Welcome to the Office of Mental Health and

Transcription

Berks County
Mental Health
Developmental Disabilities
HealthChoices
2012-2013
Annual Report
The Berks County Mental Health/Developmental Disabilities
and HealthChoices Programs
Annual Report
July 1, 2012 - June 30, 2013
Berks County Board of Commisioners
Christian Y. Leinbach, Chair
Mark C. Scott
Kevin S. Barnhardt
Administrator
Edward B. Michalik, Psy.D.
Berks County MH/DD Advisory Board
Commissioner Kevin S. Barnhardt
John J. Bastek
Jenny Boukitab
Edward Chastka, M.D.
Jonathan D. Encarnacion
Raymond J. Hubbard, M.D.
Rev. Msgr. John B. McCann, STL, MSW
James Miller, MSW
Chief Christopher Neidert
Cathy Pilat
Robert Lee Rizzetto
Zylkia Rivera
Judge Jeffrey L. Schmehl
Brian G. Wlazelek, Ph.D.
MH/DD/HealthChoices Staff
Mary Hennigh, RNC, BS, Deputy Administrator-Adults
Michele Ruano-Weber, MA, Deputy Administrator-Children
Lydia Singley, LSW, HealthChoices Program Manager
Sheila Arnold, BA, Fiscal Officer
Sheila Bressler, LSW, CASSP Coordinator
Tiffany Bachert, BA, Fiscal Manager
Rebecca Dorsey, MPA, Quality Officer
Anne Marie Kline, Administrative Assistant to the MH/DD/
HealthChoices Programs
HealthChoices Advisory Committee
Chris Axford
Sheila Bressler
Sharon Drummond
Patty Ferry
Jim Hehn
Michele Jones
Sabrina Key
Kevin Leyland
Kathy Noll
Cathy Pilat
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Our Vision
The Mental Health/Developmental Disabilities
system will be a partnership of consumers,
family members, service providers and
policymakers, which creates options responsive
to individual needs and preferences.
Our Mission
To provide quality care as well as the delivery
of efficient public services and supports
for individuals with mental illness and
Developmental Disabilities so that they can
increase their opportunities and abilities
to lead lives of dignity and independence.
Acknowledging that Recovery is an ongoing
process, MH/DD is committed to promoting
personal growth, choice, and inclusion of
consumers in their community.
Our Values
We value an environment that promotes
• Excellence
• Quality Service
• Compassion and Empathy
• Fiscal Responsibility
• Creativity
• Flexibility
• Choices Across Systems
• Avoiding Duplication of Services
• We respect individuals and families and the
choices and decisions they make
• We recognize our similarities as human
beings and appreciate our differences
• We celebrate and embrace:
Hope
Wellness
Prevention
Family Involvement
Creative and Practical Solutions
Berks County Mental Health/Developmental Disabilities/HealthChoices Programs
A Message From the Administrator
June 30, 2014
Dear Citizens of Berks County,
On behalf of the Berks County MH/DD/HealthChoices Program Staff, and in collaboration with the Executive
Staff of the Council on Chemical Abuse, I am pleased to present to the Berks County Community our seventh
annual report for Fiscal Year 2012-2013. This report is overdue as we awaited final certification of our Human
Services Block Grant fund reports.
In addition to our regular program activities in Fiscal Year 2012-2013, we were pleased to partner with law
enforcement and the Berks County Intermediate Unit to sponsor the appearance of the I Love You Guys
Foundation. Its purpose was to promote comprehensive school and affiliated organizational planning designed
to prevent and mitigate circumstances involving active shooters in our schools.
Another new initiative, the Human Services Block Grant Program, afforded Berks County the ability to use
human service categorical monies to provide services to individuals who had previously been placed on waiting
lists. Implementing more meaningful approaches to serve the MH/DD population, including co-sponsoring
a large conference for mental health and intellectual disability service providers, offering training for the
behavioral health provider staff on improving services to the Latino population, and funding a Trauma-Informed
Course Curriculum to train forty-seven clinicians from our provider system, were among the most notable
accomplishments during the 2012-2013 Fiscal Year.
Although we may be facing potential budget cuts as we prepare to close the chapters on Fiscal Year 2013-2014,
the flexibility of the Block Grant Program helps to minimize the negative impact these reductions have on our
citizens. For example, we have successfully used the Block Grant to provide substance abuse treatment to a
number of individuals, who otherwise might have gone without care.
In our next report, you will learn more about the completion of reports associated with Senate Resolution #6 and
House Bill #226. These two important pieces of legislation address violence prevention within our communities
and schools.
In closing, I wish to express both my personal and professional appreciate and admiration of my staff and that
of or sister human service agencies, the Board of Commissioners, Chief Operating Officer, Advisory Board, and
community stakeholders for supporting our program initiatives. I feel both a sense of accomplishment and a
sense of urgency as we face the upcoming year. Together, we can achieve a great deal!
Sincerely,
MH/DD Administrator
Annual Report 2012 - 2013
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Contents
2 Personnel
2 Berks County MH/DD Program Vision, Mission Statement, and Values
3 Message from the Berks County MH/DD Program Administrator
4 Table of Contents / About MH/DD
Mental Health/Developmental Disabilities Program
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6
7
8
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10
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11
12
14
16
18
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Mental Health Program Revenue and Expenses
Developmental Disabilities Program Revenue and Expenses
Individuals Served by Cost Center - Mental Health and Developmental Disabilities Program
C
hildren and Adolescent Service System Program (CASSP)
CASSP Highlights
D
isaster Crisis Outreach and Referral Team (DCORT)
C
ommunity Hospital Integration Project Program (CHIPP)
F orensic Mental Health Services
Berks County Community Support Program
Early Intervention Services
Developmental Disabilities Service System Update
Human Services Block Grant
Crisis Services
HealthChoices Program
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20
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25
26
27
28
29
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31
32
B
erks County HealthChoices Program - Membership
H
ealthChoices Program Utilization - Demographics
HealthChoices Program - Services
HealthChoices Program - Services for Youth
HealthChoices Program - Adults vs. Children Served
HealthChoices Program Level of Care Utilization
H
ealthChoices Program Utilization - Diagnostic Groups
HealthChoices Program Expenditures - Diagnostic Groups
HealthChoices Program Utilization - Youth Demographics
HealthChoices Program Level of Care Utilization - Youth
H
ealthChoices Program Utilization - Youth Diagnostic Groups
HealthChoices Program Expenditures - Youth Diagnostic Groups
HealthChoices Program Utilization Trend 2002 - 2013
HealthChoices Program Reinvestment Plan History
Resources
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36
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Terminology
Alphabet Soup
Web Site Reference Guide
Contributors
About MH/DD
The Mental Health/Developmental Disabilities Program of Berks County is regulated by the Pennsylvania Department of
Public Welfare through the Office of Developmental Programs, the Office of Mental Health and Substance Abuse Services,
and the Office of Child Development and Early Learning. The Program maintains responsibility for all MH/DD/EI funded
programs and services. In collaboration with the Council on Chemical Abuse, the Program provides oversight for the
behavioral health care component of the HealthChoices Program.
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Be r ks Cou n t y
Me ntal H ea lt h Pro g ra m
F iscal Yea r 2 0 1 2 - 2 0 1 3
Mental Health Program
Total Revenue: $15,176,604
Berks County
General Fund
$341,970
2.25%
Department of
Public Welfare
$9,562,302
63.01%
Interest
$4,820
0.03%
*Other Revenue
Sources
represent a
combination
of Medical
Assistance, Social
Security Income,
Private Insurance,
Human Service
Development
Funds, Other
County Funds,
Program Service
Fees, Provider
Costs over
Allocation, and
Donations.
Other*
$5,267,512
34.71%
Total Expenditures: $15,176,604
Other (CHIPP)
$3,032,893
19.98%
Targeted Case
Management
$4,550,758
29.99%
$1,999,440
13.17%
Crisis Services /
Emergency Services
$2,417,149
15.93%
Community Employment
Community Residential Services
Day Treatment
Family Based Services
Family Support Services
Housing Support
Inpatient
Outpatient
Vocational Rehabilitation
Social Rehabilitation
Psychiatric Rehabilitation
$74,700
$504,981
$61,108
$4,320
$11,617
$137,488
$28,697
$343,870
$61,139
$176,304
$595,216
Administration
$1,090,352
7.18%
Community
Services
$1,145,317
7.55%
Administrative
Management
$940,695
6.20%
NOTE: Detail may not sum to totals due to rounding.
