HomeMy WebLinkAbout2015-06-12 Plan FINAL DRAFTFranklin County Human Services Plan
Fiscal Year 2015/2016
To Be Submitted: June 26, 2015
The Public is invited to review and comment on this Plan. Please email
comments to Rick Wynn, Human Services Administrator
(rcwynn@franklincountypa.gov), or Shalom Black, Grants Director
(seblack@franklincountypa.gov). Or, mail comments to: Human Services
Administrator, 425 Franklin Farm Lane, Chambersburg PA 17202
PART I: COUNTY PLANNING PROCESS
Describe the county planning and leadership team and the process utilized to develop the plan
for the expenditure of human services funds. Counties should clearly identify:
1. Critical stakeholder groups including individuals and their families, consumer groups,
providers of human services, and partners from other systems;
Planning team members include human services providers and stakeholders as well as
consumers and advocate family members. In addition, the team includes staff support from each of the departments included in the block grant. Appendix D includes a comprehensive list of the
members of the planning team and their affiliations.
The leadership team is comprised of key fiscal and human service administration staff and
includes: Human Services Administrator, Fiscal Specialist, Human Services Fiscal Director, MH/ID/EI Administrator, County Grants Director, and the Assistant County Administrator.
2. How these stakeholders were provided with an opportunity for participation in the
planning process, including information on outreach and engagement;
We have a small but active Planning Team that deliberates on the larger Block Grant Plan,
monitors implementation, and recommends adjustments throughout the year. In addition to
participating in the Human Services Block Grant (HSBG) meetings, program consumers and
their families are often asked for their input through surveys, evaluations, and informal feedback;
this feedback informs the operation of Block Grant-funded programs.
In addition, most of our categoricals have their own advisory boards which inform the direction
of each department and Block Grant-funded programs:
• The Franklin/Fulton Drug and Alcohol Advisory Board holds six meetings a year, three in Franklin County, three in Fulton County. The seven members include two
commissioners (one from each county), representatives from a church, a Federally-
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Qualified Health Center (FQHC), and Fulton County Probation Office, as well as a
member who is in recovery and another who has a family member affected by substance abuse. They provide input into the Block Grant Plan, are informed of Block Grant impact, and are made aware of any D&A requests for new funding.
• The Franklin County Housing Task Force consists of about 25 people who meet bi-
monthly on issues around housing and homelessness. Representatives from both County shelters and the HAP program attend regularly, along with Housing Authority staff, staff from the domestic violence shelter, Salvation Army, an FQHC, two
Boroughs, and several religious organizations. They also receive updates on Block
Grant plans and funding requests. The Task Force now combines their meetings with
those of the Program Coordinating Committee hosted by the County Housing Authority, a change which has engaged additional community members and offered opportunities for presentations on local housing resources.
• The Franklin/ Fulton County Mental Health/ Intellectual Disabilities/ Early Intervention
Advisory Board meets bi-monthly, with 13 members, including one Commissioner from Fulton and one from Franklin. The committee requires representation from each county: four members from Fulton County; nine members from Franklin County. At
least two representatives appointed to the Board are physicians (preferably, a
psychiatrist and a pediatrician). Four participants are consumers or family members,
of which half represent Intellectual 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.
The MH/ID/EI Administrator provides HSBG updates as applicable during the Board
meetings. They have impact on decisions related to MH/ID/EI funding and decisions, which indirectly can impact the HSBG.
• The Children & Youth Advisory Board meets five times each year. Members come
from various sectors, including the County Commissioners, law enforcement,
academia, school districts, providers, and staff. They receive updates on the Family Group Decision Making program funded by the Block Grant.
3. How the county intends to use funds to provide services to its residents in the least
restrictive setting appropriate to their needs. For those counties participating in the County Human Services Block Grant, funding can be shifted between categorical areas based on the determination of local need and within the parameters established
for the Block Grant;
Details of the services to be funded are provided under each categorical area. In general,
funding allocations have remained similar to last year, as we currently feel that we have
achieved a balance that provides for the basic needs in each categorical.
4. Substantial programmatic and/or funding changes being made as a result of last year’s
outcomes.
County Planning Team members acknowledge that the existing data lacks the breadth and
depth to make critical decisions regarding comprehensive human services that are responsive to local needs and the current service delivery environment. Through its Priority Needs
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Assessment & Outcomes Committee, the County Planning Team is working to establish an
objective decision- making framework that incorporates needs, outcomes and values when developing future human services plans.
The processes for establishing both meaningful outcomes (as opposed to outputs) and for
prioritizing our needs will take much time and planning, as outcomes and needs prioritization are
intimately related. We have started by determining the current program outputs and outcomes. We will use those outcomes as part of the process to determine our priorities and needs, with the outcomes data serving as a foundation for determining needs. We have not settled on a
model to objectively assess needs, but we know that the model must include valid and reliable
data, quality community dialogue, and strategic thinking as we plan for the future. With a solid
foundation, we can forecast desired future outcomes and goals that will be meaningful to the Block Grant programs and ultimately the community as a whole.
The collaborative nature of the Block Grant Plan process remains extremely beneficial to the
county, especially the inclusion of consumer and family perspectives. The Planning Team is
better able to take a holistic approach because they better understand each department’s mission and services. The process also yields more empathy among planners. The County Planning Team still wrestles with the weighty question of, “How can we be expected to pick
certain human services over others when there is such great need throughout all of the
programs?” But, with the collaborative nature of Franklin County stakeholders, and the forward
movement of integrating objective data into the decision-making process, this task is no longer as daunting as County Planning Team members perceived in the past.
PART II: PUBLIC HEARING NOTICE The Board of Commissioners approved the County’s Human Services Plan, as illustrated by their signatures found in Appendix A – Assurance of Compliance.
Pursuant to the Sunshine Act, 65 Pa.C.S. 701-716, the County conducted two public hearings to
receive input on the Human Services Plan detailed in this document. A draft of the Block Grant Plan was posted on the County’s website on May 15, 2015 for public review and comments. Public hearings were held at 3:00 PM on May 26, 2015, as part of the Block Grant Planning
Committee, and 9:30 AM on June 23, 2015, as part of the Board of County Commissioners
meeting. Appendix B contains the proof of publication and summaries of the public hearings. PART III: WAIVER REQUEST
The County is not requesting a waiver at this time.
PART IV: HUMAN SERVICES NARRATIVE
Created through a collaborative process utilizing local needs data and involving a cross-section
of community stakeholders, the goal of this plan is to provide a comprehensive continuum of
human services for residents in the least restrictive setting appropriate to their needs. Franklin County collaborates as a joinder with Fulton County in four of the seven funds included in the
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Block Grant. Both counties have longstanding Human Services Administrative models. Both
counties are participating in the Block Grant and submit separate plans. Franklin County’s Human Services Block Grant Planning Committee has established as its
mission: To assist in identifying need-based program priorities for promoting the health, well-
being, and self-sufficiency for all people in Franklin County by and through maximizing
resources. The services described in this plan are an outflow of this mission statement, and are measured against this guiding standard.
MENTAL HEALTH SERVICES
The discussions 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, HealthChoices, reinvestment funds, etc.
a) Program Highlights:
Highlight the achievements and other programmatic improvements that have enhanced the
behavioral health service system.
The Franklin/ Fulton County Mental Health Program provides services to Franklin/ Fulton County adults with severe and persistent mental illness and children who have a mental health diagnosis or who are at risk of developing a mental illness.
Through contracted case management, our agency provides intake, assessment, and
coordination of the following services: outpatient psychotherapy, psychiatric and psychological evaluation, medication monitoring, residential programs, vocational and social rehabilitation, short-term inpatient, partial hospitalization and 24- hour emergency services.
The following list describes program achievements and improvements: Crisis Intervention Team (CIT) – This initiative is in its third year and continuing to gain momentum. The team is now 41 strong with members representing law enforcement, first
responders, crisis, 911 dispatchers, jail officers/staff, probation officers, mental health
professionals and advocates.
• South Central Region CIT continues to follow the fidelity of the Memphis Model of CIT. During the 40 hours of training, we are fortunate to have a certified trainer for the
Veterans module.
• Outcomes: We are tracking the number of personnel trained and their disciplines. We are currently working with Shippensburg University to complete research and data
collection relating to the number of mental distress calls received by 911. Our largest
police department, Chambersburg Borough, is beginning to collect data related to the
calls labeled “mental distress.” Our goal is to gain information to begin making informed
advancements to our CIT program. o To date we have held three CIT trainings and have forty one members with
nineteen of them representing law enforcement:
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o According to the pre/post test data, knowledge of each core topic was increased a
point or a point and half after the CIT training:
Law
Enforcement
46%
First
Responders
7%
Mental Health
32%
Jail
5%
Probation
7%
Court
3%
Team
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1
2
3
4
5
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Pre Test 14-Oct
Pre Test 14-Feb
Pre Test 15-May
Post Test 14-Oct
Post Test 14-Feb
Post Test 15-May
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Mental Health First Aid
• Continues to be available in the community for those requesting the training. Currently, we have trained community members to include corrections, business, and human
services.
Supportive Employment
• Continue to work towards increasing our supported employment opportunities for those in
the workforce.
