selected trends in service utilization and demand june 2001

Selected Trends in Service Utilization and Demand

June 2001

Prepared by the Fairfax County Department of Systems Management

for Human Services12011 Government Center Parkway, Suite 946

Fairfax, Virginia 22035

To obtain an additional copy of this report, please contact the Department of Systems Management for Human Services at (703) 324-5638

or e-mail your request to [email protected]

3

Fairfax County Human Services: Response to Challenges in the Community

Selected Trends in Service Utilization and Demand• This report presents utilization and trend data for selected services and programs offered by Fairfax County Human Services. This report

seeks to illustrate the scope of human services and to highlight selected trends in service demand over time. It is not intended to provide a comprehensive picture of every human service offered by the County, nor does it provide information on program performance or client outcomes. (For a comprehensive picture of Human Services’ program, budget, and performance data, see the Fairfax County Human Services FY 2001 Performance Budget)

• The report is organized by seven “Community Challenges,” or statements of basic goals that local government shares a legal or ethical responsibility to achieve. For each challenge, there is a desired “Quality of Life” statement as well as an “Action Statement” that summarizes the Human Services approach to achieving the desired quality of life.

– Challenge 1: Providing Assistance to Promote Independence– Challenge 2: Ensuring Safe, Affordable Housing– Challenge 3: Supporting Families and Individuals in Crisis/Preventing Abuse & Neglect– Challenge 4: Protecting the Public Health– Challenge 5: Addressing Alcohol, Drug, Mental & Physical Health Issues– Challenge 6: Responding to Crime in the Community– Challenge 7: Providing Community-wide and Targeted Supports to Prevent Social Isolation and Neighborhood

Deterioration.

• Please note that with a few exceptions, this report presents information only on services provided directly by Fairfax County Human Services and some contract agencies, and does not include data on the many essential human services provided by other community-based organizations, private providers, and non profit agencies.

4

Fairfax County Human Services:Response to Challenges in the Community

• Challenge 1: Lack of Assistance to Promote Independence

• Quality of Life Statement: Fairfax County is a community in which families and individuals are able to achieve their maximum potential for self-sufficiency.

• Action Statement: Take steps to ensure that families and individuals have the supports needed to achieve their maximum potential for self-sufficiency.

5

Total Benefits Applications ReceivedFISCAL YEARS 1991 to 2001 (estimate)

• Benefits Programs (Food Stamps, TANF, and Medicaid) are a significant indicator of human need within the County. The decline in applications for benefit programs reflects general economic conditions as well as state and federal policy changes.

Source: Fairfax County Department of Family Services Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

Providing Assistance to Promote Independence

*Because of a lack of available data from the state, FY 2000 and 2001 reflect applications processed rather than applications received.

28,45631,252 31,288 28,978 30,791 29,508

24,319 24,850 25,179 24,146 24,200

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000* 2001*Est.

6

Fairfax Works: Welfare Reform in Fairfax County• Beginning in July 1995, Virginia reformed its AFDC, now TANF, program by modifying the

requirements and changing the name to Virginia Independence Program (VIP). VIP included a work requirement component, Virginia Initiative for Employment Not Welfare (VIEW), which began in April 1996.

• As of February 2001, 211 participants were currently enrolled in VIEW and receiving Temporary Assistance to Needy Families or job follow up services. Of those 211 participants, 124 are employed with an average monthly wage of $1,222.

Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church


7

Average Cases Under Care: TANF (AFDC) and Food Stamps

FISCAL YEARS 1991 to 2001 (Est)

• The continuing decline in benefit caseloads is in line with state and national trends, and likely reflects both general economic conditions and policy changes such as Food Stamp eligibility and Welfare Reform. Since the work requirement initiative of Welfare Reform was implemented in April 1996, the TANF caseload has decreased by 68%.

6,956

9,926

11,46312,496 12,996 12,517

10,628

7,101 6,945 6,854 6,500

2,761 3,597 4,105 4,505 4,513 3,869 2,819 2,086 1,656 1,243 1,080

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001Est.

TANF Food Stamps



8

Average Medicaid Cases Under CareFISCAL YEARS 1991 to 2001 (Est)

• Fluctuations in the number of Medicaid cases over the past decade are due largely to legislative changes expanding or restricting eligibility for the program. As of February 1997, Medicaid eligibility for TANF recipients was no longer automatic. As TANF recipients now have separate Medicaid determinations, their increased case counts are reflected beginning with FY 2000.

• Children enrolled in the Children’s Medical Insurance Program (CMSIP) are not included in the counts below (1,726 in FY00; 2,692 estimated in FY01)

7,4379,770

12,00314,08815,510 15,821 16,469 15,990 16,29819,087 19,500

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001Est.

Average Medicaid Cases Under Care



9

Child Care Assistance Program: Number of Children Served

FISCAL YEARS 1991 to 2000

• Since 1991, enrollment in the Child Care Assistance Program has increased by 65%. Even with the growth of the program, there are approximately 1,145 children on the waiting list.