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Be r ks Cou n t y
Deve lopm e ntal Di s a b i l i t i es Pro g ra m
F isca l Yea r 2 0 1 2 - 2 0 1 3
Developmental Disabilities Program
Total Revenue: $3,872,763
*Other Revenue
Sources
represent a
combination
of Medical
Assistance,
Social Security
Income, Private
Insurance,
Human Service
Development
Funds, Other
County Funds,
Program Service
Fees, Provider
Costs over
Allocation, and
Donations.
Berks County
General Fund
$94,016
2.43%
Other*
$262,337
6.77%
Department of
Public Welfare
$3,516,410
90.80%
Total Expenditures: $3,872,763
Administrator's
Office
$1,828,618
47.21%
Supports
Coordination
$308,497
7.97%
Community
Residential
$920,949
23.78%
Other
$36,794
0.95%
Community Based
Services
$777,905
20.09%
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Indiv idual s S erved by Co s t C en t er
F isca l Yea r 2 0 1 2 - 2 0 1 3
Crisis Services /
Emergency Services
2,920
29.72%
Targeted Case
Management
2,464
25.07%
Outpatient
594
6.04%
471
4.79%
Community Employment
Community Residential Services
Day Treatment
Family Based Services
Housing Support
Inpatient
Social Rehabilitation
Vocational Rehabilitation
Psychiatric Rehabilitation
Other (CHIPP)
66
36
38
4
4
52
5
196
15
8
47
Administrative
Management
3,378
34.38%
Community Based
Services
155
7.56%
Community
Residential
17
0.83%
Other
75
3.66%
Supports
Coordination
1804
87.95%
Note: Developmental Disabilities Program counts
include base funding authorizations only
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C h il d a n d A d ol es c en t
S e r v ice S y s t e m Pro g ra m ( C A S S P)
Berks County CASSP Vision Statement
“To assess, develop, improve, and evaluate a comprehensive, coordinated and collaborative system of
services for children, adolescents and their families with multi-system needs.”
Highlights from Fiscal Year 2012-2013
Integration and collaboration between youth, families and agency providers happens every day in Berks County
on a formal and informal level. During Fiscal Year (FY) 2012-2013, the CASSP Coordinator assisted agencies
and interagency teams to work together collaboratively and also participated in several different multi-agency
projects.
Interagency Team Meetings
The purpose of an Interagency Team Meeting is to promote a forum for cooperative planning in order
to create a comprehensive, community based, needs driven system of services and supports to help
children and families reach their goals. Interagency Team Meetings are beneficial and should occur
regularly when a child and/or family is receiving services from multiple agencies. The child’s Interagency
Team should consist of the family, the child (as appropriate) and any agency or school staff who are
working with the child and family on a regular basis. Interagency Team meetings are more productive
and successful when the following format is followed:
1.
2.
3.
4.
5.
6.
7.
Introductions
Confidentiality and Attendance Sheet – Have the necessary release forms been signed?
Statement of Purpose – What are the objectives of the meeting?
Strengths – What strengths does the youth and family have and how can the team build on these strengths?
Prior Interventions/Efforts and Outcomes - What interventions have been tried and to what effect?
Outcomes/Barriers – What outcomes do the youth, family and team want? What barriers are getting in the way of success? How can the team help the child and family achieve positive outcomes?
Roles/Responsibilities – Who is responsible for implementing the agreed upon plan and what is the time frame for implementation?
The CASSP Coordinator can be a resource for interagency teams and will provide consultation as
requested. During Fiscal Year 2012-2013, the CASSP Coordinator participated in 54 interagency
meetings concerning 17 different youth. If you need the CASSP Coordinator to assist you with an
interagency meeting please call 610-478-3271 x6584.
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C AS S P Hig h l ig h t s
CASSP Core Principles
The CASSP philosophy is based on six core principles that guide the delivery of services to children:
•
•
•
Child Centered
Family Focused
Community Based
•
•
•
Multi-System
Culturally Competent
Least Restrictive/Least Intrusive
Runaway and Homeless Youth
Youth find themselves without a home for a number of reasons. Some youth experience
homelessness along with their families. However, there are a number of youth who runaway
without their families knowledge or are thrown out of their homes by their parents or guardians
(“throwaways”). It is difficult to know exactly how many youth are homeless but the National
Runaway Safeline reports that in 2012, they received 258 calls from youth in the 610 and 484
Berks County Area Codes. (There were 2892 calls total from Pennsylvania Area Codes). While the
reasons for youth homelessness are numerous, the number one reported reason youth leave or
get thrown out is family conflict. The National Runaway Safeline reports their highest numbers of
callers are aged 18-21 and locally we are seeing the same trend in Berks County. Family Promise
of Berks County currently operates a program for runaway and homeless youth called U-Turn.
While funding is limited to actually house these youth, a day center, case management, and
food bank can help these youth as they strive to graduate from high school and work towards
independence. Family Promise, in collaboration with the Youth Committee of the Berks Coalition
to End Homelessness are working to try to enhance services in Berks County for runaway and
homeless youth.
Teen Pregnancy Prevention
National teen pregnancy prevention efforts have been in effect for almost 20 years. And while
the percentage of teens getting pregnant has declined since 2007, the United States continues
to have one of the highest rates of teen pregnancy among fully industrialized nations. A recent
report from the Public Health Management Corporation reported that the adolescent birth
rate for Reading and Berks County was higher than that of the Commonwealth and found a
need for teen pregnancy prevention services. In 2012, there were 741 reported pregnancies
to teens age 15-19 in Berks County. 33% of those pregnancies were to teens age 15-17. Of
the 741 reported pregnancies, 508 resulted in a live birth. The Teen Pregnancy Prevention
Workgroup, Co-Chaired by the CASSP Coordinator and Co-County Wellness Services, has
been focused on developing prevention resources in Berks County and has identified three
areas of focus: improving parent/youth communication, providing sexual health education to
youth, and increasing awareness about teen pregnancy with medical providers. Co-County
Wellness, through funding from the Wyomissing Foundation and in collaboration with the
local Workgroup is working together to carry out this prevention plan through a variety of local
events and activities.
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Disaster Crisis Outreach and
Referral Team (DCORT )
DCORT’s mission is to assist those individuals that have been impacted by crisis or disaster by providing
emotional support and therapeutic activities to ease stress, foster a compassionate presence, and to aid in
community resilience.
Through a Pennsylvania Statewide process, a total of 53 individuals are credentialed to provide this service
within Berks County. Deployments during this past year revolved around grief interventions with local school
districts, a local business, and veterans.
In addition, the Berks County MH/DD Program partnered with the Berks County Intermediate Unit to bring
John Michael-Keyes from the “I Love U Guys” Foundation to speak at the Keeping Kids Safe Symposium in
the Fall of 2012. This conference was the impetus for Berks County School Districts to develop a “Standard
Response Protocol” to deal with threats within the school building. It allows for a better coordination and
response between education, law enforcements, and other first responders.
For additional information, please contact Michele Ruano-Weber at [email protected].
Com mu n i t y Hos pi tal I nteg ration Project Prog ram
( CHI PP)
The Department of Public Welfare established the Community Hospital Integration Project Program (CHIPP)
in Pennsylvania in 1991-1992. The program was designed to provide increased community support services
for individuals with a long-term history of hospitalization or otherwise complex service needs. The primary
goal of the CHIPP program is to afford individuals the opportunity for growth, recovery and inclusion into
their community, have access to services and supports of their choice, and enjoy a quality of life that includes
families and friends. Additionally, the program provides diversionary services that prevent unnecessary future
hospitalizations. The diversion program through Service Access and Management, Inc. diverted 77% of all
Wernersville State Hospital referrals received during Fiscal Year 2012/2013.
Berks County has been awarded six (6) CHIPP programs to date; all six (6) of these programs have assisted
individuals in being discharged from Wernersville State Hospital back into the community. Currently, there are
four (4) contracted provider agencies serving CHIPP consumers.
Berks County’s original CHIPP began in 1997, when eighteen (18) persons served from Wernersville State Hospital
were selected to participate in CHIPP. An additional twenty (20) persons participated in 2000, when Berks County
was awarded a second CHIPP project. The third CHIPP project, awarded in 2003, involved assisting three (3)
persons. An additional fourth CHIPP project was awarded in 2004 including one (1) special needs person, and
in 2005 Berks County was awarded a fifth CHIPP serving five (5) persons. The sixth CHIPP award was received
for Fiscal Year 2006/2007; this project has assisted an additional five (5) persons. There were no CHIPP awards
for Fiscal Year 2012/2013. For Fiscal Year 2012/2013, Berks County served forty-eight (48) persons through the
CHIPP Program.
