DBHIDS 2019-2019 Annual Report

Department of Behavioral Health and Intellectual disAbility Services

2018-2019 Annual Report

Setting the Pace

Empowering Philadelphians to Take Charge of Their Health and Wellness

Table of Contents

2

Recovery. Resilience. Self-determination.

Message from the Commissioner

3

The People We Serve

4

Executive Management Team

5

Who We Are

7

DBHIDS At a Glance

8

Our Population Health Approach

9

Impact by the Numbers

10

Operational Divisions

12

Prioritizing to Address Our Changing Environment (P.A.C.E.)

14

Highlights and Accomplishments

15

Message from the Commissioner I am pleased to introduce the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) 2018-19 Annual Report: Setting the P.A.C.E. This report illustrates our priorities and commitment to advancing excellence in care for the people of Philadelphia.

As I look back on the past year, I’m humbled by all we continue to accomplish on behalf of the people of Philadelphia and the communities we serve. These accomplishments would not be possible without the hard work, dedication, and innovation of more than 1,100 employees across the six divisions within DBHIDS, our vast provider network, our City partners, our community stakeholders, and — most importantly — the people we serve. DBHIDS is a comprehensive system with a strength that comes from teamwork, collaboration, and a willingness to do whatever is necessary to ensure the people of Philadelphia receive high-quality supports, services, and treatment.

Increased access to care was a top priority in 2018-19. We continued to partner across City agencies to implement recommendations from the Mayor’s Opioid Task Force and served as a key partner for the City of Philadelphia Resilience Project. Through these efforts we made significant progress connecting people to services and saw the number of people accessing services at a five-year high.

In my role as Commissioner, I am blessed to work with wonderful staff. As a servant leader, I am immensely thankful for staff’s willingness to serve Philadelphians. Each day, I see new examples of how we bring integrated services to people with the greatest needs and how collaboration among public, private, and nonprofit entities enables efficient and effective service delivery.

I am proud of our accomplishments, and we are committed to doing more. This report serves to highlight not only what we have done but what we will continue to do to ensure Philadelphia receives the best care possible. As a new year begins, we are “Setting the P.A.C.E.” to achieve greater outcomes for the people of Philadelphia.

Sincerely,

David T. Jones Commissioner, DBHIDS President, CBH Board of Directors

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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The People We Serve As a person in recovery, I realize my mind is not always my friend — I still struggle with making healthy choices.

Getting involved and becoming a homeless case manager and certified peer specialist saved my life. Now, I use my lived experience to help others on their road to recovery.”

— Kenneth Biggs Employment Readiness Specialist

Early Intervention (EI) services helped my sons when they were infants — now Intellectual disAbility Services continues to support them. They started their own business that gives back to the community. The same person who worked with them during EI still works with them now, and they even remember the stories she used to tell them. It changed their lives — and mine.”

— Susanne Tuckerman Parent

I never thought in a million years that I’d go from trying to destroy my life to now being part of a movement and a system that helps people”. ­— Tylon Bridges Certified Peer Specialist, Merakey, USA

My journey to recovery began 24 years ago in a treatment center. The 12-step program, volunteering, and the Certified Peer Specialist Training helped me understand mental health and break the barriers of stigma.

For me, the best way to help others is to treat people with dignity, be culturally competent, and practice self-care. Being openminded and treating people with dignity will help reduce stigma.” ­— Guadalupe Santos Certified Peer Specialist

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Recovery. Resilience. Self-determination.

Mission

Vision

Values

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

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

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

Executive Management Team DBHIDS Executive Management team members help chart the course for person-driven behavioral health and intellectual disability services. They include:

David T. Jones Commissioner

Donna E.M. Bailey Chief Executive Officer, Community Behavioral Health

Jill Bowen, Ph.D. Deputy Commissioner, Administration and Finance

Andrea L. Brooks, MSW, LSW Senior Special Advisor to the Commissioner

Nicole Connell, M.Ed. Chief of Staff

George Hanson, CPA, Esq. Chief People Officer

Omoiye Kinney Communications Director

Roland Lamb Deputy Commissioner, Planning Innovation

Joe Lowry, CPA, GCMA Chief Financial Officer

Odysseus Marcopolus Chief Digital Officer

Jeffrey Orlin Administrative Services Director

Denise Taylor Patterson Director, Intellectual disAbility Services

Sosunmolu Shoyinka, M.D. Chief Medical Officer

Chris Tjoa, M.D. Chief Medical Officer, Community Behavioral Health

Sandy Vasko Director, Behavioral Health

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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DBHIDS Advisory Board Members Angelita Alomar-Gilbert | Public Health Management Corporation Hector Ayala | Hispanic Community Counseling Services Josephine Barilotti | The Consumer Satisfaction Team, Inc. Rebecca Bonner | The Bridge Way School Laura Boston Jones | North Philadelphia Health System Frances Conwell | Alliance of Black Social Workers, Inc. Ronald Crawford | Stop & Surrender/Honesty Hurts Publishing and Counseling Mary K. Doherty | CORA Services, Inc. Eric Edi, Ph.D. | The Coalition of African Communities (AFRICOM)

Emily Loscalzo, Psy.D. | Thomas Jefferson University Priya Mammen, M.D., Ph.D. | Dept. of Emergency Medicine, Thomas Jefferson University Nicole Mitchell | The Consumer Satisfaction Team, Inc. Sara Molina-Robinson | ChildLink, Birth-3 Early Intervention Service Coordination Frank Mount | Gaudenzia Barbara Nattile | Vision for Equality, Inc. Cheryl Nichols | DBHIDS, Child Find & Public Awareness Unit Stephen A. Pina | SW NuSTOP, Inc. Andre Reid | Philadelphia NAMA/NIAC Elise Schiller | Self-employed Pascal Scoles | Community College of Philadelphia

Brandon Evans | 1199C

Laura Sorensen | RHD Morris Home

Adrienne Gavern-Tomlinson | Jewish Family and Children’s Service

Chris Sweeney | NET

Ramona Griffiths | Northeast Parent Support Group

S. Reno Wright | The House of Prestige, LLC

Beverly J. Haberle | The Council of Southeast PA/ PRO-ACT Frank A. James | Biblical Theological Seminary

Community Behavioral Health (CBH) Board of Directors David T. Jones | President Roland C. Lamb | Vice President

DBHIDS Advisory Board Diversity

54% minority

Jill Bowen, Ph.D. | Secretary-Treasurer Keir Bradford-Grey | Member Thomas Farley, M.D., MPH | Member Kimberly Ali | Member Eva Gladstein | Member

CBH Board Diversity

Liz Hersh | Member William R. Hite, Jr., Ed.D. | Member Deborah Irby | Member Nicole Mitchell | Member Sandy Vasko | Member

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Recovery. Resilience. Self-determination.

50% minority

Who We Are The Department of Behavioral Health & Intellectual disAbility Services is a department under the City of Philadelphia’s Health and Human Services cabinet that oversees behavioral health care, intellectual disability supports, and early intervention services in one integrated system. Through a network of providers, partners, and community members, we fund treatment and services that promote recovery, resilience, and self-determination.

By empowering the entire community to take charge of their health and wellness, we help to create a Philadelphia where every resident can thrive.

We function as a single-payer public behavioral health and intellectual disability service system utilizing federal, state, and local dollars including Medicaid. We are comprised of six divisions that oversee services for children, adults, and families.

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Division of Intellectual disAbility Services (IDS)

Division of Planning Innovation

Division of Administration and Finance

Division of the Chief Medical Officer

Division of Behavioral Health

Division of Community Behavioral Health

PHILADELPHIA BEHAVIORAL HEALTH SYSTEM

Administrative Divisions

Operational 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.

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.

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.

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.

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.

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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DBHIDS At a Glance

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

Of the 1.5 million Philadelphians, nearly 718,000 are eligible for Medicaid. This equals 46% of the population.

1.5 million

46%

DBHIDS directly served over 170,000 individuals annually.

Outreach & Engagement

118,000

Inpatient Treatment

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

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43,301

Community Settings

Recovery. Resilience. Self-determination.

15,592 Community Behavioral Community Health managed Behavioral Medicaid mental health and substance Health use services for over managed 118,000 members Medicaid in CY 2018.

mental health and substance use services for over 118,000 members in CY 2018.

Division of Behavioral Division of Health managed Behavioral services for 43,301 uninsured Health individuals managed in FY 2019.

services for 43,301 uninsured individuals in FY 2019.

