OMHSAS Childrens Policy Presentation

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OMHSAS Childrens Policy Presentation

• Pennsylvania Council of Children, Youth and
  Family Services
• December 3, 2009

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For Our Discussion

• General Updates
• Budget Status Updates
• Evidence Based Practices
• Residential Initiatives
• RTF Assessment,
• Regulations Status
• Rate Setting, HC Provider Rate Setting Policies
  Procedures
• Sanctuary Practices
• RTF Outcomes Indicators
• CISC Out of Zone- Implemented August 1, 2009
• Transition

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OMHSAS FY 2009-10 Budget

• Community Mental Health Services
• 728,730
• Includes a 2 cut to MH Base ( 3.055M)
• Annualizes the 1 COLA (Cost of Living
  Adjustment)
• FY 2008-09 CHIPPs are annualized at 3.95M, which
  includes 30 CHIPPs at Norristown and 10 CHIPPs at
  Torrance
• Increase of 1.5 M to support post-closure
  programs related to Mayview State Hospital as
  well as annualizes the dollars to support all
  discharges
• Transfers 335,000 to ODP for three individuals
  from the state hospitals to the waiver program
• Restores the mid- year FY 2008-09 budget
  reductions
• Includes additional cuts to hospital personnel
  and operations

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OMHSAS FY 2009-10 Budget

• Mental Health Services (continued)
• 2 across the board reduction, or 3.055 M, to
  county allocations
• Cut will not be applied to CHIPP/SIPP funds
• Counties may determine how to manage the funding
  reduction
• Budget does not include a COLA
• 500,000 for EPPI

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OMHSAS FY 2009-10 Budget Unified System
Strategy

• Drug and Alcohol Services
• BHSI Funding for MH and DA - 55,331 M
• Total cut equals 1.94M ( includes Governors
  proposed 2 with additional cut)
• Distribution of all money 60DA 40 MH
• Act 152 funding is maintained at 16,227,107 for
  FY 2009-10
• Sexual Responsibility and Treatment Program (Act
  21)
• Implemented in April 2004 on the grounds of
  Torrance State Hospital
• 24 men are now being served
• SRTP program operation was transferred to the
  Commonwealth and operated by Torrance State
  Hospital (July 1, 2006)
• Special Pharmaceutical Benefit Package (SPBP)
• Decrease in funding to 2.389M

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Medicaid

• General
• Smart Pharmacy is not going forward
• GRT ( Gross Receipts Tax) in lieu of Managed
  Care Assessment at 5.9
• Behavioral Health Capitation
• Cost Containment- 35M ( state funds)
• 8 M ( state funds) Act 62 assumption
• 4M return of funds ( Risk Corridor- prev yr)
• Other
• 3.1 ICSP

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HealthChoices statewide financial experience
2007Childrens Services All users
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Residential Services

• RTF Assessment, data review
• Regulations Status
• Rate Setting, HC Provider Rate Setting Policies
  Procedures
• Sanctuary Practices
• RTF Outcomes Indicators
• CISC Out of Zone- Implemented August 1, 2009

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Residential Data profile

• 13 counties and 1 multi county- represent 85 of
  all rtf use
• PRTF and non accredited
• Providers used
• Total Admissions
• Median LOS
• Percent by day range

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Evidence Based Practices

• PCCD, OCYF, MA
• Coordinated effort to support development and
  expansion

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ICSP from infrastructure to outcomes (evidence
based practices)

• As a direct result of ICSP, counties have begun
  to
• implement evidence based programs that are proven
  to show positive impacts for children
• 13 counties have implemented the Incredible Years
  program
• 52 counties are implementing Multi-Systemic
  Family Therapy
• 23 counties are implementing Functional Family
  Therapy
• 60 counties are implementing Family Group
  Decision Making
• 12 counties are starting Multi-Dimensional
  Treatment Foster Care
• 33 counties have developed common assessments for
  serving children with multi-systems needs

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Emerging school and community-based promising
practices

• HFW is currently being implemented in PA
• School-based services including
• Evidence-based outpatient satellite services in
  schools
• Cognitive Behavioral Intervention for Trauma in
  Schools (CBITS)
• Early identification of needs, reduction of
  expulsions and building of bridges to elementary
  school through mental health consultation in
  early childhood care settings
• Consultation and training with school staff such
  as Positive Behavioral Interventions and Supports
  (PBIS)
• This is currently termed School-wide PBS in PA
• It is being used in approximately 200 schools
  with plans for implementation in several more
  schools across the state including Philadelphia
  School District

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Residential Outcomes Quality Initiative

• Preliminary Results

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10 Counties/Joinders Participating

• Berks
• Butler
• Cambria
• Carbon/Monroe/Pike
• Dauphin

• Erie
• Montgomery
• Philadelphia
• Schuylkill
• York/Adams

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Surveys Completed

• 25 RTFs participating
• Almost 400 admission surveys completed
• 50 discharge surveys completed
• Minimal number of surveys 3 months post-
  discharge completed (due to limited length of
  time pilot has been in place)

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Sample Admission Results

• 90 indicate a goal of graduating from high
  school
• 13 indicated that they had a job prior to
  placement in the RTF
• 16 indicated that they ran away from home within
  30 days of placement
• 20 admitted drinking alcohol before placement
• 5 admitted drinking more than 15 days a month
• 28 felt that the staff of the RFT did not
  believe they can be a success
• 6 had frequent thoughts of ending their life
• 69 felt that the program would help them

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Symptom ChangeAdmission to Discharge

• Depression - improved by 22
• Anxiety - improved by 14
• Attention Deficit - improved by 8
• Hyperactivity - improved by 11
• Oppositional/Defiant behavioral - improved by 3 

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Promises to Keep FY 09/10

• New Projects to support Our Objectives
• Crisis Intervention Strategy/Development
• Clarify outpatient commitment procedures
• Persons in Recovery Subcommittee
• Implement LGBTQI priority recommendations
• Develop Call for Change paper for Childrens
  Services System
• Implement MH Parity / monitor federal healthcare
  reform
• Secure Medicare information to assess access to
  behavioral health services for older adults

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Promises to Keep FY 09/10

• Priority projects to support Our Childrens
  Objectives
• Implementation of SAMHSA Systems of Care Grant-
  Year 1 Strategic Plan
• Continue Implementation of High Fidelity Wrap
  Around Pilot Counties
• Develop Plan for Call for Change
• Expand PBI ( Positive Behavioral Supports ) as
  well as School Based Behavioral Health Services

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RESOURCES..

• Resources
• parecovery.org
• www.OlderPennsylvanians.org
• pa-co-occurring.org
• www.networkofcare.org
• Service Delivery Specific to County
• Library of Resources
• State and Federal Legislation
• Local, State and National Advocacy Efforts
• Secure Personalized Features
• Interactive Features