1 OMHSAS Advisory Committee Update July 6th, 2006

2 OMHSAS: Guiding Principles The Mental Health and Substance Abuse Service system will provide quality services that:  Facilitate recovery for adults and resiliency for children;  Are responsive to individuals’ unique strengths and needs throughout their lives;  Focus on prevention and early intervention;  Recognize, respect, and accommodate differences as they relate to culture/ethnicity/race, religion, gender identity and sexual orientation;  Ensure individual human rights and eliminate discrimination and stigma;  Are provided in a comprehensive array by unifying programs and funding building on natural and community supports unique to each individual and family;  Are developed, monitored and evaluated in partnership with consumers, families and advocates;  Represent true collaboration with other agencies & service systems

3 OMHSAS Objectives 1) To assure that individuals receiving behavioral health treatment and supports have the opportunity to live and thrive in open integrated community settings through building community partnerships and integrating funding. 2) To redesign the children’s behavioral health system to better meet the needs of children and their families 3) To expand behavioral health managed care statewide 4) To commit to a quality management system that is consistent statewide, built on complete and accurate data, which measures the quality and quantity of the consumer experience in the system. 5) To assure the older adult population is recognized as a unique population and the mental health and substance abuse needs of older adults are met.

4 Administrative Updates OMHSAS to assume program, policy and fiscal responsibility for Behavioral Health FFS in FY 06/07  Program Descriptions  Rate Setting ( not inpatient)  Utilization Management  Enrollment (OMAP)  Fraud and Abuse (OMAP)  HealthChoices Quality Initiatives ( Shared Responsibility)

5 Supporting Projects Update Progress on all objectives:  Recovery : Call to Change  Service Area Planning Meetings and follow-up; seven meetings held; Allentown scheduled  Co-Occurring Capable Bulletin Issued; COSIG conference held  Housing Committee/Agenda Proposed;  State Plan Amendments Submitted  Integrated Children’s Services Initiative, residential enrollments completed; MST and FFT  Department restraint free initiative ; regional forums held

6 Supporting Projects Update Progress on all objectives;  Incident Management System ; Start Date 9/1/06  LBFC Report issued on behavioral health services for children  Priority Projects with Dept of Aging moving forward; Aging/BH Regional Forums Held; Summary Drafted  Joint Initiative with Dept of Corrections and the Board of Probation and Parole; Forensic Agenda Work Group completed; report in process ( September Advisory Committee)  Statewide HealthChoices Expansion

7 County Plan Update As part of this year’s county planning process, counties were asked to submit a (1)qualitative and an (2)administrative performance measure. The qualitative measure addresses the recovery-orientation of county programs by requiring the submission of a Vision & Mission statement that supports the facilitation of recovery of individuals with mental illness. The measure also requires evidence of consumer involvement in the development and concurrence with the Vision & Mission Statement.  A one day panel review session of the qualitative measure will be conducted in Harrisburg and should last approximately seven hours.  Counties that meet this measure will receive a financial award based upon available funding.  The review will be conducted by a panel consisting of OMHSAS staff and advisory committee members.  Although we are in the process of identifying a date, the review will take place this month.  All counties have submitted a plan that includes a vision and mission statement. The other requirements have not been determined.  Distribution of statewide aggregate county plan report is scheduled for October of this year.

8 County Plan Update The second measure was the timely, accurate and complete submission of the required Consolidated Community Reporting Performance Outcome Management System (CCR POMS) data. There are 20 county/joinders that have met the timeliness portion of the measure by having 2 quarters of encounter data submitted by June 30, So there could be no more than those 20 to receive the incentive. Of those 20 there are 3 that have a % of accepted records below 50%. The ‘reasonableness of completion’ of the submissions needs to be discussed with the individual county.

