DBHIDS Annual Report 2021-2022

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Annual Report

Addressing Trauma Achieving Equity Engaging Community Jill Bowen, Ph.D., Commissioner

Fiscal Year 2021 - 2022

THE CITY OF PHILADELPHIA DEPARTMENT OF

BEHAVIORAL HEALTH AND INTELLECTUAL disABILITY SERVICES OUR COMMITMENT

We take an active role in promoting the health and wellness of all Philadelphians through our population health approach. By empowering the entire community to take charge of their health, DBHIDS helps create a Philadelphia in which every resident can thrive.

MESSAGE FROM THE

COMMISSIONER Dear Philly, In recent years, we all have experienced several traumas including a worldwide pandemic, civil unrest locally and across the nation, multiple mass shootings, police violence, racism, and the increase in gun violence among our youth. Health disparities have been made even more apparent for people of color and for those living in poverty. Through it all, however, I am humbled by the work being done by the people who compose the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services.

Since I became Commissioner of DBHIDS in October 2020, trauma response has been at the heart of all we do. This began with the TEC lens we use to focus our efforts. TEC serves as a constant reminder to ask ourselves whether our work addresses Trauma, achieves Equity, and engages Community. Beyond TEC, it has been my goal to not only address the system, but to shift the system to be trauma-responsive, traumamitigating, and trauma-reducing.

In this annual report, you will see some of the work my amazing team accomplished in 2022. Work that includes addressing individual and community-wide trauma, expanding behavioral health services in schools, transforming Philadelphia’s crisis system through the launch of the 988 suicide and crisis lifeline, expansion of mobile crisis teams, and increasing access to housing and resources in treatment facilities and mobile services.

DBHIDS works to educate, strengthen, and serve individuals and communities so all Philadelphians can thrive. Every year, we serve close to 200,000 people with a population-health approach that seeks to promote overall wellness rather than focusing on symptoms.

We understand our services are best when we meet people where they are, which we accomplish with initiatives you’ll see in these pages including the Community Wellness Engagement Unit, Network of Neighbors, Engaging Males of Color, Mural Arts, and more.

Most importantly, we want to ensure all Philadelphians know our services are available to them as we work to ensure we are promoting the health and well-being of this city and providing every Philadelphian the opportunity to thrive.

Thank you,

Jill Bowen, Ph.D. DBHIDS Commissioner

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

Philadelphia Snapshot DBHIDS oversees a network of more than 200 providers offering a full continuum of services.

Of the 1.58 million Philadelphia residents, over 764,00 are eligible for Medicaid. This is 48% of the population.

POPULATION HEALTH IS COMMUNITY HEALTH

1.58 million

DBHIDS seeks to improve the health status of all Philadelphians, not just those who experience stigma as a result of their intellectual disability and/or behavioral health challenges.

45%

45%

DBHIDS directly served over 116,000 individuals from July 1, 2021, to June 30, 2022 (FY).

Outreach & Engagement

99,491

Inpatient Treatment

Community Settings

28,386 15,581 Community Behavioral Health managed Medicaid, mental health, and substance use services for members in CY 2021.

4

Behavioral Health Division (BHD) managed services for uninsured individuals in FY 2022.

Intellectual disAbility Services (IDS) division managed services for in FY 2022.

DBHIDS ANNUAL REPORT 2021 - 2022

Impact by the Numbers FINANCIAL

DBHIDS generates cost savings and economic impact for Philadelphia.

HEALTHCHOICES BEHAVIORAL HEALTH PROGRAM City of Federal Commonwealth Community FUNDING STREAM Government

$

of Pennsylvania

$

54% Federal 56% State

1%

43% Federal

City of Philadelphia General Fund

$

Philadelphia

$

DBHIDS

$

Behavioral Health

1% General Fund Over45% 90%State of DBHIDS funds support

nonprofit agencies.

DBHIDS is a $1.6 billion single-payer system operated by the City of Philadelphia. According to analysis by the Scattergood Foundation and Drexel University on the impact public spending has on behavioral health in Philadelphia, every $1 spent by DBHIDS results in an additional $2.50 in economic activity.

Source: The Scattergood Foundation, bit.ly/SG-Economic-Impact (2015)

QUALITY OF CARE DBHIDS is committed to ensuring our network provides quality clinical care for all who are eligible. We achieve this through: • Evidence-based practices; • Incentivizing high-quality services: Pay for performance and value-based purchasing; and • Integrated oversight and monitoring teams; Network Improvement and Accountability Collaborative (NIAC) and Community Behavioral Health compliance.

Healthier People

HIGH QUALITY LOW COST

Better Care

Smarter Spending

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2021-2022 Leadership Team DBHIDS Executive Management team members help chart the course for person-driven behavioral health and intellectual disability services.

Jill Bowen, Ph.D. Commissioner

Andrea L. Brooks, MSW, LSW Director of Strategic Initiatives

Kleckner J. Charles Director, Intellectual disAbility Services

Nicole Connell, M.Ed. Chief of Innovation and Effectiveness

Lolita J. Griffin, M.Ed. Senior Advisor to the Commissioner

Odysseus Marcopolus Chief Digital Officer

Tierra M. Pritchett, Ed.D. Deputy Commissioner

Katrina PrattRoebuck Senior Director of Systems Integration

Sosunmolu Shoyinka, MD Chief Medical Officer

Faith DysonWashington, Ph.D., MBA Chief Executive Officer of Community Behavioral Health

H. Jean Wright II, Psy.D. Deputy Commissioner

MISSION To educate, strengthen, and serve individuals and communities so all Philadelphians can thrive.

VISION We envision a Philadelphia where every individual can achieve health, well-being, and self-determination.

VALUES Equity  Equality  Excellence Integrity  Outcomes Commitment to the whole population Right to recovery, resilience, and self-determination

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DBHIDS ANNUAL REPORT 2021 - 2022

DBHIDS ADVISORY BOARD Angelita Alomar-Gilbert Hector Ayala Josephine Barilotti Rebecca Bonner Laura Boston Jones Frances Conwell Dawn Curry Mary K. Doherty Eric Edi, Ph.D. Ramona Griffiths Beverly J. Herberle Frank A. James Emily Loscalzo, Psy.D. Julia Lyon, LSW Priya Mammen, M.D., Ph.D. Nicole Mitchell Sara Molina-Robinson Barbara Nattile Cheryl Nichols Stephen A. Pina Andr Reide Elise Schiller Pascal Scoles Laura Sorensen Leslie Stickler, MSS, LSW Chris Sweeney S. Reno Wright

Provider Provider Co-chair Provider Provider Community Member Provider Provider Community Advocate Provider Provider Faith Organization Provider Community Advocate Health Care Professional Co-chair Provider IDS Advocate Family Member Provider Provider Community Member Educator Provider Health Care Provider Community Advocate Community Member

52%

MINORITY

CBH BOARD OF DIRECTORS Jill Bowen, Ph.D. President H. Jean Wright, II, Psy.D. Vice President Tierra M. Pritchett, Ed.D. Secretary Treasurer Kimberly Ali Cheryl Bettigole Eva Gladstein Liz Hersh Haneefa Richard Keisha Hudson Nicole Mitchell

MINORITY

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

PACE Overview In late 2018, The City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) launched its strategic framework — Prioritizing to Address Our Changing Environment (PACE).

The framework will guide DBHIDS’ strategic planning process over the next five years.

This road map will integrate strategies and tactics that connect with goals established by the Office of the Deputy Managing Director of Health and Human Services (HHS), the Mayor’s Office, and the State of Pennsylvania.

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DBHIDS ANNUAL REPORT 2021 - 2022

TEC Overview ADDRESSING TRAUMA, ACHIEVING EQUITY, ENGAGING COMMUNITY DBHIDS Commissioner Jill Bowen, Ph.D., evolved DBHIDS’ vision to include the important lens of TEC addressing Trauma, achieving Equity, engaging Community. The lens through which we do all of work is based on the following framework: Addressing Trauma – transform operations to be trauma informed and trauma mitigating and reduce traumatic experience in our systems Achieving Equity – transform systems to reduce behavioral health disparities and promote racial equity amongst Black, Indigenous and people of color (BIPOC) by intentionally addressing structural and systemic racism Engaging Community – shift services to become increasingly community based to ensure long term and sustained impacts of programs Since that time, intentional efforts were made to ensure that: 1.

Philadelphia is blanketed with trauma supports and those supports are trauma responsive, mitigating, and reducing.

2. Systems are transformed to reduce behavioral health disparities and promote racial equity amongst those who are Black, Indigenous, or people of color.

3. Services are shifted to be increasingly community based with increased input from community stakeholders.

The strategies to implement the tenets of TEC include: 1.

Addressing Trauma - blanketing the city with trauma supports • Individual Interventions • Community-based interventions • Website resources • Training • Communications (hard copy materials distributed across the city, films, social media, radio) • Hospital-based programs • Stakeholder committees to inform and support the work • Implementation of the TEC workplans that address areas of opportunity and expansion.

2. Achieving Equity - Reduce disparities and promote racial equity.

• Conscientious contracting • Data driven responses to racial and geographic disparities and data driven targeting of programming.

• Social Determinants of Health initiatives (housing, employment, food, transportation, technology) • Scaling/expansion of programs to ensure services are available to every community • Monitoring tools that track demographics and other data points that can ensure disparities are

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

recognized and addressed.

3. Engaging Community - Increase community-based programming and input.

• TEC Talks and Community Conversations • Providing resources at community events • Website resources • Committees that include community-based organizations and community members • DBHIDS conferences • Community roundtables • Developing more community-based programs The overarching committee is the External Stakeholder Learning Collaborative (ESLC) and five committees to create workplans to implement activities as deemed immediately important as well as long term, strategic strategies.

The ESLC serves as an external engagement mechanism to discuss and receive feedback on the vast array of trauma activities funded and/or planned by the Department, as well as an opportunity to discuss best practices, leverage opportunities to work with partners, and increase knowledge across all stakeholders in addressing trauma.

The subcommittee includes more than 100 stakeholders across the city, including community members, staff from community-based organizations, academia/local subject matter experts, and DBHIDS staff.

The subcommittees include: 1. Prolonged trauma 2. Trauma impacting children and families 3. Secondary trauma 4. Trauma related to violence 5. Defragging the system – addressing the systems challenges that contribute to trauma Accomplishments to date of the TEC work include: 1.

2.

3.

4.

5.

10

Convening a focus group of people with lived experience committing crimes in order to get feedback about what could have changed their course. This powerful focus group met and we are now reviewing their feedback to find out how we can help others with what they learned.

We have also created and distributed trauma cards with a tighter focus as a result of ESLC recommendations. The cards are intended to address gun violence and resources for early childhood providers – as well as one speaking directly to children – because of feedback suggesting those targeted audiences needed more tailored information. We have distributed our trauma cards to thousands of people via door-to-door campaigns and have provided them through the 52 free libraries across the city, as well as parks and recreation centers, playstreets, community schools, the Neighborhood Advisory Centers, and other city and community-based partners.

We launched a PSA that aired on Power 99 and Q102 providing the public with information on how to access DBHIDS trauma-support resources.

We’ve begun working on developing trauma-informed resources and trainings with early childhood education providers.

We have begun looking more closely at data overlays to ensure our outreach and engagement teams are strategically providing support in the neighborhoods where they can do the most good.

DBHIDS ANNUAL REPORT 2021 - 2022

6.

7.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has expanded as recommended by the children’s subcommittee and is now available in southwest Philadelphia.

And we have developed a behavioral health supports directory that includes resources for secondary traumatic stress and for the needs of specific groups such as LGBTQ, BIPOC, and immigrant communities.

Population Health Approach SOCIAL DETERMINANTS OF HEALTH By applying population health approach when addressing social determinants of health (SDOH) needs, DBHIDS is taking a much broader view, seeking to improve the health equity of those receiving services for behavioral health and intellectual disabilities. Over the past year, DBHIDS SDOH Equity Unit has implemented specific pilot programs as well as projects to ensure the most vulnerable Philadelphians have adequate access to health care, transportation, food, and technology that promotes individual as well as community equity.

ACTIVITIES SDOH Equity Unit: To increase and promote health equity across Philadelphia’s behavioral health system by addressing social determinants of health such as economic mobility, access to food, increasing mobility, and increasing access to technology as well as developing sustainable funding sources to enhance current SDOH programs and implementing additional programs to meet the needs of Philadelphians to increase their quality of life and life expectancy.

SDOH Supports Program Pilots: Utilizing reinvestment funds, DBHIDS Systems Integration team partnered with DBHIDS Housing and Homeless Unit and DBHIDS Behavioral Health and Justice Division to target participants and families residing independently in the community who need food, technology, and transportation. The pilot program supports 100 households across DBHIDS divisions to receive access to fresh food for one year via Philabundance partnership, increased access to technology with 100 Chromebooks for participants, and 27 transportations passes to increase mobility to participants. At this time, 73 households are enrolled in the food program known as FEEDS, 100 participants are either enrolled or received Chromebooks in the technology program known as TEA, and 27 participants are actively using their transportation pass in the MASS program.

Quick Screen: In partnership with the DBHIDS Division of Intellectual disAbility Services (IDS) and the Office of Homeless Services (OHS), the DBHIDS Quick Screen is used to briefly screen adults for mental health and/or substance use disorder history and needs. Through the development of a concise fivequestion screener using evidence-based questions and research, individuals who access IDS and OHS at their “front doors” can be linked to CBH Member Services and ongoing behavioral health assistance as needed. Our goal in 2023 is to expand DBHIDS Quick Screen to complete five question screener at two additional “front doors.”

Uniform Discharge Packet: DBHIDS SDOH Equity Unit is in the process of facilitating internal partnership 11

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

between DBHIDS and CBH to develop a uniform discharge packet to be implemented at discharge across all DBHIDS and CBH levels of care.

Community Resource Guide: Understanding the importance of how one’s environment where they work, live, play, and worship affects their outcomes through an SDOH perspective, DBHIDS System’s Integration partnered internally with DBHIDS and CBH units to develop a one-page Community Resource Guide. The Community Resource Guide is one page intentionally: to provide a snapshot of Philadelphia community resources such as housing, healthcare, food, employment, internet access, and transportation that participants, families, and supports can access for additional support. The guide is being distributed broadly throughout DBHIDS, CBH, community partners, and the Philadelphia courts.

Shifting the Culture of Employment: The Employment Programs Systems Specialist is partnering across DBHIDS units to host employment information sessions, strategically targeting participants who are interested with increasing economic mobility through employment and employment training. Employment efforts are expanding to support youth and young adults as well as individuals in the Philadelphia Department of Prisons, with a behavioral health diagnosis expecting to be released from incarceration.

In the Future: In fall 2022, a DBHIDS Employment Programs System’s Specialist will support the four DBHIDS employment providers (COMHAR, Consortium, Horizon House, and First Step Staffing) with obtaining employment referrals. In 2023, One Stop Shop, an employment resource hub will be created to provide additional resources while participants are completing FSS hiring materials in hopes the additional resources will be supportive to participants obtaining and retaining employment. The following resources will be offered; NextGen Wireless, CEO Mobile Access Unit, Philly ID, and Liberty Resources as well as handouts of the CRG and other materials.

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DBHIDS ANNUAL REPORT 2021 - 2022

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Intellectual disAbility Services

Planning Innovation

Administration, Finance, and Quality

Behavioral Health and Justice

Chief Medical Officer

Behavioral Health

Community Behavioral Health

PHILADELPHIA BEHAVIORAL HEALTH SYSTEM

DBHIDS Divisions Administration, Finance, and Quality Administration and Finance supports the provision of services in a fiscally responsible manner to ensure the sustainability of programs and the ability to continually improve.

Office of the Chief Medical Officer oversees and directs clinical strategies and policies while serving as liaison to Philadelphia’s provider community. The division is responsible for the coordination and integration of initiatives, ensuring clinically sound approaches built upon evidence-based practices.

Planning Innovation develops and implements strategies to advance the transformation of Philadelphia’s behavioral health system to a recovery-oriented system of care.

Behavioral Health Division includes the Office of Mental Health and the Office of Addiction Services and, through an extensive network, provides services to people requiring medical, social, and educational services.

Behavioral Health and Justice Division works to improve treatment outcomes in the community for people reentering from incarceration, and to decrease criminal recidivism, through a collaboration with the Philadelphia justice systems.

Intellectual disAbility Services is responsible for oversight, planning, administering, and coordinating the Infant Toddler Early Intervention Program and Intellectual disAbility and Autism supports and services.

Community Behavioral Health is a not-for-profit 501(c)(3) corporation contracted by the City of Philadelphia to provide mental health and substance use treatment services for Philadelphia County Medicaid recipients.

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

OFFICE OF THE COMMISSIONER The Commissioner sets the vision and direction for the work of the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services. The office is responsible for leadership over the seven DBHIDS divisions and for the organization, prioritization, and achievement of the Department’s overall goals.

• •

•

• •

• • •

The Commissioner of DBHIDS is the representative of the Department to internal and external communities, as well as with local, state, and federal partners Through initiative prioritization and through alignment, coordination, and integration of efforts, the Commissioner’s Office implements the Department’s priority of addressing Trauma, achieving Equity, and engaging Community (TEC) By adhering to the Department’s strategic plan, PACE, and the tenets of TEC, the Commissioner’s Office obtains measurable outcomes that move us forward toward the Department’s goals of improving the behavioral health and wellness of all Philadelphians Office coordinates with the provider network and external stakeholders to ensure equitable access to quality behavioral health services for all Philadelphians The Commissioenr supports the DBHIDS Advisory Board, the Faith and Spiritual Affairs Advisory Board, and other community convenings, and leads Executive Director’s meetings to ensure integration of stakeholder voices in policy and practice development.

The Commissioner coordinates the Department’s work addressing the social determinants of health as a whole person health approach The Commissioner implements and manages cross-agency initiatives and programs The Commissioner’s Office deepens systemic approaches to solving complex challenges, focusing on data and integration of projects to increase our understanding of the effectiveness and reach and to ensure the highest quality of trauma-informed and trauma-mitigating behavioral health and related services.

The work of the Commissioner’s Office includes: •

Systems Integration Unit – seeks to align, coordinate, integrate, and connect information across the department and city agencies to address the behavioral health needs and challenges of the residents of Philadelphia.

• TEC (Trauma, Equity, Community) – DBHIDS uses this lens for all our work by asking ourselves how our efforts address Trauma, achieve Equity, and engage Community.

• Communications Unit – facilitates all DBHIDS internal and external communications; works closely with DBHIDS, City of Philadelphia, and other partners to help educate, strengthen, and serve individuals and communities so that all Philadelphians can thrive.

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DBHIDS ANNUAL REPORT 2021 - 2022

ADMINISTRATION, FINANCE, AND QUALITY DIVISION DBHIDS’ Division of Administration, Finance, and Quality (AFQ) has an overarching responsibility to support the efforts of all DBHIDS divisions in alignment with a health economics approach. The division supports the provision of services in a fiscally responsible manner to ensure the sustainability of programs and the ability to continually improve. As with all divisions of DBHIDS, the division’s goal is to meet the needs of all Philadelphians, focusing specifically on quality, value, and outcomes in all subdivisions, including: • • • • • • •

Finance Administrative Management (Operations) Grants and Procurement Education and Training Human Resources and Workplace Wellness Data Governance Information Management and Informaiton Technology Services

FISCAL RESPONSIBILITY AND RESOURCE MANAGEMENT The Division of Administration, Finance, and Quality’s focus on finance, fiscal responsibility, and management—and the importance of these factors in sustaining resources—helps DBHIDS seek out reinvestment opportunities, secure grant funding, and manage resources so programs receive what they need to develop, grow, and sustain to address Philadelphia’s needs.

SYSTEMS APPROACH The Division of Administration, Finance, and Quality believes knowledge is empowerment. Part of its mission is to ensure internal and external communities make better decisions. The division works with stakeholders to develop strategies to create new programs, evaluate existing programs, and impact high priority areas across the Department. A systems approach allows the division to work with internal and external stakeholders to address the social determinants that affect the health of all residents. The division works directly with state and local partners, subdivisions, and internal staff to develop and fund programs, inform data, support program leadership, and identify and dedicate appropriate resources where they are needed most.

HIGHLIGHTS • • • • • • • •

32 complaints processed 1,853 invoices paid 16 RTK/open records requests logged 1,003 help desk tickets received and handled 82 NIAC visits completed 11,366 trainings completed 31 new hires onboarded 12 reinvestment plans approved

ACCOMPLISHMENTS • • • • • • •

Drafted compliance training Began QM alignment across divisions DBIHDS HR had the highest performance evaluation completion rate Incorporated CBH oversight activity into current work process Completed “New Hire” required training schedule Held four AFQ All Staff meetings Revised the re-credentialing process 15

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

“In 2022, there were many pivots, shifts and changes, and the team was nimble, flexible, and responsive to all of them. I am proud of all we have achieved and look forward to what we will achieve in the future.”

Dr. Tierra Pritchett, Deputy Commissioner

“The DBHIDS strategic framework Prioritizing to Address our Changing Environment (PACE) and Trauma, Equity, and Community (TEC) lens unites our efforts, sharpens our focus, and moves us forward.

This demonstrates the ways our many projects and initiatives align, integrate, and coordinate with the priorities of the Department.”

Katrina Pratt-Roebuck, Senior Director of Systems Integration

A LOOK AHEAD UNIT

GOAL

Quality Management

• Provider Quality Outcomes and Performance Measures • DBHIDS compliance training

Management Services

• Disposition of file record archives • Assessment of 1101 7th floor hybrid capabilities • Enhance safety measures that adapt to a hybrid environment • Updating MSD Protocols

Training and Education

• DBHIDS contract management training • DBHIDS compliance training

Fiscal

• DBHIDS contract management training • Budget template to forecast and manage requests • Creating a budget template to forecast and manage requests

Infromation Technology

• Website and Intranet updates • IT repository of all DBHIDS software applications

Human Resources

• Enhance safety measures that adapt to a hybrid environment • Safety software application • Internship/career development

All AFQ Units

• HIPAA Assessment and accompanying HIPAA Requirements • Further Updates to AFQ Policies and Procedures

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DBHIDS ANNUAL REPORT 2021 - 2022

DIVISION OF THE CHIEF MEDICAL OFFICER Chief Medical Officer (CMO) oversees and directs clinical strategies and clinical policies for DBHIDS, serving as the Department’s representative and liaison to Philadelphia’s provider community. The CMO is responsible for the alignment, coordination, and integration of clinical initiatives, ensuring clinically sound approaches built upon evidence-based practices. Its work promotes innovation and expands gold standard care.

To ensure easy access and the highest quality of services to all Philadelphia residents with diverse needs, the Chief Medical Officer serves the six divisions of DBHIDS through collaborative and synergistic strategies. The CMO works to identify new ways to improve efficiencies and effectiveness between the Department and clinical service providers. The CMO: • •

Ensures clinical best practices are implemented to guide DBHIDS in its population health approach Coordinates efforts of the Philadelphia Suicide Prevention Task Force as it works toward zero suicides in the city • Manages health and behavioral health integration, prevention, and wellness • Administers health promotions to support and improve the mental health and well-being of all Philadelphians • Provides oversight and support for the acute services division that manages behavioral health crises

CRISIS 2.0 EXPANSION AND 988 IMPLEMENTATION In preparation for the launch of the National Suicide and Crisis Lifeline 988, DBHIDS focused its efforts on expanding call center staffing and crisis services expansion to meet increased call volume in 2022; approximately 13 additional counselors and five supervisors were added to the Philadelphia Crisis Line (PCL) call center. Additionally, CMO Division in collaboration with Philadelphia Police Department (PPD) embedded PCL counselors and supervisors in the 911 Radio Room. This is a pivotal moment for the city’s landscape of crisis response; the inclusion of behavioral health crisis counselors in the 911 Radio Room allowes for the shift of behavioral health calls crisis counselors.

In recognition of our crisis services transformation efforts, Philadelphia was selected as a model city for 988 roll out, and the federal government launched the transition to 988 in Philadelphia on July 15, 2022, with Health and Human Services Secretary Xavier Becerra and other notable federal, state, and local officials in attendance.

•

PCL received approximately 70,405 calls in 2022, a 39 percent increase from the previous year with an average of almost 200 calls per day.

• There were approximately 6,212 adult Community Mobile Crisis Response Team (CMCRT) dispatches in CY 2022, a 37 precent increase from 2021.

“Listened to all their concerns and fears.

Were very welcoming and understanding which made opening easier for the family.”

“The team arrived quickly. They were excellent, empathetic, professional, and helped the individual feel at ease.”

Customer Satisfaction Survey

Customer Satisfaction Survey

Customer satisfaction surveys are conducted quarterly by the Consumer Satisfaction Team (CST) on some calls tp the Philadelphia Crisis Line that result in mobile outreach.

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

ACCOMPLISHMENTS Customer satisfaction surveys are conducted quarterly by the Consumer Satisfaction Team (CST) on some calls to PCL that result in a mobile crisis response team dispatch. Between June 16 and July 17, 2022, 75 percent of the 67 individuals requesting adult mobile crisis services for themselves or their loved ones following the mobile crisis intervention strongly agreed/somewhat agreed to finding mobile crisis team helpful and informative.

CST conducted a second round of surveys between Oct. 24 and Nov. 23, 2022, and 77 percent of the 36 individuals requesting mobile crisis services for themselves or their loved ones indicated the mobile crisis response time met their needs and valued their input.

A LOOK AHEAD BHUCC

CIST

CRC

PCL

CMCRT

988

West Phila.

Crisis Response Center, to open May 2023.

Philadelphia Crisis Line added day shift PCL Counselors in 911 Radio Room October 2022

Community Mobile Crisis Response Teams provides 24/7 regionalized citywide coverage through four providers managing teams that cover shifts throughout the day

Working with Scattergood Foundation to develop a 988 Suicide and Crisis Lifeline marketing strategy

CMCRT provides screening, assessment, resolutionfocused crisis intervention, develops safety plans, and links/ transports to appropriate treatment and/ or community service as indicated

DBHIDS is conducting listening sessions and conversations with key stakeholders and providers in January and February 2023 to engage Philadelphians in the discussion about 988

Behavioral Health Urgent Care Center: a crisis continuum service providing brief intervention and medication support for individuals in crisis who do not need a Crisis Response Center

Crisis Intervention and Stabilization Team is a longer-term - up to six weeks - crisis intervention service for individuals who require longer-term engagement

Upstream intervention to ward off crises e.g., medication refills, brief psych visit

CIST will address complex needs including family systems stressors, medication challenges, substance use, suicide risk, trauma, grief, and other SDOH stressors

This pilot staff co-location will shift behavioral health crisis call to PCL counselors

Could include drop-offs by first responders such as EMS, CMCRT, and CIRT

CIST roll out will begin early 2023

PCL staff expansion to Evening shift January 2023

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DBHIDS ANNUAL REPORT 2021 - 2022

DIVISION OF PLANNING INNOVATION DBHIDS’ Division of Planning Innovation develops and implements strategies to advance the transformation of Philadelphia’s behavioral health system to a recovery-oriented system of care using Public Health strategies.

•

Shift the treatment focus from “stabilization” to recovery responsive to the needs of people in recovery

•

Empower people to direct their recovery journey

•

Recognize and engage treatment providers, family members, and community-based supports and organizations as valuable partners in the recovery process

•

Help people move beyond their limitations and toward fulfilling lives in the community

In order to advance this transformation, the Division of Planning Innovation develops a frameworks and strategies for the change process as well as initiatives that will advance the transformation.

6,577 community members engaged by the Community Wellness Engagement Unit.

18,000+ participated in Porch Light Mural Arts Activities.

1,200+ engaging Males of Color program activities, including 350 males in the criminal justice system.

Network of Neighbors assisted over 3,440 people in 141 communities and in 60 schools.

HIGHLIGHTS Network of Neighbors will support the Port Richmond community impacted by the explosion and hold an Information Session for the neighbors early 2023. (FY23) Engaging Males of Color film “We Breathe, We Live: Brotherly Love Protest Stories” screened at the 2022 Hollywood International Diversity Film Festival. The film created in collaboration with First Person Arts has received over 10,000 views.

“We worked with an organization from the city afterward - a trauma response group called Network for Neighbors that did a pretty amazing job helping us as neighbors process what happened and deal with the grief that happened in the neighborhood,” M. Young, Fairmount resident

I was talking to her [CWEU Team Member] about how I needed to get an assessment for my 4-yearold daughter. She connected me to the Therapeutic Nursery at Children’s Crisis Treatment Center. Not only was I able to have my daughter assessed, she was also able to get into the Therapeutic Nursery.

She helped me and she still calls and checks in with me and my daughter. She supported me with making the process stress-free.”

June Pomme, Germantown resident

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

“I met the CWEU team in Mifflin Square Park and was interested in the resources they had for Community Behavioral Health as well as homelessness... they pointed me in the right direction and I’ve made some progress ... I appreciate [CWEU] and things are working out very well now. I’m happy that you guys helped me get into a shelter ... I’m getting back on my feet, working, and getting my life back on track.”

Naja P., South Philly resident

A LOOK AHEAD Network of Neighbors Expansion During FY23 we will continue to expand our Network of Neighbors to four regionalized teams throughout Philadelphia by May 2023. Regionalization of the teams will ensure adequate citywide coverage for Network of Neighbor responses. Through Network of Neighbors, we will continue to offer the opportunity for DBHIDS with community-facing roles and the community to be trained in Mental Health First Aid. Engaging Women and Girls of Color Workgroup During FY23 we will continue to expand this initiative to address the needs of women and girls of color by identify resources to create the infrastructure needed to ensure this workgroup is transitioned into a fully funded initiative.

Engaging Males of Color Initiative The film TRIGGER is both a call to understanding and a call to action about the roles each of us has to play in combatting the gun violence epidemic in Philadelphia and beyond. TRIGGER will continue to be screened across the city. The film premiers in October 2022 and has screened a total of four times with various audiences. The film will be screened with schools, recreation centers, and other community partners.

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DBHIDS ANNUAL REPORT 2021 - 2022

BEHAVIORAL HEALTH DIVISION DBHIDS’ Behavioral Health Division provides mental health services for adults and children requiring medical, social, and educational services. The office provides these services through an extensive network of contracted provider agencies located throughout Philadelphia.

MAJOR ACTIVITIES Recovery House Licensure: The DBHIDS Housing and Homeless Services Unit/Recovery House (RH) Initiative is proud to announce that all DBHIDS-funded recovery houses have been licensed by the Pa. Department of Drug and Alcohol Programs (DDAP). DDAP initiated a licensure program for drug and alcohol recovery houses that receive funding or referrals from public sources at the direction of the state legislature. The RH Initiative began planning and implementing the recently adopted regulations in January 2022, meeting weekly and refining processes and procedures. The RH Initiative was successful in completing all online applications and in-person site reviews resulting in licenses for all sites.

Low Demand Couples Recovery House: Due to the increased number of unsheltered couples on the street, the Behavioral Health Division TIP Housing Unit added a new recovery house to the DBHIDS network. The Walker Foundation Low Demand Recovery House opened in July 2022 with a specific focus on providing couples who may still be actively using but have an interest in coming in off the streets a safe and secure environment to begin their recovery journey. The house’s eight participants (four couples in total) were all referred by outreach teams. The program provides three meals a day and holds community meetings to help residents set goals and check in on their progress. Drug use is not allowed on site. The program was licensed by the (DDAP) in July 2022.

Decriminalization of homelessness/Master Leasing: Having a criminal record can make it harder to secure employment, housing, and other resources, and makes a return to homelessness highly likely. Low barrier housing strategies for the most vulnerable populations reduce criminal behavior among subpopulations and reduce risks of being targets of crime. When individuals are stably housed, they have fewer nonviolent offenses (survival crimes such as theft, robbery, trespassing, loitering and sex work). Exiting jail or prison is a major risk factor to housing instability, creating a revolving door.

The Behavioral Health Division (BHD) supports programs that aim to reduce the number of unsheltered individuals on the street and provide treatment specifically to those experiencing mental health challenges, substance use disorders, and those reentering the community after involvement with the criminal justice system. In particular, the BHD supports the Pathways to Housing PA Housing First program that maintains an 85 percent housing retention rate.

Housing Transformation 2.0: Housing Transformation 2.0 (HT2) follows up on the first Residential Transformation that began in 2010, during which large congregate mental health programs were downsized to create new independent housing opportunities in the community. HT2 was offered as a solution in response to several challenges including increased demand for residential programs, limited permanent supportive housing options, minimum wage increases, COVID-19, and staffing shortages.

HT2 works with residential providers to achieve equity for frontline staff and to ensure individuals are living in and engaged in the community in the least restrictive setting possible. In 2021, the Behavioral Health Division helped multiple providers complete programmatic changes and achieve cost efficiencies to enhance the residential continuum, meet the minimum wage requirement, and increase access to independent living.

PEACE Initiative: Across the country, health care systems are challenged to identify the appropriate care setting and sufficient resources for individuals with serious mental illness that also require additional physical health supports such as skilled nursing and personal care. The Behavioral Health Division TIP 21

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

Housing Unit has partnered with CBH, the Office of Homeless Services (OHS), assorted Philadelphia nursing homes, and Community Health Choices providers to support the Partners Establishing Accessible and affordable housing, Caring for older adults Empathetically (PEACE) Initiative. This initiative serves as a long-term housing program for older adults who may be experiencing homelessness, behavioral health challenges and/or complex physical needs, and assists with obtaining and offering safe, dignified, and sustainable housing that will meet individuals’ needs in the least restrictive and most inclusive environment.

Since its inception in June 2021, 206 individuals have been placed in nursing home and personal care boarding home levels of care as of December 2022.

MORS Team: The DBHIDS Mobile Outreach and Recovery Services (MORS) team works closely with individuals seeking behavioral health recovery support services in communities deemed high-risk for substance use disorder (SUD) to help reduce the rate of fatalities citywide. The MORS team provides assessment in real time where the individual is located and expedites access to treatment. In FY2022, the MORS team expanded from five to seven members, with two additional Mobile Certified Peer Specialists joining the team.

In FY22 the MORS team engaged 1,685 individuals.

FY22 MORS SERVICE DATA Engaged

TOTAL 1,685

Screened

251

Linked to Care

221

Transported

44

Incomplete

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Journey of Hope: Testimonials from Journey of Hope (JOH) alumni who are now JOH staff providing peer support to individuals experiencing homelessness and substance use disorder while at JOH as well as after they leave the program and become alumni.

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DBHIDS ANNUAL REPORT 2021 - 2022

“I was sleeping in the concourse section of City Hall one afternoon when some folks saw me and decided to help. They took my information and said that they would get right back to me, and they did. By the time this happened I had given up on everything and anything working out in my favor. Upon entering into the Journey of Hope (JOH) program, I was given safety, security, a clean room to sleep in, and a chance to reconnect with myself - the self I left behind as my addiction grew. JOH offered me a new way to live and some tools to do so with, so long as I wanted it - it being a life instead of a horrible existence - so I brought into what they offered me. I felt as if I had no choice in the matter. So, while part of me fought the change, I accepted the help, the support that I needed in order to live again.

“Since coming onboard and working with JOH staff, things have been really good for me.

Being a part of a group of folks who only want to help, has worked miracles in my life. I have been given back a great deal of worth and self-esteem, just by being part of such a great team of folks to work with. Also it has been great learning about the inner workings of the entire housing process.”

Nathaniel Lewis, Certified Recovery Specialist

“Journey of Hope became the most vital asset in my life. After I left the program, I had bouts of continued harmful drug use. During these times I felt kind of ashamed and reluctant to seek out support. After getting myself together and developing my life a little more I reached back out to Journey of Hope Manager, Deanna Lear, and told her I had just finished my recovery specialist training. I didn’t have my certification yet, but I was encouraged by her to interview for a Certified Recovery Specialist position that is part of a new pilot program designed to offer support to individuals who are currently in Journey of Hope and after individuals leave Journey of Hope. I’m happy to say that I got the job and now will assist others in Journey of Hope. It’s my goal to be a strong support for those who move on from Journey of Hope and then have some struggles after they are gone. I want to prevent former clients from having the same shame that I felt that kept me from reaching out to supports after I had left the program.

“The process for me has come full circle. I went from being a client, to being alumni, to being now employed with the company. I owe a lot to Journey of Hope. I feel like the luckiest person alive and intent to be a huge asset for the company but more importantly to our clients.”

Stephen Colbert, Certified Recovery Specialist

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

Kensington Hospital Wound Care: The 100-Day Challenge was led by the Office of Homeless Services (OHS) and DBHIDS in collaboration with the Opioid Response Unit (ORU) to connect unsheltered individuals in Kensington to a shelter and/or treatment for those with substance use challenges. Existing and new resources were brought online including accessible housing options and/or opportunities for enrollment in behavioral health care treatment.

TOTAL INDIVIDUALS SEEN

1,254

Wounds treated (all dressed)

2,140

Prescriptions given

730

Follow ups

362

Transferred to treatment

62

Transferred to Emergency Rooms

18

Dental abscesses

7

Suboxone Inductions

7

New Clinic indivuduals

13

Scabies Treatment provided

14

Narcan administered

5

“People like me don’t get treated right at the hospital, so it’s nice to come and feel like you belong in society, while getting the help you need.”

“Thanks so much for your help!

This program helps me keep my dignity and allows me to get care three times a week.”

Wound Care Outreach Initiative Participant

Wound Care Outreach Initiative Participant

INITIATIVE HIGHLIGHTS As a result of the 100-Day Challenge, the Behavioral Health Division, in partnership with the DBHIDS Systems Integration Unit, provided support to the Kensington Hospital Wound Care Outreach Initiative.

A total of 1,254 individuals were seen and over 2,000 wounds were treated and dressed. A breakdown regarding resources/services provided is detailed below The doctor on-staff was able to provide a doctor-to-doctor case consult for an Alternative Response Unit (AR2) client who was unable to get admitted to behavioral health treatment due to having an open wound.

The doctor on the medical van was able to treat the wound, fax a picture of the wound to the doctor at the behavioral health facility, and provide medical clearance for the person to have same-day admission to behavioral health treatment.

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DBHIDS ANNUAL REPORT 2021 - 2022

A LOOK AHEAD Partnership with Philadelphia Department of Prisons: The DBHIDS Behavioral Health Division is partnering with the Philadelphia Department of Prisons (PDP) on a grant aimed to improve substance use disorder treatment and recovery outcomes for adults in reentry with a focus on promoting racial equity and removing barriers to access for communities that have been historically underserved, marginalized, and adversely affected by inequality. The proposed Peerstar Expansion SUD Pilot program will aim to increase the capacity of the jail to support incarcerated individuals experiencing SUD or co-occurring serious mental illness and substance use disorders (SMI/SUD) by facilitating connections to communitybased medication assisted treatment (MAT), therapeutic treatment, and reentry supports.

Mobile Methadone Treatment: Methadone has been used to treat opioid dependence since the 1950s.

Research shows it is the most protective medication against overdose fatality. As a result, the DBHIDS Single County Authority (SCA), within the Behavioral Health Division, is seeking a provider to implement an evidence-based Mobile Methadone Pilot Program to further assist individuals on their journey to recovery.

The purpose of the proposal is to operate a mobile methadone van that will facilitate same-day methadone inductions, offer ongoing methadone maintenance, and provide warm handoffs to brick-and-mortar treatment programs.

PEACE Plus: Individuals are living in homeless shelters, acute care hospitals, extended acute psychiatric units, and other residential options which do not provide the least restrictive, most inclusive care and services. The stigma associated with this population, lack of funding for structured supplemental behavioral health services in nursing facilities, lack of staff core competencies, and lack of regulatory support to provide the necessary behavioral health care and services needed are among some of the reasons nursing homes today deny admission for these individuals.

DBHIDS has embraced the challenge of meeting the needs of this aging population with serious mental illness (SMI) and has partnered with federal, state, and local stakeholders to develop a thoughtful and robust framework incorporating existing reimbursement models and best practices to provide longterm behavioral health and skilled nursing supports to these individuals. The PEACE Plus framework and model will address complex behavioral health needs and medical needs in a safe and stabilized living environment with enhanced supplemental services. The program’s philosophy will be to create a most inclusive, least restrictive, welcoming, safe, and supportive environment where infirm older adults with complex behavioral health needs and/or prior criminal history – and who need long-term skilled nursing services – can receive care and services to address their holistic needs free of stigma.

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

BEHAVIORAL HEALTH AND JUSTICE DIVISION BHJD is committed to working towards reducing justice involvement for Philadelphians with behavioral health challenges including serious mental illness. BHJD organizes its work according to the Sequential Intercept Model, identifying opportunities to intervene at various points of criminal justice involvement to divert individuals from further penetration of the system and connect them to supports and services.

BHJD also aligns with Stepping Up and focuses its efforts on lowering the number of individuals with SMI and co-occurring substance use disorders in county jail, admissions to county jail, the length of stay in county jail, and recidivism, and increasing connections to treatment and support.

MAJOR ACTIVITIES The Behavioral Health and Justice Division is committed to working towards reducing justice involvement for Philadelphians with behavioral health challenges including serious mental illness. BHJD organizes its work according to the Sequential Intercept Model, identifying opportunities to intervene at various points of criminal justice involvement to divert individuals from further penetration of the system and connect them to supports and services.

HIGHLIGHTS BHJD completed the planning and development phase of the 911 Triage program after nearly two years. The operational phase of the program was assumed by the DBHIDS Crisis Services Unit, which has imbedded Crisis Counselors to assist with calls to 911 that have a behavioral health nexus with the intention of minimizing a police-only response to these calls.

The Crisis Intervention Response Team (CIRT) co-response program, which pairs a CIT-trained police officer with a mental health professional to respond to behavioral health-related police incidents, was expanded in 2022 with the procurement of a second CIRT provider, Elwyn, to add to the existing CIRT services delivered by Merakey. In 2022 CIRT teams delivered 375 behavioral health encounters and the accompanying outreach teams provided 374 care coordination services.

•

Trained 380 police officers in Crisis Intervention Team (CIT) training in 2022 and marked the significant achievement of training over 4,000 police officers from the Philadelphia Police Department and other law enforcement partners since the program began in 2007. In addition to the traditional CIT training, BHJD delivered an adapted version of CIT to 131 911 radio room personnel so that every call taker and dispatcher is equipped to identify behavioral health-related 911 calls.

• Supported the Resources for Human Development Returning Citizens program during 2022 by providing referrals and partial financial support to house 25 people recently released from the Philadelphia Department of Prisons.

• In collaboration with Resources for Human Development, opened the Christine Gibson Peer Support House, an eight-bed crisis residence program staffed by peers to support the successful community reintegration of Philadelphians with behavioral health challenges and criminal justice involvement.

The peer-led program is novel in its scope and size and may serve as a model for future peer-run programming across the state.