The hallmark of Berks County’s CHIPP model is rooted in the choice of the person served. Choice begins prior to
the person’s discharge from the state hospital. The person and their CHIPP community team work together to
identify housing options within the community. Regardless of the type of residence selected, ongoing, enhanced
support and clinical services are provided to the person served via the Blended Case Manager and one of the
four (4) service providers: Supportive Concepts For Families, Inc., Threshold Rehabilitation Services, Inc., Horizon
House, and Project Transition.
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CHIPP funds have also contributed to the development of the “Mosaic House”. The clubhouse is designed
within the framework of a psychiatric rehabilitation model. Members and staff work side by side to
promote the clubhouse’s ‘work-ordered’ day. A Consumer Satisfaction Team (CST) has also been created
to assess ongoing consumer satisfaction with services and providers.
Berks County’s “flexible” model of service delivery has recognized the value of serving each individual’s
‘unique’ needs in a tailored fashion. This community-based program has provided persons with mental
illness the opportunity for growth, recovery and inclusion in their community.
Forensic Mental Health Services
The Berks County MH/DD Program continued our commitment to serve individuals involved in the
criminal justice system this past year. Our Program continues to support the various Treatment Courts,
Forensic Case Management and the Community Re-entry Center. Liaisons remain in place for the state
hospitals and state correctional institutions as well as for diversion and the forensic transitional housing
program.
The Treatment Courts offer qualified individuals treatment as an alternative to extended incarceration.
Individuals with Mental Health and/or Substance Abuse issues are screened to participate in the
program that includes substance testing, reporting requirements, sanctions and rewards along with
treatment. In Fiscal Year (FY) 2012-2013, 32 individuals were served by the Mental Health Treatment
Court and 1 person went through the DUI Court program. The Pennsylvania State Parole Re-Entry Court
enabled 8 individuals to participate in treatment increasing their ability to maintain their parole and
support their mental health.
The Forensic Case Managers from Service Access and Management (SAM), Inc. opened a total of 386
cases during the past year. Case Managers assisted individuals with setting goals, applying for Medical
Assistance and making referrals to community services as needed. Upon release, cases were transferred
to Blended Case Management in the community. The Community Re-entry Center had 48 individuals
supported by our Forensic Unit this past year.
Our SAM liaisons for the state hospitals and state correctional institutes assist the courts with
paperwork throughout admission and are instrumental in setting up treatment options for consumers
upon their discharge/release.
The Berks County MH/DD Program in partnership with Berks Connections/Pretrial Services continues to
support both diversion and transitional housing services offered for individuals involved in the justice
system. The Mental Health Forensic Liaison had 319 contacts this past FY with 148 assessments and
referrals provided, including 18 unsecured bail diversions. The transitional housing service, designed
for four people, is being used to assist non-violent individuals with mental illness who are released
from Berks County Prison (BCP) or to avoid incarceration. This housing, managed by Berks Counseling
Center, offers support and supervision along with other community programs such as case management,
Assertive Community Treatment(ACT) and Peer Support, just to name a few. Individuals remain in
their apartment for up to six months, providing sufficient time to develop natural supports and secure
regular housing. Since December 2012, 11 individuals have used this program with two individuals
successfully moving on, one elopement and four removed for non-compliance with program rules. All
four apartments are currently occupied.
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Be rks Cou n t y
Com mu nit y S u p p ort Pro g ra m ( C S P)
The Berks County Community Support Program (CSP) actively engages consumers,
family members, and mental health providers in a structured forum to support our
mission and to work toward the attainment of our vision statement “that every adult
with a serious mental illness, including persons with co-occurring disorders, will enjoy
the highest quality of life”. Projects focus on integration, education, and advocacy,
while fostering adherence and inclusion of established principles. The structure of
the Berks County CSP consists of standing committees (Executive and Advisory) and
subcommittees (CHIPP, Community Resource, and Quality Improvement/Recovery)
and commission ad hoc groups (Housing) as needed.
Executive Committee
In addition to maintaining oversight of CSP, the Executive Committee was involved in the following
activities:
• Maintained membership with Berks County Television (BCTV) and produced a show once a
quarter on various topics of interest.
• Planned and coordinated presentation of educational component at each Advisory
Committee meeting.
• Provided scholarship monies to assist consumers in attending conferences.
• Held quarterly housing education forums in lieu of a committee to provide timely, accurate
information to consumers regarding housing needs/options.
• Evaluated expansion of service types for existing programs for compliance with CSP
principles and provided relevant feedback to the County office.
Advisory Committee
The Advisory Committee is charged with keeping the general open membership informed of all
activities undertaken and to expressly solicit input from stakeholders. Activities included:
• Bimonthly reports from CSP subcommittees.
• Educational presentations at bimonthly meetings; topics covered over the past fiscal
year include, but were not limited to: Housing Planning Update and use of HealthChoices
Reinvestment Funds, Recovery Oriented Systems Indicators (ROSI), overview of Office of
Vocational Rehabilitation services (OVR), Relationships, How to Manage Stress Through the
Holidays, and Greater Reading Mental Health Alliance-Location, Leadership and Advocacy.
• Sharing stakeholder’s questions/comments on local and state issues in the delivery of
services.
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Community Resource Subcommittee
• Updated, printed and distributed the Consumer Resource Guide including websites and peer
support services.
• Led survey and brainstorming session of constituents to ascertain training/education needs.
• Organized a half day conference on “Integrating Physical and Behavioral Health” and
“Overview of Community Care Behavioral Health (CCBH) HealthChoices Services in Berks
County”.
• Applied for and received a grant from the Northeast Region CSP to defray the cost of the
conference, allowing for “no charge” attendance.
CHIPP Subcommittee
• Provided regular updates as to number of consumers diverted from Wernersville State
Hospital on a monthly basis. Reported on the progression of the completion of consumer
plans prior to discharge from the State Hospital.
• Assists in planning for Consumer Resource Day at Wernersville State Hospital.
• Lead member of the Continuity of Care and Service Area Planning team and provided regular
reports/updates to CSP constituents.
Quality Improvement/Recovery Subcommittee
• Revised the CSP Indicator Questionnaire to include state mandated ROSI indicators and
distributed to providers.
• Compiled results and submitted to the Berks County MH/DD Program. Chose one indicator
to initiate a quality improvement plan as reportable to the state. Reported improvement in
consumer representation on boards and affirmative action hiring policies including consumers.
• Hosted a presentation by Greater Reading Mental Health Alliance on “In Our Own Voice”.
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E ar ly I nt e r v e nt ion S ervic es
Early Intervention in Pennsylvania is a program that
helps families develop their child’s potential. Infants
and toddlers, between the ages of birth to three years
of age, who have special needs due to developmental
delays or disabilities, are eligible to receive early
intervention services. The program involves
collaboration among parents, early intervention
providers, childcare providers, and others in the
community who are involved with children before
they enter school. The program enhances family and
caregiver relationships with children and works within
the routines and activities unique to each family and
community to build on the child’s strengths, and
maximize the child’s experiences and opportunities.
The Infant/Toddler Early Intervention (EI) Program for
children ages birth to three years is administered by
the Pennsylvania Department of Public Welfare, Office
of Child Development and Early Learning, and locally
is operated through the Berks County Mental Health/
Developmental Disabilities Program. The County
MH/DD Program contracts with Service Access and
Management, Inc. (SAM, Inc.) to ensure that families
have access to a service coordinator and to necessary
supports and services.
Services provided to eligible children differ based on
the individual needs of each child and family. Services
may be provided in the child’s home, child care center,
play group and/or Head Start Program. Services are
provided at no cost to families.
Referral Sources:
% Children Referred
Physicians
Parent/Family Members
Hospital or Pre/Post Natal Facility
Other Social Service Agency
Other
CONNECT Direction Service
Early Intervention Provider
Other Health Care Provider
Local Education Agency*
Head Start/Early Head Start
44.90%
35.50%
6.20%
5.00%
4.30%
3.00%
0.60%
0.30%
0.10%
0.10%
*MAWA/School District
Children may be referred to Early Intervention
with more than one reason indicated on the
referral form
Gender of Children Referred for Early
Intervention Services
Total Referred: 994
Females
383
39%
Males
611
61%
Average Monthly Number of Children Referred
to Early Intervention: 103
Percentage of Referrals by Age
0 - 11 months
12 - 23 months
24+ months
30%
31%
39%
Referral Reasons:
# of Children Referred
General Development Check
Communications Mastery
Physical Development
Social/Emotional Development
NICU Care
Other
Low Birth Weight
Medical Diagnosis or Conditions
Cognitive Development
& Skill Acquisition
Sensory Status
Affected by Illegal Substance Use/Prenatal Drug
Elevated Lead Blood Levels
Newborn Hearing Screening/Audiologist
Substantiated Child Abuse or Neglect
Environmental Issues
645
580
245
143
135
126
93
45
32
28
14
11
11
2
1
Medical Assistance Eligibility
Eligible
Not Eligible
623
371
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Gender of Children Served by Early
Number of Children
Served by Provider
Total Served: 1,737
AKT Pediatrics
Barbera Behavior Consulting
Connective Intervention Services
Easter Seals Eastern PA (Berks)
Hands on PT
Happy Hearts
Helping Hands Therapy Inc.
