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Demand for Services Growing

Wait for community services called 'too long' and 'hurtful'

Getting off the waiting list for community services takes too long, was a repeated comment from the residents who spoke at the Loudoun County Community Services Board (CSB)'s May 8 public hearing.

"The time people have to wait for services is too long and is hurtful," said Robert "Bob" Lassiter, director of the Loudoun County Community Services Board, a 15-member board appointed by the Board of Supervisors that is celebrating its 30th anniversary this year. "You're not getting adequate care. ... For some services, you can't have any wait at all."

Eight people attended the public hearing to comment on the development of a Mental Health, Mental Retardation and Substance Abuse Services plan that will address the county's needs for the next six years. The CSB and 39 other boards are required to provide information to the state for the State Comprehensive Plan, which is updated every two years for budgeting purposes. The state asks for different information with each update.

This year, the state sought a one-day snapshot of those on waiting lists for mental health, mental retardation and substance abuse services as of March 31. The waiting lists provided "a realistic number of people waiting for services. It's a real way of planning that's based on real people rather than based on epidemiology," Lassiter said.

THE STATE REQUIRED each Community Services Board to count those on the waiting list for state-priority populations in the three areas of mental health, mental retardation and substance abuse services.

"The state comprehensive plan deals with services provided to the populations they define," Lassiter said. "Our mission is much broader than that."

The county CSB listed 126 residents waiting for mental retardation services, 36 residents for adult mental health services and 57 residents for adult substance abuse services. As for child and adolescent services, 13 residents were waiting for mental health services and 16 residents for adolescent substance abuse services.

"The idea here is for the state to understand what the gap is between services and demand," Lassiter said, attributing the gap to the county's population growth and a fast-growing youth population. "The demand for services is growing. The number of people waiting for services continues to grow."

Last year, the CSB served 2,626 residents needing mental health services, 626 residents needing mental retardation services and 1,871 residents needed substance abuse services, as stated in the 2002 annual report.

"We just haven't been able to keep up," said Candy DeButts, deputy county administrator, adding that state cutbacks "places more of the burden for taking care of people in need on the local jurisdictions."

In 2002, the state provided 14 percent of the CSB's budget, while the county provided 68 percent and the fees, Medicaid and federal funds provided the rest.

THE CSB PRIMARILY serves residents needing mental health, mental retardation and substance abuse services, with support for other agencies including the county public schools and the courts as a secondary mission. The services are in the areas of emergency, outpatient, day program and residential care, each associated with a fee.

"We go beyond the state's interest to service the local community," Lassiter said.

The CSB also provides:

* Outreach in all three service areas.

* Emergency services, including short-term crisis counseling, critical incident stress debriefing and referrals.

* Early intervention services from birth to age 3 for those with developmental delays or concerns.

* Prevention services to provide mental health and substance abuse information to schools, service providers, civic organizations and others.

* Job placement and coaching services for individuals with mental illness or mental retardation.

* Case management services for individuals with mental retardation.

THE GREATEST NEED for the county is in providing residential services in the mental retardation service area, along with outpatient services and adult residential programs in the mental health and substance abuse areas, Lassiter said. "The pressures around the waiting list have grown in the last three to four years more than they had in the past," he said. "We're really not being responsive. ... While our programs grow, we have the population growth that increases the demand for services. It's a matter of keeping up."

DeButts pointed out the need for improving prevention services. "The more resources we could put toward prevention, the less we have to put toward intervention, which is far more costly," she said.