Selected Trends in Service Utilization and Demand June 2001

1. Fairfax County Human Services Response to Challenges in the Community Selected Trends in Service Utilization and Demand June 2001

2. Prepared by the Fairfax County Department of Systems Management for Human Services12011 Government Center Parkway, Suite 946Fairfax, 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 wwwdsm@co.fairfax.va.us

3. Fairfax County Human Services: Response to Challenges in the CommunitySelected 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. Providing Assistance to Promote Independence 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. *Because of a lack of available data from the state, FY 2000 and 2001 reflect applications processed rather than applications received. Source: Fairfax County Department of Family Services Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

6. Providing Assistance to Promote Independence 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. Providing Assistance to Promote Independence Average Cases Under Care: TANF (AFDC) and Food StampsFISCAL 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%. Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

8. Providing Assistance to Promote Independence 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) Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

9. Providing Assistance to Promote Independence Child Care Assistance Program: Number of Children ServedFISCAL 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. Source: Fairfax County Department of Family Services, Office for Children. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church

10. Providing Assistance to Promote Independence Children Approved for Free and Reduced School LunchesJUNE 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%. Source: Fairfax County Public Schools. Includes Fairfax County and the City of Fairfax.

11. Providing Assistance to Promote Independence 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. Providing Assistance to Promote Independence 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. Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

13. Providing Assistance to Promote Independence 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. 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. Source: Fairfax County Department of Community and Recreation Services . Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

14. Providing Assistance to Promote Independence Home Delivered Meals Program: Persons and Meals ServedFISCAL YEARS 1992 to 2000 • 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. Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church. * 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.

15. Providing Assistance to Promote Independence Adult Day Health Care: Number of Participants ServedFISCAL 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. Source: Fairfax County Health Department. Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church.

16. Providing Assistance to Promote Independence Care Network for Seniors:Number of Initial Assessments and Clients EnrolledFISCAL YEARS 1992 to 2000 • 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. Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

17. Providing Assistance to Promote Independence 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. Source: Fairfax County Department of Community and Recreation Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

18. Providing Assistance to Promote Independence Mental Retardation: Waiting List for Residential ServicesBASED 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. Source: Fairfax-Falls Church Community Services Board Data as of 3/27/01

19. Providing Assistance to Promote Independence 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. Source: Fairfax-Falls Church Community Services Board Note: Persons served included persons funded with Medicaid waiver.

20. Providing Assistance to Promote Independence Special Education Graduates Entering Mental Retardation ServicesPROJECTIONS FOR FISCAL YEARS 2000 to 2005 96 88 87 87 86 82 * 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)

21. Fairfax County Human Services: Response to Challenges in the Community • 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. Ensuring the Availability of Safe, Affordable Housing 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)

23. Ensuring the Availability of Safe, Affordable Housing 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. 20.0% 10% 4% Source: Fairfax County Redevelopment and Housing Authority. Includes Resident of Fairfax County and Cities of Fairfax and Falls Church.

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. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect 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. * 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. Source: Department of Systems Management for Human Services.

26. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect Services to the Homeless:Number of Persons Served in Shelters FISCAL YEARS 1994 to 2000 • 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%. 2,383 2,271 2,230 2,016 2,099 1,961 Total Number of Persons Served 1,696 Source: Department of Family Services; Virginia SHARE Report

27. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect Services to the Homeless:Persons Served in Alternative Shelter PlacementsFISCAL YEARS 1994 to 2000 • 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. Source: Fairfax County Department of Family Services Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

28. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect Child Protective Services:Number of Investigations per YearFISCAL YEARS 1990 to 2000 • 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. Source: Fairfax County Department of Family Services Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

29. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect Foster Care and Adoption:Average Number of Children in Care per MonthFISCAL YEARS 1991 to 2000 • 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. Source: Fairfax County Department of Family Services Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

30. Supporting Families & Individuals in Crisis; Preventing Abuse & Neglect Adult Protective Services:Number of Investigations per YearFISCAL YEARS 1991 to 2000 • 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. Source: Fairfax County Department of Family Services. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

31. Fairfax County Human Services: Response to Challenges in the Community • 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. Responding to Threats to the Public Health Communicable Disease Control:New Cases of Tuberculosis and Rates per 100,000CALENDAR 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. Rates per 100,000 Fairfax Rate VA Rate Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