• Outcomes: We tracked the number of employees engaged in Supportive Employment and the percent change compared to last year. FY 14-15 doesn’t include individuals who are transitioning into supported employment and we are still trending towards an
increase.
Employment
Fiscal Year 12-13 Fiscal Year 13-14 % Change 12-13 to 13-14 Fiscal Year 14-15 % Change 13-14 to 14-15
AHEDD 46 65 41.3% 79 21.5%
OSI 20 18 -10.0% 15 -16.7%
Total 66 83 25.8% 94 13.3%
*14-15 is completed through Apr
WRAP® WRAP® Education continues to grow in our community. Currently, we have had 48 people who have completed level 1 WRAP and 290 that have attended an overview session learning about
WRAP. Please refer to the collaboration section of the intellectual disabilities narrative for more
information.
System Service Needs
In a review of system service needs, MH/ID/EI recognized that historically, our system has
required improvements in data collection related to quality of care. In response, MH/ID/EI
partnered with other entities in our community to identify which areas should be analyzed for our system. We created workgroups and assigned them to priority areas for system indicators analysis. The following topics arose as needing improvement; we detail what has been done
since last year to improve these areas.
Readmission rates
• We continue to have a workgroup comprised of outpatient providers, behavioral health
unit, advocates, crisis, case management, HealthChoices, managed care, and the
County. The group is focused on identifying any commonalities and discrepancies in our
services compared to neighboring communities. The information will be combined with
results of a survey from individuals that have experienced multiple admissions with the goal of creating an action plan.
• Outcomes: We tracked the annual readmission rates and the percent change compared
to previous years. From 2012 to 2013, there was a significant decrease across the board
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in admissions, readmissions, and bed days. Our decline in bed days continued
throughout 2014.
Franklin Hospital Data
2011 2012 2013 % Change (12 - 13) 2014 % Change (13 - 14)
Admission 279 313 174 -44% 161 -7%
Unduplicated 160 165 98 -41% 89 -9%
Readmission 119 148 76 -49% 72 -5%
Bed Days 4927 4563 2480 -46% 2014 -19%
b) Strengths and Needs:
Please identify the strengths and needs for the following target populations served by the
behavioral health system:
Older Adults (ages 60 and above)
• Strengths: o Mental Health and Aging are working collaboratively on trauma informed training for staff. Recognizing that trauma can happen anytime in a person’s life, and that symptoms may present at different phases of life and in different behaviors, is
imperative when completing assessments.
o Scheduled to meet with the local nursing home continuum of care committee to
determine how to partner and become active members within each other’s service system. o Continue to provide training regarding older adults and mental health to law
enforcement and first responders through CIT program. This includes best way to
intervene and resources available.
• Needs: o To provide outreach services in peoples’ homes whereby a team composed of
aging and mental health (and potentially nursing) staff would provide assessment
and resource-sharing services to older adults to address quality of life issues.
Adults (ages 18 and above)
• Strengths:
o The leadership academy continues to meet for eight weeks featuring professions
from our community as the presenters. The goal of the academy is preparing the
students to gain skills that assist when holding a position on an advisory board or board of directors. To date, 50 have graduated over the past 5 years. Currently,
the class will graduate 14 students at the end of May.
• Needs: o Public transportation continues to be voiced as a need. For the past few years, MH/ID has had a contractual agreement with Franklin County Integrated
Transportation to provide funding for transportation to mental health-related
appointments for individuals who are not Medicaid eligible.
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Transition-age Youth (ages 18-26)
• Strengths:
o The focus is on employment opportunities and skills training for transition-age
youth. We are offering education sessions to the families and support system so
they are also aware of what is available in our community.
• Needs:
o Employment and housing options are needed in our community for transition-age
youth. o Independent living skills training is needed for this population. General activities of daily living such as balancing a check book, paying bills, grocery shopping,
cooking, and cleaning are some examples.
Children (under 18). Counties are encouraged to also include services like Student
Assistance Program (SAP), Respite, and CASSP Coordinator Services and Supports in the discussion.
• Community events: o Kick-off Your Drug Free Summer will continue this year and has proved successful not only with the amount of participation but in the fact the communities have taken over the program and now we are a partner instead of the organizer.
o Mental Health also participated in Summit Health’s Wellness Days. We hosted a
station titled Positive Identify where we saw 1,607 third grade students from
Franklin County. We teach them the importance of good character traits through positive self-esteem and the impact of bullying.
• Respite: The demand for overnight respite increased this fiscal year. The number of
children served for FY 14-15 is unduplicated.
Year Totals 12-13 Year Totals 13-14 Year Totals 14-15
Overnight Hourly Overnight Hourly Overnight Hourly
Children Served 10 5 10 6 10 2
Hours of Respite 480 39 600 37 624 12
Cost $3,540.20 $773.76 $4,425.25 $734.08 $4,602.26 $238.08
*14-15 is completed through April
• Children and Adolescent Service System Program (CASSP): We tracked the number of
families and schools accessing service and supports:
Franklin CASSP Calendar year
2012 2013 2014 2015
Meetings Held 155 220 169 79
New Referrals 40 58 22 14
Higher level of care 14 18 18 7
*2015 is current through April
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Strengths: o The provision of school-based mental health services to all secondary schools in Franklin County. o The provision of the Student Assistance Program (SAP) in all of the secondary
schools in Franklin and Fulton Counties. In Franklin County, in the 2014-15 school
year, there were 10 total groups (3 girls circle, 4 grief/loss, 1 D&A, 1 social skills
and 1 total wellness); with 67 total sessions.
SAP Screening info
# students screened % MH % D&A % CO
2014-15 (through Apr) 353 72% 6% 22%
2013-14 337 82% 3% 15%
2012-2013 284 76% 3% 21%
2011-2012 285 73% 7% 20%
Needs: o Funding to provide SAP within the elementary schools in both counties.
Identify the strengths and needs for the following special/underserved populations. If the county
does not serve a particular population, please indicate.
• Individuals transitioning out of state hospitals
Strengths: o Franklin County continues to partner with the state hospital to create a community support plan with input from the individual, their treatment team and family/friends.
Prior to discharge, this plan is reviewed again by the same group and follows the
person into the community.
Needs: o There is a committee currently working to identify needs and make recommendations to decrease the number of hospitalizations.
o There appears to be a need for more supported housing to assist in the transitions
and also to provide some diversion from needing higher levels of care.
• Co-occurring Mental Health/Substance Abuse
Strengths: o The Implementation committee created a co-occurring credentialing process for providers. It is mirrored from the OMHSAS bulletin that was created. In June, Franklin/Fulton MH/ID and HealthChoices will begin to credential those outpatient
providers that want to be recognized as a credentialed provider. Please refer to
the transformation priorities for further detail. o Training related to co-occurring illness continues to be offered free to our providers. Needs:
o Financial support is needed to afford clinicians the time to prepare for and
complete the Certified Co-Occurring Disorders Professional (CCDP) credential.
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• Justice-involved individuals Strengths:
o There are health navigators that work at the Franklin County Jail to assist inmates
in completing insurance applications and applying for any other financial resources
they may be eligible for upon release. This assists them in re-entry to the community. o Also refer to the CIT update in program highlights.
o Franklin County was a recipient of a trauma-informed SAMHSA grant that included
a strategic planning session as well as training on June 4. Our audience for this
was focused on criminal justice professionals. o Franklin-Fulton MH/ID/EI, TMCA HealthChoices, and the Franklin County Jail completed a study of our local jail population. The results indicate that most of the
inmates were not involved with the mental health system prior to entry in the jail.
o We have applied for a grant to provide supportive housing for individuals with
mental health who do not have a home plan. It would also provide emergency housing support for individuals on probation who risk returning to Jail if they lose
their housing. If funded, the program would begin in July 2015.
Needs:
Early identification and assessment of individuals with MH issues who become
involved in the criminal justice system.
A facility that would be available 24/7 to provide assessments for individuals that
do not need to go to jail but need some support or diversion.
• Veterans: Strengths:
o During the week of CIT training, law enforcement is continuing to be educated
about experiences of Veterans returning home after combat.
o Participating in the 2nd annual Veteran’s Conference being held locally to share the
services available and access information. Needs:
o A method of better engagement is needed. Stigma also seems to play a role in
lack of access.
• Lesbian/Gay/Bisexual/Transgender/Questioning/Intersex (LGBTQI) consumers
Strengths:
o Through CIT, Law Enforcement is being educated about experiences of persons
identifying as transgendered. Needs:
o List of local MH providers trained to understand the needs of LGBTQI consumers
• Racial/Ethnic/Linguistic minorities
Strengths:
o MH/ID/EI does have a contractual agreement with an agency which provides
translation and interpretation services.
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o During Children’s Wellness Day, the presentation has posters and signs in
Spanish to assist in sharing the healthy message to those that are still learning English. Needs: None identified.
• Other, if any (please specify) None identified.
c) Recovery-Oriented Systems Transformation:
Describe the recovery-oriented systems transformation efforts the county plans to initiate in the
current year to address concerns and needs.
For each transformation priority, provide:
• A brief narrative description of the priority
• A time line to accomplish the transformation priorities
• Information on the fiscal and other resources needed to implement the priorities (how
much the county plans to utilize from state allocations, county funds, grants,
HealthChoices, reinvestment funds, etc., and any non-financial resources).