4,7005,304

4,673

6,067 6,164 6,4436,820

7,848 7,751

4,701

3,000

4,000

5,000

6,000

7,000

8,000

9,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Children Enrolled

Source: Fairfax County Department of Family Services, Office for Children. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church


10

Children Approved for Free and Reduced School Lunches

JUNE 1991 to 2000

• Of the almost 156,000 children enrolled in the Fairfax County Public Schools during the 1999-2000 school year, 28,980 (or 18.6%) were approved for free or reduced-price lunches on the basis of their family’s income. This rate is down from the FY99 rate of 19.4%.

9,343

14,38416,397

18,478 18,600 19,095 19,866 20,383 20,807 20,148

3,630 4,625 4,924 5,312 5,968 6,960 6,825 7,696 8,565 8,832

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Reduced Free

Source: Fairfax County Public Schools. Includes Fairfax County and the City of Fairfax.


11

Family Self-Sufficiency Program

• Family Self-Sufficiency (FSS) is an innovative HUD initiative which combines Section 8 and Public Housing subsidy programs with support services to assist families in achieving independence from all welfare and federal subsidy programs over a five year period.

• FSS allows families to benefit from increases in employment income. As employment income increases, the housing authority creates interest-earning escrow accounts, equal to the increase in rent which resulted from increased earnings, that provide a savings “nest egg” for use in moving off subsidy programs. Participants must sign a five-year contract that outlines goals to eliminate barriers to self-sufficiency, such as employment or education. Participants receive the escrow funds upon successful completion of their contract.

• As of March 2001, 31 Section 8 tenants and 11 Public Housing tenants participate in the FSS program. To date, 71 families have graduated from the program.

• 36 participants have escrow accounts, 29 of which are active.

Source: Fairfax County Redevelopment and Housing Authority. * One participant still receives a child care subsidy.


12

Home Based Care: Monthly Caseload and Clients ServedFISCAL YEARS 1992 to 2000

• Home Based Care provides homemaker and companion services for elderly persons and adults with disabilities who live alone or with family members, preventing costly and inappropriate institutionalizations. Eighty percent of Home Based Care clients are 60 years of age or older.

530 552 528

898

600

1,000

636

912

615

1,059

561

1,010

556

926

633

1,006

587

1,184

1992 1993 1994 1995 1996 1997 1998 1999 2000

Avg Monthly Caseload # Clients Served per Year



13

Senior Centers: Operations and Meals ServedFISCAL YEARS 1997 to 2000

• There are 13 Senior Centers located throughout the County which provide community services, noon time meals, transportation, opportunities to socialize, and a variety of activities for senior citizens.

0

50,000

100,000

150,000

200,000

250,000

1997 213,137 104,820 78,399

1998 176,720 104,699 99,240

1999 179,412 82,296 101,193

2000 182,439 80,238 103,021

Total Attendance

# of Meals Served

# of Rides (one way)

Source: Fairfax County Department of Community and Recreation Services . Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church


NOTE: Attendance and number of meals served are variable each year due to cancellation days for snow and ice. Number of meals served reflects only meals served at Senior Centers.

14

Home Delivered Meals Program: Persons and Meals Served


• The Home Delivered Meals program provides a variety of nutritious hot meals to home-bound adults. In recent years, the program has also offered liquid meal supplements (e.g., Ensure) as well as hot food. Need for the program exceeds the County’s ability to provide services.

196,141217,184 221,501 233,636 237,657260,069

215,675* 212,588** 222,681

1,3231,143955935 935 949752778 876

1992 1993 1994 1995 1996 1997 1998 1999 2000

Meals Served Persons Served

* The decrease in FY 96 is due to changes in state guidelines for counting liquid supplements as meals. ** Served more clients for a shorter period of time.

Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.


15

Adult Day Health Care: Number of Participants Served

FISCAL YEARS 1992 to 2001 (estimate)

• Adult Day Health Care Centers are located in Annandale, Lewinsville, Lincolnia, and Mount Vernon. The Herndon Harbor will open in May 2001.

• There is a growing need for long-term care options in Fairfax County. Between 1995 and 2000, the number of persons over age 85 is estimated to have increased by 32%. By 2010, it is estimated that there will be a 150% increase in this age group.

292321 314 319

281321

281 287 284331

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001Est.

Total Participants Served

Source: Fairfax County Health Department. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church.


16

Care Network for Seniors:Number of Initial Assessments and Clients Enrolled


• The Care Network for Seniors Program is a multi-agency long term care initiative that provides case management services to senior citizens age 60 and over. Case management through the Care Network connects eligible clients with appropriate services, based on a complete evaluation of their needs.

257

1,004

508

1,330

565

1,300

797

1,308

582

1,707

784

1,106

7591,039

646

2,107

724

2,127

1992 1993 1994 1995 1996 1997 1998 1999 2000

# Clients Enrolled in Case Management # Assessments


Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

17

Transportation for Human Services Programs:Fastran and Ridership (One-Way Rides)

FISCAL YEAR 2000

• Fastran provides door-to-door transportation for residents with physical and cognitive disabilities and for senior citizens. The program serves those who have no other means of access to programs and services sponsored by Human Services, and complies with the Americans with Disabilities Act (ADA). The program provided over 542,000 rides in FY 2000.

