’s ability to identify and treat co-occurring mental health and substance use disorders through the following activities:

In 2006, the name of this initiative was changed from the Virginia COSIG Project to the Virginia Services Integration Program (VASIP) to indicate that the integration of mental health and substance abuse treatment and other infrastructure development activities being promoted through the Virginia’s COSIG grant are not limited to the timeframe or funding of the federal grant – this process is part of our larger system transformation effort and will continue after the federal grant ends in September 2009.

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Since its inception in early 2005, the VASIP/COSIG initiative has made a number of important accomplishments in furtherance of our goal of infrastructure development and service integration. These include the following:

Goal Area: Develop infrastructure to support service integration at all levels of the public system through implementation of Minkoff’s C ontinuous, Comprehensive, Integrated System of Care Model (CCISC).

Indicators (outcomes as of June 2007):

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Goal Area: Develop capacity to provide treatment and other services to persons with CODs and promote the adoption of Evidence-Based Practices through workforce development and training activities.


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Goal Area: Develop State Steering Committee to provide stakeholder input into VASIP/COSIG activities.


Current and Upcoming Activities

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