• A plan/mechanism for tracking implementation of priorities.
TRANFORMATION PRIORITY
1 Comprehensive, Continuous, Integrated System of Care Model implementation (CCISC) to
develop a service system that is co-occurring capable.
2 Transition age and forensic population housing option to assist entry into the adult system
and re-entry to the community from incarceration. It will offer supports for successful transition to independent living.
3 Public Awareness Campaign to assist the community in understanding mental health and
substance use disorder and how to access services.
4 Increase integration between mental health and the aging population.
5 Data collection to increase knowledge of quality of services in order to assist in making better decisions for service delivery.
1. Comprehensive, Continuous, Integrated System of Care Model implementation (CCISC)
to develop a service system that is co-occurring capable.
i. Implementation team is working on a credentialing process to recognize local providers that have completed the criteria to be co-occurring capable.
1. The certification program is scheduled to begin the process in May
with the outpatient providers interested in becoming a recognized
county certified co-occurring program.
2. On June 19, 2015 we are hosting a Networking Day just for providers. The goal is to foster the relationships between community
providers and increase their knowledge of each other’s specialties to
allow for better referrals.
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ii. Change Agent Committee continues to meet on a quarterly basis.
Researching evidence based programs that focus on the co-occurring population and will then make a recommendation to providers to begin use if possible.
2. Transition age and forensic population housing option to assist entry into the adult
system and re-entry to the community from incarceration. It will offer supports for
successful transition to independent living. i. The Criminal Justice Advisory Board (CJAB) received a grant to focus on housing and contracted with New Hope Shelter to start a Recovery House
to serve 6 or more individuals without home plans who have D&A issues.
ii. Franklin County submitted a grant proposal in January 2015 for Mental
Health and Justice Housing Initiative to the Pennsylvania Commission on Crime and Delinquency. The proposed project would provide three furnished master-lease apartments including utilities as a transitional option
for persons with Mental Health/Co-Occurring Disorder who are currently
incarcerated due to no approved home plan. An additional emergency
housing fund would serve as a short term option for those at imminent risk of losing their housing and returning to jail. County-administered housing management and supportive services are included in the proposal.
3. Public Awareness Campaign to assist the community in understanding mental health and
substance use disorder and how to access services.
i. I Am the Evidence awareness campaign through the PA Mental Health Association ii. Health Fairs, Job Fairs
iii. Email blasts
iv. Chamber of Commerce
v. Community Events 1. As of June 30 2015, Mental Health will have participated in over 30 community events of various audiences. The goal of community
events is to provide education about mental wellness.
4. Increase integration between mental health and the aging population.
i. CIT continues to be an avenue for law enforcement to learn strategies to relate to the older adults. ii. Sponsoring trauma training for the staff at the aging office.
5. Data collection to increase knowledge of quality of services in order to assist in making
better decisions for service delivery.
i. Working with the providers to gather data that is comparable among the similar services and determine if those receiving services are satisfied.
INTELLECTUAL DISABILITY SERVICES Describe the continuum of services to enrolled individuals with an intellectual disability within the
county. For the narrative portion, please include the strategies that will be utilized for all
individuals registered with the county, regardless of the funding stream. For the chart below,
regarding estimated numbers of individuals, please include only those individuals for whom base or block grant funds have or will be expended. Appendix C should reflect only base or
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block grant funds except for the Administration category. Administrative expenditures should be
included for both base/block grant and waiver administrative funds. It is the mission of Franklin/Fulton Mental Health/Intellectual Disabilities/ Early Intervention to
partner with the community to develop and assure the availability of quality MH/ID/EI services
and supports for individuals and families. Through the use of a person-centered planning
approach and the utilization of Prioritization of Urgency of Need for Services (PUNS), the ID program assists individuals in accessing services and supports within their community regardless of the funding stream. The PUNS gathers information from the person-centered
planning approach to identify current and anticipated needs. This information allows
Franklin/Fulton Mental Health/Intellectual Disabilities/Early Intervention to budget and plan for
the continuum of services and to develop programs to meet the needs of the community. Programs support client engagement and provide access to services for employment, training, housing and family support as appropriate. As of March 31, 2015, there were 527 people
registered in the Intellectual Disabilities program in Franklin County, of which 33 were
participants in the life sharing program.
The following goals and desired outcomes are detailed in the Quality Management plan (Appendix E) for Franklin/Fulton Intellectual Disabilities Program as required by the
Administrative Entity. The full QM Plan can be found in Appendix E.
• To meet the goal of security and safety in home and community for participants, we will monitor the number of restraint incidents quarterly through analysis of the HCSIS Incident Data:
Since of July 1, 2013, there have been 0 restraints in Franklin County.
• The QM outcome, “People are abuse free,” is measured by the QM 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 HCSIS Incident Data, the target trends to prevent
future incidents will be analyzed by the Risk Management Team, and quarterly reports will be
provided by the Quality Management Council: For 2014-2015, ODP redefined I-2-I abuse, to
make sure the definition is consistent across the state. As a result, the state expects to see I-2-I
abuse reports sharply increase, followed by a plateau which Franklin/Fulton will use as baseline data. The baseline data is 115 incidents of I-2-I abuse per QM plan (2 years- see chart below).
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• To assure the health and safety of individuals receiving services, Franklin/ Fulton
Intellectual Disabilities Program will use the objective of reducing the number of medication errors by 10% by June 30, 2017. This is a new objective to measure for
2015-2017. The baseline data is 270 medication errors from July 2013- April 2015.
The remaining three Quality Management goals can be found in the narrative on Employment,
life sharing and Collaboration.
Estimated Individuals
served in FY 14-15
Projected Individuals to be
served in FY 15-16
Supported Employment 68 68
Sheltered Workshop 5 5
Adult Training Facility 2 1
Base Funded Supports Coordination
68 70
Residential (6400) 2 1
Life Sharing (6500) 0 0
PDS/AWC 28 30
PDS/VF 0 0
Family Driven Family
Support Services
0 0
Supported Employment: Describe the services provided, changes proposed for the current
year, and identify a proposal for supporting growth of this option. Please add specifics
regarding the Employment Pilot if your County is a participant.
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The "Transition to Adult Life Success" program engages young adults with disabilities in
discussions and activities pertaining to areas of self-determination and career exploration. The "Transition to Adult Life Success" 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.
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
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 Supports have outcomes of “placing individuals with intellectual disabilities in a competitive job.” They were expecting to place 10 individuals in new jobs and as of December 2014, they have placed
6 individuals in jobs.
Transitional Work Services support individuals transitioning to integrated, competitive employment through work that occurs at a location other than a facility subject to 55 Pa. Code Chapter 2380 or Chapter 2390 regulations. Transitional work service options include mobile
work force, work station in industry, affirmative industry, and enclave. Franklin/ Fulton County
currently serves all individuals using Transitional Work Services in the Waiver.
Pre-vocational service assists individuals in developing skills necessary for placement into competitive employment. Pre-vocational Services focus on the development of competitive
worker traits, using work as the primary training method.
The ID department is concentrating on Community Employment which includes supported employment and transitional work for the Quality Management Goal. The outcome for the Quality Management Plan is “people who choose to work are employed in the community.” As
of April 1, 2015, there were 65 Franklin County residents in community employment. Franklin
County’s QM objective is to increase by 5% the number of people who want to work to achieve
community employment. The baseline data as of April 1, 2015 is: 223 people have some type of employment goal and 124 people have community employment. This gives a baseline of 56%.
During the summer of 2015, the ID Program will also fund a summer youth work program
through Occupational Services, Inc. to provide paid work experience opportunities to 16
students who have learning disabilities or intellectual disabilities. The program will target students in Franklin County school districts who do not have the opportunity for extended school year, transition activities or paid work during the summer months.
Base Funded Supports Coordination: Describe the services provided and changes proposed
for the current year.
Base Funded Supports Coordination includes home and community based case management
for individuals in nursing facilities and in community residential settings. These services are only
paid for individuals who have had a denial of Medical Assistance Coverage. There are 49
people who have base funded Supports Coordination. There are 12 people who have the OBRA Waiver and have base funded Supports Coordination. There are 7 people who reside in
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an ICF/ID and receive base funded Supports Coordination. Currently no one is leaving a State
Hospital system from Franklin or Fulton Counties, so transition services are not needed at this time. We have MA denials for 6 people who are receiving base services over $8000.
Life Sharing Options: Describe the services provided and identify how you propose to support
growth of this option.
According to 55 Pa. Code Chapter 6500: “Family Living Homes are somewhat different than other licensed homes as these settings provide for life sharing arrangements. Individuals live in
a host life sharing home and are encouraged to become contributing members of the host life
sharing unit. The host life sharing arrangement is chosen by the individual, his or her family and
team and with the life sharing host and Family Living Provider Agency in accordance with the individual’s needs. Licensed Family Living Homes are limited to homes in which one or two individuals with an intellectual disability who are not family members or relatives of the life
sharing host reside.” Satisfaction surveys have shown that people in life sharing living
arrangements are more satisfied with their life. This along with the Office of Developmental
Programs’ QM plan that people choose where they wish to live have driven the objective for the 2015-2017 Life Sharing, “to increase the number of people in life sharing.”
The Franklin County Intellectual Disabilities Program will support the growth of life sharing in the
following ways:
1. The AE and SCO will support people interested in a residential placement to meet with life sharing providers and life sharers who have openings to promote life sharing as the first option for residential placement.
2. Once per year at the annual ISP meeting, the AE will review the ISP of anyone who has a
residential placement to assure the SCO has discussed moving to life sharing from other
residential placements. If the person would benefit from life sharing or is interested in moving, the AE will follow up as in #1 above. 3. The AE Life Sharing Point Person will discuss with providers at least annually if they
know of anyone who may benefit or want to move from a 6400 licensed home to a life
sharing home.
4. Franklin County has 33 people living in life sharing Homes, representing 32% of the people in residential placement. 5. There are life sharing Homes in Franklin County with residents from other counties living
in them. These people are supported by the home county at this time.
Life sharing 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 life sharing Homes in Franklin County (see chart below for Franklin/ Fulton QM
information). All 33 people have waiver funding to support the services they need in the life
sharing home. The Intellectual Disability Program’s Quality Management Outcome is “people
live where they choose.” The QM objective is to increase the number of people in life sharing by 10% (n=3) by June 30, 2017.
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Cross Systems Communications and Training: Describe your current efforts and changes
proposed for the current year. Explain how collaboration incorporates risk management and avoidance of State Center and/or State Hospital admissions.
ID collaborated with the Copeland Center for Wellness and Recovery and Mental Health to pilot
WRAP® for People with Developmental Distinctions, which supports people with both a mental
illness and Developmental Disability. WRAP® is a recovery oriented evidence-based model that is accepted internationally. Franklin/ Fulton County and Philadelphia are the pilot areas. The first group was held at OSI in 2013. The second group has 6 participants and is currently being
held. The County is planning on sponsoring a WRAP® for People with Developmental
Distinctions Group for other providers to be able to send individuals for WRAP training. The
County is also on the committee that wrote the WRAP® for People with Developmental Distinctions curriculum in collaboration with The Copeland Center, OMHSAS, NASDDDS and ODP. This curriculum is the next step for WRAP® for People with Developmental Distinction to
become evidenced-based. The County has supported WRAP® efforts to explain this new
program at conferences and trainings. WRAP for People with Developmental Distinctions has
been presented at the Positive Practices Team Meeting, at the Northeast HCQU Day of Learning, at the WRAP® Summit in PA and at Franklin County Human Services Training Days. It is scheduled to be presented at the IM4Q Conference in July and the WRAP® Around the
World Conference in August.
In addition to WRAP®, the Quality Management Plan will also include an outcome to “collaborate and implement promising practices to assist people in achieving outcomes.” The
objective for the 2015-2017 QM Plan will be to identify individuals who have a dual diagnosis
and/or a Behavior Support Plan, then develop a toolkit for them to assist in recovery and
achieve their outcomes. The first year will be used to gather the baseline data and to develop
the toolkit. The second year of the QM plan will be used to start the implementation.
Emergency Supports: 1. Describe how individuals will be supported in the community if no
waiver capacity is available within the County capacity commitment.
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If waiver capacity is unavailable, individuals will be supported out of funds in the Block Grant.
Base money will be provided to graduates for day programs and transportation to maintain their residence at home, and so their parents can maintain their employment status. The ID Apartment Program has 3 people living in their own apartment with less than 30 hours of
support per week. There are plans to increase this program by adding another apartment.
Base funds are used to subsidize the rent. The Franklin County ID department will increase the
availability for combinations of Family Aide, Day Programs, Transportation, and Respite so that
individuals can continue to live at home instead of residential programs which are more costly.
Franklin County is hopeful that waiver slots will be given to new graduates (17 in June 2015) in
the 2015-2016 fiscal year. We are waiting to hear about waiver slots for the fiscal year.
2. Provide details on your County’s emergency response plan including:
• how your County meets emergency needs of individuals outside of normal work
hours;
• does your County “reserve” any base dollars to meet emergency needs;
• what is your County’s emergency plan in the event an individual needs emergency services, residential or otherwise, whether identified during normal work hour or
outside of normal work hours.
Franklin County responds to emergencies outside of normal work hours in Procedure Statement ID-2014-505 Incident Management. In this procedure statement, all Program Specialists are listed as well as the MH/ID/EI Administrator with their cell phone numbers. These contacts can
be used after hours for any emergency. All providers have been trained in the policy. The
Incident Management Program Specialist checks the HCSIS database on a daily basis to
assure that all the incidents provide for 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 and the Supports
Coordination Organization to set up these services whether during normal business hours or
after.
Administrative Funding: Describe the maintenance of effort to support the base or block grant
funded services, as well as the functions of the Administrative Entity Operating Agreement.
The administrative funding supports three program specialist positions. Two Program
Specialists support all base contract functions. The third position collects and analyzes data for the Intellectual Disabilities portion of the Block Grant and monitors base providers. For FY 14-15, the program specialists will also use base admin monies to implement and maintain the new
apartment program.
Waiver Admin monies primarily support the three program specialist positions. Each program specialist has specific duties in the AE Operating Agreement for which they are responsible. Program Specialist #1 is primarily responsible for waiver capacity. This program specialist
makes sure all clients served have the correct waiver to meet their needs. She is also
responsible for Waiver Capacity Commitment, Residential Vacancy Management, Unanticipated
Emergencies, Waiver Enrollment and Pre-surveys for IM4Q which are all in the AE Operating
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Agreement. IM4Q data is analyzed and used to measure objectives in the Quality Management
Plan (Appendix E, Attached). Program Specialist #2 is primarily responsible for Incident Management/ Risk Management.
She is responsible for making sure incidents are entered, investigated and finalized in a timely
manner. She also approves all incident reports at the county level. She is responsible for
assuring for the safety and well-being of all individuals involved in an incident. She reviews all incidents within 24 hours of occurrence. She also takes all incident data and other associated data to facilitate the Risk Management Committee. She is responsible for the delegated
functions in the AE operating agreement. She is also responsible for the level of care
determinations and re-determinations. These duties are also part of the AE Operating
Agreement. Two goals in the QM plan that are part of incident management are Restraint Reduction and Individual to Individual Abuse reduction.
Program Specialist #1 and #2 also are responsible for Intakes for eligibility, offering free choice
of willing and qualified providers, approval and authorization of Individual Support Plans,
Provider Recruitment and notice of Fair Hearing and Appeals. These duties are included in the AE Operating Agreement.
Program Specialist #3 is primarily responsible for Quality Management. She is to make sure the
PUNS are done and completed in a timely manner. She also assures Provider Qualifications,
Provider Monitoring, the AE Oversight Monitoring and any Corrective Actions Plans from the monitoring is completed in a timely manner. She is also responsible for the writing,
implementation, data collection and analysis of the data for the Quality Management Plan. She
is the facilitator of the Quality Improvement Council and acts as the Closing the Loop Point
Person for IM4Q. These duties are indicated in the AE Operating Agreement. She also acts as
the community liaison for the ID program at community events.
HOMELESS ASSISTANCE SERVICES
Describe the continuum of services to individuals and families within the county who are homeless 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. Include achievements and improvements in services to families
experiencing or at risk for homelessness, as well as unmet needs and gaps.
Homeless and near homeless assistance is provided through the County’s Information and
Referral Coordinator, PATH, ESG and HAP. There are two main shelters within the County, the
Franklin County Shelter and the Waynesboro New Hope Shelter. South Central Community
Action Program (SCCAP) runs the Franklin County Shelter for the Homeless and is contracted to administer the County’s HAP funds.
Franklin County is currently contracted with Waynesboro New Hope Shelter and SCCAP to
administer the 2013-2015 Emergency Solutions Grant, which includes short-term rental
assistance under the rapid rehousing and homelessness prevention programs, as well as shelter support. Franklin County also provides permanent supportive housing through the
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Mental Health Program and offers an independent living program through the Intellectuals with
Disabilities funding. Franklin County’s Housing Task Force is coordinated by the Housing Program Specialists and
staff from the Franklin County Housing Authority. Numerous community agencies are
represented at the Task Force meetings with the goal of working together to pinpoint community
housing needs and develop action plans to address those needs. Members of the Task Force also collaborate to organize homeless outreach events and establish community collaboration for donations to the local homeless shelters.
The MH Housing Program Specialists work closely with a provider to ensure that adequate
housing assistance and supports are in place for PATH-funded individuals. Case management is included as part of supportive services offered in two supportive housing programs within Franklin County. Twenty individuals are able to participate in the programs consecutively.
Franklin County’s Housing Program Specialists are able to support these enrolled individuals
with case management services and also work collaboratively with the individual’s case
manager through the agency contracted to provide mental health case management services.
Estimated Individuals served
in FY 14-15
Projected Individuals to be served
in FY 15-16
Bridge Housing 0 0
Case Management 228 214
Rental Assistance 228 214
Emergency Shelter 64 64
Other Housing
Supports
0 0
In FY 14-15 the Block Grant Committee approved to shift unspent funds into HAP for the Rental
Assistance program in the amount of $7,663. Beginning in the new FY 15-16, the projected number of individuals to be served is lower based upon the original funded amount under the HAP program.
For each of the following categories, describe the services provided, how the county evaluates
the efficacy of those services, and changes proposed for the current year, or an explanation of why this service is not provided:
• Bridge Housing
Due to the limited funds available, Franklin County has not expanded into bridge housing support.
• Case Management Case Management services activities offered by SCCAP, as defined by the HAP Guidelines,
may include but are not limited to the following:
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o Intake and assessments (service plans) for individuals who are in need of supportive
services and who need assistance in accessing the service system.
o Assessing service needs and eligibility as well as discussion with the client of available
and acceptable service options.
o Referring clients to appropriate agencies for needed services.
o Providing referrals to direct services such as budgeting, life skill training, job preparation,
etc.
o Providing advocacy, when needed, to ensure the satisfactory delivery of request
services.
o Protecting the client’s confidentiality.
o Follow-up to assure compliance with the continuity, appropriateness, and effectiveness of
service.
Case Management services are contracted out to South Central Community Action Program
(SCCAP). Every rental assistance applicant will be part of HAP case management. Specifically,
case management provides referrals with regard to budgeting, parenting, hygiene, sanitary
housekeeping, accessing resources, life skills, and becoming more self-sufficient. A service plan
is established and signed by each applicant that includes referrals to address factors that led to
the housing crisis, in addition to other factors that may have contributed to the problem.
SCCAP’s HAP Program Coordinator is responsible for completing all intakes and assessments
for the Homeless Assistance Program. This process includes assessment of other needs,
especially those contributing to the housing crisis.
Each year, the fiscal specialist for HAP conducts an evaluation and monitoring visit at SCCAP to ensure that all program requirements are being met, and that client charts are complete, signed and accurate.
• Rental Assistance
HAP’s Rental Assistance Program provides funding for rent and security deposits for eligible low-income applicants who are homeless or near homeless as defined below. Individuals or families are homeless if they:
o Are residing in a group shelter; domestic violence shelter; hotel or motel paid for with
public or charitable funds; a mental health, drug, or alcohol facility; jail; hospital with no
place to reside; or living in a home, but due to domestic violence needs a safe place to reside; o Have received verification that they are facing foster care placement of their children
solely because of lack of adequate housing, or need housing to allow reunification with
children who are in foster care placement; o Are living in a “doubled-up” arrangement for six months or less on a temporary basis; o Are living in a condemned building; o Are living in housing in which the physical plant presents life and/or health threatening
conditions; e.g. having dangerous structural defects or lacking plumbing, heat, or utilities;
or
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o Are living on the streets, in cars, doorways, etc.
Individuals and families are near homeless if they are facing eviction (having received either written or verbal notification from the landlord that they will lose their housing unless some type
of payment is received. Verbal notification must be followed up with written documentation).
Individuals served by the HAP program must have been a resident of Franklin County for six (6) months prior to applying for assistance.
Priority for Rental Assistance will be given to Franklin County applicants who can demonstrate
that they will be able to become self-sufficient within three (3) months with regard to housing.
Applicants are required to cooperate with case management services and clients will be required to sign a service plan showing areas of responsibility between the case manager and the client.
Clients served by the HAP Rental Assistance Program will fall into one or more of the following
categories: o Franklin County families with children who are homeless or near homeless.
o Persons fleeing domestic violence.
o Individuals who have fallen on hard times who need temporary assistance to get back on
their feet. o Homeless families with children who are candidates for Transitional Housing.
To receive financial assistance, the individual or family must be at or below 150% poverty. As
appropriate, those who do not meet the income guidelines will be referred to other agencies that
may be able to provide needed services. Income requirements will be waived for persons fleeing domestic violence and for those who are experiencing a housing crisis due to a disaster such as fire or flood (upon State approval by the State HAP Manager as stated in the guidelines).
The amount of Rental Assistance allocated will be determined by the facts of the case. A service
plan is created for each household. The plan addresses the conditions precipitating the housing crisis. It also addresses the acquisition of permanent housing, including the schedule for disbursement of rental assistance funds.
As part of the same site visit that evaluates case management and emergency shelter, the fiscal
specialist for HAP conducts an evaluation and monitoring visit at SCCAP to ensure that all program requirements are being met.
• Emergency Shelter
The Franklin County Shelter for the Homeless is located centrally at 223 South Main Street in
Chambersburg, PA. The Shelter provides 10 bedrooms, two of which are family rooms, with the
capacity to house up to 18 individuals at one time. The Franklin County Shelter for the
Homeless is the last safety net for the residents who may find themselves without a place to
live. One of its major goals is to move homeless residents back into permanent housing and toward self-sufficiency. In order to accomplish this, the Shelter staff provides case management
activities, setting goals with the residents to be accomplished during and after their stay, and
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cooperates with other agencies within the County to direct residents to the available resources
that will help them achieve their established goals. Clients are also required to participate in a basic life skills program.
In order to become a client at the Franklin County Shelter for the Homeless, an individual/family
must be legally homeless. If legally homeless, the potential client completes a Common
Application for Assistance and Assessment package, which includes a self-declaration of homelessness. A potential client will only be considered a client once he/she has completed the intake forms. Upon completion of the form, the client/family works with the staff to identify
his/her/their particular causes for homelessness. Once the causes have been identified, the
client/family, in coordination with the staff, develops a plan of action including specific goals to
be achieved during their stay at the Shelter. Long term goals that lead to the attainment of stable housing are also set. The caseworker assesses the client’s work history, medical history, and educational background. This information becomes a permanent part of the client’s file.
The staff identifies the client’s family needs such as nutritional education, parenting classes, and
drug/alcohol treatment services. Using this information, staff, under the supervision from the
Program Coordinator, acquires the necessary information or services to address that particular client/family’s needs.
In 2014, the Shelter provided temporary shelter to 131 homeless individuals representing a total
of 3,918 nights of shelter. From January through March 30, 2015, the shelter has served a total
of 40 individuals representing a total of 1,104 nights of shelter. Homeless Assistance Program funds are needed to support the daily operational costs of the
Franklin County Shelter for the Homeless as it tries to adapt to the steady increase in homeless
needs and extensive supportive services. The shelter staff is finding that an increasing number
of homeless individuals need more than 30 days of emergency shelter due to the lack of employment opportunities.
• Other Housing Supports
Franklin County has not used HAP funding for other housing support services. Independent
living and forensic apartments are available through other funding sources.
Homeless outreach events and activities are held multiple times throughout the year in Franklin
County. PATH collaborates with the Franklin County LINK program and the community to make these events possible. Previous events include “Help for the Hungry and Homeless” and “Help
for Heat and Housing.” The events are advertised to target the literal homeless community.
Events are held in recognition of National Hunger and Homeless Awareness week in November.
At outreach events, human service agencies are present in one location as a “one stop shop” to
assist those experiencing homelessness. For example, individuals can have a volunteer assist in completing applications for services such as transportation, case management services,
medical assistance, PATH, etc. Additionally, individuals are provided with information on where
free community meals are held, and are provided with a hot meal at the event, as well as safety
and emergency supplies. Participants are encouraged to complete a brief satisfaction survey
upon entrance to the events as well as at the conclusion of the events.
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Street outreach is conducted on a regular basis between Point In Time counts and structured
outreach events. Homeless outreach is completed in partnership with housing agencies, human service providers, formerly homeless volunteers, and PATH staff. Former homeless volunteers are encouraged to participate in outreach activities and street outreach.
In order to evaluate the efficacy of the program, we use the Point-In-Time (PIT) counts, and
compare them to previous years, to measure homelessness in our county. We track the numbers served and the waiting lists for local housing providers. In addition, we track the number of providers attending the county’s Local Housing Options Team, and document
identified needs and potential solutions for individuals and families experiencing a housing
crisis.
Describe the current status of the county’s Homeless Management Information System
implementation.
Franklin County has actively participated in HMIS for approximately five years, entering data
from existing programs. Two HUD Permanent Supportive Housing Programs and one Shelter Plus Care Program through Franklin County are currently entering data into the PA-HMIS system and have been doing so for over four years. The PATH program began entering data
into PA-HMIS at the beginning of fiscal year 2013-2014. Intake forms for the Supportive Housing
Programs, Shelter Plus Care, and PATH are organized to capture the information that needs to
be entered into the PA-HMIS system. The goal is to have individuals entered in to PA-HMIS immediately following enrollment in the housing programs. Multiple staff members are familiar with entering data into the system as well as running reports.
CHILDREN and YOUTH SERVICES
Briefly describe the successes and challenges of the county’s child welfare system and how
allocated funds for Child Welfare in the Human Services Block Grant will be utilized in
conjunction with other available funding (including those from the Needs Based Budget and
Special Grants, if applicable) to provide an array of services to improve the permanency, safety
and well-being of children and youth in the county.
The Franklin County Children and Youth Service (FCCYS) is the local public child welfare
agency responsible for ensuring that the children of Franklin County are safe and receiving the
essentials of life. The agency provides services to any child from birth to 18 years of age who
has been abused, neglected, exploited, is incorrigible and/or truant, as well as services to their
families. Additionally, youth who were determined to be ‘dependent’ prior to their eighteenth
(18th) birthday and request to re-enter care are provided child welfare services.