Integrated Therapy
K & S Therapies
Ken-Crest Services
Lamm and Associates
Marni Arragon
Ready, Set, Go
Right Start Children’s Services
Step by Step Pediatrics
The Arc Alliance Children’s Services
Therapy Resource Center
Tina Copeland
WeeTalk Speech & Language Service
Females
638
37%
Males
1099
63%
Average Monthly Number of Children Served by
Early Intervention: 931
Racial / Ethnic Category of Children Served
White
Other
African-American, Black
Unknown
Multi-Race
Asian
American indian or Alaskan Native
52.00%
39.00%
5.88%
1.90%
0.60%
0.57%
0.05%
Reasons for Terminating Early
Eligible for IDEA
Part B, exit to other
community services
1
0.24%
Not eligible for
IDEA Part B, exit
with no referrals to
other programs
29
7.07%
Not eligible for
IDEA Part B, exit
with referrals to
other programs
1
0.24%
Total of other
reasons for
terminating
services**
197
48.05%
Found eligible for
IDEA Part B
125
30.49%
Successful
completion of IFSP
prior to age 3
57
13.90%
2
5
15
114
176
7
105
87
66
39
1
4
3
273
163
93
67
1
214
School District of Children Served by Early
Intervention
Antietam SD
Boyertown ASD
Brandywine Heights SD
Cocalic SD
Conrad Weiser ASD
Daniel Boone ASD
Ephrata ASD
Exeter Township SD
Fleetwood ASD
Governor Mifflin SD
Hamburg ASD
Kutztown ASD
Muhlenberg SD
Oley Valley SD
Reading SD
Schuylkill Valley SD
Tulpehocken ASD
Twin Valley SD
Upper Perkiomen ASD
Wilson SD
Wyomissing ASD
28
70
27
2
42
73
1
84
50
80
46
31
95
26
797
30
41
39
7
104
61
** Other reasons for discharge include withdrawn by parents, deceased, moved,
unsuccessful attempts to contact, ineligible for Early Intervention.
15
De v e lopm en ta l Di s a b i l i t i es
S e r v ice S y s t em U p dat e
Berks County continues to operate services for individuals with developmental disabilities
utilizing the fundamental concept of Everyday Lives. Everyday Lives means that with the support
of family and friends, individuals with developmental disabilities decide how to live their lives,
what supports they need and who will provide those supports to them. It also means that they
are responsible for their decisions and actions.
The Office of Developmental Programs (ODP) oversees the business processes that are used
to operate Developmental Disability Services. These processes are contained in the Home
and Community Services Information System (HCSIS) which is the standardized, statewide
information system used to support the program. The processes include consumer registration,
service notes, Individual Support Plan (ISP) and monitoring for people receiving services.
2012-2013 Activities
• During this year, Service Access & Management, Inc. (SAM, Inc.) continued to operate one of
the Supports Coordination Organizations (SCO) within Berks County. This was in response to an
initiative that was started in Fiscal Year 2008-2009, where the Office of Developmental Programs
(ODP) directed that Supports Coordination Activities needed to operate separately from the
administration of Waiver activities. Service Access & Management, Inc. continues to operate a
Waiver Administration Unit that completes specific activities on behalf of the Berks County MH/DD
Program, the Administrative Entity (AE).
• The administrative eligibility and intake functions are now operating under the Waiver
Administration Unit as opposed to the SCO as they had been in previous years.
• Ongoing efforts to enroll persons served in Lifesharing continued to be a priority. Monthly
meetings were implemented for teams to discuss this service as an option and assist families
and providers in overcoming any barriers to accessing this level of care. Consumer profiles were
created for all persons interested in this service in order to match them with the most appropriate
Lifesharing provider.
• Dual diagnosis initiatives continued to be a focal point throughout the year and increased emphasis
was placed on Supports Coordinators (SCs) and treatment providers to support persons served
through all phases of a psychiatric hospitalization to ensure they receive adequate services and
support.
• Berks County continued the development of the Berks County Quality Transition Council. The
Council continues to strive to get input on the development of the Quality Improvement Plan from
all stakeholders, which include consumers, parents, provider staff, Berks County MH/DD Program
staff, and SAM, Inc. staff.
16
Supports Coordination Activities
• In September and October of 2012 the SCO underwent several staffing changes. The management
to supports coordinator ratio was changed and the program began operating on a ratio of one
supervisor per six staff. This restructuring eliminated the operation of two management positions.
During this time the SCO began to operate under a new Director, Shara Garipoli.
• During the Fiscal Year 2012-2013, SAM, Inc. provided Supports Coordination Services to 1713
individuals. The SCO supported approximately 799 individuals with Waiver funding.
• SAM, Inc, continued to operate with a waiting list for services. The needs of individuals are
identified through the Prioritization of Urgency of Needs for Services (PUNS) process. The PUNS is
reviewed and updated as an individual’s needs change with the assistance of the individual, family
and other team members. The PUNS process is the manner in which information for individuals
who need services is gathered across the state.
• The SCO continued to focus on improving the quality and timeliness of ISPs being submitted per
ODP standards.
Individuals with the following needs in Berks County are identified as follows:
• Emergency- 165
• Critical- 216
• Planning- 147
1. During 2012, ODP provided Counties with additional waiver slots to individuals graduating from
high school during the 2012 and 2013 years. ODP also provided Counties with additional waiver
slots for individuals residing with a caregiver 60 years or older with an emergency need for service.
2. In Berks County, twenty-five new waiver slots were allocated during this time frame; 11 were
based on the ageing caregiver criteria, 12 were based on the graduate criteria, and 2 were
unanticipated emergency slots.
3. Berks County continued to implement the ODP state-wide standardized assessment called the
Supports Intensity Scale (SIS). The assessment process is completed by a conflict-free organization,
Ascend, that contracts with ODP. The information gathered through this process is incorporated
into the individual’s annual Individual Support Plan (ISP) in order to ensure that needs identified
through the assessment are addressed.
4. Berks County continues to provide individuals and those supporting them with information about
choice; choice of Supports Coordination, Services, and Providers.
5. Berks County provides information to individuals and families about the individual’s right to be
free from abuse and neglect.
17
Hum a n S e rvic es B loc k g ra n t
In accordance with Act 80 of 2012, the Department of Public Welfare developed a block grant pilot project with
twenty Counties. This project was intended to streamline planning and reporting requirements for County
Human Services Programs. The following funding streams were included in the Block Grant: Mental Health
Community Base Funded Services, Behavioral Health Services Initiative (BHSI), Intellectual Disabilities Community
Base Funded Services, Child Welfare Special Grants, Act 152 Funding, Homeless Assistance Program Funding
(HAP), and Human Services Development Funds (HSDF).
Berks County was fortunate to be allowed to join Fiscal Year 2012-2013, Human Services Block Grant Pilot
Project. A Planning Team was formed as the basis for this coordinated initiative. The Planning Team consisted
of Wolf Hrabyk (MH/DD-Adults), Michele Ruano-Weber (MH/DD-Children), Sheila Arnold (MH/DD Fiscal
Officer), Sheila Bressler, Child and Adolescent Service System Program, (CASSP), Tiffany Bachert (MH/DD Fiscal
Manager), Jeffrey Gregro (JPO), Wendy Seidel (CYS), Michele Fronheiser ( CYS Fiscal Operations Officer), Stan
Papademetriou (Berks SCA), Kathleen Noll (Berks SCA), Jennifer Wang (Berks SCA Fiscal Manager), and Mary
Henry-Moss (Human Services Coordinator).
Many of these same members worked together during the Integrated Children’s Services Plan process. One of
this group’s tasks was to identify various community stakeholders as well as to establish base line data from the
various funding streams. The drug/alcohol system had the ability during this fiscal year to move Act 152 monies
not being expended to the BHSI funding stream where there was a greater need.
The Block Grant has allowed additional flexibility to Counties based on localized needs. Berks County continues
to remain part of this Project. Based on its success, legislation was passed to allow additional Counties the
opportunity to participate in the project.
The MH/DD Program is the lead on this project for the County of Berks.
