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Fairfax County Board Expands Scope of Community Services Board Audit

Social service agency scrutinized for projected $9 million shortfall that threatens services to children and disabled.

The Fairfax County Board of Supervisors unanimously agreed to take a closer look at the financially-troubled Fairfax-Falls Church Community Services Board at its June 6 board meeting.

Supervisors agreed to expand the scope of a financial audit for the CSB, an agency which provides social services to thousands of the county’s most vulnerable residents and has come under fire for an $8 million budget shortfall.

"As we all know, the (CSB) is facing serious fiscal challenges. This board has taken several actions to deal with those challenges and has directed the Human Services Council to facilitate a public review process to prioritize, review and evaluate the impact of the CSB’s proposed Budget Management Plan," according to a motion made by Supervisors John Foust (D-Dranesville), Jeff McKay (D-Lee), Cathy Hudgins (D-Hunter Mill) and Chairman Sharon Bulova (D-At-Large.)

Relations between the CSB and the board have been strained since the agency revealed a larger-than-expected budget deficit in early May. Some supervisors suggested the information about the financial-troubled agency came too late in the budget process to adequately explore the reasons behind the shortfall and develop viable solutions.

At its May 22 meeting, the second tense meeting with CSB director George Braunstein, board members expressed unanimous frustration and disappointment that the agency was considering scaling back services for at-risk children, people with intellectual disabilities and substance abuse problems to address the current $8 million shortfall that is projected to increase to $9.4 million in the fiscal year 2013.

"It troubles me that we’re stuck with this here, stuck with this now, and we’re not in budget (discussions) where we can do anything about it," said Supervisor Pat Herrity (R-Springfield) at the meeting.

Herrity called for a financial review of the agency "to ensure that the CSB is not unnecessarily wasting money, considering their looming budgetary problems."

"We hit a rough patch this year," said CSB executive director George Braunstein. He said the agency is caught between skyrocketing demands for services - especially services for children diagnosed on the autism spectrum and young adults with intellectual disabilities - and dwindling state and federal dollars.

"The CSB, at least during first three years, managed to absorb local budget reductions and not reduce access to services, "Braunstein said. "The strategies we used the last three years just didn’t work this past year."

In fiscal year 2011, CSB expenditures totaled approximately $155 million dollars. In February, the CSB notified the county of a potential $8.3 million hole in its current budget, which prompted the board to establish a $4.2 million cushion during the budget discussions.

Bulova noted that CSB programs in other parts of Virginia are funded with a combination of federal and state dollars, but in Fairfax County, 70 percent – or approximately $100 million dollars - comes from the county.

Supervisor Jeff McKay (D-Lee) said the CSB’s convoluted revenue structure complicates issues.

The CSB’s funding and revenue structure comprises federal, state and local funding, with Medicaid, private insurance and consumer fees as revenues.

"Because of the magnitude and complexity of the issues, we believe it is important that a comprehensive plan be prepared and that staff and this board refrain from pursuing the CSB review in a piecemeal manner," McKay said in the motion.

In a June 1 memo, County Executive Edward Long directed senior staff in the Department of Management and Budget and the Department of Human Services to work with the CSB to address fiscal and accountability concerns raised by the board.

Within the next three weeks, Long said he will present the board with a specific plan that outlines an approach for addressing the CSB’s fiscal and accountability issues, including concerns related to cost-effective service delivery; financial management oversight; revenue collections, including Medicaid, private insurance, and consumer fees; outsourcing opportunities; and provider rate negotiation processes.

In the interim, the motion approved Tuesday directs the Auditor of the Board to:

*Conduct a cost/benefit analysis of the current CSB contracting and billing strategies

*Analyze existing co-pay and fee-for-service policies and practices to identify potential enhancements.

On Monday, representatives of social service agencies attended the first of three public hearings hosted by the Human Services Council and the CSB to advocate for CSB programs, including the Infant and Toddler Connection, which provides evaluations and early intervention services for infants and toddlers (up to age three) who have a developmental delay.

ITC therapies include physical, speech, occupational and vision and hearing. Any delays in treatment, according to medical experts, can compound and intensify developmental delays, creating significant learning problems when children enter school. Braunstein said the demand for ITC services has jumped 38 percent in the past two years, with 165 children currently on the waiting list.

"The CSB serves our most vulnerable neighbors, those who often cannot make it without a caring hand," said Supervisor John Cook (R-Braddock). "We are going to need to shift some resources from those programs serving less needy folks, so we can help those most in need."