Services are provided to families who request and voluntarily accept services or who have been
ordered to participate in services by the Franklin County Courts. Services are designed to
promote the safety, permanency, and well-being of children and their families. These are
specialized services dealing with the problems of children whose families need help in caring for
them. Reports involving abused, neglected, exploited or truant/incorrigible children are
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investigated and in-home services and/or placement services are provided to families who meet
Children and Youth legal criteria. Children and Youth can help intervene in family disputes and
crises; however, Children and Youth does not have the authority to determine, mediate or
change Court-ordered custody or visitation agreements. Government intervention is justified
when the family cannot, or will not, provide for the child’s safety and/or basic needs. Placement
of a child by Children and Youth can only occur if ordered by the Juvenile Court. FCCYS
provides an array of services (either in-house or through private contracted providers) to
accomplish the goals set forth above.
Block Grant funding is limited to only one of the many programs provided by FCCYS: Family
Group Decision-Making. The Needs-Based Budget supplies funding for most of the other
programs in FCCYS. The services provided by FCCYS provide a wide range of options to meet
the needs of the families we serve.
One of the key challenges facing FCCYS is the increase in referrals and subsequent need for
services. Our Intake Department is struggling to keep up with referrals to FCCYS. The critical
initial assessment of needs at the intake level put an enormous amount of safety responsibility
on the Intake Caseworkers and their supervisors. The timeliness, volume of referrals, and
paperwork demands are significant.
While the caseload numbers within the Intake Unit are high, we have been able to sustain
reasonable caseload numbers for our ongoing caseworkers and have seen improved results in
our casework practice. Workers are performing well within recommended Best Practice
Standards and continue to implement these recommendations in their daily case management.
We have implemented internal checks and balances to assure that every worker is aware of and
utilizing these standards. State and Federal mandates are addressed and made a part of
casework practice.
The agency continues to enhance the quality of casework practice and provide in-house
trainings to the caseworkers on how to engage family members as resources for children.
FCCYS continually looks at casework practices in an effort to refine and improve our services to
children and their families. Our County has a very active Children’s Roundtable and our Juvenile
Court Judges and County Commissioners are actively involved with child welfare as well as
juvenile delinquency matters. Our staff attend relevant trainings and participate in regional
meetings (Quality Assurance meetings, regional supervisor meetings, IL meetings, PCYA
conferences, etc.) FCCYS staff are encouraged to “think outside the box” and are encouraged
to bring new practices/ideas that may improve our work with children & families to the attention
of management.
Identify a minimum of three specific service outcomes from the list below that the county
expects to achieve as a result of the child welfare services funded through the Human Services
Block Grant with a primary focus on FY 2015-16. Explain how service outcomes will be
measured and the frequency of measurement. Please choose outcomes from the following
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chart, and when possible, cite relevant indicators from your county data packets, Quality Service
Review final report or County Improvement Plan as measurements to track progress for the
outcomes chosen. When determining measurements, counties should also take into
consideration any benchmarks identified in their Needs-Based Plan and Budget for the same
fiscal year. If a service is expected to yield no outcomes because it is a new program, please
provide the long-term outcome(s) and label it as such.
Outcomes
Safety 1. Children are protected from abuse and neglect.
2. Children are safely maintained in their own home whenever
possible and appropriate.
Permanency 1. Children have permanency and stability in their living
arrangement.
2. Continuity of family relationships and connections are
preserved for children.
Child & Family
Well-being
1. Families have enhanced capacity to provide for their
children’s needs.
2. Children receive appropriate services to meet their educational needs.
3. Children receive adequate services to meet their physical
and behavioral health needs.
Outcome Measurement and
Frequency
The Specific Child Welfare
Service(s) in the HSBG
Contributing to Outcome
Children are safely
maintained in their own
home whenever possible and
appropriate.
Percent of children who
were not placed in a
residential setting.
FGDM
Continuity of family
relationships and
connections if preserved for
children.
Number of months
children are in placement
prior to reunification.
FGDM
Families have enhanced
capacity to provide for their
children’s needs.
Number of families
participating in FGDM.
FGDM
Program
Name:
Family Group Decision Making (FGDM)
Please indicate the status of this program:
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Status Enter X
Funded and delivered services in 2014-2015 but not renewing in 2015-2016
Requesting funds for 2015-2016
(new, continuing or expanding
from 2014-2015)
New Continuing Expanding
X
• Description of the program, what assessment or data was used to indicate the need for
the program, and description of the populations to be served by the program. If
discontinuing funding for a program from the prior FY, please explain why the funding is being discontinued and how the needs of that target population will be met. If services or
activities will decrease, explain why this decision was made and how it will affect child
welfare and juvenile justice services in your county.
Family Group Decision Making (FGDM) is a process in which family members, community members and others collaborate with the child welfare agency to create a plan for a child or youth. The family members define who comprises their family group. In FGDM, a trained
coordinator, who is independent of the case, brings together the family group and agency
personnel to create and carry out a plan to safeguard children and other family members.
FGDM processes position the family group to lead decision making, and the statutory authorities agree to support family group plans that adequately address agency concerns. The statutory authorities also organize service providers from governmental and non-governmental agencies
to access resources for implementing the plans.
The key to successful FGDM practice is engaging the family group — those people with kinship and other connections to children, youth and their parents. This includes those who may not be currently connected to children and youth — for example, paternal relatives who are often
excluded or marginalized.
FGDM affirms the culture of the family group, recognizes a family’s spirituality, fully acknowledges the rights and abilities of the family group to make sound decisions for and with its young relatives and actively engages the community as a vital support for families. FGDM
has the potential to energize hope, guide change and foster healing. Through FGDM, a broad
support network is developed and strengthened, significantly benefiting children and their family
groups. Government, local and tribal programs also benefit, learning from and relying on the family group and community as resources that strengthen and support families in ensuring that their children have a clear sense of identity, lasting relationships, healthy supports and limits,
and opportunities for learning and contributing.
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FY 14-15 FY 15-16
Description of Target Population Children & family members Children & family members
# of Referrals 31* 35
# Successfully completing
program 19* 30
Cost per year $44,543 $59,349
Per Diem Cost/Program
funded amount $44,543 $59,349
Name of provider FCCYS FCCYS
*Note that numbers are for 7/1/14-6/9/15
Were there instances of under spending or under-utilization of prior years’ funds?
Yes No
DRUG and ALCOHOL SERVICES
This section should describe the entire substance abuse service system available to all county
residents that is provided through all funding sources, including state allocations, county funds,
federal grants, HealthChoices, reinvestment funds, etc.
The Franklin/Fulton Drug and Alcohol Program (FFDA) provides funding for all levels of care for
substance abuse treatment. These levels include inpatient detoxification, rehabilitation, halfway
house, partial hospitalization, intensive outpatient, outpatient, and early intervention outpatient
services for Franklin and Fulton county residents. FFDA also provides case management services and oversight of medication assisted treatment.
This overview should include:
1. Access to services;
2. Waiting list issues; 3. County limits on services;
4. Coordination of care across the system;
5. Any emerging substance use trends that will impact the ability of the county to provide
substance use services.
This overview should not include guidelines for the utilization of ACT 152 or BHSI funding
streams issued by DHS. The focus should be a comprehensive overview of the services and
supports provided by the Single County Authority and challenges in providing services.
1. Information regarding access to services:
In order to provide funding for all levels of care, there are contracts established with facilities
across the Commonwealth. Currently, there are three outpatient treatment providers and one
inpatient drug and alcohol treatment facility located in Franklin County. Within Fulton County,
there is one outpatient treatment provider.
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2. Waiting list issues:
Treatment services are provided to any eligible resident despite age, gender, race, and
ethnicity. However, we serve individuals by our priority populations. These priority populations
are identified in the following order: Pregnant Injection Drug Users, Pregnant Substance
Abusers, Injection Drug Users, and all others.
An estimated 569 Franklin County residents will be funded for treatment services through the
drug and alcohol program in fiscal year 2015-2016. FFDA projects that 419 individuals will
receive level of care assessments. Level of care assessments are completed by contracted
outpatient providers or FFDA Case Management staff.
3. County limits on services:
It must be confirmed that an individual is a resident of Franklin or Fulton County before
treatment can be authorized and funded. A photo ID is required. If one cannot be provided, the
program can accept a current check stub, a current lease with their name on it, a current utility
bill in their name, or other acceptable documentation that Franklin or Fulton County Assistance
Office uses to determine whether an individual is eligible for Medical Assistance.
An individual who receives funding from the program must not have Medical Assistance or
health care coverage at the time they are receiving services. A liability form is also completed
for each individual to determine whether they will have a cost for the treatment. Funding
restrictions do not apply to pregnant female individuals who are in need of treatment. There are
also exceptions made for adolescents where the program will fund for treatment services if they
do not want their parent or guardian to know they are enrolled in services.
4. Coordination of care across the system:
Research has shown that a decrease in funding for treatment means an increase in cost for
other systems (i.e. jails, prisons, hospitals, crisis centers). Our population served continues to
increase as our funding constantly reduces each year. Therefore, Franklin/Fulton Drug and
Alcohol Program has taken the initiative to research and identify new potential funding sources
for services.
