Sustainability and Impact OMHSAS Children’s Bureau of Behavioral Health Services August 16, 2012 Presentation to OMHSAS Children’s Advisory Committee

The Evidence-based Prevention and Intervention Support Center (EPISCenter) is a project of the Prevention Research Center, College of Health and Human Development and Penn State University with funding and support from the Pennsylvania Commission on Crime and Delinquency (PCCD) and the Pennsylvania Department of Public Welfare (DPW) as a component of the Resource Center for Evidence-Based Prevention and Intervention Programs and Practices 2

Collects quarterly Performance Measure data for evidence based programs provided in Pennsylvania that are funded through Special Grant funds from OCYF, PCCD grants, or Medical Assistance. (MTFC, MST, & FFT) Provides technical assistance to providers and communities. Facilitates regular networking meetings for each program to discuss timely issues. 3

Multidimensional Treatment Foster Care (MTFC) Multisystemic Therapy (MST) Functional Family Therapy (FFT) 4

Multidimensional Treatment Foster Care (MTFC) is a treatment alternative to group, residential treatment and/or incarceration for youth who have problems with chronic disruptive behavior. Multisystemic Therapy (MST) is an alternative to out of home placement provided to youth with significant externalizing behaviors, with the primary treatment population being delinquent youth and chronic or violent juvenile offenders. Functional Family Therapy (FFT) is an intensive, short-term family therapy model provided to youth who present with externalizing behaviors ranging from oppositional, defiant, and disruptive behaviors (i.e., at risk for delinquency) to serious, chronic criminal offenses. 5

6 FFT Sites

7 MST Teams

8 MTFC Teams

On average, sites that close do so around the 3-year mark. The top reasons for closure: Not enough referrals (low need in community or other barriers/disincentives to referring) Financial (related to program census and unique aspects of EBI implementation) For maps of active programs, visit: 9

10 Total Number of Youth Served Total Number of Caregivers Served Percent of New Admissions at Imminent Risk of Placement** FFT2,027 8% MST3,1214,20962% MTFC % July 2010-Dec **More recent data suggest that the percent of youth at risk of placement may be 10-20% higher than reported here.

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FFT A total of 1,646 youth were discharged from July 2010-Dec ,483 youth who had the opportunity to complete FFT (i.e., were not administratively withdrawn): 66% were successfully discharged (completed FFT with positive outcome). 34% were unsuccessfully discharged. Of these youth, 24% were placed out-of-home. Average length of stay: 4.0 months for successful cases 2.9 months for unsuccessful cases 12

MST A total of 2,571 youth were discharged. 2,313 youth who had the opportunity to complete MST (i.e., were not administratively withdrawn): 76% were successfully discharged (completed MST and met all 3 Ultimate Outcomes) 24% were unsuccessfully discharged. Of these youth, 54% were placed out of home. The average length of stay: 4.1 months for successful cases 3.4 months for unsuccessful cases 13

MTFC A total of 41 youth were discharged from July 2010-Dec youth had an opportunity to complete MTFC (i.e., were not administratively withdrawn): 58% were successfully discharged (met treatment goals, completed MTFC point & level system, discharged to a lower level of care). 42% were unsuccessfully discharged. Of these youth, 80% were placed in a more restrictive setting. The average length of stay: 8.0 months for successful cases 3.4 months for unsuccessful cases 14

The number of EBI programs and the number of Pennsylvania counties implementing an EBI have grown steadily over the past 7 years. Across all placement types (Juvenile Justice, C&Y, M.A.- funded) there have been decreases in the numbers and rates of placement. As a whole, counties implementing EBIs have shown substantial decreases in placement rates while counties without EBIs have shown no change or even increases. 15

8 counties that did not have any EBI from were compared to 11 counties that began the implementation of their first EBI between 2007 and Placement rates were totaled across the counties in each group. Group 1, Counties without an EBI : Bedford, Carbon, Franklin, Fulton, Lebanon, Schuylkill, Somerset, and Susquehanna Group 2, Counties beginning implementation : Allegheny, Berks, Cameron, Clarion, Elk, Forest, Lackawanna, McKean, Monroe, Pike, and Potter 16

17 Juvenile Court Placement Rates: A comparison of counties with and without an EBI Placement as a Percent of Dispositions

18 Percent of Youth In Care, Ages 10-17, In a Restrictive Placement as of March 31 Children & Youth Placements: A comparison of counties with and without an EBI

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ProgramBenefit Cost per Youth (2010$) Youth Discharged (2010) Estimated Economic Benefit (crime reduction) FFT$57,3411,646$94,383,286 MST$22,0962,571$56,808,816 MTFC$33,04741$1,354, Pennsylvania’s immediate savings related to reduced placement costs = approximately $2.4 Million Youth Discharged July 2010-December 2011

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Outcomes EBI Programs Outcomes Summary, July 2010-Dec FAQ about INSPIRE Placement Trends & Program Locations Electronic Maps Youth Placements & Placement Rates in PA 22

Special Thanks to the EPISCenter, for allowing us to use the Evidence-based Intervention Programs Outcome Summary. For a full copy of this report please visit the EPISCenter at earch/researchreports earch/researchreports Website: Liz Campbell, Intervention Programs Coordinator: