CSB Chair Mark Sites Testimony to Fairfax County Human Services Council
March 5, 2013
Good evening, my name is Mark Sites, and I am here as the Chair of the Fairfax-Falls Church Community Services Board. I would like to thank you for inviting the CSB here this evening to present our views regarding the County Executive’s proposed FY 2014 budget.
We are very pleased that this proposed budget includes funds that will enable us to provide employment and day support services for young people with intellectual disability who graduate this year from Fairfax County Public Schools and need continuing services. We are also grateful that the proposed budget includes additional funds for early intervention services for infants and toddlers with developmental delays.
There is an area of concern, however, that needs your attention.
Over the past year, the CSB has maintained a staff position vacancy rate of 11.2 percent to ensure that our expenditures did not exceed revenues. For much of the year, the CSB has held vacant as many as 140 staff positions; today we still have over 100 vacant positions. As you can imagine, holding so many positions vacant for so long has put considerable stress on current employees and has negatively affected CSB’s ability to provide services in many critical areas.
This situation has also impeded our ability to collect budgeted revenues, from Medicaid, private insurance and fees. This occurs directly, by not having enough administrative staff to support the clinicians, and indirectly, by not having enough clinicians to provide billable services.
Here are just a few examples of the negative impact this is having:
- Staff shortages have forced CSB residential services to hold 18 beds open for the past nine months, resulting in an estimated loss in Medicaid revenue of $128,000. The greater tragedy is that over 500 individuals are on a waiting listfor these much-needed services for individuals with serious mental illness and co-occurring substance use disorders.
- Thirty (30) percent of all individuals coming to CSB emergency services now have to wait between one and four hours to be seen. Historically, 85 percent of all CSB emergency services clients were seen in less than one hour.
- Daytime operations of the CSB mobile crisis unit are being suspended intermittently because of insufficient staff coverage. This impacts many other county agencies, including police and Adult Protective Services.
- Last month, CSB had to cut the capacity of its Crisis Care facility by 25 percent (from 16 to 12 beds) due to lack of staff. People who might have been admitted to Crisis Care will now have to be hospitalized. This intensifies the current shortage of psychiatric hospital beds in our region.
- Our Detoxification Center has only enough staff to keep open five beds for individuals needing medical detoxification. Currently 22 people are waiting for one of those five beds, and they are likely to have to wait two to three weeks.
- The six-person adult case management team at our Springfield office is currently handling 295 active cases of individuals who have serious mental illness. This means each staff member is handling an average of 49 cases, far in excess of best practice standards for community based care, which recommend one case manager for every 20-30 cases.
- In our Intensive Community Treatment Services, a program that works with individuals who have complex mental health and substance use issues, compounded by homelessness, staff shortages mean delays in authorization for Medicaid reimbursement and compromised staff supervision.
We are asking the Board of Supervisors to add $1.1 million to our FY 2014 budget to reduce the staff position vacancy rate from 11.2 percent to approximately 9 percent, so we can fill approximately 11 vacant staff positions that are urgently needed.
We also ask that the Board of Supervisors restore three positions that have been proposed for elimination in FY 2014. We are not requesting additional funding for these three positions at this time, but we need to retain the flexibility to fill them in the future.
One is a senior management position, which is responsible for managing the implementation of the Department of Justice settlement regarding the provision of community-based services for residents of Virginia’s “training centers,” including Northern Virginia Training Center. The other two positions are in our Wellness and Health Promotion Services, which has lost two-thirds of its staff in the last two years.
As we focus your attention on these priority concerns in the County Executive’s Advertised Budget, our Board also wishes to inform you that we are gathering information to help guide decisions for FY 2015 and beyond.
We are holding three public hearings this month to help us identify community needs and gaps in our current system. It is our intention to identify services and strategies for creating a complete system that meets the needs of this community and that carries out the Beeman Commission recommendations which the Board of Supervisors endorsed.
We will be reporting our recommendations to the Board of Supervisors later this year so that they can be considered as the FY 2015 budget is developed.
On behalf of the CSB I thank you for your support today and over the years.