252,779

103,021

59,007

66,297

23,702

18,685

16,735

4,331

3,711

CSB-Mental Retardation

Senior Centers

Adult Day Care/Sr. Residence

CSB-Mental Health/ADS

Dial-a Ride

Critical Medical Care

Metro/ADA Access

Therapeutic Recreation

Other County Programs

Source: Fairfax County Department of Community and Recreation Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.


18

Mental Retardation: Waiting List for Residential Services

BASED ON FISCAL YEAR 2001 SURVEY DATA

• There are 631 individuals waiting for placement in a residential setting.• In 32% of the cases, these individuals are living with only one caregiver. In 12% of the cases,

caregivers are over age 70.• 37% of individuals on the waiting list who are living with their families are in a “high-risk”

situation; that is, the family feels they cannot continue with their current care arrangement.

Number of Caregivers

One Caregiver

32%

Two Caregivers

64%

No Caregiver4%

Age of Caregiver

Age 70+13%

Age 60-6916%

Age 50-5939%

Age <5032%


Source: Fairfax-Falls Church Community Services Board

Data as of 3/27/01

19

Mental Retardation: Residential ServicesFISCAL YEARS 1993 to 2000

• Residential Services includes group homes, supported apartments, sponsored placements, domiciliary care, and supported living arrangements. The waiting list reduction in 1995 was due to an increase in capacity and a review of the residential needs of persons on the waiting list.

500541

505506516478507

414440

402462

340

574

279

503

236

1993 1994 1995 1996 1997 1998 1999 2000

Persons Receiving Residential Services Waiting List for Residential Services

Source: Fairfax-Falls Church Community Services Board Note: Persons served included persons funded with Medicaid waiver.


20

Special Education Graduates Entering Mental Retardation ServicesPROJECTIONS FOR FISCAL YEARS 2000 to 2005

Total Number of Graduates

Case Management Only* 14 15 25 19 14 12

Vocational & CaseManagement**

73 72 63 77 72 70

2000 2001 2002 2003 2004 2005

* These consumers do not require CSB funding for Vocational Services upon graduation.

** These consumers require funding for both Vocational Services and Case Management upon graduation.

Source: Fairfax County Public Schools (Projections as of Spring 2001)


87 87 8882

9686

21


• Challenge 2: Ensuring the Availability of Safe, Affordable Housing

• Quality of Life Statement: Fairfax County is a community that has quality housing opportunities for families and individuals in all income ranges.

• Action Statement: Take affirmative steps to preserve and increase the availability of housing opportunities that are affordable to persons with low to moderate incomes.

22

Housing Assistance Programs:Public Housing and Section 8

• There are 1,064 public housing units at 31 locations across the County, including both multifamily and townhouse communities. Public Housing generally operates at 99% rate of occupancy -- the 1% vacancy accommodates the modest unit turnover that occurs throughout the year.

• The FCRHA also administers approximately 3,060 Section 8 Housing Choice Vouchers that provide assistance to tenants seeking housing in privately owned units throughout the County. Section 8 assistance is also provided to the owners of over 1,500 rental units that were developed specifically to serve eligible households.

• There are also over 2,300 other federally-assisted housing units that were developed to serve the elderly, disabled, low income individuals and families.

• In addition to federally-assisted units, there are almost 4,400 housing units that receive “assistance” via special tax and/or financing provisions. These include privately-owned tax-credit projects, Moderate-Income Direct Sales, the First-Time Buyer Program, and the Fairfax County Rental Program, among others.

Source: Fairfax County Redevelopment and Housing Authority (FCRHA)

Ensuring the Availability of Safe, Affordable Housing

23

Waiting Lists for Assisted Housing FEBRUARY 2001

• Of the 7,500 people on waiting lists for Public Housing, Section 8, and the Fairfax County Moderate Income Rental Program, nearly 60% are wage-earners, over 14% receive Social Security, and 3% receive public assistance (TANF). 75% of those on the waiting lists have less than $24,840 income per year, which is 30% of the area median income.

1,469

331

764

Elderly Handicapped Disabled

Characteristics of Persons on the Housing Waiting List

Source: Fairfax County Redevelopment and Housing Authority. Includes Resident of Fairfax County and Cities of Fairfax and Falls Church.

Ensuring the Availability of Safe, Affordable Housing

10%4%

20.0%

24

Fairfax County Human Services:Response to Challenges in the Community

• Challenge 3: Supporting Families and Individuals in Crisis; Preventing Abuse and Neglect

• Quality of Life Statement: Fairfax County is a community that promotes family and individual stability, in which all people are free from financial, emotional, or physical crises. It is a community in which all people are safe from abuse, neglect and exploitation.

• Action Statement: Provide crisis intervention, stabilization and support services to prevent or alleviate financial, physical, or emotional crisis. Prevent the incidence of and protect people of all ages from harm due to abuse, neglect, and exploitation.