Be r ks Coun t y C ri s i s S ervic es
The delivery of Berks County crisis intervention services through Service Access & Management, Inc. has changed
dramatically over the past few years. Currently, the Crisis Department employs 17 Crisis Interventionists and 4
Supervisors who staff the service 24 hours per day. Previously, the department was staffed with a combination
of employees and contractors, and there were far fewer staff on each shift. Berks County MH/DD recognized
the need to provide more funding to increase staffing and better serve the needs of the community due to a
significant rise in call volume. To illustrate the increase, in 2006, the Crisis Department received approximately
500 calls per month, while the current contact volume is often over 1000.
Not only has the number of calls increased, but the expectations of the handling of calls have also changed.
Crisis Interventionists are now able to provide a more mobile delivery of services and can interface with
individuals where it is convenient for the person in need. This mobile approach offers a better opportunity
to build rapport and make accurate assessments, as well as more accurate community referrals. Crisis
Interventionists now aim to leave the office within 10 minutes of receiving a call. This quicker response makes
meeting with a Crisis Interventionist a viable alternative to presenting at a local hospital for those seeking
immediate assistance. Crisis Interventionists are able to divert many people from hospitalizations (when it is
appropriate and safe to do so) and help them to resolve their crises and find needed resources from within their
community.
Another focus of the Crisis Department has been to further develop relationships with law enforcement
agencies. Police officers often come into contact with mental health consumers who are just starting to
decompensate but have not yet reached the point where hospitalization must be considered. By partnering
with the officers, Crisis Interventionists can take a more proactive approach by providing needed supports and
referrals early on in the hopes of avoiding a more serious crisis.
18
Ber ks Cou nt y H ea lt hC hoic es Pro g ra m
HealthChoices is Pennsylvania’s mandatory managed care program for Medical Assistance (MA) consumers. The
program is designed to improve access to and quality of care for MA consumers throughout Pennsylvania.
The Pennsylvania Department of Public Welfare (DPW) has contracted directly with Berks County for the management
of HealthChoices behavioral healthcare services to County residents. The County, in turn, sub-contracts with a managed
care organization, Community Care Behavioral Health (CCBH), to manage behavioral healthcare services on behalf of
the County HealthChoices Program. This includes provider network development, utilization management, quality
management, claims management, information systems, reporting, member services, and prevention and outreach.
Eligibility by Category of Aid
FY 2012-2013
Federal GA
55
0.1%
Healthy Beginnings
14,744
22.3%
TANF
28,453
43.1%
SSI
13,780
20.9%
Medically Needy
361
0.5%
SSI with Medicare
6,442
9.8%
Categorically Needy
2,160
3.3%
Eligibility
End of Fiscal Year
FY 2002-03 through FY 2012-13
54,089
48,575
55,359
65,727
65,410
65,995
FY 2010-11
FY 2011-12
FY 2012-13
62,070
57,458
50,313
41,447
35,919
FY 2002-03
FY 2003-04
FY 2004-05
FY 2005-06
FY 2006-07
FY 2007-08
FY 2008-09
FY 2009-10
19
He a lt hC hoic es M em b ers S er v ed
D e m o g ra phi cs
Gender
Male
8,344
49%
Female
8,777
51%
Age 65+
310
1.8%
Age 45-64
3,945
23.0%
Age Groups
Age 0-5
589
3.4%
Age 6-12
3,182
18.6%
The HealthChoices Program
served 17,121 Berks County
residents in FY 2012-2013.
Age 13-17
2,316
13.5%
Age 21-44
5,865
34.4%
Age 18-20
914
5.3%
Race/Ethnicity
Asian
58
0.3%
White
7,657
44.7%
Black
1,521
8.9%
Hispanic
3,995
23.3%
*Other/Multi-Racial
3,862
22.6%
Native American
28
0.2%
* Other race category includes
individuals who report being of multiple
racial/ethnic origin.
20
H ealthChoic e s E x pe n di t u res
De mog rap h ics
Gender
Female
$26,037,400
40%
Male
$39,519,660
60%
Age Groups
Age 0-5
$2,041,877
Age 65+
3.1%
$342,214
0.5%
Age 6-12
$15,883,751
24.2%
Age 13-17
$14,555,624
22.2%
Age 45-64
$11,910,670
18.2%
The HealthChoices Program
expended $65,557,060**
on services for Berks County
residents in FY 2012-2013.
Age 18-20
$3,425,146
5.2%
Age 21-44
$17,397,778
26.6%
Asian
$200,147
0.3%
Race/Ethnicity
Black
$7,069,568
10.8%
White
$33,032,019
50.4%
Hispanic
$12,533,891
19.1%
* Other race category includes individuals who report
being of multiple racial/ethnic origin.
** Does not include $500,000 alternative payment
arrangement for crisis services.
Native American
$217,868
0.3%
*Other/Multi-Racial
$12,503,567
19.1%
21
He a lt hC hoices Services
HealthChoices members are eligible to receive in-plan services and are offered their choice of at least
two service providers, as well as additional services that have been approved for use by the Berks County
HealthChoices Program.
In-Plan and Supplemental Services:
•
•
•
•
•
•
•
•
•
•
Inpatient Psychiatric Hospitalization
Inpatient Drug & Alcohol Detoxification, Treatment, NonHospital Rehabilitation, and Halfway House
Psychiatric Partial Hospitalization Services
Outpatient Mental Health and Drug & Alcohol Counseling
including Mobile Mental Health Treatment
Laboratory and Diagnostic Services
Medication Management and Clozapine Support
Psychiatric Evaluation and Psychological Testing
Residential Treatment Facilities for Children and
Adolescents (RTF)
Peer Support
Behavioral Health Rehabilitative Services for Children and
Adolescents (BHRS)
•
•
•
•
•
•
•
•
•
•
•
•
•
•
CRR Host Home
Methadone Maintenance
Intensive Case Management
Resource Coordination
Blended Case Management
Crisis Intervention
Family Based Mental Health Services
Drug & Alcohol Level of Care Assessment
Drug & Alcohol Intensive Outpatient
Drug & Alcohol Targeted Case Management
Drug & Alcohol Partial Hospitalization
Children’s Services enrolled as Program Exceptions
Assertive Community Treatment Team
Psychiatric Rehab/Clubhouse/Mobile Psychiatric Rehab
Continuum of Care for Children and Adolescents
Most Restrictive
Inpatient Hospital
high-security, high
intensity treament in a
psychiatric facility
Residential Treatment
Facility (RTF)
intensive treatment in a
residential setting
Community Residential
Rehabilitation Host Home
therapeutic foster-care in a
family-like environment
Partial Hospitalization Program
services provided in a clinic or school
setting for 3 - 6 hours per day to
assist a child transitioning from, or
prevent, inpatient treatment
Family-Based Treatment
provides intensive in-home
services to prevent out-of-home
placement
Behavioral Health
Rehabilitation Services for
Children and Adults (BHRS)
individualized services provided
to the child in-home, in the
community, or at school
Least Restrictive
22
Outpatient Services
community-based treatment services
provided in a clinical setting, that
includes therapy and medication
management
A d u l t s ve r su s You th Ser v ed
Percentage of Adults vs. Children Served
Youth
6,326
37%
Adults
10,795
63%
Percentage of Expenditures for Adults vs. Children
Adults
$31,299,685
48%
Youth
$34,257,375
52%
23
H ea lt hC hoic es U t i l i z at ion
L evel o f Ca re
RTF
111
0.4%
Outpatient Mental
Health
14,672
54.9%
BHRS
1,738
6.5%
Community
Support Services
3,380
12.7%
Inpatient and NonHospital Drug &
Alcohol
793
3.0%
Inpatient Mental
Health
1,165
4.4%
Outpatient Drug &
Alcohol
1,828
6.8%
Total Served: 17,121
Total Paid: $65,557,060**
RTF
$6,254,121
9.5%
Outpatient Mental
Health
$15,704,682
24.0%
Other
3,009
11.3%
BHRS
$11,637,525
17.8%
Outpatient
Drug & Alcohol
$2,374,443
3.6%
Other
$5,416,553
8.3%
Community
Support Services
$8,742,839
13.3%
Inpatient Mental
Health
$10,189,670
15.5%
Alcohol
$5,237,227
8.0%
* Other service category is comprised of supplemental services, such as Drug & Alcohol Partial Hospital,
Assertive Community Treatment Team, and Children’s Services Program Exceptions.
