HomeMy WebLinkAboutDraft HSBG Plan Submission FY 25-26Appendix A Fiscal Year 2025-2026
COUNTY HUMAN SERVICES PLAN
ASSURANCE OF COMPLIANCE
COUNTY OF: ___________________________________
A.The County assures that services will be managed and delivered in accordance with the
County Human Services Plan submitted herewith.B.The County assures, in compliance with Act 153 of 2016, that the County Human ServicesPlan submitted herewith has been developed based upon the County officials’determination of County need, formulated after an opportunity for public comment in the
County.C.The County assures that it and its providers will maintain the eligibility records and otherrecords necessary to support the expenditure reports submitted to the Department of Human Services. D.The County hereby expressly, and as a condition precedent to the receipt of state and
federal funds, assures that in compliance with Title VI of the Civil Rights Act of 1964;
Section 504 of the Federal Rehabilitation Act of 1973; the Age Discrimination Act of 1975; and the Pennsylvania Human Relations Act of 1955, as amended; and 16 PA Code, Chapter 49 (relating to contract compliance):
1. The County does not and will not discriminate against any person because of race,
color, religious creed, ancestry, origin, age, sex, gender identity, sexual orientation,or disability in providing services or employment; or in its relationship with otherproviders; or in providing access to services and employment for individuals withdisabilities.
2. The County will comply with all regulations promulgated to enforce the statutoryprovisions against discrimination.
COUNTY COMMISSIONERS/COUNTY EXECUTIVE
Signature(s) Please Print Name(s)
Date:
Date:
Date:
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Appendix B
County Human Services Plan
The County Human Services Plan (Plan) is to be submitted using the template outlined below. It is
to be submitted in conjunction with Appendices A and C (C-1 or C-2, as applicable) to the
Department of Human Services (DHS) as instructed in the Bulletin 2025-01.
PART I: COUNTY PLANNING PROCESS (Limit of 3 pages)
Describe the county planning and leadership team and the process utilized to develop the Plan for
the expenditure of human services funds by answering each question below.
1.Please identify, as appropriate, the critical stakeholder groups, including:
a.Individuals and their families
b.Consumer groups
c.Providers of human services
d.Partners from other systems involved in the county’s human services system.
Planning Team Members include Human Services department staff; other County departmental
paid staff; service providers; and stakeholders from across a variety of different disciplines.
Many of the stakeholders are advocates for participants or direct family members. This
advocacy and representation will occur through Advisory boards and other departmental
committee membership. Appendix D includes a comprehensive list of the members of the
planning team and their affiliations.
The leadership team is comprised of Human Services Administration staff and key County fiscal
staff. Members include: Human Services Administrator (Human Services Block Grant Chair);
County Assistant Administrator; County Services Fiscal Manager; County Grants Director;
MHIDDEI Administrator and Deputy Administrator; Single County Authority Drug and Alcohol
Director and Deputy Director; Area Agency on Aging Director and Deputy Director; Managed
Care Alliance Executive Director; Veterans Affairs department Director; and the Children and
Youth Administrator and Deputy Administrator. This is not a comprehensive list as there are
other department support staff who attend the planning and processing meetings.
2.Please describe how these stakeholders were provided with an opportunity for participation
in the planning process, including information on outreach and engagement efforts.
Stakeholders are actively engaged at all levels via consistent and thorough communication from
each Human Services department established to assist the community participants. The
Human Services Administrator, as the division leader, sets the pace and takes the lead by
bringing all of the departments and services collaboratively together. We encourage the family
members and other advocates and representatives with vested interests to voice ideas,
concerns, and suggestions. We support any individual who would like to apply for a seat on
one of the many committees and advisory boards in order to give insight and help with where
they see service gaps and barriers. Participation as a voting member or community participant
on the Human Services Block Grant Committee is vital to this process as a whole. Participants
are asked to give input through surveys, evaluations, informal feedback, and attendance at
meetings. Voting members are given substantial information and asked to make informed
decisions for recommendations to the County Commissioners on spending and planning. All
Human Services Block Grant meetings are advertised in the newspaper, on the County
website, and through the County’s Facebook page to elicit stakeholder conversation.
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3. Please list the advisory boards that participated in the planning process.
The Franklin/Fulton SCA Drug and Alcohol department holds Advisory Board Meetings at least
four (4) times throughout the program/fiscal year. These meetings are rotated between Franklin
and Fulton Counties for ease of travel and participation for the members and public. These
meetings are offered in person, virtual, and via telephone participation. This Advisory Board
provides input into the Block Grant Plan, is informed of the impact, and is made aware of
requests for funding, project, and service enhancements related to drug and alcohol programs.
The voting members of the Franklin Fulton SCA Drug and Alcohol Advisory Board represent
various sectors, including Criminal Justice, Business and Industry, Labor, Education, Medicine,
Psycho-Social, Student, Elderly, Client, and Community. Representation is evenly split among
genders and counties of residence.
The Franklin/Fulton Mental Health, Intellectual Disability, Early Intervention (MHIDDEI) Advisory
Board meets bi-monthly and also rotates between Franklin and Fulton County specific
designated meeting sites. These meetings are also offered in-person, hybrid virtual, and have a
telephone option. There is a composition of 13 members, including one Commissioner from
Franklin and one Commissioner from Fulton County. The Committee requires representation
from each County: four (4) member Fulton County and nine (9) members from Franklin County.
At least two representatives appointed to the Board are physicians (specifically, a psychiatrist
and a pediatrician). Four individuals are program participants or family members, of which half
represent intellectual and Developmental Disabilities / Early Intervention. Additional
representation comes from the following areas of expertise: psychology, social work, nursing,
education, religion, local health and welfare planning organizations, local hospitals, businesses
and other interested community groups. HSBG Committee meeting updates are shared during
the meetings and a representative will give an update at a Block Grant meeting also.
4. Please describe how the county intends to use funds to provide services to its residents in
the least restrictive setting appropriate to their needs. The response must specifically
address providing services in the least restrictive setting.
Franklin/Fulton Drug and Alcohol program provides prevention, intervention, treatment, and
recovery services in environments most appropriate for the individuals receiving the services.
Prevention services are delivered to youth in school-based or after-school environments suited
to their age and the selected evidence-based program. Intervention services are provided to
eligible individuals through various contracted service providers. Treatment services are
delivered based on the state’s use of the American Society of Addiction Medicine (ASAM)
criteria determining the appropriate level of care indicated by risk assessments. Services are
delivered in the least restrictive manner suitable for the individual. The highest levels of care
(withdrawal management and residential) include 24/7 monitoring and supervision, with
treatment services delivered within the provider’s setting. Less restrictive levels of care (halfway
intervention) are provided by the individual’s chosen provider in a community-based setting.
Recovery support and housing services are offered based on the individuals’ recovery needs,
ranging from ancillary treatment needs to direct treatment care in a community-based setting.
The department assists individuals in identifying the recovery supports and services that best fit
their current stage of recovery.
Franklin-Fulton Mental Health, Intellectual and Developmental Disabilities follows the principal of
providing the least restrictive services and promotes the offering of individualized services which
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will best meet the participants’ needs rather than putting an individual in a program that will not
elicit the best outcomes for that person. An individual is assessed for the need of services and
supports in the IDD program by using a SIS (Supports Intensity Scale) which is mandated by the
Office of Developmental Programs.
5. Please describe any substantial programmatic and funding changes being made as a result
of last year’s outcomes.
There are no planned substantial changes this fiscal year. We reserve the option to add new or
expand programs and services to answer gaps or barriers or needs during the reallocation
process of 2025-2026FY.
PART II: PUBLIC HEARING NOTICE
Two (2) public hearings are required for counties participating in the Human Services Block Grant.
One (1) public hearing is needed for non-block grant counties.
1. Proof of publication;
a. Please attach a copy of the actual newspaper advertisement(s) for the public hearing(s).
b. When was the ad published?
c. When was the second ad published (if applicable)?
*If other media options were utilized, such as social media, internet, etc., for the public
hearing announcement, please attach a copy(screenshot) of the notice, along with the date(s)
posted.
2. Please submit a summary and/or sign-in sheet of each public hearing.
NOTE: The public hearing notice for counties participating in local collaborative arrangements
(LCA) should be made known to residents of all counties. Please ensure that the notice is
publicized in each county participating in the LCA.
PART III: CROSS-COLLABORATION OF SERVICES
For each of the following, please explain how the county works collaboratively across the human
services programs; how the county intends to leverage funds to link residents to existing
opportunities and/or to generate new opportunities; identify partners and agencies involved in the
provision of services; and provide any updates to the county’s collaborative efforts and any new
efforts planned for the coming year. (Limit of 4 pages)
1. Employment:
Franklin Fulton Transition Councils collaborate with the Office of Vocational Rehabilitation
(OVR) in identifying individuals who will benefit from Pre-employment Transition Services;
Paid Work Experiences; and Job Shadowing within the school districts and as well as
students who need to connect with adult services. The Franklin/Fulton IDD program
participates in the Transition Council, which includes representatives from OVR, School
districts, and providers to promote and support the Employment First Model as well as
facilitation of student to adult transition reviews.
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The Franklin County Human Services Resources and LINK Access Coordinator works
collaboratively with the PA Career Link office; OVR; United Way; AHEAD; and other vested
service provider organizations to make referrals, connections, and break barriers to help
individuals complete applications; locate resources; make appointments; be prepared for
meetings; better understand the web of processes; obtain documentation; make connections,
etc.
Franklin Together, the County Reentry Coalition made up of numerous stakeholders and
representatives from various fields, remains committed to pursuing local employers to assist
in the engagement of employing returning citizens to the community after incarceration.
Franklin Together has reached out to Parole Officers, Drug Court staff, and judicial officials.
The Outreach Committee has identified transportation as one of the main barriers to
successful employment in rural Franklin County and throughout the upcoming year. The
Committee will also continue to seek creative ideas to help overcome the transportation
barrier.
2. Housing:
The Franklin County Human Services Intellectual and Developmental Disabilities (IDD)
department partners with the County Housing program to support an Independent Living
Apartment program for people living in their own residences who need less than thirty (30)
hours per week of support services. The County subsidizes the rent with base funds and
therefore individuals are able to live in affordable and safer neighborhoods with natural
supports available. There are currently ten (10) individuals participating in this program.
The Healthy Franklin County Policy and Advocacy Committee continues to place affordable
access to housing on its priority list for social determinants of health needs. In 2024, a forum
was created to focus on housing security as a priority issue. Housing remains a top social
determinant of health need as lack of stable housing and rent/mortgage insecurity affect
many other aspects of an individual’s physical and mental health. At the 2024 housing
symposium, attended by many community members, vested stakeholders, and social
service/medical personnel, attendees were asked to create a campaign story in order to build
relationships with policy makers while identifying other ways to leverage and align with
alternative groups. An additional forum, part three, is being developed for 2025/2026 which
will continue efforts to educate others in regard to housing security, the need for additional
housing units, increased resources and support needs. Participants will continue to identify
and discuss gaps, barriers, and needs while making solid plans to begin offering additional
solutions.
A Landlord Summit / Housing meeting will be held in August 2025 at the Coyle Free Public
Library. All landlords, building owners, and other alternative potential housing resource
owners are invited and strongly encourage to attend for education, discussion, networking,
and brainstorming as to what they need to continue to be successful in the County and to
attract others to become key stakeholders for housing resources. The Franklin County
Housing Authority, Franklin County Community Connections, and other housing groups will
all cosponsor and facilitate this get together.
The Community Connections case management staff works through the Coordinated Entry
process with the assistance of multiple housing providers to help ensure a good match for
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individuals in need of housing. There are a few housing options that can be offered through
funds from the Homeless Assistance Program (HAP), Projects for Assistance in Transition
from Homelessness (PATH), Housing and Urban Development (HUD), the Emergency
Solutions Grant (ESG), the PA Housing Finance Agency (PHFA), Home 4 Good, the PA
Affordability and Rehabilitation Enhancement Fund (PHARE), and 8-1-1 Housing. These are
limited options for transitional, master lease, rental assistance, rapid rehousing, and
emergency housing supports. These would be available to individuals and families meeting
housing income and other eligibility criteria. There are tools which are used for assessment
and rating scale purposes.
PART IV: HUMAN SERVICES NARRATIVE
MENTAL HEALTH SERVICES
The discussion in this section should take into account supports and services funded (or to be
funded) with all available funding sources, including state allocations, county funds, federal grants,
Health Choices, reinvestment funds, and other funding.
a) Program Highlights: (Limit of 6 pages)
Please highlight the achievements and other programmatic improvements that have enhanced
the behavioral health service system in FY 24-25.
Franklin County is participating in a Sequential Intercept Mapping (SIM) workshop in September.
The workshop will be facilitated by Policy Research Associates, Inc. (PRA) who are known
internationally for its work regarding adults with mental and substance use disorders who are
involved or at risk for involvement in the criminal justice system.
The mapping workshop will bring together key local criminal justice, behavioral health, and
community stakeholders to identify existing resources for responding to the needs of adults with
mental and substance use disorders who are involved or at risk for involvement in the criminal
justice system, as well as gaps in services and opportunities for cross-system collaboration and
partnerships. The workshop will result in the development of strategies for identifying and diverting
individuals in the target population out of the criminal justice system and connecting them with
community-based treatment providers and support services. It will also include the development of
a map of local systems that illustrates how the target population priorities for change, and action
plans.
The Crisis Intervention Team (CIT) used grant funds to create 300 sensory bags for first
responders to be used during incidents or on scene to help soothe victims and others involved in
the call. These bags have a communication board, a wipe board, sunglasses, noise cancelling
headphones, a fidget spinner, and various other fidgets. As of June, 100 bags have been
distributed within our communities.
Franklin and Fulton Counties court system attended Pennsylvania’s Judicial Summit on Behavioral
Health in October 2024. The purpose of the summit was to foster collaboration between the court
system and the behavioral health field. Each of our counties sent a working team to the summit
that created a strategic plan. Those plans were submitted to the Administrative Office of
Pennsylvania Courts (AOPC) and the committees have continued to meet and work on the plan.
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Healthy Franklin County is a community collaborative using the collective impact model to align
resources and work together to improve the health and well-being of all Franklin County residents.
Over the past twelve (12) years the collaborative has grown and now has over eighty (80)
volunteers representing forty (40) organizations. This past year we added a new task force, United
for Prevention and Recovery, focusing on substance and drug use in our community.
Healthy Franklin County’s Behavioral Health Taskforce coordinated the Tap Talks: Mental Health
Series which featured several speakers/topics including: Dr. Sherri Yoder with Thriving Thoughts
Global on January 15 about destigmatizing mental health and having Grounded Conversations
with 35 in attendance; Dr. Mike Diller with WellSpan Health who spoke about self-care strategies
on February 19 with 25 in attendance; Dr. Ridge Salter with WellSpan Health presented about the
impact of physical activity on mental health on March 19 with 40 people in attendance; Dr. Jose
Ricado-Osorio with Shippensburg University who presented on the benefits of music and dance on
mental health on April 16 with 15 in attendance; Dr. Heidi Hutchison from WellSpan Health
presented about the importance of gut health and nutrition on mental health with 35 in attendance.
The Healthy Franklin County promoted the Move for Mental Health awareness campaign to
increase awareness of the benefits of physical activity as it relates to mental health and to promote
existing community resources, programs and supports. Physical activity has an immediate positive
impact on the brain, reducing stress and anxiety while improving focus and mood and has been
shown to reduce the severity of depression and other mental illness. As part of the campaign,
Healthy Franklin County promotes the Everybody Walks Across Pennsylvania free, 8-week
walking program coordinated by Penn State Cooperative Extension in the spring and the fall. 98
Franklin County residents participated in the fall and spring cohorts logging 4500+ miles. Over the
last year, 457 individuals visited the Move for Mental Health webpage which features a variety of
free, local mental health resources and supports.
Healthy Franklin County supported Suicide Prevention Month & Recovery Month purple light
campaign in September; distributed 988 window clings (240 English / 159 Spanish); creating a new
event to launch in September 13, 2025 at the Waynesboro YMCA – Carnival of Care: Embracing
Mental Health to highlight suicide prevention resources and mental health supports for families in
Franklin County (Summit Endowment approved a grant to pilot the new event which is planned to
continue annually).
The Occupational Services Inc. S.I.T.E.S. Program, (Serving Individuals Transitioning to
Employment Success), was developed to offer post High School Adults with Mental Health
challenges, additional guidance and support than is available through other programs. SITES uses
a holistic approach to work with MH individuals and differs from other programs by specifically
addressing the individual barriers to successful employment. Their approach in working with MH
individuals provides them with the tools necessary to both obtain and maintain long-term
community employment.
The SITES Program focuses on three main learning categories: Life Skills, Social Skills, and Career
Skills. This focus works well together to help provide the often-missing pieces to the long-term
employment puzzle. The most recent SITES Statistics show that what we do is working. Since its
start in 2018, some 80% of those who have participated in and completed the SITES MH Program
have moved on to successful community employment, while only 10% of those who withdrew or did
not complete the program obtained their own job. The Occupational Services Inc. S.I.T.E.S.
Program will continue to be an important key to getting and keeping individuals living with mental
illness more prepared and successfully community employed in the years ahead.
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Keystone Rural Health Center, a Federally Qualified Health Center, is a provider of outpatient
behavioral health services in Chambersburg, PA. In 2024 Keystone served 7, 268 patients with
45,190 patient visits for psychiatry evaluations, medication management and therapy. This includes
43 patients seen for Transcranial Magnetic Stimulation and 13 patients received 142 treatments
with Spravato. They also treated 1,429 individuals with co-occurring drug and alcohol issues with
Medication Assisted Treatment.
They work in tandem with many community organizations including the local Children’s Advocacy
Center to serve 32 children and the Franklin County Jail to provide services to 34 people reentering
the community or being diverted from jail.
Keystone also provides Crisis Intervention services, which include telephone, mobile and walk-in in
addition to the 988 National suicide and Crisis Lifeline. Most services are currently provided in the
hospital, but we are moving to a model that more closely aligns with the national recommendations
for Crisis Intervention. They also would like to expand our 988 provision to include chat and text,
platforms that are so important to our younger generations.
Keystone will be opening a behavioral health walk-in program on July 1. The plan is to have Crisis
available at this location but to also have psychiatric providers available to see the patient when
they come in the door for an evaluation and to begin medication management. Referrals will be
made for follow-up care.
Beginning in February, Keystone Health rolled out a text platform in their health portal that allows
individuals to communicate with the nurses and schedule appointments. This platform increases the
engagement opportunities afforded to those accessing behavioral health services. Data shows that
the behavioral health population is the heaviest users of this platform since the rollout.
TrueNorth Wellness provides a supported living program that has eighteen (18) apartments.
Residents live independently with support staff available 24/7. This past year the program has been
able to reestablish programming as staffing became stable. Some of the offered programs focus on
fitness, nutrition, life lessons, social skills and strategies and activities of daily living.
TrueNorth has a strong belief in community and supporting their neighbors. This summer they
received some of that support themselves when Chick-fil-a employees volunteered at their housing
complex while the store was shut down for remodel. The employees offered their knowledge of
gardening, cleaning and light maintenance.
Shippensburg University Department of Psychology students also teamed with TrueNorth to host a
Recovery Talent Show. Students and residents worked together for several months to put together
a show that allowed individuals to showcase their crafts and hobbies that have proven to aid in their
path of recovery.
Mental Health Association of Franklin and Fulton Counties (MHA) has implemented a Peer
Recovery Resource Center and has two (2) locations, Chambersburg and Waynesboro. These
centers support those with opioid use disorder and any co-occurring substance use disorder or
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mental health conditions. These Centers are offering events and supports to individuals in the
community. Workshops that they have hosted since implementation have focused on anxiety in the
workplace and effective strategies to cope with work-related stress and also a presentation on
mindfulness. They also had an event to celebrate the 80’s. There were prizes for the best dressed,
best hair and best 80’sdance.
