SD10 - Executive Summary of the Joint Subcommittee Studying the Comprehensive Services Program for At-Risk Youth and Families Program SJR 96 (2006)


    Executive Summary:
    Senate Joint Resolution 96(2006) established the Joint Subcommittee to Study the Comprehensive Services for At-Risk Youth and Families Program. During the first year of the study, the 2006 interim, the joint subcommittee held four meetings to evaluate the administration and cost effectiveness of the Comprehensive Services Act (CSA) Program. During the same period, the Joint Legislative Audit and Review Commission (JLARC) carried out an evaluation of the administration of the CSA.

    During the second part of the study, the 2007 interim, the joint subcommittee continued it's evaluation of the administration and cost effectiveness the Program. At its first meeting, the joint subcommittee received a report on JLARC's findings with regard to the administration and cost of the program and the interagency response to JLARC's report. The joint subcommittee also received information on JLARC's findings contained in the Commission's Follow-up Report: Custody Relinquishment and the Comprehensive Services Act and information on the State Executive Council's response to that report.

    At it's second meeting, held at Elk Hill Farm, the joint subcommittee heard information about the role of private providers; received an update on developments affecting the cost and administration of the Program; heard a presentation about First Lady Anne Holton's For Keeps Initiative, which focuses identifying and eliminating barriers to permanent placements for older foster children; and received information regarding activities of the Secretary of Health and Human Resources related to children's mental health needs.

    The third meeting began with a comprehensive overview of the Hampton Comprehensive Services Program, including information on how the program has evolved and how the program works to develop services and provide supports necessary to keep children out of residential care. The joint subcommittee also heard comments from representatives of local government regarding the impact of the Comprehensive Services Program on localities and the challenges localities face in administering the program. The meeting concluded with a preliminary discussion of legislative recommendations for the 2008 session of the General Assembly.

    The first half of the final meeting of the joint subcommittee for the 2007 interim included a presentation by the Annie E. Casey Foundation's Strategic Consulting Group, which has been working in the Commonwealth in partnership with the First Lady's For Keeps Initiative. The Group's presentation included information on the status of Virginia's foster care efforts and recommendations for improving the foster care system.

    During the second half of the final meeting of the 2007 interim, the joint subcommittee focused on finalizing recommendations for the upcoming session. Following some discussion, the joint subcommittee resolved to move forward with legislation to:

    Require family assessment and planning teams to develop residential service plans for youth placed in residential facilities.

    Require the Office of Comprehensive Services to include in its child-level data set a field (i) identifying the facility in which a child receives services, including any residential service provider's identification number, (ii) indicating the circumstances under which each child ends each service, and (iii) indicating the circumstances under which each child exits the Comprehensive Services Act program.

    Require the State Executive Council to oversee the development and implementation of a set of uniform performance standards, including standards for evaluation of local decisions regarding levels of care and participant outcomes.

    Require the State Executive Council to oversee the development and implementation of a program for the collection of data on (i) the cost of services purchased through the CSA program, (ii) treatment foster care services and residential services payments made through the Medicaid program, and (iii) child-specific payments made through the Title IV-E foster care program.

    Require the State Executive Council to oversee development and implementation of data collection standards and collection of data for a client-specific database.

    Require the State Executive Council to oversee development and implementation of uniform standards of utilization review to include review of how individual need for services is determined, how services are procured, and how services are delivered.

    Add data regarding the number of youth and families eligible for CSA-funded services, the type of services provided, and the cost of services to the list of data that the State Executive Council is required to collect and for which the State Executive Council is required to develop and implement data collection standards.

    Require the State Executive Council to develop and implement uniform data collection standards to collect data on residential service providers and residential services provided under the Comprehensive Services Act program and to develop uniform outcome measures to evaluate residential services provided under the Comprehensive Services Act program.

    Require the Director of the Office of Comprehensive Services for At-Risk Youth and Families to provide an annual workshop to train CSA staff and other interested parties on best practices and evidence-based practices related to the CSA Program.

    Require community policy and management teams to identify children in residential care facilities who can be appropriately served in their homes and communities and to develop a plan for the return of such children from residential care to their homes and communities.

    Require the State Executive Council to develop and implement an intensive case management services system, including uniform standards for case management for children in residential care.

    The joint subcommittee also resolved to:

    Request the Department of Social Services to study ways of increasing the number of foster families in the Commonwealth.

    Request that the Joint Subcommittee be continued for another year.

    In addition to these legislative recommendations, the joint subcommittee further resolved to recommend budget amendments to:

    Create a differential local match rate for funds used for residential care services and community based services, with the match rate for residential services higher than that for community based services, and

    Allow localities to keep a portion of any funds allocated to the locality in a given year but not spent in that year, for reinvestment in community based services.

    It was also resolved by the joint subcommittee to support the activities and recommendations of the Annie E. Casey Foundation's Strategic Consulting Group, working in the Commonwealth in cooperation with First Lady Anne Holton's For Keeps Initiative. The recommendations expressed by the Group include:

    Adoption of a statewide philosophy that supports family-focused, child-centered, community-based care with a focus on permanence for all children;

    Establishment of a state-level practice model focused on family-focused care and permanence that is reinforced by a uniform training program for resource families as well as local staff in DSS and CSA (integrated with the Department of Mental Health, Mental Retardation and Substance Abuse Services' practice model);

    Creation and implementation of a statewide strategy to increase availability and utilization of relative care and non-relative foster and adoptive placements to ensure that children can be placed in the most family-like setting that meets their needs;

    Enhancement of the Department of Social Services', the State Executive Council's, and the Office of Comprehensive Services' capacity to develop and disseminate policies and best practices, and provide technical assistance to localities in support of the newly-established practice model;

    Continued development of current efforts to create a robust performance monitoring/quality assurance system to identify and measure outcomes, monitor quality of practice, and improve accountability; and

    Strengthening of financial incentives to reduce reliance on congregate care and serve children in the least restrictive settings possible or in their homes.