Executive Summary of the Interim Activity and Work Conducted by the Virginia Commission on Youth during 2005 pursuant to §§ 30-174 and 30-175).

Biennial Update of the Collection of Evidence-based Treatment Modalities for Children and Adolescents

The 2002 General Assembly, through Senate Joint Resolution 99, directed the Virginia Commission on Youth to coordinate the collection of empirically-based information on treatments recognized as effective for children, including juvenile offenders, with mental health treatment needs, symptoms and disorders. The resulting publication entitled Collection of Evidence-based Treatments for Children and Adolescents with Mental Health Treatment Needs (Collection) was compiled by the Commission on Youth with the assistance of an advisory group of experts pursuant to the resolution. The Collection was published in House Document 9 and presented to the Governor and the 2003 General Assembly.

The 2003 General Assembly passed Senate Joint Resolution 358, which required the Commission to update the Collection biennially. The Commission on Youth designed this initiative to be assisted by an advisory group, which was to provide overall guidance, including direction and philosophy for the update of the Collection. The Collection 2nd Edition was published in 2005.

The Collection 2nd Edition provides an updated listing of evidence-based treatments and practices that have proven most effective for children and adolescents with mental health treatment disorders. Additionally, this report includes information on maladaptive behaviors. Other features are a comprehensive glossary, a listing of commonly-used acronyms, information on provider licensing requirements, and a section on antidepressants and suicide. The Collection 2nd Edition may be accessed on the Reports Section on the Commission on Youth's website ( http://coy.state.va.us).

Senate Joint Resolution 358 also required the Commission to disseminate the Collection via web technologies. As specified in this resolution, the Commission received assistance in disseminating the Collection from the Advisory Group, the Secretary of Health and Human Resources, the Secretary of Education, and the Secretary of Public Safety. The dissemination of the Collection via web technologies was a tremendous success. The Commission on Youth received over 39,000 web hits in one month alone.

Following presentations by Commission on Youth staff at the September 20 and November 21, 2005 meetings, the Commission on Youth adopted the recommendations which follow. (See Senate Document No. 10 (2005) ( https://rga.lis.virginia.gov/Published/2005/SD10 )

CONTINUATION OF STATEWIDE DISSEMINATION EFFORTS

Recommendation 1
By letter, request all agencies in the Secretariat of Health and Human Resources, the Secretariat of Public Safety, and the Secretariat of Education, post the second edition of the Collection to their respective web sites to cost-effectively and efficiently facilitate access to this information.

EXPANSION OF STATEWIDE DISSEMINATION EFFORTS

Recommendation 2
By letter, contact local mental health providers as well as local juvenile justice officials to inform them of the second edition of the Collection as well as how such information may be accessed. Such contact will be via the Virginia Association of Community Services Boards, the State and Local Advisory Team through the State Executive Council, and through the Department of Criminal Justice Services.

Recommendation 3
By letter, request that the Virginia Bureau of Insurance, the Virginia Medical Society, the Psychiatric Society of Virginia, and the Virginia Academy of Pediatrics, inform their members the second edition of the Collection as well as how such information may be accessed.

ENCOURAGING THE USE OF EVIDENCE-BASED TREATMENTS

Recommendation 4
By letter, request that the Secretary of Health and Human Resources, as well as the Department of Juvenile Justice, the Department of Education, and the Department of Criminal Justice Services, continue to encourage the use of the evidence-based treatments in programming and development of any future projects.

Recommendation 5
Direct the Commission on Youth, in conjunction with the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services, to convene a statewide conference with the express purpose of identifying and communicating to behavioral healthcare professionals evidence-based practices for children and adolescents with mental health disorders. To plan for this conference, the Commission shall organize a Conference Planning Committee comprised of representatives from all of the Commonwealth's child-serving agencies. An update on the progress of the conference plan shall be reported to the Commission on Youth prior to the 2007 General Assembly session.

Recommendation 6
By letter, request the Department of Mental Health, Mental Retardation, and Substance Abuse Services to include information regarding evidence-based treatment modalities and practices recognized as effective for the treatment of children, including juvenile offenders, in upcoming conferences or trainings, as applicable.

SCHOOL-BASED DISSEMINATION OF EVIDENCE-BASED TREATMENTS

Recommendation 7
By letter, request that the Virginia Department of Education inform school divisions of the second edition of the Collection so that it may be utilized by guidance offices, school-based health offices, and school special education services.

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At-Risk Youth Served in Out-of-State Residential Placements

Virginia places great importance on children remaining with their families whenever possible. However, when this is not possible, children may be placed in out-of-state residential placements. The purpose of the Comprehensive Services Act for At-Risk Youth and Families (CSA) is to create a collaborative system of services and funding that is child-centered, family-focused, community-based and cost-effective when addressing the strengths and needs of troubled and at-risk youths and their families in the Commonwealth (§ 2.2-5200). A primary purpose of the law is to preserve and strengthen families through providing appropriate services in the least restrictive environment, enabling children to remain in their homes and communities when possible, while protecting the welfare of children and maintaining public safety.

The Interstate Compact for the Placement of Children located within the Department of Social Services is responsible for approving and monitoring the interstate placement of children, including those children placed through the Comprehensive Services Act. With consideration of the impact of the child and family and the financial impact on the state, the Commission on Youth undertook this study on at-risk youth served in out-of state residential placements in order to determine the number of children receiving services in out-of-state residential treatment centers in lieu of being served in the Commonwealth; to determine the reasons these children are being placed out of the Commonwealth, as well as the cost; and to assess if there is service ability in the Commonwealth to serve these children.

