DBHIDS Annual Report

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Annual Report

Addressing Trauma Achieving Equity Engaging Community

Fiscal Year 2020 - 2021

THE 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, It’s difficult to imagine a time during which the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) could play a role more crucial for the people of Philadelphia than it has over this past year.

The multiple prolonged traumas that confront us – the COVID-19 pandemic, ongoing opioid epidemic, recurring gun violence, centuries of systemic racism and economic disparities and other stressors – are precisely the factors that elevate the need to have supports and services available to individuals and communities in support of both behavioral health and behavioral wellness.

I am proud to say that DBHIDS has stepped up during this difficult time to help the City face these traumas and to educate, strengthen, and serve individuals and communities so that all Philadelphians can thrive.

One key factor in helping us achieve this mission has been the lens DBHIDS began using this past year to focus our efforts – TEC, which stands for Trauma, Equity, and Community. With every DBHIDS undertaking, we have been asking ourselves whether it addresses Trauma, achieves Equity, and engages Community. TEC. This has helped us hone our priorities, our strategy, and our transformational efforts.

As important as the accomplishments you will see in this Annual Report are, and how proud all who work and partner with DBHIDS should be in what was achieved, we again face forward. DBHIDS always looks toward tomorrow for the City of Philadelphia – readying for what is on the horizon and continuing to build a future where every individual can achieve health, well-being, and self-determination. We will scale up what works and we will leverage the wisdom of communities and the knowledge of our providers.

I am certain we can move closer to that vision because of the incredible team across seven divisions here at DBHIDS, as well as our strong network of providers, City partners, community stakeholders, and the people we serve.

DBHIDS stands dedicated to addressing trauma, achieving equity, and engaging community – today and tomorrow. We rise to the challenges, we heal within communities, we support one another, and we build that future where individuals, families, and communities thrive!

Thank you,

Jill Bowen, Ph.D. Commissioner

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

The People We Serve The program helped me be around people because I really don’t like people like that and ya’ll make me feel safe.”

— SSP, age 11 Camp Mariposa Participant

Thank you Community Wellness Engagement Unit for caring about us without even knowing or meeting us! God bless you immensely!”

— Gun Violence Victim’s Mother District 5

DBHIDS understands the earlier we intervene with behavioral health issues, the faster we can provide professional care, and support wellness as a community. We know that healing occurs in the community and that behavioral health services need to be accessible to all.

This also requires paying attention to how the social determinants of health and the confluence of factors such as poverty, experiences of trauma, access to care, educational and economic opportunities, and the social and physical environment, impact one’s overall health.

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I like that my housemates are like family. I love them all! My Employment Specialist is amazing and is always there for me when I need her. I’m excited to start taking Uber to work too!” ­— Lauren Neilson Division of Intellectual disAbility Services It has been difficult during the pandemic. We don’t go many places except for work. I love my job. My job coach helps me safely interact with my coworkers. They remind me to keep my mask on, wash my hands, and keep everything clean like the lockers, equipment, and mirrors. I always stay professional and my boss says I do a great job.” ­— Participant SPIN, Inc.

One day, I was so sick of getting high. When I called, I couldn’t believe someone picked up the phone. I ain’t used since that day. Now, I got 13 months clean.” ­— BS. Toni JEVS Methadone Program

DBHIDS ANNUAL REPORT 2020 - 2021

Kupitia Mpango wa IRWA, nilipata fursa ya kukutana na kuingiliana na viongozi wa jumuiya kutoka asili na uzoefu mbalimbali jambo ambalo lilifanya mijadala yetu kuwa ya kuvutia na ya kuvutia. Nilijifunza mengi kuhusu mbinu nyingi za uongozi wa jumuiya na kutetea afya na ustawi wa wanachama ndani ya jumuiya zetu.”

“Through the IRWA Program, I got the opportunity to meet and interact with community leaders from many backgrounds and experiences which made our discussions very rich and engaging. I learned a great deal about the many approaches to community leadership and advocating for the health and wellbeing of members within our communities.”

— Blessing Bwititi Immigrant and Refugee Wellness Academy

我寻求改变的原因不是因为我必须这样 做，而是因为我想这样做。我想成为更好的自 己并支持社区中的人们” “The reason I seek for a change is not because I have to, it’s because I want to. I want to be a better version of myself and support people in my community.”

— Yushan Chou Immigrant and Refugee Wellness Academy

成为学院的一员是我的荣幸，我非常感 谢演讲者、组织者和学院成员提供的学习机 会” “It has been a privilege to be part of the academy and I really appreciate the learning opportunity from both the speakers, organizers, and the members of the Academy.”

— Yuhong He Immigrant and Refugee Wellness Academy

‫اذه يف ةكراشملا ىلع يتردق ينلعج دقل‬ ‫قرف ثادحإ عيطتسأ يننأ كردأ جمانربلا‬ “‫يناغفألا يعمتجم يف‬ “Being able to engage in this program has made me aware that I can make a difference in my Afghan community.”

— Maryam Ahmadi Immigrant and Refugee Wellness Academy

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

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 2020 - 2021

DBHIDS Advisory Board

CBH Board of Directors

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

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

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

Minority

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

DBHIDS At a Glance

DBHIDS plays an important role in improving the overall health status of all Philadelphia residents.

Of the 1.58 million Philadelphia residents, 725,000 are eligible for Medicaid. This is 45% of the population.

1.58 million

45% 45%

DBHIDS directly served over 153,000 individuals annually.

Outreach & Engagement

100,012

Inpatient Treatment

30,665

Community Settings

22,431

We oversee a network of more than 200 providers offering a full continuum of services.

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Community Behavioral Health managed Medicaid, mental health, and substance use services for 100,012 members in CY 2019.

Division of Behavioral Health (DBH) managed services for 30,665 uninsured individuals in FY 2020.

Intellectual disAbility Services (IDS) division managed services for 22,431 in FY 2020.

DBHIDS ANNUAL REPORT 2020 - 2021

Our Population Health Approach Population Health = Community Health 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.

Social Determinants of Health Poor health and health disparities do not result from medical causes alone. In fact, environment and lifestyle factors have seven times more impact on overall population wellness than health care.

A population health approach seeks to address these factors to reduce health disparities and safeguard everyone’s right to optimal health and self-determination.

Population Health at DBHIDS By providing excellent clinical care as well as community-level interventions and services, a population health approach helps us create a Philadelphia in which every member — not just those who seek out behavioral health or intellectual disability services — can thrive.

We achieve these outcomes through a wealth of internal initiatives and external community-based partnerships.

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ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

Impact by the Numbers Financial

DBHIDS generates cost savings and economic impact for Philadelphia.

HealthChoices Behavioral Health Program Funding Stream

$

Federal Government

$

Commonwealth of Pennsylvania

54% 56% State

1%

Federal

$

City of Philadelphia

$

DBHIDS

$

Community Behavioral Health

45% 1% General Fund State Over 90% of DBHIDS funds support

nonprofit agencies.

43% Federal

City of Philadelphia General Fund

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 our members. We achieve this through: • Evidence-based practices

Healthier People

HIGH QUALITY LOW COST

Better Care

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Smarter Spending

•

Incentivizing high-quality services: Pay for performance and value-based purchasing

•

Integrated oversight and monitoring teams; Network Improvement and Accountability Collaborative and Community Behavioral Health compliance

DBHIDS ANNUAL REPORT 2020 - 2021

Employment

705

individuals received employment supports through DBHIDS’ division of Intellectual disAbility Services in 2020 resulting in employment for 540 individuals with intellectual disabilities or autism.

63

individuals were employed in 2020 through DBHIDS’ partnership with First Step Staffing, an agency that connects individuals in recovery to entry-level employment.

355

individuals accessed 1,704 paid work opportunities in 2020 through Color Me Back: A Same Day Work and Pay Program. This program is managed by Mural Arts’ Porch Light community wellness program, a collaboration with DBHIDS. Color Me Back was designed in partnership with the Scattergood Foundation, SEPTA, and Mental Health Partnerships.

Housing The Housing and Homeless Services Unit manages resources focused on preventing and ending homelessness and increasing housing opportunities for community inclusion for persons with significant behavioral health challenges.

INITIATIVE

PEOPLE SERVED

AVERAGE LENGTH OF STAY

TIP Housing and Residential

1,645

3.7 years

Recovery House Initiative

2,306

53 days

Journey of Hope

334

138 days

Safe Havens

633

138 days

Student Supports Support Team for Education Partnership (STEP) aims to: • • •

Ensure child and family wellbeing by offering interventions early on that encourage healthy coping skills Connect children and families to community resources Serve students’ behavioral and social needs, to enable students to engage meaningfully with school, community, and social connections • Coach caregivers and teachers on new ways to create safe environments that meet social/emotional needs • Help schools strengthen their approach to climate through a trauma-in-formed lens.

DBHIDS launched STEP in collaboration with the School District of Philadelphia, the City of Philadelphia, and CBH. STEP was fully implemented in September 2019. 2,663 students were served, a 16% increase compared to fiscal year 2019 to 2020, reaching 394 additional students during school year 2019-2020. STEP has provided 38,024 total hours of child-level and school-level activities.

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Brighten the Corners by James Burns. 2021 114 W. Queen Lane and 5224 Greene St. photo: Steve Weinick

DBHIDS ANNUAL REPORT 2020 - 2021

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Intellectual disAbility Services

Planning Innovation

Administration and Finance

Behavioral Health and Justice

Chief Medical Officer

Behavioral Health

Community Behavioral Health

PHILADELPHIA BEHAVIORAL HEALTH SYSTEM

DBHIDS Divisions 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.

Division of Behavioral Health 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.

Division of Behavioral Health The Behavioral Health Division (DBH) includes the Office of Mental Health and Office of Addiction Services.

Through an extensive network, DBH provides mental health and substance use treatment services for uninsured and under-insured 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. This network of services includes: 11 Community Mental Health Centers

30+ Specialized Behavioral Health Agencies

5 Crisis Response Centers

In partnership with these contracted providers, the Division of Behavioral Health offers access to a comprehensive range of behavioral health services. These services include but are not limited to: • • • • • •

Emergency and crisis intervention Social and psychiatric rehabilitation Individual and group counseling Family support Residential support Outreach

• Recovery support • Person-driven service • Early intervention • Substance-use prevention

Behavioral Health and Justice Division In 2020, The Behavioral Health and Justice Division (BHJD) was launched as the seventh DBHIDS division after years as the Behavioral Health and Justice Related Services unit. As the seventh 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.

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DBHIDS ANNUAL REPORT 2020 - 2021

Intellectual disAbility Services The Division of Intellectual disAbility Services is responsible for oversight, planning, administering, and coordinating intellectual disability and autism supports and 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 for persons with an intellectual disability or autism. IDS works with the Commonwealth, which provides the funding 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.

Early Intervention Services The Philadelphia Infant Toddler Early Intervention Program is an entitlement program for infants and toddlers from birth to three years of age who have or are at risk for having a developmental delay.

People and their family members want to have an “everyday life” that is typical of the general population, and DBHIDS supports these values.

We offer quality supports and services so individuals will have choices in their lives, meaningful relationships, and participation in their community as valued citizens.

Community Behavioral Health Philadelphia is the only county in Pennsylvania that opted to create its own 501(c)(3) Behavioral Health Managed Care Organization. CBH provides reinvestment opportunities that advance the system in priority areas. In CY2019: • •

735,387 eligible members 116,236 members served

23.1% 52.2%

African American

Hispanic

18.6%

50.2% Male

49.8% Female

White

2.3% Asian 3.6% Other

Based on Utilization 15

ADDRESSING TRAUMA. ACHIEVING EQUITY. ENGAGING COMMUNITY.

Highlights and Accomplishments Housing Transformation 2.0 Housing Transformation 2.0 is a response to increased demand for residential programs, limited permanent supportive housing options, minimum-wage increases, and COVID-19, and recent staffing shortages. This response works with residential providers to achieve equity for front-line staff and ensure individuals are living in and engaged in the community in the least restrictive setting possible.

Crisis Initiative 2.0 DBHIDS is currently expanding crisis services across the city of Philadelphia. Services include: • • • • • •

Mobile Crisis Response Teams Community Mobile Crisis Response Team (short term) Crisis Intervention and Stabilization Team (long term) Children’s Interim Response Team to expand the existing Co-responder Team Adult Crisis Response Center procurement nearing completion Behavioral Health Urgent Care Center

Infrastructure • •

Philadelphia Crisis Line staffing expansion Philadelphia Crisis Line licensure and accreditation • Behavioral Health Navigator staff “Philadelphia Crisis Line East“ – embedded in the 911 Radio Room • Care Traffic Control: crisis services dispatch command center • Data-sharing portal

Addiction Care Interventions • • • • •

911/Behavioral Health Justice Division and Philadelphia Crisis Line Collaboration Statewide 988 Committees (planning for 988 conversion July 15) Mobile Teams Learning Collaborative Crisis Steering Committee Family Crisis Reform Group

TEC Initiative “TEC stands for addressing trauma, achieving equity, and engaging community. The TEC initiative ensures an accessible continuum of services that addresses the various types and stages of trauma for all Philadelphia residents. The guidling priniciples of TEC are: • • • • •

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Enact a comprehensive strategy to support people and communities across the City, experiencing a variety of traumatic events or circumstances Understand existing and needed resources, utilize best practices, and make data driven decisions Deepen our work with stakeholders to ensure equitable access to resources and to bring solutions Recognize the impact of traumas associated with many factors Recognize the resources – in-school prevention, supports and treatment, evidence-based models in the continuum, community outreach, support and engagement

DBHIDS ANNUAL REPORT 2020 - 2021

Highlights and Accomplishments Individual Interventions •

2,000 children screened and over 100 clinicians trained in Trauma-Focused Cognitive Behavioral Therapy

•

Intensive Behavioral Health Service programs in 224 schools served over 6,000 children

•

7,700 Student Assistance Programs assessments

• 86,000 calls to the Philadelphia Crisis Line • 3,278 officers trained in Crisis Intervention Response since 2007

Community Interventions •

Network of Neighbors assisted over 3,000 people in 166 communities in 88 schools

•

8,000 participated in Porch Light Mural Arts program activities, of which over 300 were Afghan refugees

•

Over 11,000 engaged in Engaging Males of Color program activities

•

5,000 community members engaged by the Community Wellness Engagement Unit

Training Courses •

621 DBHIDS staff have completed Trauma Awareness training

•

4,046 courses provided in various specialized trauma practices including Mental Health First Aid

Hospital-based Services •

921 Cure Violence service referrals

•

273 people provided case management in the Healing People Initiative

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Keys to Change by Phillip Adams and Kensington area Veterans. 2022 3206 H Street photo: Steve Weinick

Addressing trauma, achieving equity, and engaging community.

Jefferson Tower 1101 Market St. Philadelphia, PA 19107 215-685-5400 DBHIDS.org

@DBHIDS

Photo credit: Steve Weinik and Ted Pendergrass