25

1,234

2,418

578

1,330

620

2,147

2,686

3,100

1,842

1,391

556

1,958

3,459

1,916 1,411

716

1,734

3,213

Rent Assistance Utility Assistance EmergencyFood

EmergencyShelter*

Other Asst forBasic Needs

MedicalExpense

Assistance

FY98 FY99 FY00

Coordinated Services Planning: Emergency Assistance FISCAL YEARS 1998 to 2000

• In FY 2000, Coordinators answered over 50,000 calls to the Human Services number (222-0880), representing nearly 27,000 requests for assistance. Coordinators assist clients by providing broad-based assessments and linkage to community-based and County services with a focus on prevention and self-sufficiency. The types of requests for crisis assistance listed below represent approximately one-third of the total types of requests received by CSP.

Source: Department of Systems Management for Human Services.

Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect

* CSP staff began conducting intake interviews for the County’s emergency shelters in 1999, resulting in an increase in the number of shelter requests handled by CSP.

26

Services to the Homeless:Number of Persons Served in Shelters


• Homelessness affects both single individuals and families with young children. While the total number of persons served decreased slightly from FY 1999 to FY 2000, the number of persons in families increased by over 11% while the number of single individuals served decreased by 11%.

Single Individuals inShelters

1,725 1,372 1,121 1,410 1,667 1,739 1,552

Family Members in Shelters 658 589 575 606 604 491 547

1994 1995 1996 1997 1998 1999 2000

Source: Department of Family Services; Virginia SHARE Report


2,383

1,9611,696

2,0162,271

Total Number of Persons Served

2,230 2,099

27

Services to the Homeless:Persons Served in Alternative Shelter Placements


• When space is not available at County-funded shelters and there are no other housing alternatives, homeless families with children are served in motels.

• The decline in the number of homeless persons served in motels from FY 94 to FY 97 was attributed both to increases in homeless prevention programs operated by County staff and community-based organizations, as well as to increased capacity in transitional housing. However, in FY 99 a lack of affordable housing in the area resulted in a significant increase in the demand for shelter, longer shelter stays, and more motel placements.

709

653

337

315

6101081

12241994

1995

1996

1997

1998

1999

2000



28

Child Protective Services:Number of Investigations per Year


• CPS investigations fluctuate from year to year with no predictable pattern. The number of investigations remained consistent in FY 98 and FY 99, and decreased by almost 10% in FY 00.

2,5212,7952,777

2,525

3,1103,442

2,8983,0743,2323,0962,746

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

# CPS Investigations



29

Foster Care and Adoption:Average Number of Children in Care per Month


• From FY 96 to FY 00, there has been a 27% decrease in the average number of children in Foster Care each month. The length of time a child is in foster care has decreased from 3.1 years in 1998 to 2.85 years in 2000. These trends are the result of intensive prevention, early intervention efforts, and new legal requirements that strengthen permanency planning efforts for foster children and their families.

610 610 586 603675

788 747658 617

571

235317 282 250

199 234 207

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Average # of Children per Month # Children Entering Foster Care



30

Adult Protective Services:Number of Investigations per Year


• The typical APS client is elderly, white, female, and lives alone or with a relative. However, 21% of those referred were under the age of 60. These individuals have a range of disabilities, including mental retardation, multiple sclerosis, head and spinal cord injuries, cancer, and AIDS.

• The decrease in investigations conducted in FY 1996 was consistent with state-wide trends.

• In FY 2000, 68% of the cases investigated resulted in a person needing protective services.

670575554 589 630 590 698

536615 651

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

No. of Investigations per Year

Source: Fairfax County Department of Family Services.Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.


31


• Challenge 4: Threats to the Public Health

• Quality of Life Statement:

Fairfax County has a healthy community environment which is free of threats to the public health.

• Action Statement:

Provide protection from communicable diseases and environmental hazards, and provide related prevention services to improve the public health.

32

Communicable Disease Control:New Cases of Tuberculosis and Rates per 100,000

CALENDAR YEARS 1991 to 2000

• New Cases are persons diagnosed with active TB during the calendar year. Following these cases requires directly-observed therapy to ensure compliance and control the development of drug-resistant TB. The increase in cases in 1996 may reflect an improved reporting system. The increase in the 2000 Fairfax rate is representative of an overall increase in TB cases across Northern Virginia.

67 60 70 6378 73

8910176 77

7.9 8.37.1

8.37.7 8.1 8.3

9.1

6.17.4

5.8 5.5 5.4 5.2 5.2 5.1

7.1

11.2

7.4

4.2

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

# of New TB Cases Fairfax Rate VA Rate

Rates per 100,000

Responding to Threats to the Public Health

Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

Fairfax Rate

VA Rate

33

Communicable Disease Control:Persons Receiving Preventive Treatment for Tuberculosis


• Preventive treatment ensures that persons infected with Tuberculosis will not progress to active disease. The Health Department screens all refugees and immigrants for TB. The decline in persons receiving preventive treatment in FY 95-96 is due in part to fewer refugees coming into the area. The increase in FY 97 reflects, in part, the result of contact investigations where large number of persons were screened. The decrease in FY 98 through FY 00 reflects current recommendations to start only those persons on preventive treatments who are committed to complete the course of therapy.

