SJR 96: Comprehensive Services Act and the At-Risk Youth and Families Program

June 19, 2007

The joint subcommittee was created in 2006 to review the administration of the Comprehensive Services Act (CSA) by state and local agencies and make recommendations for improvement of program services, as well as strategies for cost containment. The first meeting of the 2007 interim was held on June 19 in Richmond.

Presentations:

Evaluation of Residential Services
Ms. Nathalie Molliet-Ribet of the Joint Legislative Audit and Review Commission (JLARC) gave a brief review of the agency’s study, Evaluation of Residential Services Delivered Through the Comprehensive Services Act. The study found that residential rates were generally appropriate, though some for-profit group homes charge rates that may not reflect intensity of services. The study also determined that access to a full array of services was key to controlling spending and improving care. However, JLARC found, most local programs had been forced to place children in residential facilities due to lack of community-based alternatives. The most critical service gaps identified included crisis services, family support, assessment, and foster families. To address these gaps, JLARC offered a number of recommendations.

Regulatory Response to JLARC’s Evaluation
Raymond R. Ratke, Deputy Commissioner, Department of Mental Health, Mental Retardation, and Substance Abuse Services provided an overview of the interagency response to recommendations delivered in JLARC's Evaluation of Children’s Residential Services Delivered Through the comprehensive Services Act and answered questions posed by the joint subcommittee.

Recent Developments
Ms. Kim McGaughey of the Office of Comprehensive Services (OCS) briefed the joint subcommittee on developments affecting the CSA Program, including efforts to increase access to community services, utilization of Innovative Service Grants, and development of a relationship with the Annie E. Casey Foundation strategic consulting group for the purpose of developing best practices to reduce out of home care and to increase investment in expanded community services. Ms. McGaughey also discussed OCS efforts to strengthen CSA community teams, focusing on developing guidelines, tools, best practices, and skill building. Efforts to improve decision-making through development of various assessment tools, replacement of the service fee directory, refinement of the CSA data set and tracking of CSA performance measures were also discussed. Ms. McGaughey concluded by providing the priorities that OCS will focus on in the coming months.

JLARC'S Follow Up Report
Ms. Molliet-Ribet introduced the topic of custody relinquishment, describing JLARC'S Follow Up Report: Custody Relinquishment and the Comprehensive Services Act. The report, requested by the joint subcommittee in December, was intended to estimate the fiscal impact of the December 6, 2006, Attorney General opinion finding custody relinquishment unnecessary for children to receive mandated services under current state law. During the course of the review, however, it was discovered that state policy also contributed to custody relinquishment. This policy was found to be in conflict with the law. Upon release of the Follow-Up Report, Ms. Molliet-Ribet emphasized, immediate action was taken to revise state policy to comply with state law. Ms. Molliet-Ribet also reported that the Follow-Up Report sought to estimate the fiscal impact on the CSA Program resulting from changes in state policy undertaken in response to the findings of the Follow-Up Report. The final estimated impact of the program was $21.2 million, with the state share equaling $13.4 million and the local share equaling $7.8 million. In conclusion, Ms. Molliet-Ribet noted that proper implementation of the new state policy would hinge upon clear definitions of key terms. Additionally, gaps in availability of community-based services could compound the fiscal impact of repealed State policy and undermine the state's ability to serve children in the least restrictive setting, as required by the CSA.

Interagency Response
Ms. McGaughey reported that the Secretary had taken immediate steps to release a memorandum containing emergency guidelines to ensure compliance with state law. Stakeholder groups were organized and interagency guidelines were drafted and distributed to be available during the required sixty day comment period. The State Executive Council is expected to take action on the guidelines on August 8, and the guidelines are expected to go into effect on August 15.

Next Meeting
The next meeting of the joint subcommittee will be posted on the study website when available.

Chairman:
The Hon. Emmett W. Hanger, Jr.

For information, contact:
Sarah Stanton and Patrick Cushing, DLS Staff

Website:
http://dls.state.va.us/CSA.htm

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