In investigating the issue, Commission on Youth staff sought to:

• Identify data sources regarding out-of-state placements;
• Review the Interstate Compact on the Placement of Children to ascertain if there is adequate documentation regarding out-of-state placements;
• Meet with state agencies which place children to ascertain affected population and with other child-serving local agencies to determine frequency of out-of-state placements;
• Compile a data collection instrument to review the use of out-of-state residential facilities (if data is not otherwise available)
• Compile a description of services provided in out-of-state facilities that are not available within the Commonwealth;
• Conduct a cost analysis of out-of-state placements; and
• Assess unmet needs.

Following presentations at its November 21, 2005 meeting by the Virginia Department of Social Services, and the Commission on Youth staff, the Commission on Youth adopted the recommendations which follow.

VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Recommendation 1
Request that the Department of Social Services update its policy manual for the Interstate Compact for the Placement of Children (ICPC) by June 30, 2006.

Recommendation 2
Request the Department of Social Services, in conjunction with the Virginia Institute for Social Services Training Activities (VISSTA), develop a training manual for the Interstate Compact for the Placement of Children (ICPC) progress. All local social services workers in the areas of foster care and adoption and their supervisors should be trained on the ICPC progress. This training should be ongoing and shall be included in the training of all new social services case workers in the areas of foster care and adoption.

Recommendation 3
Request the Department of Social Services to monitor the placement of children served by the Interstate Compact for the Placement of Children (ICPC) through an automated reporting and tracking system. This will include information on children served by ICPC including those referred by other agencies. The Department of Social Services, in developing this system, will determine whether this system should be linked to the OASIS system, as well as other existing data systems. The Department of Social Services shall report on these activities to the Commission on Youth prior to the 2007General Assembly Session.

Recommendation 4
Request the Department of Social Services to report annually to the General Assembly about the number of Virginia's children being served in out-of-state placements, including those being served in residential facilities. The report shall include information regarding the number of children receiving services in out-of-state residential treatment centers, the reasons these children are being placed out of the Commonwealth, and the cost.

Recommendation 5
Request that the Department of Social Services review the state's Interstate Compact for the Placement of Children (ICPC) system, including its management, staffing, caseloads, paper and electronic process, tracking systems, and databases to develop amore efficient, accountable ICPC system for all those who participate in the ICPC process. Further, the Department of Social Services shall ensure that Virginia is incompliance with all state and federal laws and regulations. The Department of Social Services shall report on these activities to the Commission on Youth prior to the 2007 General Assembly Session.

OFFICE OF COMPREHENSIVE SERVICES

Recommendation 6
Request the Secretary of Health and Human Resources, in conjunction with the State Executive Council (SEC), to investigate the feasibility of utilizing a unique child identifier across all child-serving agencies. Request the SEC to coordinate with the data workgroup to evaluate the need to modify the reasons for service fields so that they are more helpful for ascertaining the reasons for service for program development. A report on these activities shall be made to the Commission on Youth prior to the 2007 General Assembly Session.

Recommendation 7
Request that the Office of Comprehensive Services (OCS) to improve the information available in and revise the system through which provider information is placed in the Service Fee Directory. Request that OCS update the Directory and request that locality-specific, service-specific, and licensing information be included.

Recommendation 8
Request the State Executive Council to coordinate with the data workgroup to evaluate the need to modify the reasons for service fields so that they are more helpful for ascertaining the reasons for service for program development.

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Information & Referral System and 2-1-1 Services

As part of the 2004 Commission on Youth study on Strengthening Families in Virginia, the Commission identified Virginia's Information and Referral System (I&R) as an important means to access information and referrals for health and human services. I&R is a fast, free and confidential way to locate hundreds of services in communities across the state. By calling the current toll-free number (1-800-230-6977), citizens of the Commonwealth are connected to a trained profession, who can provide referrals to a wide variety of health and human services including:

• Basic human needs,
• Physical and mental health resources,
• Work initiatives,
• Support for seniors and those with disabilities,
• Support for children, youth and families,
• Volunteer opportunities in the community,
• Nutrition,
• Tax credits, and
• Jobs.

While Virginia has a statewide information and referral system that is available as a free resource to citizens, the Commission on Youth found that the system was underutilized due to the hard-to-remember toll-free number and lack of public awareness. As a result, in 2004, the Commission recommended that Virginia's I&R system move to a statewide 2-1-1 system. 2-1-1 is a three-digit telephone number to reach I&R for free information and referrals. 2-1-1 streamlines access to existing services, eliminates confusing and frustrating searches, expands hours of operation, reduces the number of non-emergency calls to 9-1-1, increases multi-lingual accessibility, and coordinates access to information about thousands of federal, state, and local programs and sources of specialized help.

In 2005, the Commission on Youth has endeavored to further support and assist specifically with the coordination of efforts to develop a linked, comprehensive I&R System for Virginia via 2-1-1.

At its November 21, 2005 meeting, the Commission on Youth agreed to pursue funding through a budget amendment during the 2006 General Assembly Session for the purpose of implementing a statewide 2-1-1 system.