1. Systems Transformation: Toward a Unified System
SERVICE AREA PLANNING
Mayview
SPRING 2008

2. Service Area Planning, 2008
OMHSAS guiding principles and major objectives
Service Area Planning Goals: What Progress has been made?
Statewide
What does the future hold?
Harrisburg State Hospital Update
Closure of Mayview State Hospital: Status
Forensics
Transformation
Other News and Notes
11/6/2018

3. 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.
11/6/2018

4. OMHSAS Objectives
Transform the children’s behavioral health system to a system that is family driven and youth guided.
Implementation of services and policy to support recovery and resiliency in the Adult Behavioral Health System.
Assure that behavioral health services and supports recognize and accommodate the unique needs of older adults.
11/6/2018

5. Service Area Planning (SAP)
Implementation of services and policy to support recovery and resiliency in the Adult Behavioral Health System
Service Area Planning (SAP)
State Plan developed 2002
SAP Goals Developed
SAP meetings
Summary reports, April 2006 and February 2007
SAP requests and updates incorporated into county planning documents
11/6/2018

6. Service Area Planning GOALS
Implementation of services and policy to support recovery and resiliency in the Adult Behavioral Health System
Service Area Planning GOALS
Goal 1: Within five years no person will be hospitalized at a State Mental Hospital for more than two years.
Goal 2: Within five years no person will be involuntarily committed to a community hospital more than twice in one year.
Goal 3: Within five years the incarceration rate of the target population will be reduced.
11/6/2018

7. SAP: Objective 1 Statewide General : FY 2003/2004 to FY 2007/2008
The percentage of individuals staying in our facilities more than 2 years dropped from 53% to 49%, the overall census dropped by 14%.
11/6/2018

8. SAP: Objective 2
Statewide (HC) average of involuntary commitments per 1000 adults (4Q 2007)
Allegheny
Beaver - 2.6
Greene - 1.3
Washington County - .9
Lawrence - 2.8
Washington County has decreased its number of persons involuntarily committed and sustained for several quarters in HealthChoices.
11/6/2018

9. SAP: Objective 2
HealthChoices target: 10% (or less) of readmissions within 30 days of a discharge from 2007
Statewide average for readmission rates within 30 days for inpatient services for adults (HC) was 17% (4Q 2007).
Progress in many counties; statewide range is 10% - 31%.
Substance abuse impacts readmission rates; higher readmission rates for individuals with co-occurring disorders.
11/6/2018

10. SAP: Objective 3 Forensic Picture
Statewide Census: Average Length of Stay < 90 days; 40% individuals served have been found incompetent to stand trial.
Norristown:
Mayview: 70
Warren: 27
Mayview
DPW has withdrawn the RFP to privatize the forensic units; the Mayview forensic unit will move to Torrance State Hospital.
11/6/2018

11. SAP: Objective 3 Forensic service developments include:
Additional training for law enforcement, county jail staff, parole officers, probation officers and other first responders
Use of Sequential Intercept Model for Justice-related services
Participation in Criminal Justice Advisory Boards
Implementation of diversion and re-entry programs
Continued use of forensic case managers
11/6/2018

12. Mayview State Hospital Update
Forensic Services
Commonwealth has decided not to pursue privatizing of the MSH Forensic Center.
MSH Forensic Center will be moved to Torrance State Hospital by 12/31/08.
Forensic Transition Team has been selected and transition planning has begun.
11/6/2018

13. State Hospitals/CHIPPS
8 state hospitals and 1 long term nursing care facility; Mayview State Hospital to close 12/31/08
Since FY – A 65% reduction in state hospitals’ census (projected through June 30, 2009)
Staff complement will decrease by 53%
CHIPP (through June 30, 2008) –
2,792 individuals discharged
13,116 individuals received diversionary services
Community funding of $212,078,029
State Hospitals as community partners: PRRT team, CRT teams, consultation and respite (Danville)
11/6/2018

14. CHIPP Funding History (Cumulative)
11/6/2018

15. 11/6/2018

16. 11/6/2018

17. Mayview State Hospital Update
Current census is 160 individuals; 440 civil section staff.
Census at the time of announcement was 225.
Community Support Planning continues to occur for every individual who currently resides at Mayview.
Every individual residing at the hospital will have had at least one planning meeting by May 1, 2008.
Downsizing of the patient units has been delayed by a month.
11/6/2018

18. Mayview State Hospital Update
More community supports being developed-- extended acute services, Assertive Community Treatment teams and supported housing.
County/OMHSAS
track all serious incidents
provide medical consultation
review any death from a natural cause
participate in Root Cause Analysis (RCA) as appropriate
provide increased physical health coordination
engage with providers in training
11/6/2018

19. Mayview State Hospital Update
RN team from Mayview State Hospital has partnered with the Counties to assess each patient discharged from the hospital since Wave 1 to assure that medical needs are being met.
60 Assessments are completed to date.
11/6/2018