Intellectual disAbility Intellectual Services division disAbility served 15,592 in FY 2019.

Services division served 15,592 in FY 2019.

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 (see pie chart below). A population health approach seeks to address these factors to reduce health disparities and safeguard everyone’s right to optimal health and selfdetermination.

Factors that Influence Health Status

Personal health practices and coping skills

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.

Health services

Income and social status

Social support networks

Employment and working conditions

Determinants of Health

Biology and genetic endowment

Physical environments

Healthy child development

Education

Health Behaviors Smoking Obesity

Social Economic Factors

40%

Stress

30%

Nutrition Blood Pressure Alcohol Drug Use

10% 10% 10% Clinical Care

Genes & Biology

Physical Environment

Determinants of Health City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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Impact by the Numbers Financial

We generate cost savings and economic impact for Philadelphia.

HealthChoices Behavioral Health Program Funding Stream

mmonwealth Pennsylvania

City Federal of Philadelphia

Commonwealth DBHIDS of Pennsylvania

1% General Fund

54% 45% State

Federal

54% Federal

City

Community of Philadelphia Behavioral Health

DBHIDS

45% State

Community Behavioral Health

1% General Fund

Over 90% of DBHIDS funds support non-profit agencies.

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

Quality of Care DBHIDS is committed to ensuring our network provides quality clinical care for our members.

We achieve this through:

Healthier People

• Evidence-based practice • Incentivizing high-quality services: Pay for performance and value-based purchasing • Intergrated oversight and monitoring teams; Network Improvement and Accountability Collaborative and Community Behavioral Health compliance

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Recovery. Resilience. Self-determination.

HIGH QUALITY LOW COST

Better Care

Smarter Spending

Employment

individuals received employment supports through DBHIDS’ division of Intellectual disAbility Services resulting in employment for 448 individuals with intellectual disabilities or autism.

593

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

123

individuals accessed 1,681 paid work opportunities 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.

571

Supportive Housing people provided with supportive housing options in 2018-2019 by DBHIDS.

193% increase

Expanded capacity of the DBHIDS Recovery House Network from 160 beds to 470 beds.

Education Launched the Support Team for Education Partnership (STEP) in collaboration with the School District of Philadelphia, the City of Philadelphia, and CBH. It was fully implemented in 21 public schools and one charter school in September of 2019.

DBHIDS and CBH contract with:

in across

27providers 250

schools

44

zip codes

Services include: Prevention Services Early Intervention Support Services Student Assistance Programs Medication Assistance Treatment Services

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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Operational Divisions Division of 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.

Keeps administrative costs very low – less than 10%

Offers language interpretation services

Provides member support 24 hours/ 7 days per week.

CBH has demonstrated the ability to provide effective integrated care as a behavioral health carve-out. Our collaborative partnerships with the physical health managed care organizations have resulted in CBH’s second Pay for Performance award from the PA Department of Human Services.

CBH awarded evidencebased practice designations to 27 programs serving children, demonstrating our commitment to offering an array of high-quality, community-based treatment options.

CBH has earned the National Committee for Quality Assurance’s (NCQA) Managed Behavioral Health Organization (MBHO) Full Accreditation.

27

6%

CY 2018 CBH Members At A Glance

2

6%

15%

55%

19% Nearly 718,000 eligible members

Over 118,000 used services

6%

Eligible members: 47% male 53% female

15%

6%

6%

6%

2%

15%

19%

ELIGIBLE MEMBERS

Black/African American

Black/African American

Recovery. Resilience. Self-determination.

Black/African American 2% 3% 6%

15% 19%

MEMB Hispanic, Any Race

6%3%

19%

55% 52% 52% 19% 24%

Used services: 55% 51% male 55% 49% female 19%

ELIGIBLE MEMBERS

12

ELIGIBLE MEMBERS

24%

2%

19% 24%

ELIGIBLE MEMBERS MEMBERS USING SERVICES MEMBERS US MEMBERS USING SERVICES

Black/African American Any Race Hispanic, Any Race Other White Asian Hispanic,

Hispanic, Any Race

White

Asian

Other

White

Division of Intellectual disAbility Services 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 Pennsylvania 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, who 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. IDS coordinates this program in Philadelphia County and reports to the Pennsylvania Department of Human Services Office of Child Development and Early Learning, which also provides the funding for this program.

8,006

intake referrals in FY 2019.

This reflects an 11.2% increase from FY 2018.

Anyone can make a referral to Early Intervention and all referred children will receive a developmental assessment; many will also receive a multidisciplinary evaluation.

Division of Behavioral Health This division includes the Office of Mental Health and the 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

More than specialized behavioral health agencies

5

crisis response centers

In partnership with these contract 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

• Outreach

• Social and psychiatric rehabilitation

• Recovery support

• Individual and group counseling

• Person-driven service

• Family support

• Early intervention

• Residential support

• Substance-use prevention

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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Prioritizing to Address Our Changing Environment (P.A.C.E.) A strategy to unite our efforts, sharpen our focus, and move us forward. Our strategic plan is centered around five priority areas.

The plan includes strategic goals, as well as division objectives, to ensure we remain internally aligned, responsive to urgent community needs, and well positioned to address emerging challenges.

Developing a strategic plan demonstrates our commitment to promoting recovery, resilience, and self-determination. A clear path forward will help DBHIDS set priorities for delivering services and programs in a manner that aligns with our values and our population health approach.

PREVENTION AND EARLY INTERVENTION Further develop services around community needs to enhance wellness and early identification.

HEALTH ECONOMICS Improve processes and practices to enhance cost efficiency and value.

TREATMENT AND SERVICES Increase access to services.

INFRASTRUCTURE AND INTELLIGENCE Increase the use of business analytics and information flow to inform service delivery and improve outcomes.

INNOVATION Innovate to improve programs and processes.

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Recovery. Resilience. Self-determination.

Highlights and Accomplishments DBHIDS staff are committed to improving the lives of all Philadelphians!

38,000 people who

live, work or study in Philadelphia trained in Mental Health First Aid. 1st Community Wellness Engagement Team launched in Council District 7.

1,000 Certified Peer Specialists trained and ready for employment.

3,103 Narcan kits distributed

throughout Philadelphia communities.

5,854 individuals

received free overdose awareness and reversal training.

264 Community Engagement Events

Philadelphia Resilience Project The City of Philadelphia’s emergency response to combat the opioid crisis.

As part of the Philadelphia Resilience Project DBHIDS led Mission Area 6: Increase Treatment Options, and collectively achieved the following accomplishments:

Made policy changes to increase Medication Assisted Treatment accessibility across the system.

Expanded “warm handoffs” at Temple Main and Episcopal campuses.

Contracted with First Step Staffing to connect individuals in recovery to entry level employment.

Executed all three phases of the Encampment Resolution Pilot, which closed three homeless encampments.

Launched Treatment Availability Database (TAD) which provides real time information about availability of beds.

City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services | 2018-2019 Annual Report

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Empowering Philadelphians to Thrive There are many pathways to access services.

Crisis Response Centers

Phone Numbers

Friends Hospital 4641 Roosevelt Blvd.

215-831-2600

CBH Member Services 888-545-2600 Mental health and addiction services for people with and without insurance

Einstein Medical Center 5501 Old York Road 215-951-8300

National Suicide Prevention Lifeline Veterans dial 1

800-273-8255

Domestic Violence Hotline

866-723-3014

Homeless Outreach

215-232-1984

Intellectual disAbility Services

215-685-5900

NAMI Warmline

267-687-4381

Episcopal Hospital 100 E. Lehigh Ave. 215-707-2577 Hall Mercer 245 S. 8th St. 215-829-5433 Children’s Crisis Response Center 3300 Henry Ave., Suite 3N 215-878-2600

Online Services HealthyMindsPhilly.org Free, 24/7 online behavioral health screening, access to Mental Health First Aid trainings, and resources

24/7 Hotlines For mental health and addiction services call 888-545-2600 For mental health crisis call 215-685-6440 For Adult Protective Services call 800-490-8505

Treatment Access Center

Philadelphia’s behavioral health managed care system for Medicaid recipients Learn more at CBHPhilly.org

NET Access Point 844-533-8200 or 215-408-4987 499 North 5th Street, Suite B, Phila., PA 19123 netcenters.org Offering Buprenorphine and Vivitrol Induction 24 hours/day and 7 days/week.

Photo credit: Steve Weinik, Sonia Little, Serge Levin

To learn more, visit DBHIDS.org.

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