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Rappahannock Rapidan Community Services

Review of Fiscal Year 2022 and Presentation of
Fiscal Year 2023 Budget

JIM LAGRAFFE

EXECUTIVE DIRECTOR

RAPPAHANNOCK RAPIDAN COMMUNITY SERVICES

JULY 26, 2022

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We began FY’22 thinking we were turning the corner and coming

out of the Coronavirus Pandemic. We planned and budgeted with
this in mind. We knew nothing of the upcoming Delta Variant and
the new wave of infection, closures, restrictions and stress it would
bring to staff already exhausted by the previous year.

As I have come to expect, the staff at RRCS stepped up once again;

beyond what should reasonably be expected. I continue to be so
proud of the professionalism, caring and commitment they display
everyday supporting those members of our community that rely on
them to be safe.
For our community, I want to publicly say Thank You!
Jim

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The Year in review- Challenges

❑COVID Pandemic Continues- the Delta variant causes continued closings/ reductions
❑Fees down over $1,500,000 over projections
❑Community sees increase in Behavioral Health Challenges as stress from pandemic continues
❑Planning District sees 59 fatal overdoses in calendar 2021- a 34% increase
❑Emergency Custody Orders up 36%
❑Staffing shortages at State and Local levels hamper ability to provide needed care- State Hospital Bed
Crisis continues
❑Emergency Services challenged in finding hospital placements for individuals in need of services
❑Stressors at local emergency departments and with law enforcement agencies
❑Gas prices skyrocket
❑Stipend approved by Board to assist staff
❑Staff Compassion Fatigue

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The Year in Review – Changes

New Agency Leadership Faces/ Places
❑ Sheryl Reinstrom – Associate Executive Director*
❑ Gege Brown- Sr. Director of Finance
❑ Duncan Graham- Sr. Director of Information Technology
❑ Shirley Diaz- Sr. Director of Human Resources
❑ Don Janes- Director of Quality Improvement*
❑ Tammy Barboza- Director of Communications and Public Relations*
❑ Kim Marcey- Director of Housing and Facilities
❑ Sheri Sobkowiak- Director of Case Management
❑ Lorraine Sheffield- Director of Intellectual and Developmental Disabilities

❑Change in DBHDS leadership/ plans adds increased confusion to direction of system

❑DBHDS Regionalization efforts of services continues
❑ Mobile Crisis
❑ Crisis Call Centers
❑ To date, limited local impact in improving service environment
❑ Expression of concern for Regional service model expressed to Commissioner

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The Year in Review Growth-

New/Expansion of Services
❑S.E.E. Recovery Center- opens
❑Offers barrier free entry to services/ Reduces stigma/Offers non-hospital local option
❑On pace for 10,000 visits in 1st year of operation, servicing almost 2,000 unique individuals,
❑Provides Harm Reduction Kits to community
❑Parent Child interactive Therapy (PCIT)
❑Healthy Ideas program Started
❑Liberty House approved to accept Hospital diversions
❑Zero Suicide Initiative
❑STEP-VA- steps implemented
❑Service Veterans and Military Families
❑Peer and Family Support Services

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The Year in Review Growth-

New/Expansion of Services
❑Parkside Housing development project receives approval
❑Continued Development of Madison Rd project in Orange
❑RRCS receives expanded Housing Vouchers for PSH, SRAP, Housing Choice
❑Hospital Hill project in Fauquier financial support received from PATH Foundation and County
❑RRCS looks to purchase office location in Madison County
❑Will allow for local service location in county
❑Goal of service location in all 5 counties supported

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The Year in Review Growth-

Increased Funding Support
❑County Governments increase financial support
❑15.6% increase in local match dollars
❑Assists covering living wage costs and a 5% increase in costs
❑Madison County service location in development with support from the County
❑Orange County offers to gift former Sheltering Arms building for expansion
❑Fauquier adds financial support to Hospital Hill project
❑12.5% rate increase added to many Medicaid fees
❑Allows for financial stability after reduced fee revenue from pandemic closures
❑Philanthropy continues
❑Path Foundation supports Hospital Hill, Co-Response Programs, other programs
❑Culpeper Wellness Foundation, Northern Piedmont Community Foundation support Co-response, SEE
Center

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FY’22 Service Reports

Delivery Outcomes as Submitted in our
Performance Contract with DBHDS and
Area Plan on Aging

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 Rappahannock Rapidan CSB 2.

Service Outcomes Madison

Mental Health/Behavioral Health Services (7.8% of Reg. Pop)

Acute psychiatric Inpatient Services 2 (14)

Outpatient Services 54 (706)

Medical Services 22 (399)

PCIT (Parent-Child Interactive Therapy) 2 (5)

Case Management Services 27 (428)

Mental Health rehabilitation 0 (17)

Supervised residential 2 (18)

Supportive Residential Services 2 (30)

Hospital Transition 4 (81)

Peer Services 6 (95)

Total Supported 121 (1793)

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 Rappahannock Rapidan CSB 2.