2,687

2,0382,329

1,962

1,4211,839

1,326905*

1,597

1992 1993 1994 1995 1996 1997 1998 1999 2000

# Persons Receiving PreventiveTreatment for TB



* Data through 12/31/99

34

Communicable Disease Control:Sexually Transmitted Disease Cases Treated


• Cases of sexually transmitted diseases increased slightly during FY00, reflecting statewide trends.

3,094

3,5293,295

2,711 2,692

2,025 1,879

1,285 1,459 1,500

1,000

2,000

3,000

4,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000



35

Communicable Disease Control:New Reported Cases of HIV+ and Rates per 100,000

CALENDAR YEARS 1991 to 2000

• All new cases of HIV+ are reported to the VA Health Department each year. Rates of HIV and AIDS in Fairfax County are lower than the state rate.

77

114

147

100 93

45 56 6476

24

9.111.8 11.0

6.1 6.47.9

23.9

18.220.5

15.0 15.212.5 13.5

17.3

4.8

13.5

26.6

22.2

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000*

# of New HIV+ Cases Fairfax Rate VA Rate



Rates per 100,000

Fairfax Rate

VA Rate

* Data through 6/30/00.

36

HIV Case Management Program: Caseloads of Persons with Asymptomatic HIV Infection


• The Heath Department operates a case management clinic for persons infected with HIV who are not yet displaying the symptoms of illness with AIDS. The clinic monitors health status, promotes the time period of healthy life, and prevents the spread of infection.

48

6271

92 9283 90

96 9282

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

# Persons with Asymptomatic HIV Infection



37

AIDS/HIV Program: Cumulative Cases of AIDS(By Numbers of Deaths and Persons Living with AIDS)

1990 through 2000

Source: Virginia Department of Health and CDC Includes Residents of Fairfax County and Cities of Fairfax and Falls Church

Cumulative Cases of AIDS

# of Deaths # Living with AIDS

# Living with AIDS 125 134 187 343 353 400 425 464 479 572

# of Deaths 221 293 372 440 521 666 710 730 730 755

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

1,327

346427

559

783

874

1,0661,135

1,194

57%

43%


1,209

38

Environmental Health Services: Community Health & Safety Number & Type of Complaints Investigated per Year


• The Housing Branch of Environmental Health investigates complaints and takes actions to control sub-standard and blighted housing; disease-carrying rodents; trash and garbage complaints; and other public health hazards.

492

737

400

656

314

726

148

779

521 483

933

1,059

629690

1,304

646

127

791

475

136

690

303

541

161172

Housing* Rodents Trash General Environment ** # Vacant/PlacardedHouses

FY 1996 FY 1997 FY 1998 FY 1999 FY 2000

* Housing includes Property Maintenance and Lead. **General Environmental includes animal waste, birds, bats, insects, safety hazards, hazardous materials, indoor air quality, air pollution, and biological agents.

Source: Fairfax County Health Department.


39

Environmental Health Services: Consumer Services Number and Type of Inspections and Investigations


• The Consumer Services Selection conducts safety and public health inspections of public establishments, such as restaurants, swimming pools, and other public facilities.

2,874

1,093

2,602

1,681

1,030

157

987

2,652

894

192

968

1,064

222249

1,105

902

2,773

212

2,781

890

# of Food Establishments

# of Other PublicEstablishments*

Consumer ComplaintsInvestigations

Foodborne IllnessInvestigations

1996 1997 1998 1999 2000

* Reduction in the number of establishments in 1997 was due to deregulation of 215 child care facilities, 31 pet shops, and 600 hair salons. Source: Fairfax County Health Department


40


• Challenge 5: Addressing Alcohol, Drug, Mental and Physical Health Issues

• Quality of Life Statement: Fairfax County is a community in which all people have access to a wide variety of affordable services for mental health, alcohol and drug abuse, and physical health care .

• Action Statement: Contribute to the availability of mental health services, alcohol and drug treatment services, and physical health care services that are affordable to persons with low to moderate incomes.

41

Alcohol and Drug Services: Residential and Day Treatment Services


• There continues to be a waiting list for alcohol and drug residential treatment. The length of time can be up to six months, primarily for individuals awaiting residential treatment services at Cornerstones.

231 277 309401 442

374 406336

436 437

618680 674

772

940941

1993 1994 1995 1996 1997 1998 1999 2000

# Persons in Day Treatment Persons in Residential


Addressing Alcohol & Drug, Mental and Physical Health Issues

42

Youth Served in Alcohol and Drug ProgramsFISCAL YEARS 1995 to 2000

• Alcohol and Drug Services programs for youth include prevention, early intervention, case management, outpatient, day treatment, and residential services. With the additional local, federal, and state resources received, there continues to be an increased number of youth identified as needing services. Prevention and early intervention services are only available for a small number of youth.

