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Fairfax County, Virginia
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Department of Family Services – Children's Services Act

  1. Home
  2. Family Services
  3. Children's Services Act
  4. Case Manager Resources

Department of Family Services Alert:

CONTACT INFORMATION: 9 a.m. to 5 p.m., M-F
703-324-7938 TTY 711
DFSCSA@fairfaxcounty.gov
12011 Government Center Parkway - Pennino Building
Fairfax, VA 22035
Janet Bessmer
CSA Program Manager

Department Resources

  • Children's Services Act Homepage
  • Parents and Families
    • Become a Parent Representative
    • Resources for Parents and Families
    • Right To Appeal
    • Rights and Responsibilities
  • Case Managers
    • Case Manager Resources
    • Evidence-Based Treatments and Interventions
    • Family Assessment and Planning Team
  • Provider Information
  • Staff Directory
  • Community Policy and Management Team (CPMT)

Related Resources

  • Fairfax-Falls Church Community Services Board
  • Family Services
  • Health and Human Services
  • Healthy Minds Fairfax

Case Manager Resources

Translate this page into a different language.

Please note that the forms below are intended for CSA case managers.  If you are a parent or caregiver for families, please check out our resources for families to learn more about CSA services. 


CASE MANAGERS

Please do not save copies of the forms below to your local drives as they can change periodically. Downloading them from this page will ensure you have the most up to date version of the forms and avoid delays in processing packets.

To obtain a copy of the FY 2026 CSA Policy and Procedure Manual, contact the CSA program office at (703) 324-7938 or DFSCSA@fairfaxcounty.gov.

  • Systems of Care Principles and Practice Standards

  • CANS Frequency Requirements
  • Community Based Intervention Guidance for Case Managers
  • CSA Funded Transportation Guidance
  • CSA Identifier Frequently Asked Questions
  • Educational Funding Frequently Asked Questions
  • Educational Funding Frequently Asked Questions (Spanish)
  • Evidence Based Treatments funded through the Family First Prevention Services Act and CSA
  • Evidence Based Treatments: Core Competencies, MATCH-ADTC, and Dialectical Behavioral Therapy
  • Evidence Based Treatments Job Aid for Case Managers
  • Guide for VDSS-Supported Evidence-Based Practices (EBPs)
  • Guidance on Requesting Assessments and Evaluations
  • IACCT Road Map
  • In-Home Services Guidance
  • Invoice Review Guidelines
  • Medicaid & Insurance - Exploring Funding Sources
  • Parental Contribution Checklist for Case Managers
  • Preparing Youth for the Team-Based Planning Meeting
  • Residential Treatment Request & Placement Process
  • Responsibility for the Written Placement Agreement: Guidance for CSA Case Managers
  • Requesting Initial Team Based Planning Family Resource Meeting
  • Service Request Checklist
  • Utilization Review (UR) Flyer

  • Consent to Exchange CHILD'S Information - Word Doc - English
  • Consent to Exchange PARENT'S Information - Word Doc - English
  • Consent to Exchange CHILD'S Information - DocuSign Form - English
  • Consent to Exchange PARENT'S Information - DocuSign Form - English

Spanish Language Forms

  • Consent to Exchange CHILD'S Information - Word Doc - Spanish
  • Consent to Exchange PARENT'S Information - Word Doc - Spanish
  • Consent to Exchange CHILD'S Information - DocuSign Form - Spanish
  • Consent to Exchange PARENT'S Information - DocuSign Form - Spanish

Additional Languages

  • Arabic – Consent to Exchange CHILD’S Information
  • Arabic – Consent to Exchange PARENT’S Information
     
  • Chinese – Consent to Exchange CHILD’S Information
  • Chinese – Consent to Exchange PARENT’S Information
     
  • Farsi - Consent to Exchange CHILD’S Information
  • Farsi - Consent to Exchange PARENT’S Information 
     
  • Korean - Consent to Exchange CHILD’S Information
  • Korean - Consent to Exchange PARENT’S Information
     
  • Vietnamese - Consent to Exchange CHILD’S Information
  • Vietnamese - Consent to Exchange PARENT’S Information 

