DELAWARE COUNTY DEPARTMENT OF HUMAN SERVICES DELAWARE COUNTY

DELAWARE COUNTY DEPARTMENT OF HUMAN SERVICES

DELAWARE COUNTY HUMAN SERVICES PLAN PUBLIC HEARING

FUNDING • Provided based on categorical allocation in the following areas • Mental Health Base Funds • Intellectual and Developmental Disabilities Base Funds • Act 152 Drug and Alcohol Funds • Behavioral Health Service Initiative Funds • Human Services Development Fund • Homeless Assistance Program

INDIVIDUALS SERVED • Over 30, 000 individuals have been assisted with services in • • • Mental Health Intellectual & Developmental Disabilities Homelessness Assistance Drug & Alcohol Human Services and Supports

FISCAL Fiscal Year 2018/2019 20% 3% 2% 1% Fiscal Year 2019/2020 3% Fiscal Year 2020/2021 2% 1% 3% 2% 1% 19% 74% Mental Health Intellectual Disabilities Drug and Alcohol (Act 152 and BHSI) Homeless Assistance Program Human Services and Supports 75%

STATE BUDGET FOR FISCAL YEAR 2020/21

PLANNING TEAM Sandy Garrison, Human Services Director and CFO Donna Holiday, Deputy Administrator MH Susan Proulx, Deputy Administrator OIDD Laura Fidorowicz, D&A Administrator Jessica Fink, Administrator Adult & Family Services Jackie Hartney, Human Services Fiscal Officer Vandy Moseray, Human Services Fiscal Officer MH/IDD and D&A Advisory Boards

STAKEHOLDERS • Children’s Cabinet & Coalition • Del. Co System of Care Co Leadership Team • Del. Co Early Childhood MH Advisory Board • MH/IDD Advisory Board • D&A Planning Council • Delaware County Advocacy and Resource Organization • ALERT • NAMI • • • Voice & Vision Community Support Program Homeless Services Coalition Magellan Behavioral Health A&FS, D&A, IDD, & MH Providers Employment Forum Delco Collaborative ODP & OMHSAS Field Offices Overdose Coalition OIDD Families w/Participant Directed Services

MENTAL HEALTH COVID-19 • During this COVID-19 pandemic all of our MH providers have developed plans which have allowed them to continue MH services in the County. Plans have varied according to the type of service. o Therapeutic sessions are being offered via telehealth and staff have been equipped with tools to teach individuals how to use ZOOM. o Site-based crisis and mobile crisis services have continued 24 hours a day/7 days a week. o The Warm Line is also still operating for those who would just like to talk. o Implementation of a COVID-19 Telehealth Helpline is also available to provide Emotional Support to the Delaware County community. This Helpline operates 24 hours a day/7 days a week. Individuals working or living in Delaware County may use this resource to speak to a Certified Peer Specialist or to a MH Professional. o The Commonwealth has also implemented a COVID-19 support and referral line. it is manned by trained listeners.

MENTAL HEALTH Increase Community Awareness & Support : Youth & Adult Mental Health First Aid • Youth: 191 Community Members Certified & 27 Instructors Certified • Youth Suicide Prevention: Question Persuade Refer (QPR), 32 Certified & 1 Instructor Certified • QPR - is a suicide prevention gatekeeper training that is available to Human Services Staff, Providers, Stakeholders and other County Systems to increase their capacity for identifying those at risk and linking them to the proper supports • Adult: 133 Community Members Trained (includes County Jail Staff)

MENTAL HEALTH COMMUNITY FORENSIC SERVICES Forensic Assertive Community Team (FACT) • The FACT model is an evidence–based model that has collaborated closely with the MH Treatment Court • The average number of FACT participants was between 7678 % from July 1, 2019 through March 31, 2020 • The recidivism among it’s participants has been 1. 1% • The team focused on building emotional well-being in the midst of COVID-19

MENTAL HEALTH • The GEO Transitional Housing program continues to be a successful re-entry program • Focus to help individuals establish and community tenure to reduce the recidivism rate by 80% • All male facility with bed cap of 18 12

MENTAL HEALTH Supported Employment: providing vocational education and support services for people wanting to work at competitive jobs of their choosing • • Individual Placement & Support (IPS) Principles are implemented IPS is an Evidence-Based Practice utilized in the community 2 Stand alone providers: Care. Link & Merakey Each provider works with around 35 participants regarding their benefits, choosing a career, and seeking either volunteer, parttime, or full-time work

MENTAL HEALTH DELAWARE COUNTY MH OUTCOMES Blended Case Management for Displaced (With SMI) • Specially trained in a Critical Time Intervention (CTI) an evidence-based model • Periods of transition, time-limited, phase approached, focused, decreasing intensity over time, community based, no early discharge • Face to face engagement occurs within 24 -48 hrs of referral • 98 Members served by Crozer’s Home at Last program (Jan 2019 February 2020) • Cumulative totals July 2019 March 2020 • • Average number of participants = 46 Discharges = 52 % Discharge Successful = 58% % Discharge Unsuccessful = 42%

ADULT & FAMILY SERVICES HOMELESS ASSISTANCE SYSTEM GOALS • Reduce the number who become homeless • Reduce the length of time people remain homeless • Exit people into permanent housing situations whenever possible • Reduce homeless recidivism • Promote financial security

ADULT & FAMILY SERVICES HOMELESS ASSISTANCE SYSTEM GOALS

DRUG & ALCOHOL OUTCOMES AND INITIATIVES Goal: Offer all services on the D&A Continuum of Care to address the opioid epidemic. Treatment Services Expansion Level of Care (LOC) Hospital Detox (4 WM) Hospital Rehab (4) Detoxification (3. 7 WM) Rehabilitation (3. 5) Halfway House (3. 1) Recovery Housing Total Bed Access 69 98 346 2351 332 214 • Publicly Funded 2019: TOTAL of 19, 429 residents served • 1, 053 County; 18, 376 Magellan Behavioral Health • Recovery Housing: 245 residents received rental assistance

DRUG & ALCOHOL OUTCOMES & ADDITIONAL INITIATIVES TREATMENT • As of July 1, 2020 all in-county contracted providers will be mandated to provide ongoing quality metrics regarding services for each LOC • As of July 1, 2020 funding will be available for all 3 forms of Medication Assisted Treatment (MAT) • MAT is no longer an exclusionary criteria for any individual entering County funded treatment • Added 66 additional recovery house beds • Crozer Keystone Health Systems is currently pursuing opening a second residential withdrawal management and rehab facility in the western part of the county at Delaware County Memorial Hospital (DCMH) • SCA hosted recovery event supporting MAT at Rose Tree Park • Conducted stigma surveys for community and persons in recovery feedback • Added “Finally Home” to D&A continuum which houses individuals with Opioid Use Disorder (OUD)

DRUG & ALCOHOL OUTCOMES & ADDITIONAL INITIATIVES PREVENTION • Added “CHASE” support group for children who live in homes where Substance Use Disorder (SUD) is present and re-occurring • 16 evidence-based prevention programs are offered to youth, families, and/or adults • “Teen Intervene” mild intervention program offered for at-risk youth: served 72 youth in 2019 • Countywide Prevention Needs & Resource Assessment in 2019 facilitated greater understanding of the high-risk consumption behaviors within Del. Co • Yearly engagement in PA Youth Survey (administration and survey results)

DRUG & ALCOHOL CERTIFIED RECOVERY SPECIALIST (CRS) MODEL: PROVIDES WARM HANDOFF TO OUR EMERGENCY DEPARTMENTS Contact number: 610 -619 -8616 • Crozer Chester Medical Center (CCMC) administers the Warm Hand-Off program, utilizing a 24/7 hotline and a team of CRS's under clinical supervision. Program started 10/1/2016. • There are 3 hospital systems with a total of 7 emergency departments serving our county. (Taylor, DCMH, CCMC, Springfield, Mercy Fitz, Riddle, and Bryn Mawr) Outcome of Engagements Since Inception Individual Engagements Entered Treatment Refused Treatment 4, 119 1, 438 2, 681

DRUG & ALCOHOL NARCAN EDUCATION & DEMONSTRATION • Crozer Chester Medical Center, Community Campus, offers monthly community Narcan trainings Contact: Autumn Miller 610 -619 -8664 or autumn. miller@crozer. org • Key Recovery offers community Narcan trainings every other month Contact: Jennifer East 484 -490 -1066 or jennifer. east@uhsinc. com • All attendees receive a Narcan kit upon completion of the training • Virtual trainings and low contact pick up have been offered during the COVID-19 pandemic • Over 800 individuals have been trained in Community Narcan

INTELLECTUAL and DEVELOPMENTAL DISABILITIES OUTCOMES FOR FY 19/20 • Four people were moved back into the community from large congregate care settings • Emergency and one-time Base/Block Grant funds were used to maintain people in community • Two Unanticipated Emergency Waiver Capacities were obtained from the State for emergencies • OIDD used the STAR from the Life. Course Tools during intake to promote an everyday life for six young adults with Autism and their families

INTELLECTUAL and DEVELOPMENTAL DISABILITIES OUTCOMES FOR FY 19/20 • Many individuals employed were furloughed during COVID-19 • Lifesharing decreased from 31 to 30 during FY 19/20 • 174 people were served in FSS in FY 19/20; focus on quality, not quantity • Due to COVID-19, unable to hold four community trainings for families as expected. However, sharing resource materials from My. ODP and PCHC websites, and information from ODP

INTELLECTUAL and DEVELOPMENTAL DISABILITIES EFFECTS of COVID-19 CASES • Positive cases significantly reduced among individuals from Del. Co in the past several weeks COVID-19 ISSUES • Not enough Personal Protective Equipment (PPE) early on • Staffing shortages CHANGES IN PROVIDER OPERATIONS • Screening of individuals and staff • Quarantine for exposed individuals and staff • Isolation for those who were displaying symptoms • Limiting staff exposed to each individual to reduce transmission

INTELLECTUAL and DEVELOPMENTAL DISABILITIES EFFECTS of COVID-19 OTHER CHANGES • Testing, and soon Universal Testing • ODP Appendix K allowed for service flexibility (ex. remote service delivery of CPS, in-home services, therapies and Supports Coordination) • ODP Announcements and webinars for stakeholders • ODP weekly meetings with Supports Coordination Organizations (SCOs), Counties and Providers • Phila Coordinated Health Care (PCHC) and the Department of Health vital in providing accurate health information related to COVID-19

INTELLECTUAL and DEVELOPMENTAL DISABILITIES EFFECTS of COVID-19 Del. Co OIDD Changes • Regular meetings with Providers and SCOs • Residential Provider Readiness, Residential Provider Stability, and In-Home Support Services Tools to help providers serve individuals safely during the crisis • SCOs used Wellness and Transition Tools to ensure individual and family safety and transition back into services • Assist with distribution of cloth masks for individuals and their families

INTELLECTUAL and DEVELOPMENTAL DISABILITIES OIDD GOALS for FY 20/21 NEXT STEPS • Assist all providers with services to be provided in “new normal” • Promote Lifesharing as a safer alternative to group care • Continue moving people to the community from large congregate settings • Promote use Life. Course Tools through remote presentations • Restore and Increase the number of people working in the community • Increase use of STAR during intake process

OUR COMMITMENT Delaware County Human Services is committed to high quality, cost effective, least restrictive services that foster resiliency and recovery. These services are designed and developed with input from multiple systems and stakeholder groups.

DELAWARE COUNTY HUMAN SERVICES PLAN COMMENTS /QUESTION