1,198 1,2331,506 1,497

1,671 1,514

FY 1995 FY 1996 FY 1997 FY 1998 FY 1999 FY 2000

Number of Youth Served



43

ADS Outpatient and Case Management ServicesFISCAL YEARS 1994 to 2000

• Alcohol and Drug Services is serving youth and adults with increasingly severe substance abuse problems. The past five years show a decreasing number of persons served through increasing levels of treatment intensity.



72,899

66,923

78,003 79,12275,929 74,817

73,055

4,172 4,756 4,159 3,854 3,829 3,606 3,581

1994 1995 1996 1997 1998 1999 2000

Hours of Service Persons Served

44

Residential Services for Individuals with Mental Health ProblemsFISCAL YEARS 1994 to 2000

• As the level of clients’ problems increases (shown by the Global Assessment of Functioning scores), the number of persons served is reduced in order to provide the intensity and comprehensiveness of services that are required.

• As of June 1, 2000 there were 463 persons waiting for residential mental health treatment services.

562 551619 582 576 574 554

75%

52%

1994 1995 1996 1997 1998 1999 2000

Persons Served % of Clients with Severe GAF



45

Community Services BoardEarly Intervention Services: Number of Infants Served


• The Early Intervention Office provides services to infants and toddlers with disabilities and their families from birth to three years. Infants are eligible to remain in the program until age three when they transfer into the school system.

234

478

303

542

400

744

481

817

477

879

531

933

1995 1996 1997 1998 1999 2000

# New Admissions per Year Total # of Children Served per Year



46

Community Health Care Network:Number of Primary Care Patients and Visits


• Over one-quarter of all household earning less than $25,200 have at least one person without health insurance. The Community Health Care Network provides primary medical care for low income families without health insurance. Services are provided at the North County, Bailey’s and South County Health Centers. The North County Health Center began operation in February 1996. Currently, over 20,000 persons are enrolled program-wide.

27,450 27,183 27,674

35,769

44,687 44,263 42,231

8,288 7,638 7,166 9,51512,056 13,301 12,770

1994 1995 1996 1997 1998 1999 2000

# Patients # Visits

Source: Fairfax County Health Department Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church


47

Community Health Care Network:Client Characteristics

MARCH 2001

The CHCN serves a wide variety of patients:

• 72% of patients are wage earners or dependents of wage earners.

• 9% receive some form of public assistance, including TANF, GR, SSI, or Refugee Assistance.

• 17% have no income, and the remaining 2% receive income from other sources.

Korean3.7%

English28.3%

Vietnamese

2.9%

Urdu1.9%

Other16.0%

Arabic2.3%

Spanish41.3%

Farsi3.7%

* Other languages include Mandarin Chinese, Cambodian, French, Thai, Laotian, Hindi and Punjabi.



0 to 47.3% 5 to 9

6.8%

10 to 1710.4%

18 to 4444.7%

45 to 6423.2%

65+7.6%

Primary LanguageAge Distribution

48

Maternity Services: Number of Teen Births (Up to Age 19)


• The number of teen births among Health Department clients in FY00 remains lower than in the early 90’s, reflecting County-wide and national trends. From 1990 to 1998, the County-wide teen birth rate dropped from 26 per 1,000 to 14.4 per 1,000. The drop may also reflect efforts to prevent first and second pregnancies among teens, such as the Resource Mothers program. The % increase between FY99 and FY00 is almost equal to the % increase in the total number of maternity cases.

175 160 183 185

131151 156 168 170

1992 1993 1994 1995 1996 1997 1998 1999 2000Number of Teen Births



49

Low Birthweight Births per 100:Health Department, Fairfax Co., and Virginia Rates

1993 to 2000

• The majority of the approximately 2,000 Health Department Maternity Patients are at risk for low birth weight babies ( up to ~5.5 lbs), due to socioeconomic, demographic, or medical factors. Through early, continuous prenatal care and case management, the Health Department rate has historically been almost that of the County as a whole.

5.45.6

7.4

5.6 5.9

7.66.06.0

7.86.6

9.07.7

6.37.9 7.7

6.15.6

7.9

5.2 5.6

1993 1994 1995 1996 1997 1998 1999 2000

County-wide Rate Health Department Rate Statewide Rate



N/a N/a N/a N/a

50

Women, Infants, and Children (WIC) Nutritional Program: Program Caseload




3,966

6,4738,069

9,465 9,801 10,03210,70511,492

12,66112,857

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

WIC Caseload

51

Immunization Completion Rate for Two Year Olds:County Rate* vs. Health Department Rate


• The Health Department provides immunizations for over 20,000 children every year. Although the immunization program does not have income-eligibility guidelines, the program primarily serves children from lower-income families. The goal for the year 2000 is an immunization rate of 90%.

67%79%

69%80%

62%

78%69%

78% 75% 74% 76%81% 81%74% 80%80%

0%

90%

1993 1994 1995 1996 1997 1998 1999 2000

County-wide Rate* Health Dept. Rate

* County Rate based on retrospective study done in the Schools.