Central Pennsylvania Food Bank conducted a community hunger mapping project in Franklin
County. Increased understanding of local food insecurity is a distinct advantage, but this report
sought to do more; its goal was to guide meaningful, lasting improvements in the experiences of
food insecure neighbors and to make progress toward ending hunger in the long term. It discovered
that nearly one (1) resident in eight (8) experienced food insecurity in Franklin County as of 2023.
As a result, the Central Pennsylvania Food Bank has offered several actionable items that can
assist in reducing the food insecurity for Franklin County residents. Increased collaboration among
providers to include pantries, ensuring participation in available programs, and increasing outreach
are a few of those actions recommended in the plan.
Franklin County Jail is implementing a holistic approach within collaboration of other community
agencies which has developed some valuable partnerships fostering positive ReEntry for their
inmates. Working with Keystone Behavioral Health there is now a patient sortal that inmates can
access on the tablets and they can set up an appointment with a personal care physician within
fourteen (14) days of release. Inmates can begin Moral Resonation Therapy (MRT) and complete
the program in the community when released. Medicated Assisted Treatment (MATs) is available to
begin in the jail and then receive a warm hand off to continue in the community. The most recent
success rate of the program is 62%.
New Visions of South-Central PA Inc. was awarded the contract for a new four (4) county
(Cumberland/Perry & Franklin/Fulton) Long Term Structured Residential (LTSR). New Visions will
provide a LTSR environment for adults with serious, chronic mental illness and who require
intensive treatment due to complicating conditions such as involvement with the criminal justice
system, co-existing substance abuse disorders, or physical health conditions. The program will be
designed to provide individualized support and rehabilitation programs to the residents in a single-
room occupancy, shared living space facility. Since some residents may be involuntarily committed
to the facility, it will be equipped with locks on entrances and exits to prevent elopement or
unauthorized access.
Each resident will have an individualized treatment plan developed by the resident and a
multidisciplinary treatment team including persons involved in the resident's larger service plan such
as other service providers, support persons, and family members. The plan will provide each
resident with a comprehensive rehabilitation program that will have as its goal developing and
maintaining maximum independence and self-determination. Anticipated opening date will be mid-
year 2026. This program will be forensically based and will treat mental health in the forensic
population.
One participant’s search for meaningful employment started with AHEDD. Over time, as AHEDD
staff got to know his personality, skills, and goals, AHEDD’s team identified a great job match for
him: a Sales Associate position at Martin’s Food Market.
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Since starting at Martin’s in 2019, he has grown into a confident and dependable employee. His
responsibilities include collecting carts from the parking lot, maintaining a clean work environment,
and ensuring products are properly placed throughout the store. The team at Martin’s knows they
can rely on him to complete his tasks diligently and offer help to anyone in need.
He worked closely with his Employment Specialist at AHEDD to build the skills and confidence
needed to thrive. The Employment Specialist shared, “He has been a great participant! He did the
work to succeed, and no longer needing services is proof that he accomplished his goals.”
While we love supporting our participants, our goal is to help them achieve independence. We are
incredibly proud of him for reaching this milestone and concluding services this year with both
AHEDD and Franklin Fulton MH/IDD/EI. With the experiences he’s gained, we’re confident he will
continue to succeed on his employment journey.
Franklin County Adult Probation has a new 4-legged officer, and he is a golden retriever named
Dudley. His addition to the department reflects their ongoing commitment to evidence-based
supervision strategies. His presence will help build trust, reduce anxiety and strengthen
engagement with the individuals they serve. He will be available in courtrooms as emotional support
as well as in the community when needed.
b) Strengths and Needs by Populations: (Limit of 8 pages #1-11 below)
Please identify the strengths and needs of the county/joinder service system specific to each of
the following target populations served by the behavioral health system. When completing this
assessment, consider any health disparities impacting each population. Additional information
regarding health disparities is available at https://www.samhsa.gov/resource/tta/national-
network-eliminate-disparities-behavioral-health-nned.
1. Older Adults (ages 60 and above)
• Strengths:
Franklin County Older Adults Advocacy Team (FCOAAT) continues to have
monthly meetings and work together to coordinate services for the older adults’
population. The team has representatives from mental health, aging, criminal
justice, community outreach, housing, and others as needed. The team has also
been used for emergency meetings when crisis situations arise.
Mental Health Association provides Senior Reach. Seniors receive at least a
weekly phone call from a trained call specialist. This has proven to be a powerful
tool in the means of reducing stress and preventing loneliness and depression.
There are at least two (2) psychiatrists that specialize in working with older adults.
Keystone Health Services continues to offer a Community Based Clinical Team
made up of a medical assistant and LPN to facilitate telehealth appointments for
individuals 60 or older from their homes.
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• Needs:
There is a continued struggle for a higher level of care for our aging population. It
is difficult to find placement and support for individuals with behavioral health
needs and the available housing support programs are not equipped to offer the
medical and physical supports needed.
More assisted living devices are needed in homes to maintain safety (bars, canes,
canes, walkers, med alert buttons, lifting chairs). More individuals as they are
aging need a variety of surgery and/or devices to maintain health and wellness
(dentures and oral surgery, hearing aids, pacemakers, ankle, shoulder, neck and
hand issues, colonoscopies and the prep that goes along with them). Long term
diabetic issues require dieting and doctoring that many struggle to maintain while
living independently. Weight and blood pressure issues also bring their unique
complications.
Income levels create a limited availability for older adults to find health supported
housing and often creates a financial strain on their families. It can also result in
the individual being placed outside of their community, isolating them from their
support system or even becoming homeless.
According to United States Census (retrieved 7/1/24), Franklin County’s
population consists of 82% over the age of sixty (60). More support is needed for
those with dementia living in the community. It appears that individuals are staying
home longer and need increased in-home support.
2. Adults (ages 18 to 59)
• Strengths:
Tuscarora Managed Care Alliance (TMCA) has a Bridge Rental Subsidy
Supportive Housing Program which assists Medicaid Eligible members to apply
for housing choice vouchers, locate rental properties of the individual’s choice,
maintain landlord relationships and enter leases in the member’s name. The
program will pay rent until the individual becomes eligible for HUD Housing
Choice vouchers. Reinvestment Contingency funds are available for security
deposit and utility deposits. Post placement, supportive living staff are available to
assist the member to maintain housing with activities such as budgeting,
household maintenance, community support linkage and navigation, landlord
relationships and neighbor relationships.
• Needs:
Due to several reasons, our community is struggling with waiting lists for
outpatient counseling. There is a lack of credential counselors for commercial
insurance that has proven a hardship.
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Partial Hospitalization program would provide an appropriate step down from
inpatient treatment and potentially serve as a diversion from inpatient psychiatric
admissions.
Extended Acute Care (EAC) would reduce the number of referrals to Danville
State Hospital and some of the long inpatient stays. Access to this level of
intermediary inpatient psychiatric treatment was lost seven years ago due to Holy
Spirit Hospital’s decision to repurpose the beds in their EAC unit which was
shared by both Cumberland/Perry and Franklin/Fulton. Having access to an EAC
significantly reduced state hospital utilization since many individuals were able to
successfully stabilize so that discharge directly back to the community was a
reality.
Supported living support and guidance to those living individually in the
community especially after stepping down from a higher level of care. It would
include medication oversight, support for all activities of daily living (ADLs)
(cooking, cleaning, money management, grocery shopping). It helps to stabilize
the individual which allows them to work on goals. It is noted that when
individuals do not maintain or have some accountability for medications, trips to
the behavioral health unit are seen, trips to crisis intervention, homelessness,
missed appointments, and less care given to their medical needs all occur. With
Supported Living, supported living specialists can meet with the individual as
needed to maintain a healthy balance in their lives.
3. Transition age Youth (ages 18-26) - Counties are encouraged to include services and
supports assisting this population with independent living/housing, employment, and post-
secondary education/training.
• Strengths:
Peer Support Services are available for transitional age youth.
TMCA has implemented a transition age youth (TAY) Supportive Housing program.
The program is targeted to serve three (3) TAY annually in rental units.
Keystone Pediatric Developmental Center established a Life Skills Center for
individuals aged 12-21 who have injury illness or developmental delays to help
them learn or regain skills for daily living. During individual or group Life Skill
classes their occupational and speech therapists help kids and young adults
develop skills they need to be more independent.
Juvenile Probation is in the process of implementing an independent living
program through Adelphoi to teach adolescents who are involved with Juvenile
Probation needed independent living skills, financial skills, and job skills.
• Needs:
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Due to several reasons, our community is struggling with waiting lists for outpatient
counseling. There is a lack of credentialed counselors for commercial insurances
that have proven to be a hardship.
Once an individual becomes the age of a transitional youth without a serious
mental illness diagnosis the supports and services are no longer available.
For many individuals transitioning into adulthood and independence, there is a
need for support in learning skills for ADLs, to live independently and how to care
for a home that is not available.
4. Children (under age 18) - Please describe your county’s efforts to support children,
youth, and families through home and community-based services. Please be specific in
describing how you believe these efforts will decrease Psychiatric Residential Treatment
Facility utilization.
• Strengths:
AHEDD has a grant for the Transition to Adult Life Services (TALS) program that is
used in Franklin County school districts. The program helps facilitate 11th and 12th
grade students with an Individualized Education Plan (IEP) transition into the
workforce.
Child and Adolescent Service System Program (CASSP) services are available to
all children who are experiencing behavioral/mental health concerns. CASSP
brings families and providers around the table to determine the best services and
support for the child in need.
TMCA offers the following evidence-based practices (EBP) for children: Parent
Child Interactive Therapy (PCIT), Alternative for Families Cognitive Behavioral
Therapy (AF-CBT), Trauma Focused CBT (TF-CBT), Applied Behavioral Analysis,
(ABA), Family Based Mental Health Services (FBMHS), Peer Support Services
School-based mental health counseling services are available in most public
schools in both Franklin and Fulton counties.
Sprouts is a relatively new group treatment program for preschool aged children
experiencing skill deficits and/or developmental delays in areas such as: Cognitive
and Social Interactions, Communication and Language, Play and Daily Living, and
Emotional Regulation and Sensory Difficulties.
Mental Health Association of Franklin/Fulton offers an on-line support group “Safe
Space” for individuals age 14-18 the second Thursday of every month from 6-8pm.
Kidz Therapy Zone offers a respite program to the community to help give parents
a break. They offer two (2) three (3) hour sessions twice a month, which have been
operational for four (4) years and one (1) twelve-hour session per month.
Program Children Served
(Jul-May)
3-hour respite 146
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12-hour respite 21
Unduplicated
number of children served
40
• Needs:
According to Pennsylvania Youth Survey (PAYS), the adolescents in grades 6th,
8th, 10th and 12th grades have reported above the state average for many of the
mental health related questions. It appears that the students are feeling sad,
hopeless and worthless, which are signs of depression. The Community That
Cares coalition will be looking into activities, skills, education and other methods
to increase resilience skills for the youth.
Access to support, activities and environments that foster healthy mental and
emotional wellbeing.
There is a lack of credential counselors for commercial insurance which makes it
difficult for children and adolescents with private insurance to access outpatient
therapy.
Extensive waitlists exist for Intensive Behavioral Health Services which help
children with behaviors that cause difficulties in their lives which can get in the
way of learning and positive family relationships.
Partial Hospitalization program would provide an appropriate step down from
inpatient treatment and potentially serve as a diversion from inpatient psychiatric
admissions.
There are no Community Rehabilitation Residentials available within our
community and very few across the state for children or adolescents to utilize
before placement at a Residential Treatment Facility.
Please identify the strengths and needs of the county/joinder service system (including any health
disparities) specific to each of the following special or underserved populations. If the county does
not currently serve a particular population, please indicate and note any plans for developing
services for that population.
5. Individuals transitioning from state hospitals
• Strengths:
Service Access & Management, Inc (SAM) has an assigned case manager that
functions as the Danville State Hospital liaison. The liaison monitors the status of
individuals at the state hospital and connects them with services in the community
when they are ready for discharge. The social workers at the state hospital
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County of Franklin - Human Services Plan 2025-2026
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communicate well and make sure that the person has completed their Medicaid
application and other necessary paperwork, etc. prior to discharge.
Community based services that are available include outpatient, peer specialist,
and housing supports to mention a few.
Franklin and Fulton Counties have active Community Support Programs (CSP).
The monthly meeting consists of an educational component as well as community
news. It is offered as a hybrid meeting, so folks can attend virtually or in person.
• Needs:
More supportive housing with assistance for transitioning back to the community.
Our county lost access to an extended acute care setting several years ago and
has not had any success in securing a contract with any providers to regain
access for our community residents. This level of care would prove helpful in both
as a step down from the state hospital and from a diversionary perspective.
6. Individuals with co-occurring mental health/substance use disorder
• Strengths:
Franklin County has an active task force committee, United for Recovery and
Prevention, that has just undergone a revitalization. The task force is an entity of
Healthy Franklin County and compromise of members representing mental health,
substance use, prevention programs, EMS, county government, provider
agencies and others. Currently the strategic goals are focusing on reducing early
deaths from substance use, strengthening overdose prevention, enhancing
prevention programs, improving systems of care, supporting housing and
employment, promoting family support and reducing stigma and isolation.
Mental Health Association of Franklin and Fulton Counties (MHA) has
implemented a Peer Recovery Resource Center and has two (2) locations. These
centers support those with opioid use disorder and any co-occurring substance
use disorder or mental health conditions. These Centers are offering events and
supports to individuals in the community.
Franklin County has two (2) dually licensed outpatient providers. Pennsylvania
Counseling Services has a location in downtown Chambersburg and Pyramid
Healthcare has two (2) locations in one (1) in Chambersburg as well as
Waynesboro.
• Needs:
Providing outpatient treatment to individuals with co-occurring mental health and
substance use disorders remains a complex undertaking. Local providers holding
both mental health and substance use licenses continue to struggle with hiring
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and retaining qualified professionals who can effectively serve this population. As
a result, delays in access to services, particularly psychiatric medication
management and therapeutic supports—are common. Additionally, many
outpatient mental health programs do not incorporate evidence-based, FDA-
approved medications for substance use or opioid use disorders, often leading to
fragmented care that addresses mental health needs without simultaneously
treating substance-related issues.
7. Criminal justice-involved individuals - Counties are encouraged to collaboratively
work within the structure of County Criminal Justice Advisory Boards (CJABs) to
implement enhanced services for individuals involved with the criminal justice system
including diversionary services that prevent further involvement with the criminal justice
system as well as reentry services to support successful community reintegration.
• Strengths:
Franklin County added a co-responder inside our court system to increase our
diversion opportunities. The idea is to divert individuals at their preliminary
hearings if they need support from the human services system. The co responder
will also work with individuals involved with adult and juvenile probation to divert
from future involvement with the criminal justice system.
Franklin County CJAB will be participating in a SIM mapping workshop in
September of 2025 that will result in the updating of our local systems map that
illustrates how the target population encounters and moves through the criminal
justice system, as well as recommendations, local priorities for change, and action
plans.
Franklin County Jail is implementing a holistic approach to ReEntry. The jail’s role
in the approach uses assessments, individual treatment plans, a ReEntry
committee, focus on mental health, medical and religious needs. This is all done
in collaboration with other agencies within the community.
Franklin Together, ReEntry Coalition, has many resources available to returning
citizens due to the vast volunteers and agencies committed to Franklin Together.
Peer facilitated support group, personal hygiene and cleaning products, care
packs and interview and employment ready skills just to name a few.
• Needs:
Franklin Together conducted a survey of inmates and returning citizens regarding
barriers to successful ReEntry and here are a few of the common findings.
Housing, employment, support system and transportation.
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8. Veterans - counties are encouraged to collaboratively work with the Veterans
Administration and the PA Department of Military and Veterans Affairs (DMVA) and county
directors of Veterans Affairs (found at the site):
https://www.pa.gov/agencies/dmva/pennsylvania-veterans/county-director-of-veterans-
affairs.html
• Strengths:
Veterans Affairs office in collaboration with the Central PA Food Bank offers a
Military Share program twice (2) a month which allows Veterans, and their families
access to food such as meat, dairy, fresh produce and dry goods. Current
enrollment in the Military Share Program totals 633 households, serving 1,342
individuals. Included in the 1,342 number of people served, 871 individuals are
above the age of 60.
As reported through the Pennsylvania Department of Military and Veterans
Affairs, Franklin County Veterans Affairs Office processed 15,155 claims between
July 2024 and May 2025 resulting in a total of $29,821,883.58 claim dollars being
awarded to Franklin County Veterans.
• Needs:
Available housing options for homeless Veterans are limited. Many homeless
Veterans suffer from mental health disorders but have not properly been
diagnosed due to the transient nature of their circumstances. The lack of housing
and stability limits their ability to achieve qualifying disability ratings through
Veterans Affairs which would provide a source of stable income and increase their
ability to self-support in a stable environment.
9. Lesbian/Gay/Bisexual/Transgender/Questioning/Intersex (LGBTQI)
• Strengths:
THRIVE is a support group hosted by MHA continues to meet monthly. It
continues to grow and be a needed support in our community.
PRIDE is a program of the Franklin County Coalition for Progress, a nonprofit
striving to advance social justice and equality for all. They are continuing to host
the PRIDE festival in October.
• Needs:
Stigma continues to be an issue within the community.
10. Racial/Ethnic/Linguistic Minorities (RELM) including individuals with Limited
English Proficiency (LEP)
• Strengths:
A few of our mental health outpatient providers have been able to secure bilingual
staff that is able to provide clinical services to individuals speaking Spanish.
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WellSpan and Keystone medical facilities have access to a system that connects
a live translator on a computer screen to assist during appointments.
Franklin County does have a Hispanic Center that is active and collaborates with
human services.
Franklin County has contracted with their own interpretation and translation
services called Propio to better assist in communicating with individuals who
speak a language other than English.
• Needs:
Access to more bilingual professional staff is a need in our community. We have
recognized that there are several dialects of Spanish in our community.
More providers with access to language line or assistance with interpretations
services.
Cultural education and understanding of those living in our community.
11. Other populations, not identified in #1-10 above (if any, specify) (including tribal
groups, people living with HIV/AIDS or other chronic diseases or impairments, acquired
brain injury (ABI), fetal alcohol spectrum disorders (FASD), or any other groups not listed)
• Strengths:
Keystone Health Services provides community outreach services which bring HIV
education, risk assessment, and testing to individuals and groups in the
community. Their education program is designed to accommodate the diversity of
our community. They tailor the presentations to meet the needs of the audience,
focusing on making education an interactive experience with an open dialogue of
questions and answers. Their goal is to share scientifically proven information that
will dispel the myths and misinformation about HIV/AIDS. Education can take
place in churches, schools, workplaces, housing developments, clinics, hospitals,
colleges, businesses, health fairs, newspapers, and on radio and television. They
partner with local organizations to provide an education and/or testing event. The
services are free for both hosting organizations and participants.
Keystone Health Services is now the sole grantee in Pennsylvania providing
services to migrant agricultural workers across the Commonwealth. The
Agricultural Worker Program operates seasonally. In addition to service sites,
health care workers go into migrant camps to provide basic health care and
assess the need for further treatment. When needed, vans bring migrants and
their families to the service sites.
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• Needs:
Support for individuals and families affected by traumatic brain injury living in our
community.
Support for individuals and families affected by fetal alcohol syndrome living within
our communities.
c) Recovery-Oriented Systems Transformation (ROST): (Limit of 5 pages)
i. Previous Year List:
Priority Narrative Action Steps Timeline Progress Made
1. Crisis
Intervention
Service
system
(☒
Continuing
from prior
year ☐ New
Priority)
a. Mental Health
secured grant
funding for a
crisis system
assessment and
for
implementation
toward the
SAMHSA best
practice model
Data analysis, focus
groups, stakeholder
meetings
June 2025 The committee
continues to put
together a plan
for a crisis
system that will
serve our 2
counties. It is a
struggle without
the regulations.
