Authority: Title 2.1, Chapter 46, Code of Virginia.

A. Out of this appropriation, $1,064,245 the first year from the general fund and $1,064,245 the second year from the general fund nongeneral funds shall be paid into the trust fund on the books of the State Comptroller, designated as "Community Services Trust Fund for Youth and Families." The general fund balance in the Fund shall not revert to the general fund at the end of the fiscal year, but shall be reappropriated for expenditure in the succeeding fiscal year. The nongeneral funds shall be transferred from the Department of Social Services.

B. The Department of Education shall serve as fiscal agent to administer funds cited in paragraphs A and C. The Director of the Department of Planning and Budget shall have authority to transfer the amounts cited in each of these paragraphs to the Department of Education and to transfer funds between fiscal years to reimburse localities for mandated expenditures in excess of projections.

C.1.a. Out of this appropriation, $74,407,005 from the general fund and $48,064,343 from nongeneral funds the first year and $72,842,934 $79,342,934 from the general fund and $30,890,661 $30,048,491 from nongeneral funds the second year, shall be used for the state pool of funds, pursuant to § 2.1-757, Code of Virginia. This appropriation shall consist of a Medicaid pool allocation, and a non-Medicaid pool allocation.

b. The Medicaid state pool allocation shall consist of $23,424,987 from the general fund and $39,644,345 from nongeneral funds the first year and $12,806,543 from the general fund and $21,628,493 from nongeneral funds the second year. The Office of Comprehensive Services will transfer these funds to the Department of Medical Assistance Services as they are needed to pay Medicaid provider claims.

c.1) Revenue derived from local governments for the local match share of Medicaid provider payments, when collected by the Office of Comprehensive Services on behalf of the Department of Medical Assistance Services, shall be paid into a special fund on the books of the State Comptroller, designated as "Comprehensive Services Act Local Match Fund." Revenues in the Comprehensive Services Act Local Match Fund shall be transferred by the Office of Comprehensive Services to the Department of Medical Assistance Services, in the form of a general fund appropriation, as needed for reimbursement of the local match share of Medicaid provider claims.

2) Revenues in the Comprehensive Services Act Local Match Fund shall not revert to the general fund at the end of the fiscal year, but shall be reappropriated for expenditure in the succeeding fiscal year.

d. The non-Medicaid state pool allocation shall consist of $50,982,018 from the general fund and $8,419,998 in nongeneral funds the first year and $58,368,949 $66,536,391 from the general fund and $8,419,998 in nongeneral funds the second year. The nongeneral funds shall be transferred from the Department of Social Services.

e. The Office of Comprehensive Services, with the concurrence of the Department of Planning and Budget, shall have the authority to transfer the general fund allocation between the Medicaid and non-Medicaid state pools in the event that a shortage should exist in either of the funding pools at the end of the fiscal year.

f. The State Executive Council shall deny state pool funding to any locality not in compliance with federal and state requirements pertaining to the provision of special education and foster care services funded in accordance with § 2.1-757, Code of Virginia.

g. The Commissioner of the Department of Social Services shall review all foster care prevention cases exceeding six months. The Commissioner may provide written approval up to an additional 90 days of service at a time. Local governments shall establish procedures for collecting parental co-pays in all appropriate cases.

2.a. Out of this appropriation, $28,289,845 $45,289,845 from the general fund and $1,000,000 from nongeneral funds the first year and $5,029,067 $42,593,312 from the general fund and $1,000,000 from nongeneral funds the second year shall be set aside to pay for the state share of supplemental requests from localities that have exceeded their state allocation for mandated services. The nongeneral funds shall be transferred from the Department of Social Services.

b. In each year, the director of the Office of Comprehensive Services for At-Risk Youth and Families may approve and obligate supplemental funding requests in excess of the amount in 2 a above, for mandated pool fund expenditures up to 10 percent of the total general fund appropriation authority in C1a in this Item.

c. Localities requesting funding from the set aside in paragraphs 2a and 2 b must demonstrate that their request is based upon an increase in the number of mandated children or that the treatment costs have increased due to the service needs of the children. Localities must also demonstrate they are in compliance with all the provisions of the Comprehensive Services Act, including uniform assessment, family assessment team reviews, and data collection.

3. Each locality receiving funds for activities under the Comprehensive Services Act (CSA) shall have a utilization management process, approved by the State Executive Council, covering all CSA services, and shall provide information as required by the Office of Comprehensive Services, to include, but not be limited to expenditures, number of youth served in specific CSA activities, length of stay for residents in core licensed residential facilities, and proportion of youth placed in treatment settings suggested by a uniform assessment instrument.

4. The Secretary of Health and Human Resources, in consultation with the Secretaries of Education and Public Safety, shall direct the actions for the Departments of Social Services, Education, Juvenile Justice, Medical Assistance Services, Health, and Mental Health, Mental Retardation and Substance Abuse Services, to implement, as part of ongoing information systems development and refinement, changes necessary for state and local agencies to fulfill CSA reporting needs.

5. The State Executive Council shall provide localities with technical assistance on ways to control costs and on opportunities for alternative funding sources beyond funds available through the state pool.