52


• Challenge 6: Responding to Crime in the Community


Fairfax County is a community that is safe from the threat of crime.

• Action Statement:

Administer a justice system that delivers a just and equitable response to juvenile and domestic crimes, and which reduces these crimes by addressing the factors that lead to crime in the community.

53

Community and Recreation Services: Teen Centers• CRS operates nine teen centers (one in each magisterial district). Teen centers are

charged with providing teens and at-risk youth with a variety of positive recreation activities; enhancing leisure and life skills; providing a safe and structured environment; energizing teens -- and the community that supports them; and reinforcing positive character behavior by establishing healthy and supportive peer and adult relationships.

• In the past year, Teen Center participation has grown by almost 50%, from 38,257 to 57,237. Female attendance has increased by over 80%, from 8,554 to 15,538. Participation in a variety of activities (other than basketball) has also increased significantly.

Black30%

Asian22%

Hispanic24%

Other2%

White22%

Source: Fairfax County Department of Community and Recreation Services

Responding to Crime in the Community

Ethnic Diversity of Enrollees

Girls Clubs10%

Voc./School Prep13%

Community Service

11%

Character Education

16%Activity Clubs20%

Prevention

Activities15%

Special Events &

Trips15%

Teen Center Activities

54

Number of Complaints for Juveniles and Adults

• Between 1992 and 2000 the number of non-traffic complaints to Juvenile and Domestic Relations Court has increased by 20%, while the total population has increased by only 13%.

• Cases include: Delinquency; Children in need of services and supervision; custody; visitation and support determination; criminal offenses among family members; and adults charged with offenses against minors.

10,631 10,70211,304

12,91114,160

13,06114,007 13,824 13,254

5,110 5,907 5,629 5,679 6,232 5,424 6,399 7,0515,605

1992 1993 1994 1995 1996 1997 1998 1999 2000

Adults Juveniles

Source: Juvenile and Domestic Relations Court Fairfax County and City of Fairfax.


*In FY 2000, the shift to the State’s CMS management information system has caused a decrease in the number of adult cases recorded in JUVARE.

*

55

Offenses Against Persons Complaints for Adult OffendersFISCAL YEARS 1991 to 2000

• Complaints against adults involving offenses against persons have more than doubled since 1991. Most of these cases involve intra-family violence.

1,509 1,579

2,3032,161 2,286 2,426 2,294 2,359

3,087 3,264

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Offenses Against Persons Complaints for Adult Offenders



Police adopt proactive domestic

violence policy

Legislature expands definition

of “family”

56

Violent Juvenile OffensesFISCAL YEARS 1987, 1995, and 2000

• Simple assault represents the majority of juvenile offenses against persons. Serious offenses against persons and weapons offenses have decreased substantially since 1995.

679

15672

1436936

96

374

253

58

202

645

Simple Assault Serious Offenses Sex Offenses Weapons

1987 1995 2000



57

Average Daily Population in Secure Detention Facilities


• From 1993 to 1997, the Court’s Secure Detention Facility had the capacity to house 55 juveniles at any given time. However, the need for secure detention spaces outstripped this supply. An expanded center opened during FY 98, bringing capacity to 121 beds.

63.674.1 72.3

78.8 79.388.8

80.887.3

101.1 101.3

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000



Capacity

58

Juvenile Probation Services: Average Monthly CaseloadFISCAL YEARS 1991 to 2000

• Since FY 1991, juvenile probation counselors at the Juvenile and Domestic Relations Court have operated with average monthly caseloads that exceed the state standards. Although the Board of Supervisors approved three additional counselors in FY 1994 and again in FY 1999, caseload growth has continued to exceed the caseload standard.



3539

4337

41 4247

4438 41

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Avg. Monthly Probation Caseload

Caseload Standard

(30)

BOS approves 3 new positions

BOS approves 3 new positions

59

Residential Service AlternativesFISCAL YEARS 1995 and 2000

• On any given day, there are more than 250 youth in residential facilities and programs. In FY 2000, a total of 2,583 placements were made to the programs listed below. The overall utilization rate for the Court’s residential programs was 100% in FY 2000.

1047

107

104

93

380

150

1507

60

164

83

429

340

J uvenile Detention Center

DJ J Commitments

Detention Release

Boys/Girls Probation House

Outreach Detention

Less Secure Shelter

FY 1995

FY 2000



60

Mental Health and Alcohol & Drug Services Provided: Fairfax County Adult Detention Center


• The MH Forensic Program offers emergency crisis intervention, evaluations, and case management for inmates who are seriously mentally ill, at risk for suicide, or dually-diagnosed. ADS Court Services offers evaluations, jail-based treatment and an intensive addictions program. The number of persons waiting for services continues to increase due to staff shortages.

19301690

14031553 1518 1658

959 848

553 613 597 593

Mental Health Alcohol and Drug

1995 1996 1997 1998 1999 2000

Source; Fairfax-Falls Church Community Services Board


61

Fairfax County Human Services: Response to Challenges in the Community• Challenge 7:

Providing Community-Wide and Targeted Supports to Prevent Social Isolation and Neighborhood Deterioration


Fairfax County is a community that supports and builds on the strengths of individuals, families and neighborhoods.