Our local district attorney is working to implement a program titled “Feed The Good Wolf.” This
jail diversion program identifies individuals in need of treatment at the “street” level and
coordinates services accordingly as a diversion mechanism to enter treatment rather than
acquire formal legal charges.
FFDA works closely with Adult Probation, Public Defenders Office, Children & Youth, and
Juvenile Probation to coordinate drug and alcohol services for individuals involved in the
criminal justice system. Since 2010, D&A partners with Franklin County Adult Probation to
provide a designated Case Manager who works with Level Three and Level Four offenders with
substance use disorders who are sentenced to restrictive intermediate punishment. Funding for
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this program is provided through a grant from the Pennsylvania Commission on Crime and
Delinquency.
5. Any emerging substance use trends that will impact the ability of the county to
provide substance use services:
None noted.
Target Populations
Provide an overview of the specific services provided and any service gaps/unmet needs for the
following populations:
• Older Adults (ages 60 and above)
If indicated, older adults are eligible for all levels of care for substance abuse
treatment. These levels include inpatient detoxification, rehabilitation, halfway house,
partial hospitalization, intensive outpatient, outpatient, and early intervention
outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment.
• Adults (ages 18 and above)
If indicated, adults ages 18 to 55 are eligible for all levels of care for substance abuse
treatment. These levels include inpatient detoxification, rehabilitation, halfway house,
partial hospitalization, intensive outpatient, outpatient, and early intervention
outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment. It is anticipated
that many of our priority populations, including Pregnant Injection Drug Users and
Pregnant Substance Abusers, will fall into this age demographic.
• Transition Age Youth (ages 18 to 26)
If indicated, transition-age youth are eligible for all levels of care for substance abuse
treatment. These levels include inpatient detoxification, rehabilitation, halfway house,
partial hospitalization, intensive outpatient, outpatient, and early intervention
outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment. It is anticipated
that some of our priority populations, including Pregnant Injection Drug Users and
Pregnant Substance Abusers will fall into this age demographic.
• Adolescents (under 18)
If indicated, adolescents are eligible for all levels of care for substance abuse
treatment. These levels include inpatient detoxification, rehabilitation, halfway house,
partial hospitalization, intensive outpatient, outpatient, and early intervention
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outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment. Additionally,
FFDA also contracts with providers of prevention and intervention programs focusing
on the adolescent population.
• Individuals with Co-Occurring Psychiatric and Substance Use Disorders
In conjunction with Franklin/Fulton Mental Health and Tuscarora Managed Care
Alliance, the Franklin/Fulton Drug and Alcohol Program has implemented a co-
occurring initiative in both counties. This initiative uses the Comprehensive
Continuous Integrated Systems of Care Model. All local providers participate in this
initiative for co-occurring competency. There are facilities that offer specialized
treatment programming for individuals with co-occurring conditions for providers
outside of the two counties. To evaluate the Comprehensive Continuous Integrated
Systems of Care Model (CCISC), we track the number of in-county facilities that offer
specialized treatment programming for individuals with co-occurring conditions.
• Criminal Justice-Involved Individuals
If indicated, criminal justice-involved individuals are eligible for all levels of care for
substance abuse treatment. These levels include inpatient detoxification,
rehabilitation, halfway house, partial hospitalization, intensive outpatient, outpatient,
and early intervention outpatient services for Franklin and Fulton county residents.
FFDA also provides case management services and oversight of medication assisted
treatment.
All contracted treatment providers have specialized programming for this population.
In addition, Franklin County is involved in the Restrictive Intermediate Punishment
Program that coordinates treatment needs for this population. We are currently
working closely with the Drug and Alcohol Probation Partnership (DAPP) to implement
the medical assistance jail pilot in FY 14/15. In June 2014, New Hope Shelter in
Waynesboro opened a recovery house, providing supportive housing and counseling
for offenders with addictions leaving the Jail without a home plan. This program is
funded through a grant from PCCD through Franklin County CJAB. We have also
applied for PCCD funds to begin a new program that would begin MAT and Vivitrol
treatment for inmates in the Jail prior to release, and would ensure a continued
connection with treatment following release. If funded, it would begin in July 2015.
• Veterans
If indicated, veterans are eligible for all levels of care for substance abuse treatment.
These levels include inpatient detoxification, rehabilitation, halfway house, partial
hospitalization, intensive outpatient, outpatient, and early intervention outpatient
services for Franklin and Fulton county residents. FFDA also provides case
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management services and oversight of medication assisted treatment. The County
provides drug and alcohol treatment funding to a small number of veterans due to the
majority of this population having insurance to cover their costs.
Recovery–Oriented Services
Describe the current recovery support services available in the county including any proposed
recovery support services being developed to enhance the existing system. Do not include
information on independently affiliated 12 step programs (AA, NA, etc.).
In FY 2015-2016 the Governor’s budget has proposed $2.5 million for Vivitrol and naloxone
treatment. The Department of Drug and Alcohol Programs (DDAP) sent out a Funding Initiative
Announcement to address the heroin/opioid crisis in Pennsylvania. FFDA applied to use this
funding to implement a Recovery Support Specialist within our two Counties. Because of our
successful Criminal Justice Advisory Board, we have been involved with many programs that
are designed to get those being released into treatment immediately after incarceration. FFDA
has been involved with the MA jail project from the beginning as well as Expedited Plus Plus.
We are hoping to make an impact to reduce recidivism through a Recovery Support Specialist.
HUMAN SERVICES AND SUPPORTS/ HUMAN SERVICES DEVELOPMENT FUND
For each of the five categories, Adult Services, Aging Services, Children and Youth Services,
Generic Services and Specialized Services, please complete the chart below with current and
next fiscal year’s individual information. Also for each of the five categories, please explain how
allocated funding will be utilized by the county to support an array of services to meet the needs
of county residents by providing the following in the format provided:
• The program name (if applicable)
• Changes, if any, in service delivery from previous year
• Specific service(s) - from the list of allowable services under each category in Appendix
D, describe how services are provided
• Planned expenditures for each service
Note: Please ensure that the estimated individuals in the chart and planned expenditures in the
narrative match what is included on the budget in Appendix C.
Estimated Individuals
Served in FY 14-15
Projected Individuals to be
Served in FY 15-16
Adult Services 0 0
Aging Services 0 0
Children and Youth Services 0 0
Generic Services 3,676 3,732
Specialized Services 1,152 0
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Adult Services: These programs are not funded by the Block Grant.
Aging Services: These programs are not funded by the Block Grant.
Children and Youth Services: These programs are not funded by the Block Grant.
Generic Services: Program Name/ Description (Include which populations served): Information and Referral
program (I&R)
For FY 15/16, Franklin County will continue the Information and Referral program (I&R) under HSDF. I&R provides a service that links individuals and the community through a
variety of communication channels, including in-person presentations to local agencies to
help educate the community of the various services throughout the County. The Information
and Referral Department is also the contact point for PA 211 coordination. Data from I&R’s
resource database is shared with the capital region during quarterly coordination meetings. In FY 15/16 Franklin County is projected to receive 1,858 contacts through our office and
1,874 through our contracted after- hours provider.
The Information and Referral Coordinator assists people who are in crisis, and/or
experiencing emergency situations. This position also advocates on behalf of those individuals who are in need of additional support. The Coordinator is certified by the Alliance
for Information and Referral Systems (AIRS). By way of a national exam, the Coordinator is
recertified every two years.
Changes in Service Delivery from Previous Year: None
Specific Service(s): Centralized information and referral
Planned Expenditures: $106,239
Specialized Services: Please provide the following:
Program Name/ Description: (Include whether it is a new service or combination of services)
If funding becomes available within the FY 15/16, elementary intervention groups will
continue through HSDF. This service is being offered to schools in Franklin County that acknowledge having students who might be struggling in school or at home with issues such
33
as bullying, aggression, low grades, etc. Students are identified and referred to the groups
by teachers, staff or faculty. Groups are held in each school during a time and day designated by the school. The facilitators use various curriculum including (but not limited to) Too Good for Violence, Girls Circle and Boys Council. The additional funding will allow the
elementary intervention groups to be expanded throughout the school year and offered to all
the elementary schools in Franklin County. The schools will also be offered multiple groups
through the year based on need and referrals. The elementary intervention program reaches approximately 120 youths through 17 groups completed. The youth show increased connection to school and adults. We continuously receive positive group feedback.
Red Ribbon Week is another important program that was funded in FY 14/15 and will
continue to be financed in 15/16 if funding becomes available. This program reaches approximately 12,000 students in grades K-12 in a one week time period. This is completed by organizing assemblies in elementary, middle and high schools throughout Franklin
County. The main focus is to promote awareness regarding drug and alcohol substance use
and abuse. Each level of education has a theme based upon the age group.
The Interrupted Group Program is another program that will possibly be funded if monies become available within the fiscal year. This program has three different curriculums:
Interrupted Tobacco, Alcohol and Marijuana. Referrals for the programs come from School
District Administration, Magisterial Court District Judges, SAP teams, Juvenile Probation,
Children and Youth Services and Franklin/Fulton County Drug and Alcohol Program. This program is offered for youth who have some experimentation or limited use of substances. They are aimed at preventing further use and directed toward serving youth before they
require expensive intervention/treatment.