33. Responding to Threats to the Public Health Communicable Disease Control:Persons Receiving Preventive Treatment for TuberculosisFISCAL YEARS 1992 to 2000 • 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. * Data through 12/31/99 Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

34. Responding to Threats to the Public Health Communicable Disease Control:Sexually Transmitted Disease Cases Treated FISCAL YEARS 1991 to 2000 • Cases of sexually transmitted diseases increased slightly during FY00, reflecting statewide trends. Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

35. Responding to Threats to the Public Health Communicable Disease Control:New Reported Cases of HIV+ and Rates per 100,000CALENDAR 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. Rates per 100,000 VA Rate Fairfax Rate Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church. * Data through 6/30/00.

36. Responding to Threats to the Public Health HIV Case Management Program: Caseloads of Persons with Asymptomatic HIV InfectionFISCAL YEARS 1991 to 1999 • 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. Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

37. Responding to Threats to the Public Health AIDS/HIV Program: Cumulative Cases of AIDS(By Numbers of Deaths and Persons Living with AIDS)1990 through 2000 1,327 1,209 1,194 Cumulative Cases of AIDS 1,135 1,066 43% 874 783 559 427 346 57% Source: Virginia Department of Health and CDC Includes Residents of Fairfax County and Cities of Fairfax and Falls Church

38. Responding to Threats to the Public Health Environmental Health Services: Community Health & Safety Number & Type of Complaints Investigated per YearFISCAL YEARS 1996 to 2000 • 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. * 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. Responding to Threats to the Public Health Environmental Health Services: Consumer Services Number and Type of Inspections and InvestigationsFISCAL YEARS 1996 to 2000 • The Consumer Services Selection conducts safety and public health inspections of public establishments, such as restaurants, swimming pools, and other public facilities. * 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. Fairfax County Human Services: Response to Challenges in the Community • 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. Addressing Alcohol & Drug, Mental and Physical Health Issues Alcohol and Drug Services: Residential and Day Treatment ServicesFISCAL YEARS 1993 to 2000 • 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. Source: Fairfax-Falls Church Community Services Board

42. Addressing Alcohol & Drug, Mental and Physical Health Issues 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. Source: Fairfax-Falls Church Community Services Board

43. Addressing Alcohol & Drug, Mental and Physical Health Issues 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. Source: Fairfax-Falls Church Community Services Board

44. Addressing Alcohol & Drug, Mental and Physical Health Issues 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. Source: Fairfax-Falls Church Community Services Board

45. Addressing Alcohol & Drug, Mental and Physical Health Issues Community Services BoardEarly Intervention Services: Number of Infants ServedFISCAL YEARS 1995 to 2000 • 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. Source: Fairfax-Falls Church Community Services Board

46. Addressing Alcohol & Drug, Mental and Physical Health Issues Community Health Care Network:Number of Primary Care Patients and Visits FISCAL YEARS 1994 to 2000 • 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. Source: Fairfax County Health Department Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

47. Addressing Alcohol & Drug, Mental and Physical Health Issues Community Health Care Network:Client CharacteristicsMARCH 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. Age Distribution Primary Language * Other languages include Mandarin Chinese, Cambodian, French, Thai, Laotian, Hindi and Punjabi. Source: Fairfax County Health Department. Includes Residents of Fairfax County and Cities of Fairfax and Falls Church.

48. Addressing Alcohol & Drug, Mental and Physical Health Issues Maternity Services: Number of Teen Births (Up to Age 19)FISCAL YEARS 1992 to 2000 • 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. Source: Fairfax County Health Department Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

49. Addressing Alcohol & Drug, Mental and Physical Health Issues Low Birthweight Births per 100:Health Department, Fairfax Co., and Virginia Rates1993 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. N/a N/a N/a N/a Source: Fairfax County Health Department Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church

50. Addressing Alcohol & Drug, Mental and Physical Health Issues Women, Infants, and Children (WIC) Nutritional Program: Program CaseloadFISCAL YEARS 1991 to 2000 Source: Fairfax County Health Department Includes Residents of Fairfax County and the Cities of Fairfax and Falls Church