  • Team-Based Planning Meeting Request Form
  • IFSP-EZ
  • Meeting Action Plan (MAP)
  • Meeting Action Plan (MAP) - Spanish
  • Case Manager Request for Community-Based Services
  • Case Manager Request FAPT Meeting
  • Substance Abuse Disorder Request (For CSB Only)
  • Psychiatric Hospitalization Diversion

CANS Information 

  • CANS Manual - Standard CANS Birth - 4 years old
  • CANS Manual - Standard CANS 5+
  • CANS Glossary
  • CANS Manual - Enhanced DFS CANS Birth - 4 years old
  • CANS Manual - Enhanced DFS CANS 5+

CANS Certification and CANVaS Information:

  • CANS Certification and Training
  • CANVaS Instructions - contains information on setting up a CANVaS account and entering CANS ratings in the CANVaS system
  • CANVaS Account Request form
  • CANVaS Login


Starting October 31, 2025, all CANVaS users will need to use "OKTA Verify" to log in to the CANVAS system. View instructions to set up Okta Verify.

For assistance with your CANVAS account please visit www.vita.virginia.gov/contact.

  • Parental Contribution Checklist for Case Managers
  • Parental Contribution Assessment (includes waiver/reduction request form)
  • Parental Contribution Assessment (Spanish) (includes waiver/reduction request form)
  • Parental Contribution Assessment (DocuSign Form)
  • Parental Contribution Assessment (Spanish - DocuSign Form)

Parental Contribution Informational Documents

  • Parent Contribution Information for Families 2025
  • Parent Contribution Information for Families 2025 (Spanish)

  • Encumbrance Form

CSA Provider Directory

The directory is broken down by service category. Please note, ABA services are Evidence Based Treatment and not be under Community Based Services. Providers will appear on the list multiple times if they have multiple service categories. 

Please use the Provider Concern Form to document your concern with about a CSA provider. Please note that these submissions are not reviewed immediately.

If this is an emergency or situation that requires immediate attention, please first contact the proper authorities and consult with your supervisor prior to completing this form. If needed, contact CSA staff directly.

  • Child Specific Contract Request
  • Child Specific Contract Request Attachment
  • Provider Reporting Requirements
  • Provider Reporting Requirements at a Glance (Short version)

Dialectical Behavior Therapy Training Slide Deck

  • Administrative Reconsideration Request
  • CSA Eligibility Form
  • Intensive Care Coordination Budget/Extension Request
  • Amend Service Authorization Request Form (Fix Memo)
  • Contract Services/Placement by Other Agencies Case Information (Special Education Students)
  • IAACT Inquiry Form
  • Wrap Fairfax ICC Referral Form
  • UMFS ICC Referral Form
  • Transportation Estimate Calculator (Excel)
  • CSA Case Status Change Form
  • County to County Transfer
  • Parental Agreement
  • Parental Agreement - SPANISH

CSA provides mandatory and supplemental trainings to help prepare staff who interact and work with the CSA program to effectively serve children, youth, and families who access services through our system(s).  

Required Trainings
 
All new CSA case managers are required to participate in the three-part training series within the first 12 months of hire. The intended audience is CSA lead case managers, supervisors of lead case managers, Family Assessment and Planning Team (FAPT) members, and CSA staff. Attendance is also required of FCPS and FCCPS school social workers, FCPS-MAS staff, probation officers, and CSB therapists who work with the CSA program.  

  • Part I: Intro to System of Care - Overview of Systems of Care principles and Practice Standards.
  • Part II: Facilitating Family Resource Meetings (FRMs)
    Outlines the process on how and when to request a family resource meeting. Covers the essential elements of conducting a family meeting to include: preparing for the meeting, orienting youth and families to the meeting process, facilitating the meeting and developing an action plan that identifies the needs, strengths, and objectives for the team.
  • Part III: Accessing CSA Services (Part II is required before attending Part III)
    Overview of CSA eligibility criteria, referral process, forms, CANS requirements, resources, contracts, and utilization review process.

Lunch n Learns:

  • TBA

Annual Training Opportunities:

  • Commonwealth of Virginia's Children's Services Act Conference
  • Northern Virginia Coalition of Private Provider Associations
  • NOVA Annual CSA Symposium and Provider Expo (Wednesday, March 18, 2026)
    • Save the Date
    • Event Brochure

Upcoming Community Outreach Events

  • TBA

To receive updates regarding CSA training opportunities, sign up for the CSA Connections newsletter. 

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