Healthy U is a curriculum that will perhaps be funded in FY 15/16 if monies become available. This program has been developed by the Healthy Communities Partnership staff that is designed to follow the Wellness Wheel principles of health and wellness and includes
the following topics: Healthy Values, Healthy Resiliency, Healthy Choices, Healthy Mind,
Healthy Movement, Healthy Food, Healthy Relationships, Healthy Technology and Healthy
Surroundings. Many of these lessons have discussions about substance use and abuse and many have Mental Health components. The curriculum is designed to be 10 sessions in length with a pre- and post-test component. Curriculum and materials will be developed for
four age groups: 1) K-2nd grades, 2) 3rd-5th grades, 3) 6th- 8thgrades, and 4) 9th- 12th
grades and a component for adults. Funding would be used to hold Healthy U groups in
classrooms throughout the county. This is a new program. Changes in Service Delivery from Previous Year: All services were funded by HSDF in 14-15
but will not continue unless HSBG funding becomes available.
Planned Expenditures: $0.00 unless funding becomes available within the fiscal year to provide the programs listed above.
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Interagency Coordination: Describe how the funding will be utilized by the county for planning
and management activities designed to improve the effectiveness of county human services. The Information and Referral Coordinator organizes a two-day training event that is available for
Human Services professionals. Average number of attendees to this event is 395. She also
organizes the Introduction to Human Services training that is available two times a year to new
employees within the County government as well as agencies in the community.
Estimated HSBG Expenditures for Interagency Coordination: $13,097
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Appendix A: Signatures
36
Appendix B: Minutes
37
38
Appendix C
County:
1. ESTIMATED 2. HSBG 3. HSBG PLANNED 4. NON-BLOCK 5.
INDIVIDUALS ALLOCATION EXPENDITURES GRANT COUNTY
SERVED (STATE AND FEDERAL) (STATE AND FEDERAL) EXPENDITURES MATCH
MENTAL HEALTH SERVICES
ACT and CTT
Administrative Management 287 273,420 7,263
Administrator's Office 652,559 6,686
Adult Developmental Training - Adult Day Care
Children's Evidence Based Practices
Children's Psychosocial Rehabilitation Services
Community Employment & Emplmt Rel Svcs 119 298,739 8,126
Community Residential Services 53 1,470,108 38,318
Community Services 492 323,250 8,520
Consumer-Driven Services
Emergency Services 168 37,898 1,031
Facility Based Vocational Rehabilitation 31 66,696 1,814
Family Based Mental Health Services 3 23,081 628
Family Support Services 15 4,024 109
Housing Support Services 31 52,421 49,485 1,426
Mental Health Crisis Intervention 1,920 273,162 7,430
Other
Outpatient 401 282,570 5,340
Partial Hospitalization
Peer Support Services 15 44,625 1,214
Psychiatric Inpatient Hospitalization 2 45,317 1,233
Psychiatric Rehabilitation 10 77,652 2,112
Social Rehabilitation Services 133 251,921 6,852
Targeted Case Management 197 281,499 7,657
Transitional and Community Integration
TOTAL MH SERVICES 3,877 4,458,942 4,458,942 49,485 105,759
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County:
1. ESTIMATED 2. HSBG 3. HSBG PLANNED 4. NON-BLOCK 5.
INDIVIDUALS ALLOCATION EXPENDITURES GRANT COUNTY
SERVED (STATE AND
FEDERAL)
(STATE AND
FEDERAL) EXPENDITURES MATCH
INTELLECTUAL DISABILITIES SERVICES
Administrator's Office 571,466
Case Management 70 50,409
Community-Based Services 250 314,471 46,500
Community Residential Services 4 38,840
Other
TOTAL ID SERVICES 324 975,186 975,186 0 46,500
HOMELESS ASSISTANCE SERVICES
Bridge Housing
Case Management 214 48,321
Rental Assistance 214 45,540
Emergency Shelter 64 15,000
Other Housing Supports
TOTAL HAP SERVICES 492 113,658 108,861 0
CHILD WELFARE SPECIAL GRANT SERVICES
Evidence Based Services 35 59,439
Promising Practice
Alternatives to Truancy
Housing
TOTAL CWSG SERVICES 35 59,439 59,439 0
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County:
1. ESTIMATED 2. HSBG 3. HSBG PLANNED 4. NON-BLOCK 5.
INDIVIDUALS ALLOCATION EXPENDITURES GRANT COUNTY
SERVED (STATE AND
FEDERAL)
(STATE AND
FEDERAL) EXPENDITURES MATCH
DRUG AND ALCOHOL SERVICES
Case/Care Management
Inpatient Hospital
Inpatient Non-Hospital 69 182,107
Medication Assisted Therapy 3 23,400
Other Intervention
Outpatient/Intensive Outpatient 80 44,462
Partial Hospitalization
Prevention
Recovery Support Services
TOTAL DRUG AND ALCOHOL SERVICES 152 290,526 249,969 0
HUMAN SERVICES AND SUPPORTS
Adult Services
Aging Services
Children and Youth Services
Generic Services 3,732 71,506
Specialized Services
Interagency Coordination 13,097
TOTAL HUMAN SERVICES AND SUPPORTS 3,732 95,968 84,603 0
7. COUNTY BLOCK GRANT ADMINISTRATION 0 56719 0
GRAND TOTAL 8,612 5,993,719 5,993,719 49,485 152,259
41
42
Appendix D
Block Grant Planning Committee
Committee Members:
• Megan Shreve (HAP Provider)
• Sheldon Schwartz (Mental Health/Intellectual Disabilities Community Rep)
• Kim Wertz (MH Advocate)
• Anne Larew (ID Advocate)
• Manny Diaz (Drug and Alcohol Community Rep)
• Karen Johnston (Prevention Provider)
• Ann Spottswood (Summit Health)
Staff Members:
• Carrie Gray* (Assistant County Administrator)
• Jean Snyder (Fulton County)
• Rick Wynn* (Human Services Administrator)
• Stacy Rowe* (Fiscal)
• Christy Briggs* (Fiscal)
• Sharyn Overcash (Human Services)
• Tracy Radtke (Mental Health Housing Specialist)
• Steve Nevada* (Mental Health/Intellectual Disabilities/Early Intervention Director)
• Lori Young (Intellectual Disabilities)
• Shalom Black* (Grants Director)
• Doug Amsley (Children and Youth Services Director)
• Traci Kline (Aging Director)
• April Rouzer (Drug and Alcohol Director)
*denotes Leadership Team Members
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Appendix E: Overview of 2015-2017 Quality Management Plan
Outcome Objective for 2015-17 Trends and baseline data
People are safe and restraint free. Monitor the number of restraints and take action
immediately as warranted.
There have been 0 restraints since July 1, 2013.
People live where
they choose.
Increase the number of
people in Lifesharing by 10% (n=4) by June 30, 2017.
IM4Q (satisfaction surveys) have shown that
people are more satisfied with their life in Lifesharing arrangements. As a result,
Lifesharing is promoted as the first residential
option offered to individuals. Lifesharing increased from 30 people on July 1, 2013 to 35
people on April 30, 2015. The 35 people in
Lifesharing will be used as baseline.
People are abuse free. Reduce the number of Individual to Individual Abuse
incidents by 5% by June 30,
2017.
Individual to Individual Abuse has risen in the past 2 years. ODP has redefined Individual to
Individual Abuse and as a result, there has been
an increase. There were 38 incidents per year in FY 2012-2013. There were 71 incidents in
FY 2013-2014. There are 52 incidents as of
April 30, 2015 for FY 2014-2015.
People are healthy and safe. Reduce the number of medication errors by 10% by
June 30, 2017.
Medication errors are the most incidents in any given quarter throughout the 2013-2015 QM
plan year. The baseline data is 270 medication
errors for the 2013-2015 QM plan year.
The AE will
collaborate and implement promising
practices to assist people in achieving outcomes.
Identify baseline data of
people who have a dual diagnosis and/or have a
Behavior Support Plan. Develop a toolkit to offer to
people to continue to engage in recovery and educate them
on achieving their outcomes.
The AE has concentrated the collaboration in
the last plan year with the focus on serving people who have both an intellectual disability
and a mental health challenge (dual diagnosis). Franklin/Fulton County is piloting the WRAP® for People with Developmental Distinctions in
collaboration with MH and the Copeland Center. The AE meets with the Tuscarora Managed
Care Alliance to discuss policy changes to
better serve people who have a dual diagnosis.
People who choose to work are employed
in the community.
Increase the percentage of people who want to work to
achieve community employment (Supported
Employment and Transitional
Work) by 5% (n= 61%) by June 30, 2017.
The number of people who are competitively employed has increased to 66 in QM Plan year
2013- 2015. The ID program has decided to measure community employment which will
include supported employment and transitional
work. This will be compared to the number of people who have an employment goal which
indicates they want to work. The baseline data
that will be used is 66 people are employed, 58 people are Transitional work and 223 people
have an employment goal. This gives a
baseline percentage of 56%.
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