6. Out of this appropriation, $50,000 from the general fund each year is provided for a combination of regional and statewide meetings for technical assistance to local community policy and management teams, family assessment and planning teams, and local fiscal agents. Training shall include, but not be limited to, cost containment measures, utilization management, use of alternate revenue sources, and administrative and fiscal issues. A state-supported institution of higher education, in cooperation with the Virginia Association of Counties, the Virginia Municipal League, and the State Executive Council, may assist in the provisions of this paragraph. Any funds unexpended for this purpose in the first year shall be reappropriated for the same use in the second year.

7. The State Executive Council shall work with the Department of Medical Assistance Services' existing preauthorization and utilization management contract with a qualified medical review organization, in order to provide utilization management of residential placements provided to youth under the Comprehensive Services Act who are not Medicaid eligible. A payment of $175,000 each year from the general fund shall be transferred to the Department of Medical Assistance Services for such utilization management services. The Department of Medical Assistance Services, in cooperation with representatives of the Virginia Association of Counties, the Virginia Municipal League, and the State Executive Council, shall develop the criteria and guidelines to be followed by the utilization management provider. The State Executive Council shall deny funding to any locality that fails to comply with the provisions of utilization management pursuant to § 2.1-746, Code of Virginia.

8. Out of this appropriation, $70,000 the first year and $27,500 the second year from the general fund is provided for the Office of Comprehensive Services to contract for the development of a uniform Web-based system for CSA reporting requirements.

9. The State Executive Council shall implement a uniform assessment instrument consistent with the recommendations of the Joint Legislative Audit and Review Commission's findings from its review of the Comprehensive Services Act.

10. The Office of Comprehensive Services shall determine a mechanism for reporting children served by the program that will allow for data to be collected on the number of foster care children receiving only maintenance payments, and the amount paid for these children.

11. For purposes of defining cases involving only the payment of foster care maintenance, pursuant to § 2.1-755, Code of Virginia, the definition of foster care maintenance used by the Virginia Department of Social Services for federal Title IV-E shall be used.

12. The State Executive Council shall develop policies and procedures to validate compliance for any locality that exceeds prior year expenditures by more than 15%. These areas for review shall include, but not be limited to, utilization management practices, compliance with state and federal foster care and special education provisions, parental co-pays, child support collections, and the use of federal funds.

D. The funding formula to carry out the provisions of the Comprehensive Services Act for At-Risk Youth and Families is as follows:

1. Allocations. The allocations for the Medicaid and non-Medicaid pools shall be the amounts specified in paragraphs C 1 b and C 1 d in this Item. These funds shall be distributed to each locality in each year of the biennium based on the greater of that locality's percentage of actual 1997 Comprehensive Services Act pool fund program expenditures to total 1997 pool fund program expenditures or the latest available three-year average of actual pool fund program expenditures as reported to the state fiscal agent.

2. Local Match. All localities are required to appropriate a local match for the base year funding consisting of the actual aggregate local match rate based on actual total 1997 program expenditures for the Comprehensive Services Act for At-Risk Youth and Families. This local match rate shall also apply to all reimbursements under this Item, including trust fund reimbursements under paragraph A in this Item as well as administrative reimbursements under paragraph D 3 in this Item. Revenue derived from local governments for the local match share of Medicaid provider payments, when collected by the Office of Comprehensive Services on behalf of the Department of Medical Assistance Services, shall be paid into a special fund on the books of the State Comptroller, designated as the "Comprehensive Services Act Local Match Fund." Revenues in the Comprehensive Services Act Local Match Fund shall be transferred by the Office of Comprehensive Services to the Department of Medical Assistance Services as needed for reimbursement of the local match share of Medicaid provider claims. Revenues in the Comprehensive Services Act Local Match Fund shall not revert to the general fund at the end of the fiscal year, but shall be reappropriated for expenditure in the succeeding fiscal year.

3. Local Administrative Costs. Out of this appropriation, an amount equal to two percent of the fiscal year 1994 pool fund allocations, not to exceed $1,466,398 from the general fund each year, shall be allocated among all localities for administrative costs. Every locality shall be required to appropriate a local match based on the local match contribution in paragraph D 2 of this Item. Inclusive of the state allocation and local matching funds, every locality shall receive the larger of $12,500 or an amount equal to two percent of the total pool allocation. No locality shall receive more than $50,000, inclusive of the state allocation and local matching funds. Localities are encouraged to use administrative funding to hire a full-time or part-time local coordinator for the Comprehensive Services Act program. Localities may pool this administrative funding to hire regional coordinators.

4. Definition. For purposes of the funding formula in the Comprehensive Services Act for At-Risk Youth and Families, "locality" means city or county.

E. Any unexpended general fund balance in this Item on June 30 each year shall not revert to the general fund but shall be reappropriated for expenditure in the succeeding year.

F. The State Executive Council shall assist the joint legislative subcommittee and executive commission, which are reviewing the public system of care for mentally disabled persons, in studying the use of state-operated facilities by Community Policy and Management teams for the provision of services under the Comprehensive Services Act.

G. The Department of Planning and Budget, in conjunction with the Office of Comprehensive Services, shall examine the Comprehensive Services Act regarding expenditure growth, Medicaid utilization patterns, and use of Title IV-E. The Director, Department of Planning and Budget, shall submit a report to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees no later than September 1, 2000, with the findings from the examination, including initial recommendations regarding the appropriate funding levels for the first and second year of the biennium. As a part of the study, the Director shall examine whether the current forecasting and budgeting process for the program needs to be changed.