20. Mayview State Hospital Update
Mayview team’s assessments: Majority of consumers have progressed significantly in their recovery process since their discharge from Mayview.
The team is impressed with the consistent follow up in medical care that they have observed.
Three consumers have developed relationships with their families that did not exist at Mayview.
Two consumers have jobs; two others expressed interest in employment.
Ten consumers either in their own apartments or supportive housing are involved with groups or Clubhouse activities.
Twenty consumers enthusiastically discussed their current life in the community and their satisfaction with living arrangements as well as services provided by the community.
11/6/2018

21. Residential Placement Since 8/15/07
Nursing Home 4
Independent Living 11
Transferred to NC hospital 1
Transferred to NJ & living independently 1
Discharged & returned to Canada
Died while still at MSH 2
CRR
Enhanced PCH
Family Setting
LTSR
Personal Care Home 2
Supported Housing
Criminal Detention
11/6/2018

22. Mayview State Hospital Update
State Operated Services
Staff are being selected.
Search Team is touring various potential locations for the CTT, LTSR and small homes.
11/6/2018

23. A Call to Change…. A call for transformation in the Adult system
Recovery supporting system
Peer delivered, consumer operated services
Housing
Other Employment
Centers of Excellence -- Raise the Bar!
Children’s Transformation
Transitional Age Youth
Older Adults
11/6/2018

24. OMHSAS: FY 2008-09 Budget Unified System Strategy
Community MH Services
$1.011 B total state and federal funds, net increase of $7.577 M; state funds increase $ M
No Cost of Living Adjustment
CHIPP funding of $ M for the discharge of 166 individuals from the state hospitals
5 Warren * 75 additional discharges from Mayview
10 Torrance
60 Norristown
16 Clarks Summit
Transfer $ M from Medical Assistance for Structured Treatment Services
Elimination of funding for Psychiatric Services in Eastern PA
11/6/2018

25. OMHSAS: FY 2008-09 Budget Unified System Strategy
Drug and Alcohol Services
FY Act 152 budget is $ M
BHSI IGT funding of $ M
BHSI funding is $45.3 M (MH: $ M, D&A: $ M)
No Cost of Living Adjustment
Sexual Responsibility and Treatment Program (SRTP, Act 21)
Implemented April 2004 on grounds at Torrance State Hospital
17 men are now being served
SRTP program operation was transferred to the Commonwealth and operated by Torrance State Hospital (July 1, 2006)
11/6/2018

26. Behavioral Health HealthChoices
67 HealthChoices Counties
28 counties accepted right of first opportunity
1 direct state contract with BH-MCO (Greene County)
23 counties contract directly with state
15 counties accepted right of first opportunity for 7/01/07 implementation
Incorporates broad behavioral mandates
Variety of models including full risk county contracts, subcontracts with Administrative Services Organization and full risk subcontracts
11/6/2018

27. OMHSAS: HealthChoices
1.590 M people enrolled in HealthChoices (1/1/08)
Projected enrollment for SFY is M
Funding FY is projected to be $2.397 B statewide:
Southeast Zone total $958.5 million
Southwest Zone total $449.1 million
Lehigh/Capital Zone total $384.9 million
Northeast Zone total $128.1 million
NCSO 23 county expansion zone $203.1 million
NCOO 15 county expansion zone $273.4 million
Mental Health portion* $2.137 billion
Substance Abuse portion* $259.8 million
*(includes admin.)
11/6/2018

28. HealthChoices Reinvestment
Statewide: $298M in reinvestment
Southwest Zone - $61M
Mayview SAP includes Allegheny, Beaver, Lawrence, Washington and Greene
Peer Support, D&A Outreach and Treatment; Start-up including Family Based and Crisis Services Housing, mobile medication, psychiatric rehab, other supplemental
11/6/2018

29. Housing Update
OMHSAS Housing Policy – Plan requirements for any current housing activities (Reinvestment, CHIPP, Base Funds; CRR Conversion); County Plan requirement
Housing Plan Training Sessions and Technical Assistance
Close to 50 counties attended first training session; next session this month
Approved Housing Plans
Beaver, Delaware, Lehigh, Montgomery, Northampton, Philadelphia, York/Adams, Allegheny
Capital and Operating (PHFA partnership, local Housing Authority partnerships); Bridge Subsidies; Contingency Funds; have committed over $30 M
Supportive Housing works!
Service system MUST rise to the occasion: Mobile – c.m., peer, crisis, rehab, ACT. Housing authorities & developers are counting on behavioral health system response.
11/6/2018

30. Certified Peer Specialists
General update:
Number of trained CPS: 794
Number of trained CPSS:
Over half of our trained peers are working!
Number of service descriptions submitted:
Number of approved service descriptions:
Number of programs current enrolled in MA: 15
17 in process
Southwest region: Most counties have peers
11/6/2018

31. You Are The Evidence !!!!!! I’m The Evidence For how belief inspires
How hope transforms and
How giving heals the soul
I’m The Evidence
For what can be achieved
How feeling connected can ground and
How there is invaluable worth in an act of faith
For how an example can lead
How far encouragement can take you and
How one step begins a journey towards endless possibilities
2008 Transformation Designs
11/6/2018

32. Support The Journey Recovery Recovery
Recovery is remembering who you are through the darkness and using your strengths to become all that you were meant to be.
Support The Journey
11/6/2018