2. Increase
access to
high quality
mental
health care
(☐
Continuing
from prior
year ☒ New
Priority)
a. Increase
awareness and
availability of
mental health
resources
i. MH will purchase
license agreement
with PESI, for training
and consider other
training as they
become available
continual MH purchased 3
courses. The
subjects were
trauma, geriatric
and youth.
QPR, Mental
Health First Aid,
Too Good for
Drugs are just a
few provided in
the communities.
ii. Provide training and
support for local
community to include:
business, neighbors,
providers etc.
continual
b. Promote
mental health
prevention,
treatment
resources and
tools that can be
used without
clinical support.
i. Promote Move for
Mental Health
campaign
ii. Promote Everybody
Walk Across PA in fall
and spring
iii. Promote Thriving
Thoughts Global
Grounded Events
(third Thursday)
Promote
campaign
messages
through digital
messaging and
word of mouth.
ii. Continue and
expand existing
community campaigns
that educate the public
about effective ways
Promote
campaigns
through health
fairs and
messaging.
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County of Franklin - Human Services Plan 2025-2026
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to manage mental
wellness.
iii. Develop a model
for integrating
behavioral health
services, training and
resources into Primary
Care offices to include
education for special
populations such as
older adults, TBI, fetal
alcohol syndrome, and
LGBTQI.
Little to no
progress on this
goal
3. Housing
placements
and
supportive
services
needed for
individuals
with intense
behaviors
(☒
Continuing
from prior
year ☐ New
Priority)
a. Housing need
for our mental
health forensic
population
i. Working with
Cumberland/Perry
County to create a
partnership for a 16
bed LTSR
Project is under
contract and
provider is
working with
architects to
begin plans for
the building. The
land has been
purchased.
ii. Coming Year List:
o Based on Section b Strengths and Needs by Populations, please identify the top
three (3) to five (5) ROST priorities the county plans to address in FY 25-26 at
current funding levels.
o For each coming year (FY 25-26) ROST priority, please provide:
a. A brief narrative description of the priority including action steps for the current fiscal year.
b. A timeline to accomplish the ROST priority including approximate dates for progress steps and
priority completion in the upcoming fiscal year.
o Timelines which list only a fiscal or calendar year for completion are not acceptable and
will be returned for revision.
c. Information on the fiscal and other resources needed to implement the priority. How much the
county plans to utilize from state allocations, county funds, grants, Health Choices,
reinvestment funds, other funding and any non-financial resources.
d. A plan mechanism for tracking implementation of the priorities.
o Example: spreadsheet/table listing who, when and outputs/outcomes
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County of Franklin - Human Services Plan 2025-2026
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Priority Narrative Action
Steps Timeline Resources
Needed Tracking
Mechanism
1. Crisis
Intervention
Service system
(☒ Continuing
from prior year
☐ New Priority)
a. Mental Health
Managed Care,
D&A are working
to move our
crisis system
toward the
SAMHSA best
practice model
Create a working
plan of a
sustainable crisis
system for our
county joinder.
June 2026 Computers,
phones, GPS
tracking system,
vehicle and this
will be adjusted
as plan is
created.
This is monitored
through
Franklin/Fulton
County
MH/IDD/EI,
TMCA, DHS Waiting for the
crisis regulations
in order to
implement into our
system.
2. Increase
access to high
quality mental
health care
(☒ Continuing
from prior year
☐ New Priority)
a. Increase
awareness and
availability of
mental health
resources
i. MH will
purchase license
agreement with
PESI, for training
and consider
other training as
they become
available
continual
$3,000
$500
This is
monitored
through the
Franklin/Fulton
County
MH/IDD/EI.
ii. Provide training
and support for
local community
to include:
business,
neighbors,
providers etc.
continual
b. Promote
mental health
prevention,
treatment
resources and
tools that can be
used without
clinical support.
i. Promote Move
for Mental Health
campaign
ii. Promote
Everybody Walk
Across PA in fall
and spring
iii. Promote
Thriving Thoughts
Global Grounded
Events (third
Thursday)
$6,500 This is monitored
through the MH
task force and
Healthy Franklin
County.
ii. Continue and
expand existing
community
campaigns that
educate the public
about effective
ways to manage
mental wellness.
Walk the Walk /
Carnival of Care
$1,500 This is
monitored
through
Chambersbu
rg Cares, the
MH task
force and
Health
Franklin
County.
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County of Franklin - Human Services Plan 2025-2026
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3. Housing
placements
and supportive
services
needed for
individuals with
intense
behaviors
(☒ Continuing
from prior year
☐ New
Priority)
a. Housing need
for our mental
health forensic
population
i. In partnership
with
Cumberland/Perr
y County MH/ID,
we have secured
a provider of the
LTSR. We are
working in
conjunction with
architects to
create blueprints
and then begin
building.
June 2026 The needed funds
will be determined
during action
steps.
This is monitored
through
Franklin/Fulton
MH/IDD/EI,
Cumberland/Perry
MH/ID and DHS
d) Strengths and Needs by Service Type: (#1-7 below)
1. Describe telehealth services in your county (limit of 1 page):
a. How is telehealth being used to increase access to services?
Keystone Behavioral Health is contracting with a telehealth service that allows the
extension of available hours and access to credential staffed that increases the
commercial insurance companies allowing more individuals access.
Wellspan is utilizing telehealth in the behavioral health unit to access psychiatric services
for patients.
Many providers have access to telehealth inside their own offices. Individuals with
interest can arrange their services via telehealth if they choose.
b. Is the county implementing innovative practices to increase access to telehealth for
individuals in the community? (For example, providing technology or designated spaces
for telehealth appointments)
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Currently, there is not a plan to increase access; however, it is being considered during
our new crisis system implementation. There is a project is place trying to increase the
access but not yet completed.
c. What are the obstacles the county encounter in the deployment of telehealth services?
(limited access to reliable internet, digital literacy, privacy concerns, and cultural and
language barriers).
Being a rural community, there are still areas that do not have access to and reliable
internet.
2. Is the county seeking to have service providers embed trauma informed care
initiatives (TIC) into services provided?
☐ Yes ☒ No
If yes, please describe how this is occurring. If no, indicate any plans to embed TIC in FY
25-26. (Limit of 1 page)
Franklin/Fulton County MH/IDD/EI continues to update the links on its website to trauma
informed resources. They also offer training throughout the year that focuses on trauma and
offer continuing education credits (CEUs) to our provider system.
PerformCare sponsored a trauma informed training session this past year.
3. Is the county currently utilizing Cultural and Linguistic Competence (CLC) Training?
☐ Yes ☒ No
If yes, please describe the CLC training being used, including training content/topics
covered, frequency with which training is offered, and vendor utilized (if applicable). If no,
counties may include descriptions of plans to implement CLC trainings in FY 25-26. (Limit
of 1 page)
Individual agencies have cultural competence training as an annual mandate. However,
there is nothing in place across the county. Healthy Franklin County’s Health Disparities
Task Force has addressed cultural competence within their three (3) year plan. (see below)
4. Are there any Diversity, Equity, and Inclusion (DEI) efforts that the county has
completed to address health inequities?
☒ Yes ☐ No
If yes, please describe the DEI efforts undertaken. If no, indicate any plans to implement
DEI efforts in FY 25-26. (Limit of 1 page)
Narrative: Advancing Equity Through Community Collaboration – Year 3 of the Health
Disparities CHIP
In Year Three of the 2022–2025 Community Health Improvement Plan, the focus on
reducing health disparities have intensified through a multi-pronged strategy aimed at
increasing access to care, enhancing cultural competency, and strengthening public health
infrastructure. The plan, spanning July 2024 to June 2025, outlines a series of coordinated
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County of Franklin - Human Services Plan 2025-2026
29
efforts led by a diverse coalition of community-based organizations (CBOs), public health
leaders, and advocacy groups.
Expanding Access Through Technology and Navigation Support
A cornerstone of this year’s strategy is the implementation of the closed-loop referral
system, FindHelp (locally branded as HereToHelpAll.org and PA Navigate). This tool is
being rolled out among CBOs to streamline referrals and ensure follow-through. Early efforts
have focused on assessing organizational readiness and providing outreach support.
Complementing this, professional development programs for community health workers,
navigators, and case managers are being delivered to enhance their ability to connect at-
risk populations with care. Sessions have included topics such as behavioral health access,
immigrant community engagement, and self-care practices.
Addressing Social Determinants of Health (SDOH)
The plan also supports innovative programs targeting SDOH, particularly housing. A
standout achievement is a 98% success rate in transitioning individuals from homelessness
to housing, largely supported by Keystone’s resources. Community Navigator programs are
being expanded, with updates expected in October 2024.
Civic engagement is another priority, with the Franklin Votes initiative working to increase
voter participation among low-income, youth, and minority populations. Events like town
festivals and webinars are being used to distribute materials and register voters.
Policy Advocacy and Infrastructure Monitoring
The Health Disparities Task Force is actively identifying policy and advocacy opportunities
to address systemic inequities. This includes advising on the PERU Arnold Ventures Project
and contributing to the Franklin County DA’s racial justice grant. Forums and reports are
being used to track progress and shape recommendations.
Infrastructure monitoring is also underway, with a focus on housing gaps, broadband
access, and emergency shelter needs. Data from FindHelp and qualitative insights from
practitioners are being leveraged to inform these assessments.
Enhancing Health Literacy for Immigrant Communities
Recognizing the barriers faced by individuals with limited English proficiency (LEP), the plan
includes a robust strategy to improve health literacy and cultural competency. The
Immigrant Services Work Group is updating its action plan and exploring models for a
potential Welcome Center. Workshops and outreach materials are being developed to
support immigrant families, informed by a 2022 survey that highlighted gaps in language
access and community engagement.
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5. Does the county currently have any suicide prevention initiatives which addresses all
age groups?
☒ Yes ☐ No
If yes, please describe the initiatives and any age-specific initiatives. If no, counties may
describe plans to implement future initiatives in the coming fiscal year. (Limit of 1 page)
Yes, ours is a three (3) plan:
Goal 1: Educate, train, and
provide resources directed
toward youth to help
reduce the number of
suicide deaths and suicidal
ideation.
Objective 1.1: Provide suicide
prevention training for the local
middle/high schools for staff,
students, and parents.
Objective 1.2: Identify teen/youth-
specific informational material
that can be handed out during
youth events.
Objective 1.3: Identify and attend
events that are specifically
marketed for youth and their
families to hand out information.
Objective 1.4: Identify and be
trained in youth-specific suicide
prevention trainings so they may
be offered to the community.
The coalition will hold a
minimum of 3 QPR training
sessions a year to the
local middle/high schools.
The coalition will attend at
least 2 events a year that
are specifically targeted
toward youth and their
families to hand out
information.
The coalition will be
trained in and be able to
offer youth-specific suicide
prevention training.
Goal 2: Educate, train, and
provide resources to help
reduce the number of
suicide deaths in the 18-35
age category.
Objective 2.1: Provide suicide
prevention training for the local
colleges’ students and staff.
Objective 2.2: Work with local
universities to distribute
resources and information
regarding suicide.
Objective 2.3: Provide suicide
prevention training to different
businesses that employ 18–35-
year-olds.
The coalition will conduct
at least 3 suicide
prevention training
sessions for the local
colleges each year.
The coalition will work with
local university staff to
distribute resources twice
a year.
The coalition will provide at
least 4 suicide prevention
training sessions a year to
local businesses.
Goal 3: Reduce access to
lethal means
Objective 2.1: Collaborate with
the DA and police on drug
takeback programs.
Objective 2.2: Partner with local
gun stores to provide safety locks
and offer information on limiting
access to lethal means.
The coalition will establish
collaboration with the
DA/police for drug take-
back programs within two
years.
The coalition will create a
flyer that includes suicide
prevention resources that
can be provided to local
gun shops.
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6. Individuals with Serious Mental Illness (SMI): Employment Support Services
The Employment First Act (Act of Jun. 19, 2018,P.L 229, No 36 Cl. 35 EMPLOYMENT
FIRST ACT ENACTMENT, 2018) requires county agencies to provide services to support
competitive integrated employment for individuals with disabilities who are eligible to work
under federal or state law. For further information on the Employment First Act, see
Employment-First-Act-three-year-plan.pdf (pa.gov)
a. Please provide the following information for your County MH Office Employment
Specialist single point of contact (SPOC).
Name: Jim Gilbert
Email address: jgilbert@franklincountypa.gov
Phone number: 717-264-5387
b. Please indicate if the county Mental Health office follows the SAMHSA Supported
Employment Evidence Based Practice (EBP) Toolkit:
☐ Yes ☒ No
Please complete the following table for all supported employment services provided to only
individuals with a diagnosis of Serious Mental Illness (SMI), defined as persons age 18 and
over, who currently or at any time during the past year, have had a diagnosable mental,
behavioral or emotional disorder that is listed in the current DSM that has resulted in
functional impairment, which substantially interfere with or limits one more major life
activities.
Previous Year: FY 24-25 County Supported Employment Data for ONLY Individuals with Serious
Mental Illness
• Please complete all rows and columns below
• If data is available, but no individuals were served in a category, list as zero (0)
• Only if no data available for a category, list as N/A and provide a brief narrative explanation.
Include additional information for each population served in the Notes section. (For example, 50% of
the Asian population served speaks English as a Second Language, or number served for ages 14-21
includes juvenile justice population).
Data Categories County MH
Office
Response
Notes
i. Total Number Served 94
ii. # served ages 14 up to 21 14
iii. # served ages 21 up to 65 80 3 are 65+
iv. # of male individuals served 47
v. # of female individuals served 47
vi. # of non-binary individuals served 0
vii. # of Non-Hispanic White served 66
viii. # of Hispanic and Latino served 6
ix. # of Black or African American served 6
x. # of Asian served 1
xi. # of Native Americans and Alaska Natives served 0
xii. # of Native Hawaiians and Pacific Islanders served 0
xiii. # of multiracial (two or more races) individuals served 3
xiv. # of individuals served who have more than one disability 21
xv. # of individuals served working part-time (30 hrs. or less per wk.) 17
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County of Franklin - Human Services Plan 2025-2026
32
xvi. # of individuals served working full-time (over 30 hrs. per wk.) 12
xvii. # of individuals served with lowest hourly wage (i.e.: minimum
wage)
0
xviii. # of individuals served with highest hourly wage 29 $9.50
lowest
wage
xix. # of individuals served who are receiving employer offered
benefits (i.e., insurance, retirement, paid leave)
2
7. Supportive Housing:
a. Please provide the following information for the County MH Office Housing
Specialist/point of contact (SPOC).
Name: Jennifer Hutchinson
Email address: jchutchinson@franklincountypa.gov
Phone number: 717-264-5387
b. Please indicate if the county Mental Health office follows the SAMHSA Permanent
Supportive Housing Evidence-Based Practices toolkit:
X Yes ☐ No
DHS’ five-year housing strategy, Supporting Pennsylvanians Through Housing is a
comprehensive plan to connect Pennsylvanians to affordable, integrated and supportive
housing. This comprehensive strategy aligns with the Office of Mental Health and Substance
Abuse Services (OMHSAS) planning efforts, and OMHSAS is an integral partner in its
implementation.
Supportive housing is a successful, cost-effective combination of affordable housing with
services that help people live more stable, productive lives. Supportive housing works well
for people who face the most complex challenges—individuals and families who have very
low incomes and serious, persistent issues that may include substance use, mental illness,
and HIV/AIDS; and may also be, or at risk of, experiencing homelessness.
c. Supportive Housing Activity to include:
• Community Hospital Integration Projects Program funding (CHIPP)
• Reinvestment
• County Base funded
• Other funded and unfunded, planned housing projects
i. Please identify the following for all housing projects operationalized in SFY 24-25 and
25-26 in each of the tables below:
• Project Name
• Year of Implementation
• Funding Source(s)
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County of Franklin - Human Services Plan 2025-2026
33
ii. Next, enter amounts expended for the previous state fiscal year (SFY 24-25), as well
as projected amounts for SFY 25-26. If this data isn’t available because it’s a new
program implemented in SFY 25-26, do not enter any collected data.
• Please note: Data from projects initiated and reported in the chart for SFY 25-
26 will be collected in next year’s planning documents.
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County of Franklin - Human Services Plan 2025-2026
34
1. Capital Projects for Behavioral Health Check box ☐ if available in the county and complete the section.
Capital financing is used to create targeted permanent supportive housing units (apartments) for consumers, typically, for a 15–30-
year period. Integrated housing takes into consideration individuals with disabilities being in units (apartments) where people
from the general population also live (i.e., an apartment building or apartment complex).
1. Project Name 2. Year of
Implementation
3. Funding
Sources by
Type (Including
grants, federal,
state & local
sources)
4. Total
Amount for
SFY 24-25
(only County
MH/ID
dedicated
funds)
5. Projected
Amount for SFY
25-26 (only
County MH/ID
dedicated
funds)
6. Actual or
Estimated
Number Served
in SFY 24-25
7. Projected
Number to be
Served in SFY
25-26
8. Number of
Targeted BH
United
9. Term of
Targeted BH
Units (e.g., 30
years)
Totals
Notes:
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County of Franklin - Human Services Plan 2025-2026
35
2. Bridge Rental Subsidy Program for Behavioral
Health
Check box ☐ if available in the county and complete the section.
Short-term tenant-based rental subsidies, intended to be a “bridge” to more permanent housing subsidy such as Housing Choice
Vouchers.
1. Project
Name
2. Year of
Implementation
3. Funding
Sources by
Type (include
grants, federal,
state & local
sources)
4. Total $
Amount for
SFY 24-25
5. Projected
$ Amount
for SFY 25-
26
6. Actual or
Estimated
Number
Served in
SFY 24-25
7. Projected
Number to
be Served in
SFY 25-26
8. Number
of Bridge
Subsidies in
SFY
9. Average
Monthly
Subsidy
Amount in
SFY 24-25
10. Number of
Individuals
Transitioned to
another
Subsidy in
SFY 24-25
Housing
Development
Plan (HC
Reinvestment
)
2022 Reinvestmen
t
$19,700.0
0
$25,000.0
0
6 15 29 $650.00 2
Totals $19,700.0
0
$25,000.0
0
6 15 29 $650.00 2
Notes:
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County of Franklin - Human Services Plan 2025-2026
36
3. Master Leasing (ML) Program for Behavioral
Health
Check box ☐ if available in the county and complete the section.
Leasing units from private owners and then subleasing and subsidizing these units to consumers.
1. Project Name 2. Year of
Implementation
3. Funding
Source by
Type (include
grants,
federal, state
& local
sources)
4. Total $
Amount for
SFY 24-25
5. Projected
$ Amount
for SFY 25-
26
6. Actual or
Estimated
Number
Served in
SFY 24-25
7. Projected
Number to
be Served in
SFY 25-26
8. Number of
Owners/
Projects
Currently
Leasing
9. Number of
Units
Assisted with
Master
Leasing in
SFY 24-25
10. Average
Subsidy
Amount in
SFY 24-25
Totals $0.00 $0.00 $0.00 0 0 0 0 0
Notes:
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County of Franklin - Human Services Plan 2025-2026
37
4. Housing Clearinghouse for Behavioral Health Check box ☐ if available in the county and complete the section.
An agency that coordinates and manages permanent supportive housing opportunities.
1. Project Name 2. Year of
Implementation
3. Funding
Source by
Type
(include
grants,
federal, state
& local
sources)
4. Total $
Amount for
SFY 24-25
5. Projected $
Amount for SFY
25-26
6. Actual or
Estimated
Number Served
in SFY 24-25
7. Projected
Number to be
Served in SFY 25-
26
8. Number of
Staff FTEs in
SFY 24-25
Totals $0.00 $0.00 $0.00 0 0 0
Notes:
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County of Franklin - Human Services Plan 2025-2026
38
5. Housing Support Services (HSS) for Behavioral
Health
Check box ☐ if available in the county and complete the section.
HSS are used to assist consumers in transitions to supportive housing or services needed to assist individuals in sustaining their
housing after move-in.
1. Project
Name
2. Year of
Implementation
3. Funding
Sources by
Type
(include
grants,
federal,
state & local
sources)
4. Total $
Amount for
SFY 24-25
5. Projected $
Amount for
SFY 25-26
6. Actual or
Estimated Number
Served in SFY 24-
25
7. Projected
Number to be
Served in SFY
25-26
8. Number of
Staff FTEs in
SFY 24-25
PATH 2005 Federal $54.558.00 $54,448.00
$18,186.00
40 40 1
State $18,186.00
Housing
Development
(HC
reinvestment
Plan)
2022 reinvestmen
t
$185,279.00 $$250,000.00 67 70 4
Totals $258,023.00 $322,634.00 107 110 5
Notes:
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County of Franklin - Human Services Plan 2025-2026
39
6. Housing Contingency Funds for Behavioral Health Check box ☐ if available in the county and complete the section.
Flexible funds for one-time and emergency costs such as security deposits for apartment or utilities, utility hook-up fees,
furnishings, and other allowable costs.
1. Project Name 2. Year of
Implementation
3. Funding
Sources by
Type
(include
grants, federal,
state & local
sources)
4. Total $
Amount for SFY
24-25
5. Projected $
Amount for SFY
25-26
6. Actual or
Estimated
Number
Served in SFY
24-25
7. Projected
Number to be
Served in SFY
25-26
8. Average
Contingency
Amount per
person
Housing
Development
2022 Reinvestmen
t
$9,408.00 $15,000.00 23 30 $392.00
Totals $9,408.00 $15,000.00 23 30 $392.00
Notes:
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County of Franklin - Human Services Plan 2025-2026
40
7. Other: Identify the Program for Behavioral Health Check box ☐ if available in the county and complete the section.
Project Based Operating Assistance (PBOA) is a partnership program with the Pennsylvania Housing Finance Agency in which the county
provides operating or rental assistance to specific units then leased to eligible persons; Fairweather Lodge (FWL) is an Evidenced-Based
Practice where individuals with serious mental illness choose to live together in the same home, work together and share responsibility for daily
living and wellness; CRR Conversion (as described in the CRR Conversion Protocol), other.
1. Project Name
(include type of
project such as
PBOA, FWL, CRR
Conversion, etc.)
2. Year of
Implementation
3. Funding
Sources by Type
(include grants,
federal, state &
local sources)
4. Total $
Amount for SFY
24-25
5. Projected $
Amount for SFY 25-
26
6. Actual or
Estimated Number
Served in SFY 24-
25
7. Projected Number
to be Served in SFY
25-26
Housing
Expansion
2005 State Match $19,949.00 $25,000.00 2 2
Totals $19,949.00 $25,000.00 2 2
Notes: DRAFTDRAFT
County of Franklin - Human Services Plan 2025-2026
41
e. Certified Peer Specialist Employment Survey:
Certified Peer Specialist (CPS) is defined as:
An individual with lived mental health recovery experience who has received the
Department approved peer services training and certified by the Pennsylvania
Certification Board.
In the table below, please include CPSs employed in any mental health service in the
county/joinder including, but not limited to:
• case management • HealthChoices peer support programs
• inpatient settings • consumer-run organizations
• psychiatric rehabilitation centers • residential settings
• intensive outpatient programs • ACT or Forensic ACT teams
• drop-in centers
County MH Office CPS Single Point
of Contact (SPOC)
Name: Jim Gilbert
Email: jgilbert@franklincountypa.gov
Phone number: 717-264-5387
Total Number of CPSs Employed 23
Average number of individuals
served (ex: 15 persons per peer, per
week)
24
Number of CPS working full-time (30
hours or more) 2
Number of CPS working part-time
(under 30 hours) 20
Hourly Wage (low and high), seek
data from providers as needed $14.57hr / $21.60/hr
Benefits, such as health insurance,
leave days, etc. (Yes or No), seek data
from providers as needed
Yes
Number of New Peers Trained in CY
2024 7
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County of Franklin - Human Services Plan 2025-2026
42
f. Existing County Mental Health Services
Please indicate all currently available services and the funding source(s) utilized.
Services by Category Currently
Offered
Funding Source (Check all that
apply)
Outpatient Mental Health ☒ ☒ County ☒ HC ☒ Reinvestment
Psychiatric Inpatient Hospitalization ☒ ☐ County ☒ HC ☐ Reinvestment
Partial Hospitalization - Adult ☒ ☐ County ☒ HC ☐ Reinvestment
Partial Hospitalization - Child/Youth ☒ ☐ County ☒ HC ☐ Reinvestment
Family-Based Mental Health Services ☒ ☒ County ☒ HC ☐ Reinvestment
Assertive Community Treatment (ACT) or
Community Treatment Team (CTT)
☐ ☐ County ☐ HC ☐ Reinvestment
Children’s Evidence-Based Practices ☒ ☐ County ☒ HC ☐ Reinvestment
Crisis Services ☒ ☒ County ☒ HC ☐ Reinvestment
Telephone Crisis Services
Walk-in Crisis Services ☒ ☒ County ☒ HC ☐ Reinvestment
Mobile Crisis Services ☒ ☒ County ☒ HC ☐ Reinvestment
Crisis Residential Services ☐ ☐ County ☐ HC ☐ Reinvestment
Crisis In-Home Support Services ☐ ☐ County ☐ HC ☐ Reinvestment
Emergency Services ☒ ☒ County ☐ HC ☐ Reinvestment
Targeted Case Management ☒ ☒ County ☒ HC ☐ Reinvestment
Administrative Management ☒ ☒ County ☐ HC ☐ Reinvestment
Transitional and Community Integration Services ☐ ☐ County ☐ HC ☐ Reinvestment
Community Employment/Employment-Related Services ☒ ☒ County ☐ HC ☐ Reinvestment
Community Residential Rehabilitation Services ☒ ☒ County ☐ HC ☐ Reinvestment
Psychiatric Rehabilitation ☐ ☐ County ☐ HC ☐ Reinvestment
Children’s Psychosocial Rehabilitation ☐ ☐ County ☐ HC ☐ Reinvestment
Adult Developmental Training ☐ ☐ County ☐ HC ☐ Reinvestment
Facility-Based Vocational Rehabilitation ☒ ☒ County ☐ HC ☐ Reinvestment
Social Rehabilitation Services ☒ ☒ County ☐ HC ☐ Reinvestment
Administrator’s Office ☒ ☒ County ☐ HC ☐ Reinvestment
Housing Support Services ☒ ☒ County ☐ HC ☒ Reinvestment
Family Support Services ☒ ☒ County ☒ HC ☐ Reinvestment
Peer Support Services ☒ ☒ County ☒ HC ☐ Reinvestment
Consumer-Driven Services ☒ ☒ County ☐ HC ☐ Reinvestment
Community Services ☒ ☒ County ☐ HC ☐ Reinvestment
Mobile Mental Health Treatment ☒ ☐ County ☒ HC ☐ Reinvestment
Behavioral Health Rehabilitation Services for Children and
Adolescents
☒ ☐ County ☒ HC ☐ Reinvestment
Inpatient Drug & Alcohol (Detoxification and
Rehabilitation)
☒ ☒ County ☒ HC ☐ Reinvestment
Outpatient Drug & Alcohol Services ☒ ☒ County ☒ HC ☐ Reinvestment
Methadone Maintenance ☒ ☐ County ☒ HC ☐ Reinvestment
Clozapine Support Services ☒ ☐ County ☒ HC ☐ Reinvestment
Additional Services (Specify – add rows as needed) ☐ ☐ County ☐ HC ☐ Reinvestment
Note: HC= HealthChoice
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DHS Bulletin 2025-01
County Human Services Plan Guidelines
43
g. Evidence-Based Practices (EBP) Survey
Please include both county and HealthChoices funded services.
(Below: if answering Yes (Y) to #1. Service available, please answer questions #2-7)
Evidenced-Based
Practice
1. Is the
service
available
in the
County/
Joinder?
(Y/N)
2.
Current
number
served in
the
County/
Joinder
(Approx.)
3. What
fidelity
measure is
used?
4. Who
measures
fidelity?
(agency,
county,
MCO, or
state)
5. How
often is
fidelity
measured?
6. Is SAMHSA
EBP Toolkit
used as an
implementation
guide? (Y/N)
7. Is staff
specifically
trained to
implement
the EBP?
(Y/N)
8. Additional
Information
and
Comments
Assertive
Community
Treatment
No 0 N/A N/A N/A N/A N/A N/a
Supportive Housing Yes N/A Agency/County Annually No N/A
Supported
Employment
Yes N/A Agency/Co
unty
Annually No N/A Include #
Employed
Integrated
Treatment for Co-occurring
Disorders (Mental
Health/SUD)
Yes N/A CodeCat Agency/Co
unty
Annually No N/A
Illness
Management/
Recovery
No N/A N/A N/A N/A N/A N/A
Medication
Management
(MedTEAM)
No N/A N/A N/A N/A N/A N/A
Therapeutic
Foster Care
Yes N/A N/A N/A N/A N/A Provided by
C&Y
Multisystemic
Therapy
Yes TAM/SAM Agency Monthly N/A Yes Funded by HC
Functional Family
Therapy
No N/A N/A N/A N/A N/A N/A
Family Psycho-
Education
Yes N/A N/A N/A N/A N/A Information
not tracked
SAMHSA’s EBP toolkits: https://www.samhsa.gov/libraries/evidence-based-practices-resource-
center?f%5B0%5D=resource_type%3A20361
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County Human Services Plan Guidelines
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h. Additional EBP, Recovery-Oriented and Promising Practices Survey:
• Please include both county and HealthChoices funded services.
• Include CPS services provided to all age groups in total, including those in the age break outs for
TAY and OAs.
(Below: if answering yes to #1. service provided, please answer questions #2 and 3)
Recovery-Oriented and Promising Practices
1. Service
Provided
(Yes/No)
2. Current
Number Served
(Approximate)
3. Additional Information and Comments
Consumer/Family Satisfaction Team Yes HC only
Compeer No N/A
Fairweather Lodge Yes 6 Does not use County or HC dollars
MA Funded Certified Peer Specialist (CPS)- Total** Yes 158
CPS Services for Transition Age Youth (TAY) Yes 3
CPS Services for Older Adults (OAs) Yes Included with
total
Not broken down to that LOC
Other Funded CPS- Total** Yes
CPS Services for TAY Yes
CPS Services for OAs Yes
Dialectical Behavioral Therapy Yes N/A Can't see this LOC broken out
Mobile Medication No N/A
Wellness Recovery Action Plan (WRAP) Yes
High Fidelity Wrap Around No N/A
Shared Decision Making No N/A
Psychiatric Rehabilitation Services (including clubhouse) No N/A
Self-Directed Care No N/A
Supported Education No N/A
Treatment of Depression in OAs No N/A
Consumer-Operated Services Yes 1 Mental Health Association of Franklin and
Fulton Counties
Parent Child Interaction Therapy Yes HC only
Sanctuary No N/A
Trauma-Focused Cognitive Behavioral Therapy Yes HC only
Eye Movement Desensitization and Reprocessing (EMDR) Yes Can’t see this LOC broken out
First Episode Psychosis Coordinated Specialty Care No N/A
Other (Specify) Yes AF-CBT, MST, TARGET
Reference: Please see SAMHSA’s National Registry of Evidenced-Based Practices and Programs for more information on some of the
practices: Resource Center | SAMHSA
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DHS Bulletin 2025-01
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45
i. Involuntary Mental Health Treatment
1. During CY 2024, did the County/Joinder offer Assisted Outpatient Treatment (AOT) Services
under PA Act 106 of 2018?
☒ No, chose to opt-out for all of CY 2024
☐ Yes, AOT services were provided from: _______ to _______ after a request was made to
rescind the opt-out statement
☐ Yes, AOT services were available for all of CY 2024
2. If the County/Joinder chose to provide AOT, list all outpatient services that were provided in the
County/Joinder for all or a portion of CY 2024 (check all that apply):
☐ Community psychiatric supportive treatment
☐ ACT
☐ Medications
☐ Individual or group therapy
☐ Peer support services
☐ Financial services
☐ Housing or supervised living arrangements
☐ Alcohol or substance abuse treatment when the treatment is for a co-occurring
condition for a person with a primary diagnosis of mental illness
☒ Other, please specify: _____N/A____________________________________
3. If the County/Joinder chose to opt-out of providing AOT services for all or a portion of CY 2024:
a. Provide the number of written petitions for AOT services received during the opt-out
period. ______0____
b. Provide the number of individuals the county identified who would have met the criteria
for AOT under Section 301(c) of the Mental Health Procedures Act (MHPA) (50 P.S. §
7301(c)). _____0______
4. Please complete the following chart as follows:
a. Rows I through IV fill in the number
i. AOT services column:
1) Available in your county, BUT if no one has been served in the year, enter 0.
2) Not available in your county, enter N/A.
ii. Involuntary Outpatient Treatment (IOT) services column: if no one has been
served in the last year, enter 0.
b. Row V fill in the administrative costs of AOT and IOT
AOT IOT
I. Number of individuals subject to involuntary treatment in CY 2024 0 417
duplicated
232
unduplicated
II. Number of involuntary inpatient hospitalizations following an IOT or AOT for CY
2024
0 0
III. Number of AOT modification hearings in CY 2024
0
IV. Number of 180-day extended orders in CY 2024
0 83 duplicated
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County Human Services Plan Guidelines
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46
unduplicated
V. Total administrative costs (including but not limited to court fees, costs
associated with law enforcement, staffing, etc.) for providing involuntary
services in CY 2024
$0.00 $45,922.71
j. Consolidated Community Reporting Initiative Data reporting
DHS requires the County/Joinder to submit a separate record, or "pseudo claim," each time an
individual has an encounter with a provider. An encounter is a service provided to an individual.
This would include, but not be limited to, a professional contact between an individual and a
provider and will result in more than one encounter if more than one service is rendered. For
services provided by County/Joinder contractors and subcontractors, it is the responsibility of the
County/Joinder to take appropriate action to provide the DHS with accurate and complete
encounter data. DHS’ point of contact for encounter data will be the County/Joinder and no other
subcontractors or providers. It is the responsibility of the County/Joinder to take appropriate
action to provide DHS with accurate and complete data for payments made by County/Joinder to
its subcontractors or providers. DHS will evaluate the validity through edits and audits in
PROMISE, timeliness, and completeness through routine monitoring reports based on submitted
encounter data. (Pennsylvania General Assembly, (1966). Mental Health and Intellectual
Disability Act of 1966, P.L. 96, No. 6 Section 305.
http://www.legis.state.pa.us/wu01/li/li/us/pdf/1966/3/006..pdf)
File Description
Data
Format/Transfer
Mode
Due Date Reporting
Document
837 Health
Care Claim:
Professional
Encounters
v5010
Data submitted for each
time an individual has an
encounter with a provider.
Format/data based on
HIPAA compliant 837P
format
ASCII files via
SFTP
Due within 90 days of
the county/joinder
accepting payment
responsibility; or within
180 calendar days of the
encounter
HIPAA
implementation
guide and
addenda.
PROMISeTM
Companion Guides
❖ Have all available claims paid by the county/joinder during CY 2024 been reported to the state as
an encounter? ☒Yes ☐ No
k. Categorical State Base Funding (to be completed by all counties)
Please provide a brief narrative as to the services that would be expanded or new programs
that would be implemented with increased base funding in FY 25-26:
With increased base funding Franklin/Fulton County mental health would expand the crisis
system to meet the SAMHSA best practice guidelines. While we have someone to answer, we
need to focus on the someone to respond and a safe place to go for the crisis system. We
would be able to address the need for housing support for individuals with an SMI. We have a
need for more in-home support services being available to the transitional youth all the way
through to the older adults. Having more available supportive services (such as outpatient,
supportive living program, peer support services, respite, ADL’s, etc.) for individuals living in
the community. Increased funding would allow us to make our current providers of services
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47
whole or increase rates and wages for direct support staff which may assist with the staffing
concern many of the providers are currently facing.
l. Categorical State Funding-FY 25-26 [ONLY to be completed by counties not
participating in the Human Services Block Grant (i.e. Non-Block Grant)] N/A
If an allocation is expected in the following categorical for FY 25-26, please describe the
services to be rendered with these funds, estimates of number of individuals served, and plans
to use any carryover funds, if approved, from FY 24-25:
Respite services:
Consumer Drop-In Centers:
Direct Care Worker Recruitment & Retention:
Philadelphia State Hospital Closure:
Forensic Support Team:
Student Assistance Program:
m. Federal Grant Funding (to be completed by all counties, where appropriate). Please limit
response to no more than one page for each question.
• CMHSBG – Non-Categorical (70167): Please describe the services to be rendered with
these funds for the expected FY 25-26 allocation:
o Franklin/Fulton does not receive this allocation.
• CMHSBG – General Training (70167): Please describe the plans to use any carryover
funds from FY 24-25:
o Franklin/Fulton plans to utilize the funds for PESI trainings, conference, and other
applicable staff development.
• Social Service Block Grant (70135): Please describe the services to be rendered with
these funds for the expected FY 25-26 allocation:
o Franklin/Fulton plans to utilize these funds for our supported living residential
program, blended case management and supported employment services.
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• KEEP EMPOWERING YOUTH - PARTNERS, PROVIDERS, LIVED EXPERIENCE KEY-
PPLE (71022) - Please describe the project milestones you expect to achieve with these
funds and plans to use any carryover funds from FY 24-25.
o Franklin/Fulton does not receive this allocation.
SUBSTANCE USE DISORDER SERVICES (Limit of 10 pages for entire section)
This section should describe the entire substance use service system available to all county residents
regardless of funding sources.
Please provide the following information for FY 24-25:
1. Waiting List Information: If Waiting List data is not reported, please provide a brief narrative
explanation.
Services # of
Individuals*
Wait Time (days)**
Withdrawal Management 2 Same Day
Medically-Managed Intensive Inpatient Services 1 3-5 days
Opioid Treatment Services (OTS) 1 Same Day
Clinically-Managed, High-Intensity Residential Services 3 Same Day or one Day
Partial Hospitalization Program (PHP) Services 1 1-2 days
Outpatient Services 8 2-3 days
Other (specify) 1 7-14 days
*Average weekly number of individuals
**Average weekly wait time per person
• Withdrawal Management (WM) Services
During FY 24/25, individuals seeking withdrawal management were typically admitted
the same day they were referred, whether the referral originated from the community, an
emergency department, or a secure setting. Most referrals were related to withdrawal
from opioids, both illicit and prescription—as well as alcohol, which continue to be the
most common substances necessitating this level of care
• Medically-Managed Intensive Inpatient Services
In FY 24/25, five individuals received services through a medically managed intensive
inpatient program. This level of care remains limited and is typically used for individuals
with severe substance use and medical complications that require 24-hour nursing and
physician oversight. The average wait for access ranged from 3 to 5 days.
• Opioid Treatment Services (OTS)
In FY 24/25, access to Opioid Treatment Services remained limited due to a lack of
methadone providers operating within Franklin County. The SCA continued to contract
with the nearest out-of-county provider to offer this level of care. However, a notable
development occurred in May 2025 with the opening of Comprehensive Treatment
Center (CTC), the county’s first methadone clinic. The SCA plans to formally contract
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County Human Services Plan Guidelines
49
with CTC in early FY 2025, which is expected to improve local access and reduce
transportation-related barriers.
Currently, four buprenorphine providers operate in the county, though only one is under
contract with the SCA. Additionally, four practices offer oral naltrexone (Vivitrol), with two
maintaining agreements with FFDA. Physician time and availability remain limiting
factors for access to these medications, often resulting in delays of 3 to 5 days. To help
fill this gap, the SCA continues to partner with Positive Recovery Solutions to provide
mobile Vivitrol administration at a set community location once per month. The SCA also
funds buprenorphine treatment, supporting all three FDA-approved medications for
opioid use disorder (MOUD) in the community. These efforts aim to maintain treatment
continuity, particularly for individuals transitioning from inpatient treatment, incarceration,
or psychiatric care.
• Clinically-Managed, High-Intensity Residential Services
Throughout FY 24/25, individuals referred to clinically-managed, high-intensity residential
services typically gained admission the same day or within 24 hours. On average, FFDA
supported placements for approximately three individuals per week in clinically-
managed, high-intensity residential services during FY 24/25. Admission timing varied
depending on bed availability, specific priority populations (e.g., pregnant women), and
provider response times.
• Partial Hospitalization Program (PHP) Services
In FY 24/25, an average of one individual per week accessed Partial Hospitalization
Services. Wait times for this level of care typically ranged from one to two days,
depending on the provider’s capacity and the individual’s clinical needs.
• Outpatient Services
Outpatient and intensive outpatient services saw the highest utilization in FY 24/25, with
an average of eight individuals per week receiving care. These levels of service were
readily accessible, with most appointments available within 2 to 3 days. Referrals
included both step-down placements from higher levels of care and direct entries from
the community.
• Recovery Housing (Other Specify)
During FY 24/25, an average of one individual per week accessed recovery housing
services through a contracted provider. Wait times typically ranged from 7 to 14 days
and were influenced by factors such as availability and gender-specific placement needs.
FFDA maintains contracts with two DDAP-licensed recovery homes—one for men and
one for women—to support stable transitional living environments.
2. Overdose Survivors’ Data: Please describe below the SCA plan for offering overdose
survivors direct referral to treatment for FY 24-25.
# of Overdose
Survivors
# Referred to Treatment Referral
method(s)
# Refused Treatment
57 Unknown/Data not
collected
Recovery
Liaison, ER
Crisis Workers
Unknown/Data not
collected.
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The Franklin/Fulton Drug and Alcohol Program continues to advance its efforts to provide immediate,
compassionate, and coordinated care through its Recovery Liaison initiative. Using a combination of
local, state, and opioid settlement funds, our program ensures a Recovery Liaison remains available to
respond 24/7 to referrals from law enforcement, emergency departments, and first responders across
Franklin County. This role prioritizes rapid engagement following substance use-related incidents,
including but not limited to non-fatal overdoses, to support individuals in accessing treatment and
recovery resources.
The Recovery Liaison does more than respond to crisis situations; they actively work alongside clients
to identify unmet needs, reduce access barriers, and support linkage to behavioral health, medical
care, housing, and recovery support services. While overdose response is a key component, this
position serves a broader population of individuals with substance use challenges—including those
involved in the justice system or recently discharged from care. Warm Handoff data continues to be
collected and reported, and enhancements are currently underway to improve the accuracy of tracking
overdose-specific referrals in FY 25/26.
Our department has also expanded its partnerships and visibility across harm reduction and public
safety sectors. Franklin/Fulton Drug and Alcohol is now an established member of the Pennsylvania
Overdose Prevention Program (POPP), supporting the wide-scale distribution of Naloxone and drug
checking strips. Through regular collaboration with co-responder units, county jail staff, emergency
departments, and school districts, we’ve significantly increased the reach of our harm reduction
messaging and materials.
Community engagement remains a central focus of our work. Our staff has delivered harm reduction
education and training to a range of audiences—including faith-based groups, public health agencies,
and grassroots organizations—equipping them with tools and strategies to prevent overdose deaths
and reduce substance-related harm.
Additionally, EMS, BLS, and ALS personnel throughout the region are equipped with Leave Behind
Kits designed to support survivors and their loved ones following an overdose. Each kit includes:
• A branded Operation Save a Life (OSAL) pouch
• Naloxone with step-by-step instructions
• Non-latex gloves and a rescue breathing barrier
• A "Need Help Now" contact card with direct linkage to local treatment navigation
• SCA program information to encourage follow-up engagement
As we move through FY 25/26, our program remains committed to building bridges between first
responders, treatment systems, and individuals in crisis. By focusing on immediate response,
sustained recovery support, and public health partnerships, we continue to strengthen our
community’s safety net and improve outcomes for those impacted by substance use disorders.
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3. Levels of Care (LOC): Please provide the following information for the county’s contracted
providers.
LOC American
Society of
Addiction
Medicine
(ASAM)
Criteria
# of
Providers
# of
Providers
Located
In-County
# of Co-Occurring/Enhanced Programs
4 WM 2 0 0
4 2 0 2
3.7 WM 20 1 0
3.7 2 0 2
3.5 31 1 15
3.1 5 0 0
2.5 2 0 2
2.1 5 4 2
1 5 4 2
4. Treatment Services Needed in County: Please provide a brief overview of the services
needed in the county for FY 25-26 in sections a, b, and c below.
a. Provide a brief overview of the services needed in the county to afford access to
appropriate clinical treatment services:
Franklin/Fulton Drug and Alcohol Program (FFDA) recognizes that financial barriers remain
a major obstacle to accessing timely and effective clinical treatment—especially for
individuals who are uninsured, underinsured, or transitioning from crisis settings. In FY
25/26, FFDA will continue to invest in financial support mechanisms to eliminate these gaps
and expand access to all ASAM levels of care, including medication for opioid and alcohol
use disorders (MOUD and MAUD).
In particular, access to evidence-based medications—such as buprenorphine, methadone,
and injectable naltrexone—remains a critical priority. To meet this need, FFDA is
committed to supporting both provider expansion and consumer-level assistance to ensure
these medications are accessible regardless of insurance status. These services are
essential for individuals at high risk of overdose or relapse, including those recently
released from incarceration or detoxification services.
Collaboration with medical providers, behavioral health partners, and local pharmacies
continues to be a cornerstone of this work. Through a mix of direct funding, care
coordination, and partnership development, FFDA strives to reduce time-to-treatment and
improve continuity of care across the treatment system.
b. Provide an overview of any expansion or enhancement plans for existing providers:
In FY 25/26, Franklin/Fulton Drug and Alcohol is advancing several provider
enhancements, with a strategic focus on filling service gaps and expanding reach to
underserved populations. Through collaboration with the HealthChoices Program and
Tuscarora Managed Care Alliance (TMCA), the SCA is working to implement a data-
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informed, community-based Post Overdose Response Initiative. This public health
approach centers on early engagement following overdose events and connection to harm
reduction, treatment, and recovery supports.
The SCA is also focused on expanding access to MOUD and MAUD through flexible
treatment models. These include mobile services, same-day induction capabilities, and
expanded hours to better align with client schedules and reduce treatment attrition. As part
of this effort, SCA plans to contract with the newly opened methadone provider (CTC),
located within Franklin County, which will substantially improve geographic access to care.
For incarcerated individuals, FFDA has launched peer-facilitated recovery groups and is
actively working toward embedding a full-time Certified Recovery Specialist (CRS) within
Franklin County Jail. This embedded position would assist with pre-release planning,
recovery goal-setting, and warm handoff services. Coordination will include linkages to
housing, MAT continuation, behavioral health care, and employment supports. These
enhancements reflect a broader system commitment to continuity of care during reentry
and reduction of recidivism through behavioral health stabilization.
c. Provide an overview of any use of HealthChoices reinvestment funds to develop new
services:
Franklin/Fulton County continues to leverage HealthChoices reinvestment funding,
administered by Tuscarora Managed Care Alliance (TMCA), to strengthen the local
treatment and recovery system. Reinvestment resources are currently supporting the
Recovery-Oriented Systems of Care (ROSC) Specialist position within the SCA, which has
been instrumental in advancing system coordination and harm reduction infrastructure. This
includes the planning of a multi-disciplinary post-overdose response team, a strategic
priority identified by the Overdose Taskforce Steering Committee.
Several reinvestment projects are currently active:
• Recovery Bridge Housing Subsidy: Provides rent assistance to Medicaid-eligible
individuals transitioning to licensed recovery housing following treatment, ensuring
stability during early recovery.
• Certified Recovery Specialist (CRS) Expansion: Enables local outpatient providers to
employ CRSs who engage individuals transitioning from residential or withdrawal
management services, supporting sustained recovery and reducing readmission
rates. FFDA contributes to this effort by funding partnerships with Noah’s House,
Inc, Pyramid Healthcare, and Gaudenzia.
Together, these initiatives demonstrate a coordinated investment in both clinical and non-
clinical supports that reinforce recovery, reduce relapse risk, and improve overall health
outcomes for residents across Franklin and Fulton Counties.
5. Access to and Use of Narcan in County: Please describe the entities that have access to
Narcan, any training or education done by the SCA and coordination with other agencies to
provide Narcan.
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Franklin County continues to prioritize a comprehensive harm reduction strategy centered on
overdose prevention, naloxone access, and public education. Through the standing order in
Pennsylvania, intranasal naloxone remains available without a prescription at all local
pharmacies, ensuring broad community access to this life-saving medication.
The Franklin/Fulton Drug and Alcohol Program (FFDA) leads countywide overdose response
efforts through its Operation Save a Life (OSAL) initiative. This free training program equips
individuals with the knowledge and skills to recognize and respond to an overdose using
naloxone. Upon completion, Franklin County residents receive a free intranasal naloxone kit.
OSAL trainings are delivered by FFDA’s Recovery-Oriented Systems of Care (ROSC)
Specialist and Prevention Specialist, who also led extensive community outreach, including
educational sessions at schools, community events, coalition meetings, recovery gatherings,
and provider agencies. These efforts help normalize harm reduction and expand access to
critical overdose reversal tools.
Recognizing the heightened vulnerability of individuals reentering the community from
incarceration, OSAL is also offered inside the Franklin County Jail. These trainings ensure
individuals are equipped with naloxone and prepared to respond to overdose events in the
community.
OSAL is also routinely provided to county staff and professionals, while all local law enforcement
agencies and emergency medical service providers (EMS/BLS/ALS) are equipped to carry and
administer naloxone in the field. FFDA continues to offer Leave Behind Kits for participating EMS
and transport units. These kits include OSAL-branded pouches containing naloxone, usage
instructions, gloves, a rescue breathing barrier, the “Need Help Now” hotline card, and local
contact information to promote linkage to care.
Since FY 17/18, FFDA has served as the Centralized Coordinating Entity (CCE) through the
Pennsylvania Commission on Crime and Delinquency (PCCD), a role that includes the free
distribution of naloxone to a wide network of community-based first responders. The definition of
“first responder” has been broadened in recent years to include partners such as:
• EMS and Fire Services
• Law Enforcement Agencies
• School Nurses and Educational Institutions (K–12 and Higher Ed)
• Public and Private Housing Services
• Behavioral Health and Recovery Providers
• Child Welfare and Probation Departments
• Faith-based and Grassroots Community Organizations
In September 2024, Franklin County successfully hosted a Strategic Collaboration for
Overdose Prevention and Education (SCOPE) training, which brought together regional first
responders to improve overdose response coordination and harm reduction strategies.
Building on the success of this event, FFDA is now working to establish formal partnerships
with EMS agencies to continue education, expand Leave Behind Kit engagement, and
support additional outreach and recruitment efforts focused on overdose reversal and post-
overdose connection to care.
These initiatives reflect a countywide commitment to reducing overdose fatalities through
practical tools, professional partnerships, and sustained community education.
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6. County Warm Handoff Process: Please provide a brief overview of the current warm handoff
protocols established by the county including challenges with implementing warm handoff
process.
a. Warm Handoff Data:
# of Individuals Contacted 93
# of Individuals who Entered Treatment 77
# of individuals who have Completed Treatment Data not collected
Franklin County’s Warm Handoff (WHO) initiative is a cornerstone of the county’s response to
individuals experiencing substance use-related crises, including non-fatal overdoses. The
current model operates through active partnerships with Chambersburg Hospital and
Waynesboro Hospital emergency departments, where crisis staff are available to assess and
refer individuals to treatment following medical stabilization. While these connections have
helped initiate care for many residents, challenges remain in fully capturing and retaining
individuals during this critical intervention window.
In response, Franklin/Fulton Drug and Alcohol (FFDA) is working closely with WellSpan Health
to develop a formalized Warm Handoff policy to guide emergency department protocols. The
goal is to enhance coordination between hospital staff, crisis professionals, and community-
based recovery supports. The policy under development emphasizes improved linkage to care,
access to Medication for Opioid Use Disorder (MOUD), expanded harm reduction tools, and the
integration of peer support through Certified Recovery Specialists (CRS).
In addition to hospital-based outreach, FFDA funds a countywide Recovery Liaison program
designed to provide 24/7 mobile response capacity for individuals with substance use needs.
The Recovery Liaison—available on-call to law enforcement and first responders—offers field-
based engagement, brief intervention, and support with treatment referrals. While some
municipalities actively utilize this service, engagement remains inconsistent across jurisdictions.
A persistent barrier is the lack of communication from EMS or BLS/ALS units when individuals
decline transport following an overdose, limiting opportunities for real-time outreach.
To address these gaps, Franklin County hosted the Strategic Collaboration for Overdose
Prevention and Education (SCOPE) training in September 2024, aimed at strengthening
coordination between emergency responders, healthcare systems, and behavioral health
agencies. Building on the outcomes of that training, FFDA is actively exploring formal
partnerships with EMS organizations to support education, referral pathways, and Leave Behind
Kit utilization—further integrating the Recovery Liaison into post-overdose response.
Additionally, FFDA is evaluating the implementation of a Post Overdose Response Team
(PORT) model. This public health approach involves proactive follow-up with overdose survivors
and their families within 24–72 hours after the event. The model brings together multidisciplinary
partners, including recovery specialists, behavioral health professionals, and public safety
personnel—to ensure that each survivor receives a personalized plan of care, inclusive of harm
reduction, MAT access, and wraparound supports.
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Key Challenges to Address in FY 25/26 Include:
1. Inconsistent Use of the Recovery Liaison: While the program is fully operational, several
law enforcement agencies and EMS providers do not consistently notify the liaison
following overdose events or substance-related calls. Strengthening protocols, ongoing
outreach, and training efforts (including additional SCOPE sessions) will continue to
address this.
2. Emergency Department Disengagement: Clients often leave the emergency department
prior to completing a crisis intake or connection to treatment. The new WHO policy aims
to improve engagement through faster connection to peer support, on-site recovery
education, and MOUD induction when appropriate.
Together, these enhancements are designed to make Franklin County’s Warm Handoff process
more responsive, flexible, and person-centered—ensuring that no opportunity is missed to
connect someone to life-saving treatment and recovery services.
INTELLECTUAL DISABILITY SERVICES
The Office of Developmental Programs (ODP), in partnership with the county programs, is committed
to enabling individuals with an intellectual disability and autism to live rich and fulfilling lives in their
community. It is important to also afford the families and other stakeholders’ access to the
information and support needed to help be positive members of the individuals’ teams.
This year, we are asking the county to focus more in depth on the areas of the Plan that will help us
achieve the goal of an Everyday Life for all individuals.
With that in mind, please describe the continuum of services to registered individuals with an
intellectual disability and autism within the county. In a narrative format, please include the strategies
that will be utilized for all individuals registered with the county, regardless of the funding stream. In
completing the chart below regarding estimated numbers of individuals, please include only
individuals for whom Base or HSBG funds have been or will be expended. Appendix C should reflect
only Base or HSBG funds except for the Administration category. Administrative expenditures should
be included for both base and HSBG and waiver administrative funds.
*Please note that under Person-Directed Supports (PDS), individuals served means the individual
used Vendor Fiscal/Employer Agent (VF/EA) or Agency with Choice (AWC) for at least one service
during the fiscal year. The percentage of total individuals served represents all funding streams. The
percentage might not add to 100 percent if individuals are receiving services in more than one
category.
Individuals Served
Estimated
Number of
Individuals
served in
FY 24-25
Percent of
total
Number of
Individuals
Served
Projected
Number of
Individuals to
be Served in
FY 25-26
Percent of
total Number
of Individuals
Served
Supported Employment 21 3.5 26 4.4
Pre-Vocational 0 0 0 0
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Community participation 5 <1 1 <1
Base-Funded Supports
Coordination 64 11 68 11
Residential (6400)/unlicensed 0 0 0 0
Lifesharing (6500)/unlicensed 0 0 0 0
PDS/AWC 25 4 28 4
PDS/VF 6 1 8 1
Family Driven Family Support
Services 15 2 17 3
Assistive Technology
0 0 0 0
Remote Supports
1 <1 2 <1
Supported Employment: “Employment First” is the policy of all Commonwealth executive branch
agencies under the jurisdiction of the governor. ODP is strongly committed to competitive integrated
employment for all.
• Please describe the services that are currently available in the county such as discovery,
customized employment, and other services.
• Please identify changes in the county practices that are proposed for the current year that will
support growth in this area and ways that ODP may assist the county in establishing
employment growth activities.
• Please add specifics regarding the Employment Pilot if the county is a participant.
The concept of "Employment First" encourages competitive integrated employment. By emphasizing
competitive, integrated work as the ideal outcome for people with disabilities, the Franklin/Fulton IDD
program is promoting this idea in a number of ways. The concept for Employment First highlights that
everyone can find a competitive, integrated job, including those with severe disabilities. Through
meaningful work, ODP's Employment First initiative aims to give people with disabilities the chance to
become financially independent, develop self-confidence, and fully engage in their communities. We
have seen a slight decline in the number of competitively employed individuals in Franklin/Fulton
counties for a variety of reasons which surrounds the individual’s choice to work.
The Transition to Adult Life Success (TALS) program engages young adults with disabilities in
discussions and activities pertaining to areas of self-determination and career exploration. The TALS
program activities include presentations on employability, community resources and post-secondary
opportunities, one-to-one services include connecting with employers, job shadowing, community-
based work assessments, and work incentive counseling. There were nine (9) students in the TALS
program in Franklin County in Fiscal Year 2024-2025. The TALS program has a goal of placing eight
(8) individuals into a competitive job. Three (3) individuals had been placed into a competitive job in
2024-2025 with another three (3) during the school year.
Supported Employment Services include direct and indirect services provided in a variety of
community employment work sites with co-workers who do not have disabilities. Supported
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Employment Services provide work opportunities and support individuals in competitive jobs of their
choice. Supported Employment Services enable individuals to receive paid employment at minimum
wage or higher from their employer. Providers of Supported Employment Services have outcomes of
“placing individuals with intellectual disabilities in a competitive job.” Of the 18 people receiving base
funded supported employment, 14 have competitive jobs.
Small Group Employment Services consist of supporting participants in transitioning to competitive
integrated employment through work that occurs in a location other than a facility subject to 55 Pa.
Code Chapter 2380 or Chapter 2390 regulations. The goal of Small Group Employment Services is
competitive integrated employment. Participants receiving this service must have a competitive
integrated employment outcome included in their service plan and it must be documented in the
service plan how and when the provision of this service is expected to lead to competitive integrated
employment. Participants who work during the provision of Small Group Employment Services must
be paid at least a minimum wage and the compensation must be similar to compensation earned by
workers without disabilities performing the same work. Small Group Employment Services options
include mobile workforce, workstation in industry, affirmative industry, and enclave. While there are no
base funded individuals participating in Small Group Employment Services, there are nine (9)
individuals utilizing Small Group Employment Services via waiver funding.
Discovery is a targeted service for a participant who wishes to pursue competitive integrated
employment but due to the impact of their disability, their skills, preferences and/or potential
contributions, cannot be best captured through traditional, standardized means, such as functional
task assessments, situational assessments and/or traditional normative assessments which compare
the participant to other or arbitrary standard of performance and/ or behavior. Discovery involves a
comprehensive analysis of the participant in relation to the following:
• Strongest interest in one or more specific aspects of the labor market;
• Skills, strengths and other contributions likely to be valuable to employers or valuable to the
community if offered through self-employment; and
• Conditions necessary for successful employment or self-employment.
All employment providers use Discovery as part of their supported employment process. At this time,
no one in Franklin County uses Discovery as a discrete service. Information on certification for this
process continues to be shared with providers.
Community Participation Support is defined as “providing opportunities and support for community
inclusion and building interest in and developing skills and potential for competitive integrated
employment.” Services should result in active, valued participation in a broad range of integrated
activities that build on the participant's interests, preferences, gifts, and strengths while reflecting his or
her desired outcomes related to employment, community involvement and membership. Community
Participation Support is intended to flexibly wrap around, or otherwise support, community life
secondary to employment, as a primary goal. This service involves participation in integrated
community settings, in activities that involve persons without disabilities who are not paid or are unpaid
caregivers. This service is expected to result in the participant developing and sustaining a range of
valued social roles and relationships, building natural supports, increasing independence, increasing
potential for employment, and experiencing meaningful community participation and inclusion. The
Franklin/Fulton IDD program will continue to support providers in providing Community Participation
Support. There were no (0) individuals who utilized base dollars to pay for Community Participation
Support during FY 2024-2025.
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The IDD department is concentrating on Competitive Integrated Employment, which includes
supported employment and small group employment for the Quality Management Goal (see Appendix
E). The outcome for the Quality Management Plan is “people who choose to work are employed in the
community.” There were 84 individuals who were employed in Competitive Integrated Employment in
FY 2023-2024. There are 78 individuals currently employed in Competitive Integrated Employment as
of June 2025. The following graph shows how employment has increased or decreased in the last five
(5) years. There was a decrease of six (6) individuals working Competitive Integrated Employment
jobs through the 202420-25 fiscal year. This decrease is correlated to individual preference or choice
regarding work, while some individuals chose to work on family/personal issues. Franklin/ Fulton IDD
employment providers will continue to support people to continue to work or to find new jobs.
Franklin/Fulton Transition Councils collaborate with the Office of Vocational Rehabilitation (OVR) in
identifying individuals who will benefit from Pre-Employment Transition Services, Paid Work
Experiences and Job Shadowing within the school districts. The Franklin/Fulton IDD Program
participates in the Transition Council, which includes representatives from OVR, school districts and
providers to promote and support the Employment First Model. OVR and the Franklin/Fulton IDD
Program facilitate the Student Transition to Adult Review (STAR) meetings for students and their
parents to focus on their plan for transitioning from high school to adult supports/services. Discussion
centers are focused on students’ interests, goals and present levels in relation to employment and
independent living and supports needed. This also provides an opportunity to register with the IDD
Program and OVR if the person has not already done so. The Franklin/Fulton County Transition
Councils created virtual transition sites during the pandemic to provide useful resource documents,
presentations, etc. that school districts and families can access at any time. The return to in-person
Transition Council meetings and Transition Fairs occurred throughout the 2024-2025 school year.
Topics of the meetings and fairs included Benefits Counseling, Power of Attorney/Guardianship
Attorney, Social Security Administration, a tour and presentation with Keystone Life Skills, Practical
Assessment Exploration System (PAES) lab at Franklin Learning Center, Best Buddies Program,
Supports Coordination Organizations, and the online PADLET resource presented by the Franklin
County Administrative Entity for IDD services.
The IDD Program and the Supports Coordination Organization (SCO) collaborate and participate in
trainings with OVR on the implementation of the Workforce Innovation and Opportunity Act (WIOA).
The IDD Program developed and used an OVR referral process to streamline, track and facilitate
accessing OVR services for Franklin County individuals.
Supports Coordination:
• Please describe how the county will assist the supports coordination organization (SCO) to
engage individuals and families to explore the communities of practice/supporting families
model using the life course tools to link individuals to resources available in the community.
• Please describe how the county will assist supports coordinators to effectively engage and plan
for individuals on the waiting list.
• Please describe the collaborative efforts the county will utilize to assist SCOs with promoting
self-direction.
Base Funded Supports Coordination included home and community case management for individuals
in nursing facilities, Medical Assistance (MA) eligible individuals who are admitted for hospitalization,
individuals residing in Intermediary Care Facilities (ICF), and individuals who do not qualify for MA.
These services are only paid for individuals who have a denial of MA coverage. There are 64 people
who have base funded Supports Coordination either because they are not eligible for MA or lost their
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MA for part of the year. There are five (5) individuals who have the OBRA waiver and have base
funded Supports Coordination, and two (2) people who reside in an ICF/ID or state center and receive
base funded Supports Coordination.
The IDD Program works closely with Supports Coordination Organizations (SCO) by holding monthly
meetings with the SCO supervisors. In these meetings, high-profile individuals or those with an
Emergency Prioritization of Urgency of Need for Services (PUNS) are discussed. The focus is on their
natural supports and any additional supports they need. Anyone may be added to this list if needed.
The monthly meetings review PUNS, Individual Service Plans (ISP), Levels of Care, incident
management, provider risk assessments, Independent Monitoring for Quality (IM4Q), and other related
areas. The agenda remains consistent each month to ensure all important issues are addressed.
The SCO is also represented on the Transition Councils and is encouraged to participate in State
Employment Leadership Network (SELN) trainings, Community of Practice employment calls, and
Secondary Transition Conferences, to promote community integrated employment. Franklin/ Fulton
County is part of the South-Central Regional Collaborative for the Community of Practice and the SCO
is part of the stakeholder group as well. The State Community of Practice has established the
following goals: family engagement, employment, and Supports Coordination. Support Coordinators
use the Lifecourse principles and activities to help individuals and families plan for the future. The
SCO supports the initiatives of the Community of Practice. See more information about Regional
Collaboratives in Administrative Funding.
In addition to the Transition Council and Regional Collaborative, the SCO also sends representatives
for the Risk Management Committee and the Quality Improvement Council.
Currently Franklin/Fulton Counties have two (2) Support Coordination Organization, Service Access &
Management, Inc. (SAM) and Expert Community Care Management (ECCM). With the addition of a
second Support Coordination Organization for Franklin County, individuals have a choice of the SCO
they utilize.
Lifesharing and Supported Living:
• Please describe how the county will support the growth of Lifesharing and Supported Living as
an option.
• Please describe the barriers to the growth of Lifesharing and Supported Living in the county.
• Please describe the actions the county found to be successful in expanding Lifesharing and
Supported Living in the county despite the barriers.
• Please explain how ODP can be of assistance to the county in expanding and growing
Lifesharing and Supported Living as an option in the county.
According to 55 Pa. Code Chapter 6100 regulations: “Family Living Homes are somewhat different
than other licensed homes as these settings provide for Lifesharing arrangements. Individuals live in a
host Lifesharing home and are encouraged to become contributing members of the host Lifesharing
unit. The host Lifesharing arrangement is chosen by the individual, his or her family and team, and
with the Lifesharing host and Family Living provider agency, in accordance with the individual’s needs.
Licensed Family Living Homes are limited to homes in which one (1) or two (2) individuals with an
intellectual disability, who are not family members or relatives of the Lifesharing host, reside.”
Satisfaction surveys have shown that individuals in Lifesharing living arrangements are more satisfied
with their lives.
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The Franklin/Fulton County IDD Program will support the growth of Lifesharing in the following ways:
• The Administrative Entity (AE) and SCO will continue to work on providing information to
individuals and families on the values and benefits of Lifesharing and correcting the “stigma”
that is “adult foster care.” We will continue to help families understand that Lifesharing is a
supportive, sharing, and mentoring environment that enhances the natural supports of the
family.
• The AE has encouraged local Lifesharing providers to develop new licensed homes to be used
for periodic and emergency respite situations that can be available when needed. This has
helped to expedite emergency respite placements which, in turn, have developed into new
Lifesharing connections.
• The AE will work with providers with the expansion of the Lifesharing service definition to
include individuals living in their own home or the home of a relative and receiving agency
managed Lifesharing services.
Lifesharing is the first residential option offered to any person who needs a residential
placement. This is documented in the Individual Support Plan. Currently, there are 33 people
living in Lifesharing homes in Franklin County. The funding that supports 33 of these individuals
in their Lifesharing homes is waiver funding.
Some of the barriers to growth in Lifesharing in Franklin/Fulton County continue to be the lack
of families interested in Lifesharing. Another barrier is the complex needs of individuals that
may be interested in Lifesharing. Lifesharing providers have the final say in who they will
support and individuals with complex needs continue to be harder to find an appropriate long-
term match. The final barrier is that caregivers that are life-sharers are aging and as they age,
their own needs increase and they are unable to continue to provide the care required. While
there are barriers to Lifesharing in Franklin/Fulton Counties, there are also successes. Many of
the people in Lifesharing have lived in their Lifesharing homes for 20+ years. One provider of
Lifesharing continues to have a plan to actively recruit Lifesharing families. Franklin/Fulton has
been successful in moving individuals from Community Rehabilitation Residential (CRR)
facilities and Children’s Foster Care to Lifesharing care when they age out of the children’s
system.
In 2024, ODP increased the Community Living Waiver (CLW) funding capacity; this waiver has
a funding capacity of $97,000 dollars. This is enough funding to support an individual that has a
low Supports Intensity Scale Needs Group (SIS) in a Lifesharing home as long as that
individual is either working or not attending a traditional day program.
Cross-Systems Communications and Training:
• Please describe how the county will use funding, whether it is HSBG or Base funding, to
increase the capacity of the county’s community providers to more fully support individuals
with multisystem needs, and complex medical needs.
• Please describe how the county will support effective communication and collaboration
with local school districts in order to engage individuals and families at an early age and
promote the life course/supporting family’s paradigm.
• Please describe how the county will communicate and collaborate with local children and
youth agencies, the Area Agency on Aging, and the mental health system to enable
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individuals and families to access community resources, as well as formalized services
and supports through ODP.
The IDD program collaborates with the following agencies to increase the support for individuals with
multiple needs. The IDD program staff attends Child and Adolescent Service System Program
(CASSP) meetings to discuss the supports needed for individuals to be supported in their community
and school. The IDD staff also has a working relationship with Home Health Aide providers to support
individuals with medical needs in their home and community. The Managed Care Organization
Specialized Needs Unit is available for individuals under the age of 18 who meet criteria. The IDD
program collaborates with the school districts by offering informational sessions to both parents and
teachers. The IDD staff attends IEPs when requested to help problem-solve and/or provide intake
information. STAR meetings facilitated by the OVR Supervisor and the IDD Program Specialist
discuss and plan for services/supports after graduation. The IDD program has also worked with school
districts and the PA Family Network to provide information to families and hold workshops after Back-
to-School Nights on different subjects. The Administrative Entity (AE) also is a member of the
Transition Council and attends the Transition Fairs at all high schools county-wide. The IDD program
partners with Children and Youth Services (CYS) through CASSP. There are also individual cases
where CYS and the IDD program are involved and the collaboration between the two (2) agencies has
resulted in the best outcome for the child while protecting the individual’s rights. Additionally, a
meeting to include the CASSP Coordinator, the Supports Coordination Organization caseworkers, the
Administrative Entity (AE), and the Mental Health staff were held in March 2025. At this meeting,
participants discussed the best overall approach regarding communication for cross-system clients to
ensure best practices in each area. These meetings are scheduled to be held quarterly.
The IDD program staff continues to present the module on Intellectual & Developmental Disabilities
services as part of the Crisis Intervention Team (CIT) training curriculum. This curriculum supports
police officers, mental health workers, and first responders in their work when they encounter
individuals with disabilities. It provides essential training for responding properly and effectively. The
course aims to improve understanding and communication during these critical interactions. It ensures
responders are better prepared to handle situations with care and professionalism when responding to
individuals with disabilities. The IDD section has been revised to better suit the audience of police
officers and first responders. The training was held in September and April of fiscal year 2024-2025
and is planned to be offered again in 2025-2026. Many of the local first responder agencies and police
departments have the majority of their staff already CIT trained.
The IDD program continues to collaborate with Mental Health, CASSP, school districts, Tuscarora
Managed Care Alliance, and PerformCare to support people who have a dual diagnosis.
Franklin/ Fulton County has had a recent increase in individuals being discharged from the jail/prison
system. While some of the individuals are registered with the AE, others are not known to the IDD
system. This delays the provision of services and supports as many do not have the documentation
necessary to determine eligibility. Franklin County has also organized a Complex System Triage Team
to discuss complex cases that may cross different departments, and to develop policies and
procedures to make it easier to support those individuals in need.
The AE is represented on the Autism Judicial Task Force. The Task Force goal is to educate court
personnel and identify ways to assist individuals with Autism, and their families, to navigate the
Judicial System. This collaboration also includes representation from Autism Services, Education,
Resources, and Training Collaborative (ASERT) and the PA Family Network. The last Autism Judicial
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Task Force meeting was held in October 2024, and we are awaiting direction from the local Judicial
System as to the collaboration needed.
Emergency Supports:
• Please describe how individuals in an emergency situation will be supported in the community
(regardless of availability of county funding or waiver capacity).
• Please provide details on the county’s emergency response plan including:
Does the county reserve any base or HSBG funds to meet emergency needs?
What is the county’s emergency plan in the event an individual needs emergency
services, residential or otherwise, whether within or outside of normal working hours?
Does the county provide mobile crisis services?
If the county does provide mobile crisis services, have the staff been trained to work with
individuals who have an ID and/or autism diagnosis?
Do staff who work as part of the mobile crisis team have a background in ID and/or
autism?
Is training available for staff who are part of the mobile crisis team?
If the county does not have a mobile crisis team, what is the county’s plan to create one
within the county’s infrastructure?
• Please submit the county 24-hour emergency crisis plan as required under the Mental Health
and Intellectual Disabilities Act of 1966.
If waiver capacity is unavailable in an emergency situation, individuals will be supported using funds
from the Block Grant. Base money can be provided for day programs and transportation to maintain
an individual’s residence at home and/or to allow their parents to maintain their employment status.
The Franklin County IDD Department will increase the availability for combinations of Family Aide, day
programs, transportation, adaptive equipment, home modifications, and respite care, so that
individuals may continue to live at home instead of in residential programs, which are more costly.
Franklin County reserves 28 days for Emergency Respite care using base funds.
The IDD Independent Apartment Program has 10 individuals living in their own apartments and who
receive less than 30 hours of support per week. Base funds are used to subsidize the rent for these
individuals. This program is the least restrictive housing option for individuals who wish to live
independently.
The AE has a Risk Management Committee that meets quarterly to discuss incident management,
review restrictive procedures, and to discuss risk mitigation and any items that may lend to a future
emergency. Under the direction of ODP, the County is implementing Provider Risk Assessments as a
proactive means to determine if a provider has risk in their operations. The AE reviewed two (2)
residential providers and two (2) unlicensed providers for whom Franklin/Fulton is the assigned AE
and also provided information to other assigned AEs about their providers in 2024-25. The AE will
complete Provider Risks Assessments as well as any unlicensed providers that are included on the
spreadsheet submitted from the Office of Developmental Programs (ODP).
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Franklin County responds to emergencies outside of normal work hours as stated in Procedure
Statement IDD505: Risk Mitigation. In this procedure statement, Program Specialists are listed, as
well as the MH/IDD/EI Administrator, with their mobile contact numbers. These contacts may be used
after hours for any emergency. All providers have been trained in the policy. Initial incidents are
reviewed daily to assure the health and safety of the individuals served; this includes weekends and
holidays. Franklin County reserves base respite funds to authorize respite services as needed in an
emergency and works with providers, Adult Protective Services, and the Supports Coordination
Organization to set up these services, whether during normal business hours or after business hours.
These services may include Lifesharing or 6400 residential care. This provides for the safety of the
person and offers a long-term solution.
The MH/IDD Department’s mission of essential functions is those critical processes the department
must maintain during the response and recovery phases of an emergency, to continue to serve its
constituents. The department’s mission-essential functions must be able to be executed within 12
hours of a major emergency and be sustainable for up to 30 days during the recovery phase of the
emergency.
The IDD Program utilizes the current contract with Keystone Behavioral Health for Crisis Intervention
Services. The Crisis Intervention Department is operated 24 hours per day, seven (7) days per week,
365 days per year. One aspect of this contracted service is Mobile Crisis and is available in Franklin
County. Any of the Crisis workers are able to provide mobile crisis services and some of the Crisis
workers have a background in working with individuals with Autism and/or intellectual disabilities.
Training is available for any staff as requested. As with the other crisis services offered, when an
individual with an intellectual disability or Autism utilizes crisis services, the Crisis staff will notify
either the Supports Coordinator or the AE if the person is not registered with the IDD program. The
Co-Responder program is also a way to divert individuals with disabilities from being incarcerated and
to seek the community resources help that they need. Please see Mental Health Section for details.
The Franklin/Fulton IDD Program supports Community Services Group (CSG), a provider of IDD
services in Pennsylvania and their mobile MH/IDD Behavioral Intervention Services to expand the
Mobile Crisis service in Franklin/Fulton County. The service would be a “time-limited service designed
to evaluate the current situation, develop treatment strategies, provide direct interventions with the
individual, deliver consultation, provide resources and develop skills so that existing supports can
continue to implement the treatment strategies developed by the team” for individuals who have a
dual diagnosis and are struggling to have an “everyday life.”
The County 24-hour Emergency Response Plan, as required under the Mental Health and Intellectual
Disabilities Act of 1966, is on file and will be provided if requested, due to the personal phone
numbers published in it.
Administrative Funding: ODP has engaged the PA Family Network to provide support and training
in the community. The PA Family Network will be providing individuals who are person-centered
trainers.
• Please describe the county’s interaction with PA Family Network to utilize the network trainers
with individuals, families, providers, and county staff.
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• Please describe other strategies the county will utilize at the local level to provide discovery
and navigation services (information, education, skill building) and connecting and networking
services (peer support) for individuals and families.
• Please describe the kinds of support the county needs from ODP to accomplish the above.
• Please describe how the county will engage with the Health Care Quality Units (HCQUs) to
improve the quality of life for individuals in the county’s program. The function of the HCQUs is
to enhance the health and wellness of individuals with an intellectual disability or autism
through collaboration with providers, counties, Supports Coordinators/Targeted Support
Managers and health care providers, as outlined in ODP Bulletin 00-18-03, Health Care
Quality Units.
• Please describe how the county will use the data generated by the HCQU as part of the
Quality Management Plan process.
• Please describe how the county will engage the local Independent Monitoring for Quality
(IM4Q) Program to improve the quality of life for individuals and families. The IM4Q provides
ODP with data on the quality of services to consumers, as required in the county’s
Administrative Entity Operating Agreement.
• Please describe how the county will support local providers to increase their competency and
capacity to support individuals who present with higher levels of need related to aging, physical
health, behavioral health, communication, and other reasons.
• Please describe how ODP can assist the county’s support efforts of local providers.
• Please describe what risk management approaches the county will utilize to ensure a high
quality of life for individuals and families.
• Please describe how the county will interact with individuals, families, providers, advocates
and the community at large in relation to risk management activities.
• Please describe how ODP can assist the county in interacting with stakeholders in relation to
risk management activities.
• Please describe how the county will utilize the county housing coordinator for people with
autism and intellectual disabilities.
• Please describe how the county will engage providers of service in the development of an
Emergency Preparedness Plan.
Franklin/Fulton IDD has a Community Mobile Nurse position to serve individuals receiving IDD
services. During the 2024-2025 fiscal year, the Community Mobile Nurse served an average of 24
individuals/families monthly.
As part of the Community of Practice Regional Collaborative, the PA Family Network serves as part
of the stakeholder group along with the AE. The PA Family Network will continue to provide weekly
Family Forums using a Zoom platform. The Regional Collaborative will continue to concentrate on the
areas previously mentioned. Franklin/Fulton’s newest Program Specialist started July 2024 and
serves as the Franklin/Fulton Chair and is a Lifecourse Ambassador. The Regional Collaborative
action plan for the 2025-2026 fiscal year includes the following; Franklin/Fulton, along with a parent
advocate, manages an online PADLET of resources that parents, staff, providers, and supporters
may access to support those receiving services to gather information regarding trainings, activities,
events, community engagement, and health options, to aide in remaining informed about ODP and
local supports and services.
Both local SCO service providers utilize the Lifecourse tool and incorporate the tool throughout
individuals’ ISPs to be person-centered in all planning. The Transition / Employment Council, along
with the Regional Collaborative member, meet throughout the school year regarding educational
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changes and updates, ODP services, employment opportunities, and networking to best support
students and maintain communication for continued success.
The IDD program uses the vast experience of the Health Care Quality Units (HCQU). Trainings by the
HCQU are held virtually, which allows individuals to participate in any scheduled training regardless of
the county you live in. They also provide individualized training as requested by providers and families.
The AE attends the Positive Practices Committee meetings as well as Regional HCQU meetings. The
HCQU is represented at provider meetings and participates in both the Risk Management Committee
and the Quality Improvement Council. Medication Errors is one (1) outcome and objective in the Quality
Management Plan. The HCQU provides training to individuals, provider homes, staff or individuals,
depending on the trends found while analyzing the data. This supports the outcome “people are healthy,
and Franklin/Fulton IDD Program will use the objective of reducing the number of medication errors by
10% by June 30, 2026”. The baseline data is 165 medication errors from July 2022 to June 2023. For
2024-2025, there were 209 medication errors which are above the baseline of 164. Overall, licensed
Residential Providers have seen a decrease in medication errors in Franklin County. A private family
home is the exception, where an ODP certified Medication Technician administers medications. Due to
this unique home, the numbers reported can dramatically increase the total number of medication errors
for Franklin County and thereby pushed the number above the baseline. This outcome will remain in the
2023-2026 Quality Management Plan.
As with the HCQU, a representative for the IM4Q local program sits on the Quality Improvement (QI)
Council. The QI Council reviews employment IM4Q data to determine satisfaction with services. The QI
Council also looks for trends in IM4Q data where satisfaction of services is below the state average. The
greatest barrier to reviewing IM4Q data is that the reports are not current. As a result, there is a lag in
developing Quality Monitoring outcomes and objectives.
The IDD program supports local providers by encouraging them to develop a relationship with the
HCQU for trainings needed for their staff to support individuals with higher levels of need. The HCQU
can also do biographical timelines, Consumer Data Collection (CDCs), medication/pharmacy reviews
and provide training. CDCs were scheduled for all residential homes on a routine basis. Providers have
been utilizing the Health Risk Screening Tool (HRST) to improve the quality of life for individuals. The
AE continues to support providers in developing relationships with the local hospital. As previously
mentioned, the MH/IDD Coordination meetings help to support providers.
The Risk Management Committee holds quarterly meetings to assess incidents to establish a higher
quality of life for individuals. The Risk Management Committee realized that Individual to Individual (I-2-
I) abuse was an issue that needed to be addressed. The QM Plan addresses the I-2-I abuse issue. The
outcome, “People are abuse free,” is measured by the objective of reducing the number of I-2-I abuse
incidents by 5%. The number of incidents of I-2-I abuse will be measured through quarterly analysis of
the Home and Community Services Information System (HCSIS) Incident Data and the target trends to
prevent future incidents will be analyzed by the Risk Management Team. The baseline data was 75
incidents of I-2-I abuse for 2022-2023. The 2023-2024 data was 42 incidents through June 2024. This is
a dramatic decrease from the previous year. For 2024-2025, there were 58 incidents of I-2-I abuse
through June 2025. This is a decrease from the baseline, however, there was a slight uptick of incidents
from the previous year. The Risk Management Committee will continue to monitor the data for trends
and respond to providers accordingly.
The IDD Program partners with the County Housing Program to support an Independent Living
Apartment Program for people living in their own apartments who need less than 30 hours of support a
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week. The County subsidizes the rent with base funds and therefore, individuals are able to live in
affordable and safer neighborhoods. There are currently 10 individuals in this program.
The AE created two (2) new outcomes for the 2023-2026 Quality Monitoring Plan. The first outcome is to
comply with the Information and Sharing Advisory Committee (ISAC) recommendation to improve racial
equity. Franklin/ Fulton AE’s outcome is to have equal availability to supports and funding regardless of
race. The Target Objective is to gather data on racial diversity in both counties as a whole and compare
with racial diversity in the IDD program(s). The second outcome is that families need connections with
other families and support services. The second Target Objective ties in with the Front Porch program
and is designed to create a family mailing list to distribute events, trainings and community resources.
For the racial equity objective, our numbers are comparable to those represented in the census. Both
outcomes are currently being reevaluated by the QM Specialist to determine whether or not the
outcomes need to be revised or changed as a result of the Plan, Do, Check, and Act Cycle. Progress on
the second outcome includes the introduction of the online PADLET site that consists of a bulletin board
type of presentation of information and resources for families to access services, trainings and
community events. The PADLET is managed by an IDD staff and a local parent advocate who update
the site at least weekly. This offers a way for families and individuals to quickly locate information and
supports within Franklin County.
The County engages providers of service by ensuring that all ISPs have backup/emergency plans
included within. Franklin/ Fulton AE continues to follow up with all providers monthly. These meetings
were initially scheduled as a result of the pandemic, but the IDD Program has continued the monthly
meetings as they are beneficial for both the AE and the providers. Through the IM4Q considerations,
Franklin/ Fulton Counties made emergency folders with the local information from the Department of
Emergency Services and Ready.gov. Due to the local Department of Emergency Services discontinuing
the notification forms that were formerly used, the AE, Crisis Intervention Team, and Regional
Collaborative are looking into other avenues to let local first responders know, in the event of an
emergency, there is a person with a disability living in a home. This project is ongoing and will continue
to be explored and implemented.
Participant Directed Services (PDS):
• Please describe how the county will promote PDS (AWC, VF/EA) including challenges and
solutions.
• Please describe how the county will support the provision of training to SCOs, individuals and
families on self-direction.
• Are there ways that ODP can assist the county in promoting or increasing self-direction?
Franklin/ Fulton Counties have three (3) individuals and their families using VF/EA. The families are
using a Support Broker to help assist with self-directing their services. The Supports Coordinator checks
in with the families regularly since this is a relatively new process to everyone in Franklin and Fulton
Counties. When the VF/EA is explained to families, they often choose Agency with Choice (AWC) if they
wish to self-direct their services. Franklin County has 22 families using AWC supports. All of the
supports and services are paid with ODP waiver funding for both the VF/EA and AWC. The County
coordinates training for families through the Arc of Franklin/ Fulton Counties (the AWC provider) and the
HCQU.
The major challenges for AWC continue to be that families have trouble finding staff, especially in the
rural areas of the county. This is due to the low wage, lack of transportation and/or locations far from any
services, as well as families having a lack of knowledge of the IDD system and the service definition
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changes. Additionally, families become frustrated with the amount of documentation and training
required. ODP assistance could be used to find creative ways to address these issues and to provide
training to families regarding AWC.
Community for All: ODP has provided the county with data regarding the number of individuals
receiving services in congregate settings.
• Please describe how the county will enable individuals in congregate settings to return to the
community.
Franklin County has seven (7) individuals in congregate settings. One (1) individual resides at State
Centers and has been given the choice to move into the community. This individual has stated that he is
happy where he currently lives and has no desire to move. One (1) person resided in a private ICF/ID
and has since transitioned back to a 6400-community home in the 2023-2024. The remaining six (6)
individuals reside in nursing homes. All but one (1) of these individuals are age-appropriate and/ or have
a nursing home level of care required, making the nursing home an appropriate placement. The one (1)
exception is a woman who is too young to be in the nursing home but repeatedly refuses appropriate
residential options that are offered to her, though she does have a long-term level of care that was
determined by ODP. The Supports Coordinator will continue to offer and encourage her to look at
residential options that are more appropriate.
Technology: ODP supports the use of assistive technology and remote supports in order for individuals
to achieve their goals and live more independently.
• Please describe how the county will enable individuals to access technology as a means to
support greater independence.
Many individuals in Franklin/Fulton counties utilize some type of assistive technology. The AE
encourages the use of assistive Technology when applicable. The AE has met with remote support
providers to learn more about the supports and technologies available to individuals. Currently, there are
no (0) individuals who utilize waiver funded assistive technology in Franklin County. There is currently
one (1) individual/family who utilize waiver funded remote supports.
HOMELESS ASSISTANCE PROGRAM SERVICES
DHS encourages Homeless Assistance Program (HAP) partners to participate in their Continuum of
Care (CoC). Continuums of Care are regional or local planning bodies that coordinate housing and
services funding for families and individuals experiencing homelessness. Please describe the continuum
of services to individuals and families within the county who are experiencing homelessness or facing
eviction. An individual or family is facing eviction if they have received either written or verbal
notification from the landlord that they will lose their housing unless some type of payment is received.
Bridge Housing Services:
• Please describe the bridge housing services offered. Include achievements and improvements in
services to families at risk or experiencing homelessness, as well as unmet needs and gaps.
• How does the county evaluate the efficacy of bridge housing services? Please provide a brief
summary of bridge housing services results.
• Please describe any proposed changes to bridge housing services for FY 25-26.
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• If bridge housing services are not offered, please provide an explanation of why services are not
offered.
Franklin County does not currently provide Bridge Housing services due to a limited
availability of funding for this program. Franklin County continues to watch for grants or
other funding opportunities to potentially apply in the future.
Case Management:
• Please describe the case management services offered. Include achievements and improvements
in services to families at risk or experiencing homelessness, as well as unmet needs and gaps.
• How does the county evaluate the efficacy of case management services? Please provide a brief
summary of case management services results.
• Please describe any proposed changes to case management services for FY 25-26.
• If case management services are not offered, please provide an explanation of why services are
not offered.
SCCAP HAP Case Management
South Central Community Action Programs (SCCAP) provides case management services through its
Family Services Department for all Franklin County Rental Assistance applicants. These services are
grounded in Person Centered Coaching—a strengths-based, goal-oriented approach that empowers
individuals to take charge of their long-term stability and well-being. Coaching focuses on helping
individuals identify and work toward their own goals, with support tailored to each person’s unique
situation.
Upon intake, each participant works with a Family Services Specialist to complete an assessment and
jointly develop a service plan. This plan identifies barriers to housing stability, includes referrals to
appropriate support services (such as budgeting, life skills, or employment support), and outlines
specific steps toward long-term housing success. Participants may continue coaching beyond initial
assistance, allowing for sustained support as they build resilience and self-sufficiency.
Achievements and Improvements
SCCAP continues to enhance its services by expanding cross-sector collaborations with partners such
as the Franklin County Housing Authority, Veterans programs, and the Franklin Together Reentry
Coalition. These partnerships improve coordination and access to critical supports like reentry services,
childcare, food pantries, utility CAP programs, WIC, and financial literacy. SCCAP also connects
individuals to Rapid Rehousing and emergency shelter options when needed, providing a seamless
continuum of care from prevention through long-term housing stability. Additionally, SCCAP offers
ongoing peer support through Support Circles, fostering community and reducing isolation among
participants.
Evaluation and Oversight
Franklin County conducts annual monitoring of SCCAP and other providers, including program and
fiscal reviews, file audits, and on-site visits. This oversight ensures compliance with program standards
and identifies any gaps in service. Ongoing communication between SCCAP and County staff allows for
real-time problem-solving and continual quality improvement. Case management success is measured
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by participant outcomes including housing retention, increased income, and progress on individualized
goals.
Unmet Needs and Gaps
Despite improvements, challenges remain. Affordable housing availability is limited, and families often
face waitlists for supportive services. Some individuals with complex needs require longer-term
engagement than current resources allow. Transportation and access to childcare also continue to
present barriers to sustained housing stability.
Proposed Changes for FY 25–26
In FY 25–26, SCCAP will further integrate Person Centered Coaching into all case management
functions, providing additional staff training and tools to enhance coaching fidelity. The agency also
plans to strengthen referral tracking and follow-up protocols to better coordinate services across
systems and reduce duplication. SCCAP will continue to advocate for system-level solutions to increase
affordable housing options and improve service access.
Appeal Process
All clients are informed of their right to appeal any denial of service, per HAP guidelines. Written notices
will include:
• The action being taken;
• The reason for this action;
• The effective date of the action; and
• The availability of an appeal process at the county and state levels.
This process is explained and documented at the time of intake.
The written appeal will first take place in the County of Franklin. The individual will be informed in writing
of the result of the appeal. Further appeals will follow the guidelines per HAP which state that after
exhausting the first level of appeal at the County, an individual may appeal to the Office of Hearings and
Appeals (OHS). All individuals are given information on the appeal process during their office visit. The
appeal plan is explained at the first appointment and a copy is signed by the individual.
Rental Assistance:
• Please describe the rental assistance services offered. Include achievements and improvements
in services to families experiencing or at risk for homelessness, as well as unmet needs and gaps.
• How does the county evaluate the efficacy of rental assistance services? Please provide a brief
summary of rental assistance services results.
• Please describe any proposed changes to rental assistance services for FY 25-26.
• If rental assistance services are not offered, please provide an explanation of why services are
not offered.
SCCAP HAP Rental Assistance Services:
The HAP Rental Assistance program in Franklin County is administered by South Central Community
Action Programs (SCCAP) and supports individuals and families who are homeless or at risk of
homelessness through short-term rental support and holistic case management. Funded through the
Homeless Assistance Program (HAP), the goal is to stabilize housing while helping clients build a
foundation for long-term independence and well-being.
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Rental Assistance Services and Eligibility
Rental assistance may be used to pay for rent, security deposits, or rental costs associated with trailers
or trailers lots. The program is designed to intervene in imminent eviction situations, assist those living in
unsafe or temporary conditions, and provide a pathway to permanent housing. Each household can
receive assistance for up to three months within a 24-month period, with benefit amounts aligned to Fair
Market Rent (FMR) limits or capped at $1,000 per month for adult-only households and $1,500 per
month for households with children—whichever is greater.
Eligibility for assistance is limited to Franklin County residents who have lived in the county for at least
six months. Clients must be at or below 200% of the Federal Poverty Income Guidelines unless they are
fleeing domestic violence or experiencing a qualifying disaster, in which case income requirements may
be waived. Rental assistance is only provided when a household demonstrates that the support will lead
to long-term housing stability, either through current income or a reasonable expectation of income
within 90 days. Those living in subsidized or Section 8 housing may also be eligible for support with
security deposits or arrears, if justified by need.
As the payer of last resort, HAP rental assistance is only provided after clients have exhausted other
available supports, including the Emergency Shelter Assistance (ESA) program, LIHEAP, and resources
from the County Assistance Office. Prior to receiving funds, clients must provide required
documentation, including eviction notices, landlord agreements, and income verification. SCCAP verifies
all housing arrangements, and landlords must agree to suspend eviction proceedings or offer a lease
agreement contingent upon payment.
Case Management through Person Centered Coaching
To ensure housing stability and promote economic self-sufficiency, all participants engage in Person
Centered Coaching, a client-led, strengths-based approach to service planning. Through this model,
SCCAP staff and clients collaboratively create individualized service plans that identify the root causes
of housing instability, set goals, and outline necessary support services. These plans often include
referrals for budgeting assistance, job readiness, parenting support, life skills training, and connections
to other community resources. Continued engagement with coaching is expected throughout the
assistance period.
Evaluation and Oversight
Program outcomes are evaluated through annual on-site monitoring by Franklin County staff. This
includes fiscal and program compliance reviews, verification of eligibility documentation, and
assessment of service plan implementation. These evaluations have shown that SCCAP’s model,
particularly when combined with Person Centered Coaching, effectively helps clients retain housing,
increase income, and reduce returns to homelessness. SCCAP also tracks program data to evaluate
impact and guide continuous improvement.
Unmet Needs, Gaps, and Improvements
In the past year, South Central Community Action Programs (SCCAP) has enhanced service delivery by
integrating rental assistance with other housing supports such as Rapid Rehousing, Emergency Shelter,
and Support Circles. Collaborative partnerships with agencies serving veterans, returning citizens, and
survivors of domestic violence have expanded access and improved wraparound care. However,
challenges remain. The limited stock of affordable housing decreased access to rental assistance
dollars, transportation barriers, and the complex needs of some families still pose significant obstacles.
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For FY 2024–2025, SCCAP plans to strengthen implementation of Person-Centered Coaching through
additional staff training, expand data systems for referral tracking, and streamline intake processes in
response to any state-level program changes. These improvements aim to ensure that families not only
avoid homelessness but are equipped with tools to thrive.
Appeal Process
All clients are informed of their right to appeal any denial of service, according to HAP guidelines.
Written notices will include:
• The action being taken;
• The reason for this action;
• The effective date of the action; and
• The availability of an appeal process at the county and state levels.
This process is explained and documented at the time of intake.
The written appeal will first take place in the County of Franklin. The individual will be informed in writing
of the result of the appeal. Further appeals will follow the guidelines per HAP which state that after
exhausting the first level of appeal at the County, an individual may appeal to the Office of Hearings and
Appeals (OHS). All individuals are given information on the appeal process during their office visit. The
appeal plan is explained at the first appointment and a copy is signed by the individual.
SCCAP is committed to maintaining a responsive and ethical Emergency Shelter program that centers
dignity, housing stability, and client choice.
Emergency Shelter:
• Please describe the emergency shelter services offered. Include achievements and improvements
in services to families at risk or experiencing homelessness, as well as unmet needs and gaps.
• How does the county evaluate the efficacy of emergency shelter services? Please provide a brief
summary of emergency shelter services results.
• Please describe any proposed changes to emergency shelter services for FY 25-26.
• If emergency shelter services are not offered, please provide an explanation of why services are
not offered.
SCCAP’s Emergency Shelter Program
South Central Community Action Programs (SCCAP) offers Emergency Shelter services to individuals
and families who meet the legal definition of homelessness. The Franklin County Shelter for the
Homeless is located at 223 South Main Street in Chambersburg and serves as the county’s primary
safety net for those without stable housing. With nine bedrooms and a total capacity of 18 individuals,
the shelter includes two family rooms and seven rooms designated for single adults or couples.
The shelter operates under a Housing First model, which prioritizes rapid access to safe, stable
housing without preconditions, followed by intensive case management and wraparound supports. Once
admitted, residents receive basic necessities—shelter, food, hygiene supplies, alongside individualized
case management to address barriers such as unemployment, mental health challenges, physical health
conditions, and lack of identification or documentation.
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Participants are enrolled through Coordinated Entry, which ensures services are prioritized for those
with the most urgent needs. Individuals or families initiate this process by contacting PA 211, completing
an assessment, and receiving a vulnerability score. Based on availability and need, individuals are either
admitted directly or connected with alternate support until space is available. All participants must meet
the HAP definition of homelessness, which includes those living in places not meant for habitation,
staying in emergency shelters or institutions, or fleeing domestic violence.
Case management services are central to the program and are structured around the development of
a client-driven service plan. Using Person Centered Coaching principles, case managers work with
residents to identify personal goals, secure benefits or employment, address health needs, and
transition to permanent housing. Clients are connected to a broad network of referrals including
behavioral health providers, job training programs, and other community resources. The overarching
goal is long-term stability and housing retention.
The program tracks three primary outcomes:
1. Increases in household income.
2. Access to necessary support services.
3. Successful transition to safe, affordable housing.
Program efficacy is monitored through an annual onsite evaluation conducted by Franklin County staff.
This includes reviews of service plans, case files, fiscal records, and compliance with state regulations.
Performance metrics such as housing placements, service engagement, and length of stay are
assessed to ensure effectiveness. The shelter also complies with standards outlined in the HAP
guidelines for physical safety, service quality, ethical treatment, and nondiscrimination.
In recent years, Franklin County has made improvements to better align shelter services with Housing
First principles and to enhance aftercare coordination. These efforts have improved housing outcomes
and reduced the length of time clients remain in shelter. However, challenges remain.
Unmet needs include a lack of low-barrier housing for individuals with complex behavioral health needs,
limited transitional options for families leaving shelter, and insufficient transportation to jobs and
services.
For FY 2024–2025, Franklin County proposes continued implementation of the Housing First model with
enhancements in several key areas:
• Additional staff training in trauma-informed care and Person-Centered Coaching.
• Expansion of partnerships with housing providers to shorten the time between shelter exit and
housing placement.
• Increased coordination with mental health providers to support residents with co-occurring
conditions.
• Development of post-shelter support services to ensure housing retention beyond exit.
SCCAP is committed to maintaining a responsive and ethical Emergency Shelter program that centers
dignity, housing stability, and client choice.
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Innovative Supportive Housing Services:
• Please describe the other housing supports services offered. Include achievements and
improvements in services to families experiencing or at risk for homelessness, as well as unmet
needs and gaps.
• How does the county evaluate the efficacy of other housing supports services? Please provide a
brief summary of other housing supports services results.
• Please describe any proposed changes to other housing supports services for FY 25-26.
• If other housing supports services are not offered, please provide an explanation of why services
are not offered.
Due to the non-availability of funds, innovative supportive housing services are not provided
through HAP. Independent living and forensic housing is available through other funding
sources.
Homeless Management Information Systems:
DHS encourages counties and HAP partners to participate in their Continuum of Care (CoC) and for
eligible providers to collect and track client-level data and services in their CoC’s Homeless
Management Information System (HMIS). HMIS tracks and analyzes the characteristics and service
needs of people at-risk or experiencing homelessness.
Please describe the county’s utilization of HMIS to include how HAP providers enter data and enrollments
into HMIS for any or all components of the program.
• If the HAP provider does not utilize HMIS, describe how the provider collects client-level data and
data on the provision of housing services. Is this data provided to the CoC that coordinates
housing and services funding for families and individuals experiencing homelessness?
• Describe any change the county has identified in the service needs of families or individuals
experiencing homelessness over the past program year.
Franklin County has actively participated in the Homeless Management Information System (HMIS) and
has taken a lead role by providing an access center as a secondary option to the 211 system, for those
who are seeking housing services. This process allows for individuals and families to be triaged,
prescreened, and assessed through HMIS so that appropriate services can assist in helping individuals
achieve permanent housing successfully. In addition, this system works as a starting point to connect
individuals and families with the Emergency Solutions Grant (ESG), HUD Permanent Supportive
Housing programs, PATH, and one Shelter Plus Care program. Individuals and families are connected
by use of referrals and/or the housing prioritization queue tools that are a part of HMIS. The goal is for
individuals to be entered into HMIS immediately following enrollment in the housing programs. Multiple
County employees are familiar with entering data into HMIS as well as running reports.
HUMAN SERVICES AND SUPPORTS/ HUMAN SERVICES DEVELOPMENT FUND (HSDF)
Please use the fields and dropdowns to describe how the county intends to utilize HSDF funds on
allowable expenditures for the following categories. (Please refer to the HSDF Instructions and
Requirements for more detail.)
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Dropdown menu may be viewed by clicking on “Please choose an item.” Under each service
category.
Copy and paste the template for each service offered under each categorical, ensuring each service
aligns with the service category when utilizing Adult, Aging, Children and Youth, or Generic Services.
Adult Services: Please provide the following:
Program Name:
Description of Services:
Service Category: Please choose an item.
Aging Services: Please provide the following:
Program Name:
Description of Services:
Service Category: Please choose an item.
Children and Youth Services: Please provide the following:
Program Name:
Description of Services:
Service Category: Please choose an item.
Generic Services: Please provide the following:
Program Name:
Description of Services: This is information and referral based services that link individuals within their
community through a variety of communication channels. These are not limited to: phone services,
emails, texting, in person appointments and walk-in opportunities, community training and other webinar/
presentations offered for specific purposes to educate and inform. We work in conjunction and
collaboration with PA Contact 211; PA Navigate; Here to Help; and other community referral /
information system services. These services are absolutely free of charge to any individual in need.
A primary function and purpose to embed these services within Human Services is to link the person in
need with every possible Social Determinant of Health (SDOH) resource option available. The individual
within this position is the ambassador and spokesperson for all things Human Services and is the direct
link/coordinator to help the individual navigate through the intricate human services web.
Service Category: Information & Referral - The direct provision of information about social and other
human services, to all persons requesting it, before intake procedures are initiated. The term also
includes referrals to other community resources and follow-up.
Please indicate which client populations will be served (must select at least two):
☒ Adult ☒ Aging ☐ CYS ☒ SUD ☒ MH ☒ ID ☒ HAP
Specialized Services: Please provide the following: (Limit 1 paragraph per service description)
Program Name:
Description of Services:
Interagency Coordination: (Limit of 1 page)
If the county utilizes funds for Interagency Coordination, please describe how the funding will be utilized
by the county for planning and management activities designed to improve the effectiveness of
categorical county human services. The narrative should explain both:
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• how the funds will be spent (e.g., salaries, paying for needs assessments, and other allowable
costs).
• how the activities will impact and improve the human services delivery system.
The County provides professional development events each year which provide information on services
available in the County, and up-to-date training that addresses challenges that are faced by those who
serve in the human services profession. The goal is to provide quality professional training that will raise
awareness on availability of services, enhance skills, increase professional development, and provide
awareness of current trends in their profession. Attendees can then use these tools to strengthen
delivery service. These services now provide a virtual platform option for maximum attendance. Internal
training, based on funding, is also available.
Other HSDF Expenditures – Non-Block Grant Counties Only
If the county plans to utilize HSDF funds for Mental Health, Intellectual Disabilities, Homeless
Assistance, or Substance Use Disorder services, please provide a brief description of the use and
complete the chart below.
Only HSDF-allowable cost centers are included in the dropdowns.
Category Allowable Cost Center Utilized
Mental Health
Intellectual Disabilities
Homeless Assistance
Substance Use Disorder
Note: Please refer to Planned Expenditures directions at the top of Appendix C-2 for reporting
instructions (applicable to non-block grant counties only).
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Appendix D
Eligible Human Services Cost Centers
Mental Health
For further detail refer to Cost Centers for County Based Mental Health Services Bulletin
(OMHSAS-12-02), effective July 1, 2012.
Administrative Management
Activities and administrative functions undertaken by staff in order to ensure intake into the county
mental health system and the appropriate and timely use of available resources and specialized
services to best address the needs of individuals seeking assistance.
Administrator’s Office
Activities and services provided by the Administrator’s Office of the County Mental Health (MH)
Program.
Adult Development Training (ADT)
Community-based programs designed to facilitate the acquisition of prevocational, behavioral
activities of daily living, and independent living skills.
Assertive Community Treatment (ACT) Teams and Community Treatment Teams (CTT)
ACT is a SAMHSA-recognized Evidence Based Practice (EBP) delivered to individuals with Serious
Mental Illness (SMI) who meet multiple specific eligibility criteria such as psychiatric hospitalizations,
co-occurring mental health and substance use disorders, being at risk for or having a history of
criminal justice involvement, and at risk for or having a history of experiencing homelessness. CTT
services merge clinical, rehabilitation and support staff expertise within one delivery team.
Children’s Evidence Based Practices
Practices for children and adolescents that by virtue of strong scientific proof are known to produce
favorable outcomes. A hallmark of these practices is that there is sufficient evidence that supports
their effectiveness.
Children’s Psychosocial Rehabilitation Services
Activities designed to assist a child or adolescent (e.g., a person aged birth through 17, or through
age 21 if enrolled in a special education service) to develop stability and improve capacity to function
in family, school and community settings. Services may be delivered to the child or adolescent in the
home, school, community or a residential care setting.
Community Employment and Employment-Related Services
Employment in a community setting or employment-related programs, which may combine vocational
evaluation, vocational training and employment in a non-specialized setting such as a business or
industry.
Community Residential Services
Care, treatment, rehabilitation, habilitation, and social and personal development services provided to
persons in a community-based residential program which is a DHS-licensed or approved community
residential agency or home.
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Community Services
Programs and activities made available to community human service agencies, professional
personnel, and the general public concerning the mental health service delivery system and mental
health disorders, in order to increase general awareness or knowledge of same.
Consumer-Driven Services
Services that do not meet the licensure requirements for psychiatric rehabilitation programs, but
which are consumer-driven and extend beyond social rehabilitation services.
Emergency Services
Emergency-related activities and administrative functions undertaken to proceed after a petition for
voluntary or involuntary commitment has been completed, including any involvement by staff of the
County Administrator’s Office in this process.
Facility-Based Vocational Rehabilitation Services
Programs designed to provide paid development and vocational training within a community-based,
specialized facility using work as the primary modality.
Family-Based Mental Health Services
Comprehensive services designed to assist families in caring for their children or adolescents with
emotional disturbances at home.
Family Support Services
Services designed to enable persons with SMI, children and adolescents with or at risk of Serious
Emotional Disturbance (SED), and their families, to be maintained at home with minimal disruption to
the family unit.
Housing Support Services
Services provided to mental health consumers which enable the recipient to access and retain
permanent, decent, affordable housing, acceptable to them.
Mental Health Crisis Intervention Services
Crisis-oriented services designed to ameliorate or resolve precipitating stress, which are provided to
adults or children and adolescents and their families who exhibit an acute problem of disturbed
thought, behavior, mood or social relationships.
Other Services
Activities or miscellaneous programs which could not be appropriately included in any of the cited
cost centers.
Outpatient Treatment-oriented services provided to a consumer who is not admitted to a hospital,
institution, or community mental health facility for twenty-four hour a day service.
Partial Hospitalization
Non-residential treatment services licensed by the Office of Mental Health & Substance Abuse
Services (OMHSAS) for persons with moderate to severe mental illness and children and adolescents
with SED who require less than twenty-four hour continuous care but require more intensive and
comprehensive services than are offered in outpatient treatment.
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Peer Support Services
Refers specifically to the Peer Support Services which meet the qualifications for peer support
services as set forth in the Peer Support Services Bulletins (OMHSAS-22-08), effective December 28,
2022, and OMHSAS-24-05, effective December 20, 2024.
Psychiatric Inpatient Hospitalization
Treatment or services provided an individual in need of twenty-four hours of continuous psychiatric
hospitalization.
Psychiatric Rehabilitation
Services that assist persons with long-term psychiatric disabilities in developing, enhancing, and/or
retaining: psychiatric stability, social competencies, personal and emotional adjustment and/or
independent living competencies so that they may experience more success and satisfaction in the
environment of their choice, and can function as independently as possible.
Social Rehabilitation Services
Programs or activities designed to teach or improve self-care, personal behavior and social
adjustment for adults with mental illness.
Targeted Case Management
Services that provide assistance to persons with SMI and children diagnosed with or at risk of SED in
gaining access to needed medical, social, educational, and other services through natural supports,
generic community resources and specialized mental health treatment, rehabilitation and support
services.
Transitional and Community Integration Services
Services that are provided to individuals who are residing in a facility or institution as well as
individuals who are incarcerated, diversion programs for consumers at risk of incarceration or
institutionalization, adult outreach services, and homeless outreach services.
Intellectual Disabilities
Administrator’s Office
Activities and services provided by the Administrator’s Office of the County Program. The
Administrator’s Office cost center includes the services provided relative to the Administrative Entity
Agreement, Health Care Quality Units (HCQU) and Independent Monitoring for Quality (IM4Q).
Case Management
Coordinated activities to determine with the individual what services are needed and to coordinate
their timely provision by the provider and other resources.
Community Residential Services
Residential habilitation programs in community settings for individuals with intellectual disabilities or
autism.
Community-Based Services
Community-based services are provided to individuals with intellectual disabilities or autism who need
assistance in the acquisition, retention, or improvement of skills related to living and working in the
community and to prevent institutionalization.
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Other
Activities or miscellaneous programs which could not be appropriately included in any of the cited
cost centers.
Homeless Assistance Program
Bridge Housing
Transitional services that allow individuals who are in temporary housing to move to supportive long-
term living arrangements while preparing to live independently.
Case Management
Case management is designed to provide a series of coordinated activities to determine, with each
individual, what services are needed to prevent the reoccurrence of experiencing homelessness and
to coordinate timely provision of services by the administering agency and community resources.
Rental Assistance
Payments for rent, mortgage arrearage for home and trailer owners, rental costs for trailers and trailer
lots, security deposits, and utilities to prevent and/or end homelessness or possible eviction by
maintaining individuals and families in their own residences.
Emergency Shelter
Refuge and care services to persons who are in immediate need and are experiencing
homelessness; e.g., have no permanent legal residence of their own.
Innovative Supportive Housing Services
Other supportive housing services outside the scope of existing Homeless Assistance Program
components for individuals and families who are experiencing homelessness or facing eviction. An
individual or family is facing eviction if they have received either written or verbal notification from the
landlord that they will lose their housing unless some type of payment is received.
Substance Use Disorder
Care/Case Management
A collaborative process, targeted to individuals diagnosed with substance use disorders or co-
occurring psychiatric disorders, which assesses, plans, implements, coordinates, monitors, and
evaluates the options and services to meet an individual’s health needs to promote self-sufficiency
and recovery.
Inpatient Non-Hospital
Inpatient Non-Hospital Treatment and Rehabilitation
A licensed residential facility that provides 24-hour professionally directed evaluation, care, and
treatment for individuals with substance use disorder in acute distress, whose addiction
symptomatology is demonstrated by moderate impairment of social, occupation, or school
functioning. Rehabilitation is a key treatment goal.
Inpatient Non-Hospital Detoxification
A licensed residential facility that provides a 24-hour professionally directed evaluation and
detoxification of an individual with a substance use disorder.
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Inpatient Non-Hospital Halfway House
A licensed community-based residential treatment and rehabilitation facility that provides services for
individuals to increase self-sufficiency through counseling, employment and other services. This is a
live in/work out environment.
Inpatient Hospital
Inpatient Hospital Detoxification
A licensed inpatient health care facility that provides 24-hour medically directed evaluation and
detoxification of individuals diagnosed with substance use disorders in an acute care setting.
Inpatient Hospital Treatment and Rehabilitation
A licensed inpatient health care facility that provides 24-hour medically directed evaluation, care and
treatment for individuals with substance use disorder with co-existing biomedical, psychiatric and/or
behavioral conditions which require immediate and consistent medical care.
Outpatient/Intensive Outpatient
Outpatient
A licensed organized, non-residential treatment service providing psychotherapy and substance
use/disorder education. Services are usually provided in regularly scheduled treatment sessions for a
maximum of five hours per week.
Intensive Outpatient
An organized non-residential treatment service providing structured psychotherapy and stability
through increased periods of staff intervention. Services are provided in regularly scheduled sessions
at least three days per week for at least five hours (but less than ten).
Warm Handoff
Direct referral of overdose survivors from the Emergency Department to a drug treatment provider.
Partial Hospitalization
Services designed for those individuals who would benefit from more intensive services than are
offered in outpatient treatment programs, but do not require 24-hour inpatient care. Treatment
consists of the provision of psychiatric, psychological and other types of therapies on a planned and
regularly scheduled basis at least three days per week with a minimum of ten hours per week.
Prevention
The use of social, economic, legal, medical or psychological measures aimed at minimizing the use of
potentially addictive substances, lowering the dependence risk in susceptible individuals, or
minimizing other adverse consequences of psychoactive substance use.
Medication Assisted Therapy (MAT)
Any treatment for addiction that includes a medication approved by the U.S. Food and Drug
Administration for opioid addiction detoxification or maintenance treatment. This may include
methadone, buprenorphine, naltrexone, or vivitrol.
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Recovery Support Services
Services designed and delivered by individuals who have experience with substance-related
disorders and recovery to help others initiate, stabilize, and sustain recovery from substance use
disorder. These services are forms of social support not clinical interventions. This does not include
traditional 12 step programs.
Recovery Specialist
An individual in recovery from a substance-related disorder that assists individuals in gaining access
to needed community resources to support their recovery on a peer-to-peer basis.
Recovery Centers
A location where a full range of Recovery Support Services are available and delivered on a peer to
peer basis.
Recovery Housing
A democratically run, self-sustaining and drug-free group home for individuals in recovery from
substance related disorders.
Human Services Development Fund
Administration
Activities and services provided by the Administrator’s Office of the Human Services Department.
Interagency Coordination
Planning and management activities designed to improve the effectiveness of county human
services.
Adult Services
Services for adults (persons who are at least 18 years of age and under the age of 60, or persons
under 18 years of age who are the head of an independent household) include: adult day care, adult
placement, chore, counseling, employment, home delivered meals, homemaker, housing, information
and referral, life skills education, protective, service planning/case management, transportation, or
other services approved by DHS.
Aging
Services for older adults (persons who are 60 years of age or older) include: adult day service,
assessments, attendant care, care management, congregate meals, counseling, employment, home
delivered meals, home support, information and referral, overnight shelter, personal assistance
service, personal care, protective services, socialization/recreation/education/health promotion,
transportation (passenger), volunteer services or other services approved by DHS.
Children and Youth
Services for individuals under the age of 18 years, under the age of 21 years who committed an act of
delinquency before reaching the age of 18 years, or under the age of 21 years who was adjudicated
dependent before reaching the age of 18 years, and requests retention in the court’s jurisdiction until
treatment is complete. Services to these individuals and their families include: adoption services,
counseling/intervention, day care, day treatment, emergency placement services, foster family
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services (except room & board), homemaker, information and referral, life skills education, protective
services and service planning.
Generic Services
Services for individuals that meet the needs of two or more populations include: adult day care, adult
placement, centralized information and referral, chore, counseling, employment, homemaker, life
skills education, service planning/case management, and transportation services.
Specialized Services
New services or a combination of services designed to meet the unique needs of a specific
population that are difficult to meet within the current categorical programs.
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Appendix D:
Human Service Block Grant Committee Members:
Gayle Brown (Aging Advocate Specialist)
Lorna Blanchard (Intellectual & Developmental Disabilities Advocate Specialist)
Zachary McCauley (Early Intervention/Family)
Michael Straley (Drug & Alcohol Advocate Specialist)
Kim Wertz (Mental Health Advocate Specialist)
Greg Colbert (Homeless Assistance Advocate Specialist)
Brenda Lamar (Member at Large Community Advocate)
Kim Crider (Health Planning Community Advocate)
Sherri Sullivan (Employment/Training/Education Community Advocate)
Bruce Levy (Faith Based Community Advocate)
Scott Graham (Housing/Homelessness Community Advocate)
Kayla Stoner (Criminal Justice Community Advocate)
Auxiliary / Staff Members:
Julie Dovey (Fulton County)
Carrie Gray (County Administrator)
John Thierwechter (Assistant County Administrator)
Stacie Horvath (Human Services Administrator)
Hali Finniff (Human Services Administration)
Tressia Day (Human Services Program Specialist / Ombudsman)
Nicole Smith (Community Access Resources / LINK Coordinator)
Melissa Wileman (Tuscarora Managed Care Alliance)
Catya Bookhamer (Tuscarora Managed Care Alliance)
Brad Coccagna (Tuscarora Managed Care Alliance)
Gen Harper (Tuscarora Managed Care Alliance)
James Eagler (Drug & Alcohol)
Tobin Kercheval (Drug & Alcohol)
Stacey Brookens (Mental Health / Intellectual & Developmental Disabilities / Early Intervention)
Erin Nye (Mental Health / Intellectual & Developmental Disabilities / Early Intervention)
John Gerak (Intellectual & Developmental Disabilities)
Rebecca Weaver (Intellectual & Developmental Disabilities)
Jane Cline (Intellectual & Developmental Disabilities)
Marion Rowe (Intellectual & Developmental Disabilities)
Nancy Strueber (Mental Health / CASSP)
Jim Gilbert (Mental Health)
Cori Seilhamer (Mental Health)
Jennifer Heidler (Mental Health Housing)
Minnie Goshorn (Children & Youth Services)
Nicole Weller (Children & Youth Services)
Tawnya Hurley (Aging)
Ashley McCullough (Aging)
Joshua Curry (Veterans Affairs)
Melodie Hoff (Grants)
Ronda Ranalli (Grants / CJAB Coordinator)
Stacy Rowe (Fiscal)
Charity Stepler/ Leslie Bowers/ Ashley McCartney/ Zach Gantz/ Allison Harvey (Fiscal Officers / All
Depts)
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