• Action Statement: In collaboration with the community, provide targeted responses to the social, housing, and civic needs of residents in neighborhoods at risk of social or economic deterioration, as well as broad-based supports for community and family well-being.

62

Housing and Community Development: Revitalization and Blight Abatement Efforts

• HCD administers a variety of revitalization efforts for Fairfax County. Programs target both commercial and residential areas as well as individual properties throughout the County. To date, revitalization plans have been adopted by the Board of Supervisors for seven designated areas:

Source: Fairfax County Department of Housing and Community Development

Providing Community-wide and Targeted Supports

- Richmond Highway/Route 1- McLean Business District- Annandale Central Business District- Lake Anne

- Central Springfield- Baileys Crossroads/Seven Corners- Merrifield

• The Community Improvement Program is a revitalization component designed to upgrade and preserve older moderate income residential communities. This program utilizes a combination of bond funds and homeowner investment to make public improvements to streets, sidewalks, and storm drainage systems.

• Revitalization efforts include a Blight Abatement Program to rid residential and commercial areas of deteriorated structures. This program is complemented by a Tax Abatement Program that provides tax credits to property owners for the rehabilitation, renovation, or replacement of older obsolete buildings

• Other initiatives include community single-point of contact services and improvements to the land development process.

63

Community and Recreation Services: Total Attendance & Daily Participation at Community Centers


• Six community centers provide opportunities for leisure, socialization, and personal growth by offering affordable recreation and enrichment activities in the community.

Total Attendance

Avg DailyAttendance perSite

Total Attendance 366,3 384,5 354,5 398,5 400,2 429,4 209,5 214,9 324,5

Avg Daily Attendanceper Site

191 208 304 214 216 237 111 111 291

1992 1993 1994 1995 1996 1997 1998* 1999 2000

Source; Fairfax County Department of Community and Recreation Services. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

*Starting in 1998, the methodology used to calculate daily attendance at community centers was changed to reflect unduplicated counts.


64

Head Start Program:Number of Children Served


• Since 1990, enrollment in Head Start has increased by 49%. Due to funding constraints, demand for the program cannot be accommodated. Currently, there are 379 children on the waiting list.

Source: Fairfax County Department of Family Services, Office for Children .

Includes Residents of Fairfax County and Cities of Fairfax and Falls Church

1,052

1,172

1,3271,417

1,478 1,4781,538 1,5681,536**

1,453*

1,294

900

1,100

1,300

1,500

1,700

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Children Enrolled


* The decrease in FY97 was the result of mandated smaller classroom sizes. ** The decrease in FY99 was the result of closing Edison House.

65

Subsidized Support for Special Needs AdoptionsFISCAL YEARS 1992 to 2000

• Subsidized adoption enables permanent placement of children with special needs by providing services and supports to adoptive families until the children reach the age of 18 or 21.

• Supports include referral to, and payment of , home-based services, counseling and treatment, child care, health and educational services, therapy, and special transportation services. The number of children getting subsidies grows as additional children are adopted. The program is supported with state and federal funds.

136177

219 228 246 283 336394

437

1992 1993 1994 1995 1996 1997 1998 1999 2000Number of Subsidized Adoptions

Source: Fairfax County Department of Family Services. Includes Residents of Fairfax Co. and Cities of Fairfax and Falls Church


66

Elementary-Age Summer Recreation: Location, Attendance and Number of Children Served

FISCAL YEARS 1993 to2000

• The summer Rec-PAC program currently serves over 6,519 children at 54 locations.• Rec-PAC is the primary source of supervised summer activities for an estimated 65%

of the children registered in the program.• Approximately 29% of the children are from families with incomes less than $36,000.• Summer 1996 marked the first time the program operated at complete cost-recovery

basis. The program recovered 100% of its costs in Summer 1998.

Source: Department of Community and Recreation Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church

135,917158,316 156,858

94,73782,743 78,354 83,213 75,794

11,246 11,545 11,722

8,0516,752 6,425 6,861 6,519

1993 1994 1995 1996 1997 1998 1999 2000

Total Attendance

Children Served

# Locations 99 98 98 67 59 47


54 54

67

School-Age Child Care Program:Number of Children Served

FISCAL YEARS 1990 TO 2000

• Since 1990, enrollment in the School-Age Child Care Program has increased by 79%. Due to increased demand for the program, SACC opens additional sites each year. Even with the expansion, there are still 1,052 children on the waiting list.

4,400

5,2095,489 5,579

6,1116,634

6,8897,196 7,307

7,880

5,279

4,000

5,000

6,000

7,000

8,000

9,000

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Children Enrolled

Source: Fairfax County Department of Family Services, Office for Children. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church


selected trends in service utilization and demand june 2001

Documents

human services approach

essential human services

scope of human services

selected services

residents of fairfax

draft report

demandthis report

performance budgetthe