Service Outcomes
Madison
Mental Health/Behavioral Health Services
Acute psychiatric Inpatient Services 2 (14)

Outpatient Services 54 (706)

Medical Services 22 (399)

PCIT (Parent-Child Interactive Therapy) 2 (5)

Case Management Services 27 (428)

Mental Health rehabilitation 0 (17)

Supervised residential 2 (18)

Supportive Residential Services 2 (30)

Hospital Transition 4 (81)

Peer Services 6 (95)

Total Supported 121 (1793

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Rappahannock Rapidan CSB

Service Outcomes
Madison
Developmental Services

Case Management Services 34 (499)

Day Habilitation 4 (143)

Supervised Residential Services 0 (34)

Supportive Residential Services 0 (0)

Skilled Nursing 0 (14)

ITC (Infant Toddler Connection) 52 (477)

Total Supported 90 (1167)

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Rappahannock Rapidan CSB

Service Outcomes
Madison
Substance Use Disorder Services

Outpatient Services 7 (162)

Medication Assisted Treatment 1 (24)

Case Management Services - Link 1 (54)

Highly Intensive Residential Services (Medically managed Withdrawal) - Detox 0 (0)

Intensive Residential Services - Boxwood 2 (50)

Peer Services 3 (56)

Total Supported 14 (346)

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Rappahannock Rapidan CSB

Service Outcomes
Madison
Emergency & Ancillary Services

Emergency Services 95 (1314)

Consumer Monitoring Services 11 (359)

Total Supported 106 (1673)

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Rappahannock Rapidan CSB

Service Outcomes
Madison
Assessments

Rapid Access 32 (531)

Boxwood 2 (53)

Jail 2 (136)

Mental Health Case Management 0 (5)

Mental Health Skill Building 0 (12)

PCIT (Parent-Child Interactive Therapy) 2 (8)

Development Disabilities Case Management 1 (43)

Total Supported 39 (788)

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Rappahannock Rapidan CSB

Service Outcomes
Madison
Housing Services

Section 8 Housing Choice Vouchers 2 (120)

Permanent Supportive Housing (PSH) 0 (35)

State Rental Assistance Program (SRAP) 0 (8)

Group Homes 0 (20)

Total Supported 2 (214)

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RRCS Aging Services

Madison
Service Outcomes Seniors
Area Agency on Aging Served
Provision of nutritious meals, health education, socialization, recreational, fundraising, and volunteerism for local
68 (295)
seniors in local Senior Centers.

Aging and disability resource connection for all information needed by seniors and caregivers needing
services and supports in our area. A principle of “No Wrong Door” is used, meaning, one call should enable 129 (820)
someone to obtain the information they need and to start a process for support and referrals. Support Coordinators
also provide insurance counseling, emergency supports, options counseling ,and care coordination services.

An adult day healthcare program provides seniors meaningful activity and a break for caregivers. 0 (8)

With the assistance of local volunteers, distribute home delivered meals and nutritional to seniors for improved
41 (542)
health and quality of life.
Human Services Transportation (CSB and AAA) provides access to needed services using a combination of
42 (445)
professional drivers, trained volunteers, and transportation specialist for improved mobility.

Volunteers 24 (176)

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Budget Preparation for

FY’23

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Financial Goals for Budget Development

❑Maximize staff compensation in light of current inflation/ workloads/ market competition
❑Ensure salary adjustments are sustainable
❑Target highest staff vacancy positions
❑Continue to align agency roles and structures

❑Keep employee Health Care contributions flat

❑Invest in needed technology
❑Conservativeness to absorb financial challenges of pandemic uncertainty
❑Development of a Capital Budget Plan to address needed property/ capital projects
❑Maintenance of existing staff/service levels

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FY’23- Budget $34,947,549

◦ Increase in revenue of $3,213,786 or 10.1% from FY’22
4 year growth- $8,498,160 or 32.12% almost all in past 2 years
◦ FY’19- $26,449,389
◦ FY’20- $27,213,868- increase of $763,911 or 2.7%
◦ FY’21- $27,630,393- increase of $416,525 or 15%
◦ FY’22-$31,733,763- increase if $4,103,370 or 14.8%

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Revenue Highlights
State Revenues
Increase of $1,383,191 or 15%
Local Sources
Increase of $842,455, or 26%- Total budgeted local tax dollars for basic services increased
$342,641 or 15.6%
Program Income
Increased by approximately $247,276. Funding for the Drug Court Case Manager and
foundation support of Co-response
Other Sources-
decrease of $132,123 mainly reduction in Medicaid Transportation revenue
Federal Funds
Increase of $806,626, or 27%

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FUNDING FOR FY 2023 OPERATIONS

FY23 Revenue Sources: $34,947,549

Other, $6,009,613 , 17.2%

State, $10,383,748 , 29.7%

Federal, $3,840,060 , 11.0%

Fees, $10,625,922 , 30.4% Local, $4,088,206 , 11.7%

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FY’23 Expense Highlights

EXPENSES - Total Budgeted Expenses in FY23 = $34,947,549
❑Personnel- $21,493,930 (62%)
❑Needs List- $517,767
❑Staff Development- $199,391
❑Facility Expense- $2,562,476
❑Equipment Expense- $2,877,790
❑Travel Expense- $824,434
❑Consultant Expense- $1,15,961
❑Admin/Transfers- $4,866,994
❑Operating Expenses Other -$1,006,573

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FY 23 Expenses by Category: $34,947,549

Program Transfers,
$4,866,994 , 13.9%
Travel, $824,434 , 2.4%

Staff Development,
$199,391 , 0.6%

Facility, $2,562,476 ,
7.3%

Contracted, $1,115,961 , Personnel,

3.2% $21,493,930 , 61.5%
Operational Expenses,
$1,006,573 , 2.9%

Equipment, $2,877,790 ,
8.2%

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RRCS Capital Budget

REVENUE FUNDING FROM CASH RESERVES $ 2,500,000

ESTIMATED EXPENSES:

Boxwood Renovation Project $ 300,000

Bridges Renovation Project 500,000

Madison Renovation Project 500,000

Hospital Drive Renovation Project 600,000

IT Infrastructure Purchases 300,000

Miscellanous Renovations and Repairs 300,000

Total $ 2,500,000

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