** Does not include $500,000 alternative payment arrangement for crisis services.
24
H e alt h C hoic es M emb ers S erved
Diagnosis
Members Served with a Mental Health Diagnosis
7,845
3,466
3,382
2,290
2,475
2,444
891
Attention Deficit
Disorders
Adjustment
Disorders
Anxiety
Disorders
Autistic
Spectrum
Disorders
Bipolar
Disorders
Conduct and
Oppositional
Defiant
Disorders
Depressive
Disorders
1,165
1,310
*Other Mental
Health Disorders
Psychotic
Disorders
Members Served with a Drug & Alcohol Diagnosis
1,047
811
563
524
328
Alcohol Disorders
Cannabis Disorders
Cocaine Disorders
Opioid Disorders
*Other Drug & Alcohol
Disorders
*Other Mental Health/Drug & Alcohol Disorders include dementia, drug or alcohol psychosis, drug or alcohol withdrawal, delirium, organic psychotic or
non-psychotic conditions, personality disorders, eating disorders, sleep disorders, tic disorders, child abuse, Developmental Disabilities, mental disorders
due to unknown causes, transient organic mental disorders, amphetamine abuse/dependence, hallucinogen abuse/dependence, inhalant abuse/
dependence, sedative-hypnotic/anxiolytic abuse/dependence, polysubstance abuse/dependence.
25
He a lt h C hoic es E xpen di t u res
Diagnosis
Expenditures for Members with a Mental Health Diagnosis
$14,630,968
$10,704,002
$7,094,759
$5,667,672
$7,298,091
$6,601,343
$2,798,494
$1,583,036
Attention Deficit
Disorders
Adjustment
Disorders
Anxiety
Disorders
$728,333
Autistic
Spectrum
Disorders
Bipolar
Disorders
Conduct and
Oppositional
Defiant
Disorders
Depressive
Disorders
*Other Mental
Health Disorders
Psychotic
Disorders
Expenditures for Members with a Drug & Alcohol Diagnosis
$4,027,857
$1,588,393
Alcohol Disorders
$1,420,093
$712,564
$701,453
Cannabis Disorders
Cocaine Disorders
Opioid Disorders
Disorders
*Other Mental Health/Drug & Alcohol Disorders include dementia, drug or alcohol psychosis, drug or alcohol withdrawal, delirium, organic psychotic or nonpsychotic conditions, personality disorders, eating disorders, sleep disorders, tic disorders, child abuse, Developmental Disabilities, mental disorders due
to unknown causes, transient organic mental disorders, amphetamine abuse/dependence, hallucinogen abuse/dependence, inhalant abuse/dependence,
sedative-hypnotic/anxiolytic abuse/dependence, polysubstance abuse/dependence.
26
HealthC hoic e s U t i l i z at ion
Youth D emo grap h ics
Amount Paid
Female
$10,246,792
30%
Includes members under the age of 18
or members up to age 21 who utilized
RTF or BHRS
Gender
Number Served
Male
$24,010,583
70%
Female
2,395
38%
Male
3,931
62%
Amount Paid
Asian
$70,111
0.2%
White
$16,098,530
47.0%
Black
$3,574,929
10.4%
Hispanic
$7,433,475
21.7%
Total Youth Served: 6,326
Total Expenditures on Youth: $34,257,375
Native American
$154,737
0.5%
Number Served
Asian
25
0.4%
White
2,512
39.7%
Black
494
7.8%
*Other
$6,925,593
20.2%
Hispanic
1,838
29.1%
*Other
1,444
22.8%
Native American
13
0.2%
Race/Ethnicity
* Other race category includes individuals who
report being of multiple racial/ethnic origin.
27
He alt h C hoic es U t i l i z at ion - Yout h
L evel o f Ca re
Total Youth Served: 6,326
RTF
111
1.1%
Outpatient Mental
Health
5,325
54.7%
BHRS
1,738
17.8%
Includes members under the age of 18
or members up to age 21 who utilized
RTF or BHRS
Community Support
Services
1,307
13.4%
Alcohol
48
0.5%
Outpatient Drug &
Alcohol
109
1.1%
Total Expenditures on Youth: $34,257,375
Inpatient Mental
Health
252
Other
2.6%
857
8.8%
RTF
$6,254,121
18.3%
BHRS
$11,637,525
33.9%
Outpatient Mental
Health
$6,911,493
20.2%
Outpatient
Drug & Alcohol
$32,189
Other
0.1%
$351,025 Inpatient
1.0%
Mental
$2,806,029
8.2%
Inpatient &
Non-Hospital
Drug & Alcohol
$476,739
1.4%
Community Support
Services
$5,788,254
16.9%
*The Other service category is comprised of supplemental services, such as Drug & Alcohol Partial
Hospital, Assertive Community Treatment Team, and Children’s Services Program Exceptions.
28
He a lt h C hoic es You t h S erved
Diagnosis
Youth Served with a Mental Health Diagnosis
2,909
2,088
1,488
1,289
795
475
381
313
57
Adjustment
Disorders
Anxiety
Disorders
Attention Deficit
Disorders
Autistic
Spectrum
Disorders
Bipolar
Disorders
Conduct and
Oppositional
Defiant
Disorders
Depressive
Disorders
*Other Mental
Health Disorders
Psychotic
Disorders
Youth Served with a Drug & Alcohol Diagnosis
126
48
41
13
3
Alcohol Disorders
Cannabis Disorders
Cocaine Disorders
Opioid Disorders
Disorders
*Other Mental Health/Drug & Alcohol Disorders include dementia, drug or alcohol psychosis, drug or alcohol withdrawal, delirium, organic psychotic or non-psychotic
conditions, personality disorders, eating disorders, sleep disorders, tic disorders, child abuse, Developmental Disabilities, mental disorders due to unknown causes, transient
organic mental disorders, amphetamine abuse/dependence, hallucinogen abuse/dependence, inhalant abuse/dependence, sedative-hypnotic/anxiolytic abuse/dependence,
polysubstance abuse/dependence.
29
H ea lt h C hoice s E xpen di t u res on You th
Diagnosis
Expenditures for Youth with a Mental Health Diagnosis
$10,354,300
$6,871,477
$5,689,844
$5,599,198
$2,171,682
$1,658,633
$637,119
Adjustment
Disorders
Anxiety
Disorders
Attention Deficit
Disorders
Autistic
Spectrum
Disorders
Bipolar
Disorders
Conduct and
Oppositional
Defiant
Disorders
Depressive
Disorders
$351,937
$379,813
*Other Mental
Health Disorders
Psychotic
Disorders
Expenditures for Youth with a Drug & Alcohol Diagnosis
$300,082
$205,390
$24,458
$200
Alcohol Disorders
Cannabis Disorders
Cocaine Disorders
$13,241
Opioid Disorders
Disorders
*Other Mental Health/Drug & Alcohol Disorders include dementia, drug or alcohol psychosis, drug or alcohol withdrawal, delirium, organic psychotic or non-psychotic
conditions, personality disorders, eating disorders, sleep disorders, tic disorders, child abuse, Developmental Disabilities, mental disorders due to unknown causes, transient
organic mental disorders, amphetamine abuse/dependence, hallucinogen abuse/dependence, inhalant abuse/dependence, sedative-hypnotic/anxiolytic abuse/dependence,
polysubstance abuse/dependence.
30
Healt h C hoices U t i l i z at ion T ren d
2002 - 2013
Members Served by Year 2007 - 2013
16,977
17,121
2011-2012
2012-2013
$66,125,837
$65,557,060
2011-2012
2012-2013
15,830
14,580
13,177
11,945
2007-08
2008-09
2009-10
2010-2011
Expenditures by Year 2007 - 2013
$61,931,805
$58,010,013
$53,505,519
2007-08
$54,712,845
2008-09
2009-10
2010-2011
31
Rei n v e stm e n t P l an H i s tory
2 0 0 1 -20 0 2
•
•
•
•
•
•
Access to Residential Drug and Alcohol Treatment Services
Community Outreach to High Risk Populations
Room and Board for CRR Host Home Services
Mental Health Respite Care
Mental Health and Drug and Alcohol Outpatient Expansion
Total Budget: $1,234,679
Capitation revenues from the
Department of Public Welfare
and investment income which
are not expended during an
Agreement Year may be used
in a subsequent Agreement
year to purchase start-up
costs for In-Plan Services, or
the development or purchase
of Supplemental Services or
non-medical services (i.e.,
“bricks and mortar” projects).
