Joint Legislative Audit and Review Commission of the Virginia General Assembly

Secretary of Health and Human Resources The Design And Implementation Virginia’sComprehensive Services ActBriefing for Commission on Revision of Virginia'sState Tax CodeAugust 18th, 20032 Problems Leading To Development of CSA How CSA Works And Who It Serves Early Study Findings and CurrentExpenditure Trends Status of Secretary’s Action Plan3 Prior to the enactment of CSA, treatment services for troubled children werepaid for through six different funding streams across four State agencies: Department of Education (DOE) Department of Social Services (DSS) Department of Juvenile Justice (DJJ) Department of Mental Health, Mental Retardation, and Substance AbuseServices (DMHMRSAS) Problems associated with the delivery of services through this fragmentedsystem included: Service duplication --14,000 cases across four agencies were found torepresent no more than 5,000 children Unequal access to care fueled by differences in the local match rates Reliance on more expensive forms of care also caused, in part, bydifferences in local match rates Program expenditures rates that grew annually by approximately 22 percent4 Upon enacting CSA, the General Assemblyestablished several program goals. Includedamong these were: provision of services to at-risk children in the leastrestrictive environment possible promotion of early intervention with children and theirfamilies who are at-risk of developing emotional andbehavior ...