Virginia operates 13 facilities: eight behavioral health facilities for adults, two training centers, a psychiatric facility for children and adolescents, a medical center, and a center for behavioral rehabilitation. State facilities provide highly structured, intensive services for individuals with mental illness, intellectual disability or are in need of substance use disorder services. In the evolutionary movement towards a single, integrated system of care, increased emphasis has been placed on the establishment of community services and on the more effective and efficient use of state facilities. This emphasis has defined the role of state facilities as one of several resources in an overall continuum of care. Patients are initially evaluated and referred to the mental health facilities by staff from Community Services Boards (CSBs). Pre-admission screening services are provided by CSBs on a 24-hours per day, 7 days per week basis.