2002- 2003
• A
ssertive Community Treatment Team
for Transitional Age Youth
• Autism Collaboration
• Crisis Intervention
• Intensive Case Management
and Resource Coordination Expansion
• Student Assistance Program Revitalization Project
• Respite Care
• Room and Board CRR Host Home Services
• Transitional Housing
• Outpatient Treatment for Sex Offenders
• Drug and Alcohol Housing - Easy Does It
• Case Management Support
• Total Budget: $3,749,393
2 0 0 3 -20 0 4
•
•
•
•
•
•
•
ccess to Outpatient Mental Health
A
Respite Care
Therapeutic Community - Project Transition
Treatment Services at the Community Re-Entry Center
Community Treatment Team
Mental Health Substance Abuse (MISA) Outpatient Services
2004- 2005
32
•
•
•
•
Respite Care
Room and Board for CRR Host Home Services
Housing - Flexible Funding
Total Budget: $ 476,756
2001 - 20 1 2
2005- 2006
•
•
•
•
•
•
•
•
•
•
Permanent Supportive Housing
Recovery-Based Therapeutic Environment
Student Assistance Program Revitalization
Buprenorphine Care Coordinator
Drug and Alcohol - Targeted Case Management
Drug and Alcohol - General
Outpatient Drug and Alcohol Treatment - Specialized
Mental Health Outpatient Practitioner
Housing for Transition-Aged Youth
2006- 2007
•
•
•
•
Respite Care
Drug & Alcohol Residential
Transitional Re-Entry Support Program
Total Budget: $ 1,909,439
2007-2008
• There were no funds available for reinvestment.
2008-2009
•
•
•
•
Respite Care
Enhanced Recovery Support Services
Benefit Application Specialist
Total Budget: $ 884,959
2009-2010
• Consumer Advocacy Center
• Total Budget: $ 844,692
2010- 2011
• Permanent Supportive Housing
• Early Recovery Housing
• Total Budget: $ 1,640,255
2011- 2012
• Drug & Alcohol Recovery Specialist
• Physical Health/Behavioral Health Plan
• Total Budget: $ 1,006,026
33
Te r m i nolo g y
ADMISSION RATE
The number of admissions into services per 1000
HealthChoices enrollees.
DIAGNOSIS
A behavioral health disorder based on DSM-5 diagnostic
criteria.
AUTHORIZATION
A process that is related to the payment of claims by
which a provider receives approval from Community Care
to provide a particular service. Authorizations typically
limit the number of units and the time in which the service
can be provided. If a service requires authorization for
payment, the lack of authorization will result in an unpaid
claim.
DIAGNOSTIC CATEGORIES
Subgroups of behavioral health disorders. This report
contains the following groupings:
CAPITATION
A set amount of money received or paid out; it is based
on membership rather than on services delivered and
is usually expressed in units of PMPM (per member
per month) or PMPD (per member per day). Under the
HealthChoices Program, capitation rates vary by categories
of assistance.
CLAIMS
A request for reimbursement for a behavioral health
service.
COMMUNITY RESIDENTIAL REHABILITATION (CRR)
CRRs are residential programs designed and operated to
assist persons with chronic psychiatric disability to live as
independently as possible in the least restrictive setting.
COMPLAINT
A process by which a consumer or provider can address a
problem experienced in the Mental Health/Developmental
Disabilities or HealthChoices Program.
CONSUMER
Individuals on whose behalf a claim has been adjudicated
for behavioral health care services during the reporting
period.
DENIAL
A denial is defined as “a determination made by a
managed care organization in response to a provider’s
request for approval to provide in-plan services of
a specific duration and scope which (1) disapproves
the request completely; (2) approves provision of the
requested service(s), but for a lesser scope or duration
than requested by the provider; (an approval of a
requested service which includes a requirement for a
concurrent review by the managed care organization
during the authorized period does not constitute a denial);
or (3) disapproves provision of the requested service(s),
but approves provision of an alternative service(s).”
34
Autism Spectrum Disorders, sometimes called Pervasive
Developmental Disorders (PDD), are a range of
neurological disorders that most markedly involve some
degree of difficulty with communication and interpersonal
relationships, as well as obsessions and repetitive
behaviors.
Bipolar Disorders – a group of mood disorders that
characteristically involve mood swings. This group
includes: Bipolar I Disorder, Bipolar II Disorder, Bipolar
Disorder Not Otherwise Specified, Mood Disorder, and
Mood Disorder Not Otherwise Specified. Depressive
Disorders – a group of mood disorders that includes
Major Depressive Disorder, Dysthymia, and Depressive
Disorder Not Otherwise Specified.
Schizophrenia and Psychotic Disorders – a collection of
thought disorders such as Schizophrenia, Schizoaffective
Disorder, Schizophreniform Disorder, and Psychotic
Anxiety Disorders – a group of disorders that includes:
Panic Disorder, Social Phobia, Posttraumatic Stress
Disorder, Obsessive Compulsive Disorder, Generalized
Anxiety Disorder, and Anxiety Disorder Not Otherwise
Specified.
Adjustment Disorder – the development of clinically
significant emotional or behavioral symptoms in response
to an identifiable psychosocial stressor or stressors.
Impulse Control Disorders – includes Intermittent
Explosive Disorder, Trichotillomania, and Impulse Control
ADHD and Disorders in Children – includes Attention
Deficit Hyperactivity Disorder, Conduct Disorder,
Oppositional Defiant Disorder, and Disruptive Behavior
Other Mental Health Disorders – includes Tic Disorders,
Learning Disorders, Communications Disorders, and Motor
Skills Disorders.
GRIEVANCE
The process by which a consumer addresses a problem
with a decision made about his/her behavioral health care
service. This may include denial of a service, approving
less service than what was requested, or approving a level
of care different from that requested.
DSM-5
The Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition, published by the American Psychiatric
Association. This manual provides a diagnostic coding
system for mental and substance abuse disorders.
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY
ACT OF 1996 (HIPAA)
This is a Federal law that allows persons to qualify
immediately for comparable health insurance coverage
when they change their employment relationships. Title II,
Subtitle F, of HIPAA gives the Health and Human Services
Department of the federal government the authority
to mandate the use of standards for the electronic
exchange of health care data; to specify what medical
and administrative code sets should be used within those
standards; to require the use of national identification
systems for health care patients, providers, payers (or
plans), and employers (or sponsors); and to specify the
types of measures required to protect the security and
privacy of personally identifiable health care information.
Also known as the Kennedy-Kassebaum Bill, K2, or Public
Law 104-191.
ENROLLMENT
The number of Medicaid recipients who are active in the
Medical Assistance program at any given point in time.
MEMBER
Eligible Medical Assistance recipients enrolled in the
HealthChoices program during the reporting period.
FAIR HEARING APPEAL
A grievance process through which a HealthChoices
member can file a written appeal, to the Department
of Public Welfare, regarding a behavioral health care
service decision. If denied services, individuals with
developmental disabilities may file a grievance with the
Office of Developmental Programs.
MENTAL HEALTH COMMITMENT
An involuntary admission into a psychiatric hospital as
per the Pennsylvania Mental Health Procedures Act. Also
referred to as a ‘302 commitment’.
Substance Abuse/Dependence Disorders – a group of
disorders related to taking drugs of abuse. The DSM-IV-TR
refers to 11 classes of substances: alcohol, amphetamines,
caffeine, cannabis (marijuana or hashish), cocaine,
hallucinogens, inhalants, nicotine, opiates (heroin or other
narcotics), PCP, and sedatives/hypnotic/anxiolytics.
Developmental Disabilities – includes Mild, Moderate,
Severe and Profound Developmental Disabilities.
OUTPATIENT REGISTRATION (OPR)
The process by which HealthChoices members are
registered with Community Care to receive specific
outpatient services. This process eliminates the need for
pre-authorization of services and allows the member to
access mental health or drug and alcohol services with the
provider for up to one year.
RESIDENTIAL TREATMENT FACILITY (RTF)
A self-contained, secure, 24-hour psychiatric residence for
children and adolescents who require intensive clinical,
recreational, educational services and supervision.
UTILIZATION
The amount of behavioral health care services used by
Medicaid recipients. Utilization is based on encounter
(paid claims) information.