9 Community Mental Health Program State Funding COLA, including a COLA on CHIPPs Psychiatric Services in Eastern Pennsylvania is stable at $3.5 million FY COLA Annualized FY CHIPP Annualization Assumes implementation of Structured Treatment Services initiative- October Implementation Assumes expansion of Behavioral HealthChoices Assumes full funding for HSH community initiatives Federal Funding Reflects a decrease in the Community Mental Health Services Block Grant Reflects a decrease in COSIG funding Reflects a decrease in SSBG Reflects the removal of federal funds available through Inter-governmental Transfer OMHSAS FY Budget Unified System Strategy

10 Sexual Responsibility and Treatment Program (Act 21) Implemented in April 2004 by contracted vendor on grounds of Torrance State Hospital Eight men are now being served SRTP services were transferred to the Commonwealth and administered by Torrance State Hospital (July 1, 2007) First constitutional challenge to the Act- Philadelphia court upheld Drug & Alcohol Services Act 152 funding decreased to $ million to reflect HC Expansion BHSI IGT funding of $12.107* million BHSI funding is stable at $ million (MH: $19.545, D&A: $24.436) HSDF Additional funds available in HSDF ($2.5M) OMHSAS FY Budget Unified System Strategy *$3 million in additional funding was provided in FY 05-06; $3 million in additional funding will also be available in FY 06-07

11 Medical Assistance $14.4 billion Medical Assistance (MA) Budget 1.9M individuals enrolled in the MA program; 1 of every 7 individuals in PA 1.1M individuals served thru HC FY 06/07 Budget Updates  Pharmacy Carve Out Not Moving Forward  Budget Stabilization Reserve Fund Established available to MCOs, Outpatient providers, Inpatient providers and Long Term Care providers  BH HealthChoices supported  Restoration of Hospital Supplemental Payments

12 HealthChoices  As of January 1, 2006, there are 1,162,392 people enrolled in HealthChoices. Projected enrollment for SFY is 1,279,769.  Funding for Fiscal Year is projected to be $1.7 Billion in the Southeast, Southwest, and Lehigh/Capital zones: Southeast Zone total:$ million Southwest Zone total:$ million Lehigh/Capital Zone total:$ million Mental Health portion:*$1,564.5 million Substance Abuse portion:*$ million *(includes admin.)

13 HealthChoices Update Northeast  Lackawanna, Luzerne, Susquehanna, Wyoming counties through a single multi-county contract began HC on July 1, 2006  Readiness Review conducted; confirmed all critical requirements in place  Program challenged with start-up occurring in the middle of a major natural disaster;  Community Care Behavioral Health is subcontractor.  Northeast field office will provide OMHSAS monitoring; Mike Orr, CRP; Celia Browning, Team Leader (570)  CCBHO will begin submitting weekly data reports; and OMHSAS weekly contract monitoring has begun.

14 HealthChoices Update NorthCentral State Option  22 county zone will begin implementation January 1, 2007  State issued RFP; 5 (five) bidders  DPW Technical Evaluation Committee has completed review- consumer, family and county government served on the evaluation committee  Recommendation will be made to the Secretary in July, 2006; decision announced by end of August NorthCentral County Option  16 counties have elected to accept the right of first opportunity  Introductory meetings held with County Executive/Commissioners of all counties  RFP will be issued late July, 2006.

15 Unified Systems Currently OMHSAS has 8 state hospitals and 1 long term nursing care facility From FY and projected through June 30, 2006 census of the individuals being served in our state hospitals will have decreased by 58% During the same period, staff complement have decreased by 47% Through the CHIPP funding opportunity, 2,462 individuals will have been discharged through June 30, 2006, and supported in the community with funding of $193,441, additional discharges are planned from Wernersville and Danville State Hospital as part of the Hospital Consolidation An additional 60 individuals may be able to be discharged as a result of administrative savings in FY 06/07. South Mountain Settlement Agreement- 11 individuals will be participating in the Nursing Home Transition Initiative to return to community-based services.

16 FY 06/07 Supporting Projects Call to Change: Pennsylvania’s Transformation  Support Local Systems Change Initiatives  Develop and Implement Peer Supports/Certified Peer Specialists- additional training/seed dollars  Implement Mobile Outpatient  Complete and Initiate Strategic Housing Plan  Complete and Initiate Forensic Work Plan  Complete Consumer and Family Assessments on every individual at our state hospitals with a length of stay over two years  Implement CHIPPS; regionalize administrative functions in State Hospital

17 FY 06/07 Supporting Projects Call to Change: Pennsylvania’s Transformation  Implement Incident Management Bulletin  Implement Integrated Co-Occurring Treatment  Implement HealthChoices State Wide  Initiate early childhood behavioral health agenda  Promulgate Residential Treatment Regulations  Implement School Based Mental Health Initiative  Issue HC Performance Report  Issue Resource Guide for MH/Aging