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DBHIDS ANNUAL REPORT 2021 - 2022

•

Delivered its Forensic Training series to 49 people in 2022. This interactive training series was targeted at behavioral health providers working with participants with justice-involvement to help them better understand and address the unique circumstances of people with forensic considerations.

A LOOK AHEAD •

New programs and timeline: BHJD is establishing a Forensic Equity Unit in 2023 to address racial disparities across systems and ensure people with behavioral health challenges and justice involvement have access to the resources necessary for successful community reintegration.

• Pilot Reentry Case Management services behind the walls at the Philadelphia Department of Prisons in 2023. This pilot will provide case management services to jailed participants with a serious mental illness to enhance coordination of care and prepare individuals for successful community reintegration.

• Expanding transitional housing supports and aims to support up to 90 people with behavioral health and justice involvement with housing subsidies over the next three years.

“Officer Andrews and Officer Jordan from the Crisis Intervention Response Team (CIRT) called and delivered a veteran today. The veteran continuously thanked Officer Andrews and Officer Jordan for taking the time to listen. The way that Andrews and Jordan conducted themselves throughout the process of getting the individual help was amazing! Officer Andrews and Officer Jordan are kind, thoughtful, empathetic, and they helped my vet feel safe and comfortable. I couldn’t have asked for anything more! Please send my thanks, my gratitude, and my appreciation to both officers and the entire CIRT team. Also thank Officer Cordero for her coordination.”

Veterans Administration Staffer

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

DIVISION OF INTELLECTUAL DISABILITY SERVICES The DBHIDS Division of Intellectual disAbility Services (IDS) is an administrative entity under contract with the Pa. Department of Human Services Office of Developmental Programs to administer services in Philadelphia County. IDS works with the Commonwealth and service providers to offer quality supports and services so individuals will have choices in their lives, meaningful relationships, and participation in their community as valued citizens.

MAJOR ACTIVITIES LifeSharing supports individuals with intellectual disabilities to live in a loving and supportive household with one person or an entire family. This program encourages and facilitates community integration, individual enrichment, increased social interactions, and skills.

COVID-19 impacted how we could extend our support to these individuals. However, FY22 saw a steady increase in the number of individuals we supported, and we closed the calendar year 2022 with 196 individuals supported through the LifeSharing initiative.

Trauma Screener: IDS, in collaboration with CBH, established the trauma screener in 2022. This project was initiated as part of the strategic initiative goals of PACE/TEC to address Health Economics, Treatment and Services. The project supports the Health Economics focus area by taking a holistic, person-focused, data-driven approach to assessing the impact of behavioral health services. This allows us to replace poorly performing services with services that achieve better outcomes, ultimately affecting the Treatment & Services focus area by ensuring that the high-quality services our individuals receive are integrated, focused, designed, and delivered with attention to the widespread impact of trauma.

Population Health Risk Mitigation: In 2022, IDS established and created a role for leading the population health initiatives for the thousands of adults and children supported by IDS and ITE. This role will coordinate the delivery of managed health care services, review and evaluate the quality and level of services or specialized Population Health Advisor work in the care and treatment of persons with ID, and function as a liaison between the city, health care providers, and health maintenance organizations.

Graduate Assistants Program: The TCQI team within IDS began working with Temple University and the Institute on Disabilities regarding the placement of graduate assistants at IDS. Processes have been developed and implemented regarding creating job descriptions, facilitating the interview process, monitoring work hours, and mediating challenges between the graduate assistants, the IDS supervisor, and Temple University. Over the course of the upcoming year, the team will have monthly meetings with the students and offer additional opportunities related to their development. In addition, the team will explore increasing the number of universities we collaborate with, with the goal of having one additional university provide graduate students to IDS. Waiver Capacity Management: IDS’ Administrative Services Management Team (ASMT) is responsible for the Management of Waiver Capacity for individuals diagnosed with an Intellectual Disability or Other Related Condition (ORC) for the City of Philadelphia through ODP Initiatives and attrition. ASMT continues to manage waiver capacities, allocate available slots to waiver-eligible individuals, and address health and safety needs as defined by the Office of Developmental Programs.

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DBHIDS ANNUAL REPORT 2021 - 2022

Through allocation and management of capacity, ASMT continues to connect eligible individuals to services and supports to positively impact their quality of life with their families and/or community living arrangements. Eligible individuals are enrolled in the Consolidated, Community Living or Person/Family Directed Services (PFDS) Waiver based on need. The ASMT is also responsible for ensuring continued eligibility for all individuals enrolled in ODP waivers through annual waiver renewal and recertification processes. By the end of FY22, ASMT oversees a total enrollment of 4,575 individuals.

“Being able to participate in my faith community is very important to me. I am fortunate to be responsible for selecting the hymns, playing the organ, and leading the singing. I have been blessed to hold this position for over 30 years. But even more important, it gives me so much pleasure to raise my voice in prayer and song along with my church family. While not all faith communities may have the funds to make all buildings physically accessible, we can work together to ensure that all may worship and feel accepted in houses of worship of our own choosing.“ Suzanne Erb, member of Speaking for Ourselves, an advocacy group for people with disabilities. She is a member of the “That All May Worship” committee and has helped IDS to draft a toolkit on the inclusion of faith for residential providers and faith groups. Suzanne is blind and the organist at her church.

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

HIGHLIGHTS Attachment and Biobehavioral Catch-Up: In September 2022, Infant Toddler Early Intervention began the yearlong training of the third cohort of eight Infant Toddler Early Interventionists in Attachment and Biobehavioral Catch-Up (ABC) for infants and the second cohort of seven Infant Toddler Early Interventionists in ABC for toddlers. By the end of FY22, two Infant Toddler Early Interventionists achieved certification in ABC for newborns, and two additional interventionists are expected to achieve certification by the end of FY23.

Systematic, Therapeutic, Assessment, Resources, and Treatment Program: START is a tertiary care research-based model of services and supports for individuals ages six and older diagnosed with IDD/MH needs. IDS and Community Behavioral Health (CBH) components of the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), in partnership with the Pa. Office of Developmental Programs (ODP) and Office of Mental Health and Substance Abuse Services, will be working together to create an integrated system of care for individuals with co-occurring mental health disorders and intellectual disabilities.

Training and Continuous Quality Improvement: The Training and Continuous Quality Improvement Team (TCQI) ensures all IDS staff received the necessary training to be successful in their positions within the division. TCQI developed and assisted in developing staff training plans and a training template for all newly hired staff. As a result, IDS now has a six-month training plan to ensure that the staff is receiving the training and meeting the expectations of their teams and the division.

Risk Management Data Tool: IDS recognizes that standardized incident and risk management processes are one method for enhancing the quality of life for people. Applying systematic safeguards is essential to developing a culture that meets the basic requirements of health and safety assurances. The Risk Management Data Tool project will pioneer a new database in collaboration with the internal data management team to collect data that will inform if immediate concerns need to be elevated to the Office of Developmental Programs. IDS teams will document adult protective services request of need reports that will be used to identify serious health and safety concerns by providers and/or supports coordination entities. This tool will also document any follow-up action(s) taken to address the risk concerns. A database or tool to identify these early signs of concern hasn’t been developed for use. This project aims to provide an innovative tool that many teams will use to identify and rectify immediate concerns, thereby serving our larger goal of safeguarding the requirements of the Philadelphians we support.

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DBHIDS ANNUAL REPORT 2021 - 2022

A LOOK AHEAD START Program in FY25-28, IDS aims at improving its two startup teams and a step-down unit with the goal of serving 100 or more Philadelphians in its first year of operations and continuing to grow over the following years.

As part of DBHIDS’s PACE plan, IDS will connect Philadelphia’s infants and toddlers at special risk for social and emotional concerns to Infant Toddler Early Intervention. To achieve and sustain this connection, IDS and ITEI will build capacity and meet these Performance Based Budget (PBB) targets by FY24: •

Ensure a rate of 500 referrals annually from community partners and City departments, including the Department of Human Services and the Department of Public Health.

• Anticipate approximately 43 Early Interventionists certified in ABC and increase the number of infants and toddlers who receive ABC and other evidence-based interventions for social, emotional, and behavioral concerns.

IDS also remains focused on its diversity initiatives with expanded programs that will Include ongoing outreach events/workshops, including training for prospective and existing staff.

CoLab: With an intent to reach out to more diverse and smaller human services providers, IDS reached out to behavioral health networks for training and has initiated a 501 Non-Profit Growth Collaborative, which is called “The CoLab Project.” The purpose of The CoLab is to assist organizations through providing support, resources, and mentoring in current struggles to become better providers for the individuals they support.

In FY24, IDS aims to make this initiative available to at least five of its smaller providers and develop “CoLab Chronicles,” information on organizational development topics that is valuable to all participants. IDS and Networks will aim to bring out the first chronicles on the topic “The Importance of Strategic Planning,” with an expected public release soon. Additional “CoLab Chronicles” will be made available thereafter as additional themes of need emerge.

“I am really of the mindset that if you bring people together and you insist that they find creative solutions, people begin to think outside of the box. And that is what makes CBH unique, and it will always make us unique.”

“Mental health has really gotten the awareness and the attention that it’s lacked for decades now. I think people are recognizing that mental health is health.”

Dr. Faith Dyson-Washington CEO, Community Behavioral Health

Estelle Richman Founder, Community Behavioral Health

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

DIVISION OF COMMUNITY BEHAVIORAL HEALTH DIVISION As healthcare rapidly changes, Community Behavioral Health remains committed to meeting the challenges and opportunities put before us. The pending end of the public health emergency will require redetermination for Medicaid recipients. We are up to the task and working with other agencies to ensure the over 700,000 Philadelphians currently eligible for Medicaid re-enroll for the benefits for which they are entitled. We are onboarding population health software and other platforms to help drive data-driven decision making. We are adopting a value-based purchasing model that rewards Providers for improved outcomes. We are developing programs for Members with complex needs and using integrated care models to increase Members’ access to behavioral health treatment and services. And we are exploring opportunities to better connect with our Members and the communities we serve.

CBH contracts with nearly 200 Medical Assistance enrolled and licensed service providers to deliver effective and medically necessary services to its members in a culturally competent manner. CBH authorizes payment for a vast array of services, including outpatient mental health, substance use, inpatient psychiatric, residential rehabilitation, family, school, and community-based programs. CBH works diligently with community partners and providers to increase access to services and reduce disparities in care while maintaining public accountability and encouraging member and family participation.

2021 AT A GLANCE

188 in-network providers with multiple sites 976 unique members received language interpreter services HIGHLIGHTS

764,780 eligible members in 2021 99,491 members utilized services LEVEL OF CARE Ancillary

UNIQUE MEMBERS SERVED 13,070

Behavioral Health Rehab for Children

8,612

Community Support***

12,868

Inpatient Psychiatric

10,484

Inpatient Substance Use Disorder

486

Non-Hospital Substance Use Disorder*

7,743

Other**

14,140

Outpatient Psychiatric

73,863

Outpatient Substance Use Disorder

16,298

Residential Treatment Facility Accredited

238

Residential Treatment Facility Non-Accredited

41

Total Unique Count †

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99,491

DBHIDS ANNUAL REPORT 2021 - 2022

AGE

UNIQUE MEMBERS SERVED

DHS ADDRESS

AUTISM DIAGNOSIS

SMI DIAGNOSIS

0-5

3,109

151

1,107

20

6-12

13,780

667

2,058

903

13-17

11,061

755

1,046

3,005

18-20

4,376

198

373

1,920

21-44

40,270

76

522

20,604

45-64

28,770

–

60

18,099

65+

2,925

–

2

1,793

1,680

4,676

44,876

Total Unique Count † 99,491

† The total unique count is not the sum of the listed data due to members utilizing more than one service within a year.

CONCLUSION DBHIDS dedicates itself to educating, strengthening, and serving individuals, families, and communities so all Philadelphians can thrive. We envision a Philadelphia where every individual can achieve health, wellbeing, and self-determination.

And we rise to this mission and this vision thanks not only to the hard work and commitment of DBHIDS employees and team members – but thanks to our remarkable partners throughout the Philadelphia community.

Working within the communities gives us unique perspectives – and allows us to come up with unique, customized solutions that benefit individuals, neighborhoods, and the city as a whole.

We don’t dictate answers to individuals or develop plans for neighborhoods. DBHIDS works with communities to give the supports and services they need to become fully self-sufficient in determining their own paths forward.

The work we do within our six divisions touches people’s lives and has an impact on individuals and communities in such a powerful and meaningful way.

We know there will always be more work. There will always be more need. And there will always be the opportunity to improve.

And – as we continue to move beyond the immediate impacts of the COVID-19 pandemic – we welcome those challenges.

Thank you, Jill Bowen, Ph.D. DBHIDS Commissioner

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DBHIDS ANNUAL REPORT 2021 - 2022

ADULT CRISIS RESPONSE CENTERS

24/7 HOTLINES

Einstein CRC 5501 Old York Road, 215-951-8300 Friends Hospital CRC 4641 Roosevelt Blvd., 215-831-2600 Pennsylvania CRC 234 S. Eighth St., 215-829-5433 Temple University/Episcopal CRC 100 E. Lehigh Ave., 215-707-2577

CHILDREN’S CRISIS RESPONSE CENTERS Philadelphia Children’s CRC 3300 Henry Ave., Falls Two Building, 3rd Floor 215-878-2600 PATH Children’s Urgent Care Center 1919 Cottman Ave., Korsin Building 215-728-4651

ONLINE SERVICES HealthyMindsPhilly.org Free, 24/7 online behavioral health screening, access to Mental Health First Aid training, and resouces.

Suicide and Crisis Lifeline 988 or 215-685-6440 Member Services mental health and substance use 888-545-2600 Care Connect Warmline substance use navigation 484-278-1679

PHONE NUMBERS DBHIDS Main Office 215-685-5400 Community Behavioral Health Member Services Mental health and addiction services for people with and without insurance 888-545-2600 National Suicide Prevention Lifeline Veterans dial 1 800-273-8255 Homeless Outreach 215-232-1984 Domestic violence Hotline 866-723-3014

CBHPhilly.org Philadelphia’s behaviroal health managed care system for Medicaid recipents.

National Alliance on Mental Illness 267-687-4381

To learn more, visit DBHIDS.org.

Follow us @DBHIDS 35

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

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DBHIDS ANNUAL REPORT 2021 - 2022

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Recovery.

Resilience.

Self-determination.

1101 MARKET ST. PHILADELPHIA, PA 19107 215-685-5400 DBHIDS.ORG

@DBHIDS

Photo credit: Steve Weinik, Serge Levin