35
Al ph abet S ou p
2176
ABA
ACT
ADA
ADD
ADL
ADHD
ADS
AFDC
AIDS
APS
ASD
AT
ATF
Home and Community Based Waiver
Applied Behavior Analysis
Assertive Community Treatment
Americans with Disabilities Act
Attention Deficit Disorder
Activities of Daily Living
Attention Deficit Hyperactivity Disorder
Adult Day Services
Aid to Families and Dependent Children
Acquired Immune Deficiency Syndrome
Adult Protective Services
Autism Spectrum Disorder
Assistive Technology
Adult Training Facility
BCM
BCTV
BECEC
BSC
BSE
BSU
BCCYS
BHRS
Blended Case Management
Berks Community Television
Berks Early Care Education Council
Behavioral Specialist Consultant
Bureau of Special Education
Base Service Unit
Berks County Children and Youth Services
Behavioral Health Rehabilitation Services
CAAC
CAC
C&Y
CAO
CASSP
CCBH
CER
C/FST
CHIPP
CISM
CLA CMS
CPS
CPS
CISD
CRR
County Administrators Advisory Committee
Certified Addictions Counselor
Children and Youth
County Assistance Office
Child and Adolescent Service System Program
Community Care Behavioral Health
Comprehensive Evaluation Record
Consumer/Family Satisfaction Team
Community Hospital Integration Project Program
Critical Incident Stress Management
Community Living Arrangement
Centers for Medicare and Medicaid Services **
Child Protective Services
Certified Peer Specialist
Critical Incident Stress Debriefing
Community Residential Rehabilitation
D&A
DD
DDAP
DPW
DRO
DSM-5
Drug and Alcohol
Developmental Disability
Department of Drug and Alcohol Programs
Domestic Relations Office
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
36
ED
EI
EPSDT
ER
ESY
EVS
Emergency Department
Early Intervention
Early Periodic Screening, Diagnosis and Treatment
Evaluation Report
Extended School Year
Eligibility Verification System
FAPE
FBMHS
FBVR
FC
FSS
Free Appropriate Public Education
Family Based Mental Health Services
Facility Based Vocational Rehabilitation
Facilitated Communication
GED
GPS
GRMHA
General Equivalency Diploma
General Protective Services
Greater Reading Mental Health Alliance
HCBS
HCQU
HCSIS
HIPAA
HIV+
Home and Community Based Services
Health Care Quality Unit
Home and Community Services Information System
Health Insurance Portability and Accountability Act
Human Immunodeficiency virus
HMO
HRP
HSDF
Health Maintenance Organization
Health Risk Profile
Human Service Development Fund
ICAN
ICF/MR
ICM
IDD
IDEA
IEP
IFSP
IM
IM4Q
IOP
IQ
ISO
ISP
ISPT
IST
ITF
IU
IV
Involved Consumer Alliance Network
Intermediate Care Facility/Mental Retardation
Intensive Case Management
Intellectual Developmental Disability
Individuals with Disabilities Education Act
Individualized Education Plan
Individualized Family Service Plan
Incident Management
Independent Monitoring for Quality
Intensive Outpatient
Intelligence Quotient
Intermediary Service Organization
Individual Support Plan
Interagency Service Planning Team
Instructional Support Team
Infant/Toddler/Family Waiver
Intermediate Unit
Intravenous
JCAHO
JPO
Joint Commission on Accreditation of Healthcare Organizations
Juvenile Probation Office
LEA
LMS
LRE
LS
LSS
LSW
Local Educational Agency
Learning Management System
Least Restrictive Environment
Learning Support
Life Skills Support
Licensed Social Worker
M4Q
MA
MAYSI
MCI
MCO
MDE
MDT
MH
MH/DD
MISA
MPI
MSW
MT
MYP
Monitoring for Quality
Medical Assistance
Massachusetts Youth Screening Instrument
Master Client Index
Managed Care Organization
Multidisciplinary Evaluation
Multidisciplinary Team
Mental Health
Mental Health/Developmental Disabilities
Mentally Ill Substance Abuser
Master Provider Index
Master of Social Work
Mobile Therapy
Multi-Year Plan
NICU
NORA
Neo-natal Intensive Care Unit
Notice of Recommended Assignment
OCDEL
OCYF
ODP
OMAP
OMHSAS
OP
OSP
OT
OVR
Office of Child Development and Early
Learning*
Office of Children, Youth and Families *
Office of Developmental Programs*
Office of Medical Assistance Programs *
Office of Mental Health and Substance Abuse Services *
Outpatient
Office of Social Programs
Occupational Therapy
Office of Vocational Rehabilitation
PaTTAN
PCP
PCP
PDE
PEN
PERP
PFDS
PH
PHP
PIN
PLF
PP&A
PROMISe
PTSD
PUNS
Pennsylvania Training and Technical
Assistance Network
Primary Care Physician
Person Centered Planning
Pennsylvania Department of Education
Parent Education Network
perpetrator of child abuse or child sexual abuse
Person/Family Direct Support Waiver
Physical Health
Partial Hospitalization Program
Parents Involved Network
Private Licensed Facility (Interim Care)
Pennsylvania Protection and Advocacy
Provider Reimbursement and Operations
Management Information System in
electronic format
Post-Traumatic Stress Disorder
Prioritization of Urgency of Needs for Services
QA
QI
QM
QMRP
Quality Assurance
Quality Initiative
Quality Management
Qualified Mental Retardation Professional
RC
RCPA
RHOT
RTF
Resource Coordination
Rehabilitation and Community Providers Association
Regional Housing Options Team
Residential Treatment Facility
SAM, Inc.
SAMHSA
SAP
SC
SCA
SEP
SIS
SSA
SSD
SSDI
SSI
Service Access and Management, Inc.
Substance Abuse and Mental Health Services
Administration **
Student Assistance Program
Supports Coordination
Single County Authority
Supported Employment Program
Supports Intensity Scale
Social Security Administration
Services and Supports Directory
Supplemental Security Disability Income
Supplemental Security Income
TASC
TCM
TSS
WIC
Treatment Access Service Center
Targeted Case Management
Therapeutic Staff Support
Women, Infants and Children
* Denotes State Program
** Denotes Federal Program
37
W eb Site
R e fer enc e
Guide
www.dpw.state.pa.us
Disabilities Law Project
http://www.dlp-pa.org/
Accessible PA-On-Line Disability Resources for Pennsylvania
http://www.accessiblepa.state.pa.us/AccessiblePA/site/
default.asp
Education Law Center
www.elc-pa.org
American Academy of Child and Adolescent Psychiatry
www.aacap.org
Federal Emergency Management Agency
http://www.fema.gov/
American Academy of Pediatrics
www.aap.org
First Signs
http://www.firstsigns.org/
American Association of People With Disabilities
http://www.aapd-dc.org/
Internet Mental Health
www.mentalhealth.com
American Association On Intellectual
and Developmental Disabilities
http://www.aamr.org/index.shtml
Juvenile Law Center
www.jlc.org
ARC of Pennsylvania
http://www.thearcpa.org/
Autism Resources
www.autism-resources.com
Autism Society of America
www.autism-society.org
Bazelon Center for Mental Health Law
www.bazelon.org
Centers for Medicare and Medicaid Services
www.cms.hhs.gov
Children and Adults with
Attention Deficit/Hyperactivity Disorder
www.chadd.org
Community Care Behavioral Health
www.ccbh.com
Council On Chemical Abuse
www.councilonchemicalabuse.org
County of Berks
www.co.berks.pa.us
Department of Aging
www.aging.state.pa.us
38
Department of Health
www.dsf.health.state.pa.us
Mental Health America
www.nmha.org
National Alliance for the Mentally Ill
www.nami.org
National Down Syndrome Society
http://www.ndss.org
PA Department of Education
www.pde.state.pa.us
PA Emergency Management Agency
http://www.pema.state.pa.us/
Parent Involved Network
www.pinofpa.org
Pennsylvania Code-Public Welfare
http://www.pacode.com/secure/data/055/055toc.html
Red Cross
http://Berks.redcross.org
Social Security Act – Title XIX
http://www.ssa.gov/OP_Home/ssact/title19/1900.htm
Social Security Administration
www.ssa.gov
Zero to Three
www.zerotothree.org/magic
Con tr i bu tor s
A special thanks to the following individuals who have contributed articles and
statistics for this year’s Annual Report:
Tanisha Becton-Johnson, Pelican Manager/Administrative Assistant, SAM, Inc.
Kristy Belschwinder, Deputy Director of Berks County Operations, SAM, Inc.
Sheila Bressler, CASSP Coordinator, County of Berks
Jolynn Haney, Consultant
Mary Hennigh, Deputy Administrator, MH/DD Program
Amy Groh, Director of Crisis, SAM, Inc.
Shara Garipoli, IDD Director, SAM, Inc.
Matthew March, CHIPP Coordinator, SAM, Inc.
Kim McConnell, Chair, Berks County CSP Advisory Committee
Michele Ruano-Weber, Deputy Administrator, MH/DD Program
Robin Teitelbaum, Director of Berks County Operations
The Berks County MH/DD Program wishes to acknowledge the providers in the
MH/DD/HC network for their efforts in delivering quality services to the residents
of Berks County.
39
Berks County Mental Health/Developmental Disabilities Program
Berks County HealthChoices Program
County Services Center
633 Court Street
15th Floor
Reading, Pa 19601
Phone: 610-478-3271
Fax: 610-478-4980
Email: [email protected]
Website: www.countyofberks.com
Berks County MH/DD Administrator
Berks County Commissioners
Christian Y. Leinbach, Chair
Mark C. Scott
Kevin S. Barnhardt

Welcome to the Office of Mental Health and

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