HomeMy WebLinkAbout2015-05-15 Plan Draft - Block GrantFranklin 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 who receive services, families of
service recipients, consumer groups, providers, 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.
1
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-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;
2
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 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. We anticipate that
this process may take several years, but feel it is a critical component in future funding
and program decisions. The data available this year is improved compared to what was available last year; staff
was able to provide process data, or outputs, this year. 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.
3
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 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
4
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:
Law Enforcemen
46%
First
Mental Health
32%
Jail
5%
Probation
7%
Court
3%
Team
5
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:
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
6
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 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 Unmet Needs:
Provide an overview of the strengths and unmet 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
7
person’s life and the 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, fifty (50) have
graduated over the past five (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. 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
8
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
• 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%
9
• Needs:
o Funding to provide SAP within the elementary schools in both counties.
Identify the strengths and unmet 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.
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
includes a strategic planning session as well as training. Our audience for
this is focused on law enforcement. 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
10
most of the inmates were not involved with the mental health system prior to entry in the jail.
Needs:
o Early identification and assessment of individuals with MH issues who
become involved in the criminal justice system. o 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 Law enforcement is continuing to be educated about experiences of
Veterans returning home after combat during the week of CIT training.
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 belonging to the transgender culture.
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. 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 unmet needs.
For each Transformation Priority provide:
• A brief narrative description of the priority
• A time line to accomplish the transformation priorities
11
• 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. 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.
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.
12
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 block grant funds except for the Administration
category. Administrative expenditure 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
13
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 Lifesharing 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 is People are abuse free. This is measured by the QM
outcome of reducing the number of 1-2-1 abuse incidents by 5%, the number of
incidents of 1-2-1 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 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).
14
• To assure the health and safety of individual receiving services outcome,
Franklin/ Fulton Co. 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, Lifesharing and Collaboration.
Estimated/Actual Individuals
served in FY 13-14
Projected Individuals to be
served in FY 14-15
Supported Employment 26 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
*This number may increase depending on the number of Graduate Initiative slots we are
given from the state. There are 17 graduates for June 2015. 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. 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
15
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. Prevocational 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, changes proposed for the current year, and how transition services from the ICF/ID and other
facility based programs will be supported.
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 an ICF/ID and receive base
funded Supports Coordination. Currently no one is leaving a State Hospital system
16
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 Lifesharing 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
Lifesharing to increase the number of people in Lifesharing.
The Franklin County Intellectual Disabilities Program will support the growth of Lifesharing in the following ways: 1. The AE and SCO will support people interested in a residential placement to
meet with Lifesharing providers and Lifesharers who have openings first to
promote Lifesharing 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 Lifesharing from other residential placements. If the person would benefit from
Lifesharing or is interested in moving, the AE will follow up as in #1 above.
3. The AE Lifesharing 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 Lifesharing home. 4. Franklin County has 33 people living in Lifesharing Homes, representing 32% of
the people in residential placement.
5. There are Lifesharing Homes in Franklin County with residents from other
counties living in them. These people are supported by the home county at this time.
Lifesharing is the first residential option offered to any person who needs a residential
placement. This is documented in the Individual Support Plan. Currently, there are 33
people living in Lifesharing Homes in Franklin County (see chart below for Franklin/ Fulton QM information). All 33 people have waiver funding to support the services they need in the lifesharing 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 Lifesharing by 10% (n=3) by June 30, 2017.
17
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. WRAP® is a recovery
oriented evidence-based model that is accepted internationally. Franklin/ Fulton County
and Philadelphia are the pilot areas. Franklin/Fulton Counties piloted the new WRAP®
for People with Developmental Distinctions which supports people with both a mental illness and Developmental Disability. 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.
18
Emergency Supports: Describe how individuals will be supported in the community if
no waiver capacity is available within the County capacity commitment. 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.
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.
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 the all 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
19
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 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 homeless and near homeless individuals and
families within the county. 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.
20
Franklin County is currently contracted with Waynesboro New Hope Shelter to administer the 2013-2015 ESG which includes financial and short-term rental
assistance under the rapid rehousing and homelessness prevention programs. SCCAP
and Waynesboro are also contracted with the County to oversee the 2013-2015 ESG
which includes shelter support, rapid rehousing and homelessness prevention. Franklin County also provides permanent supportive housing through the 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 Housing Program Specialist works closely with a provider to ensure that adequate
housing assistance and supports are in place for PATH 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 Specialist is able to support these enrolled individuals with case management services and also works collaboratively with
the individual’s case manager through the agency contracted to provide mental health
case management services.
Estimated / Actual 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
Bridge Housing:
(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) Due to the limited funds available Franklin County has not expanded into bridge housing
support.
Case Management: (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)
21
Case Management services activities offered by SCCAP, as defined by the HAP
Guidelines, may include but are not limited to the following:
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:
(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)
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:
22
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; or
hospital with no place to reside; or living in a home, but due to domestic violence
needs a safe place to reside;
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;
Are living in a “doubled-up” arrangement for six months or less on a temporary
basis;
Are living in a condemned building;
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
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:
Franklin County families with children who are homeless or near homeless.
Persons fleeing domestic violence.
Individuals who have fallen on hard times who need temporary assistance to get
back on their feet.
23
Homeless families with children who are candidates for Transitional Housing.
To receive financial assistance, the individual or family much 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:
(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)
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 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.
24
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:
(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) 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.
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.
25
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 HMIS 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 in to 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) 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 investigated and in-home services and/or placement
26
services are provided to families who meet Children & 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 CYS is the increase in referrals and subsequent need
for services. Our Intake Department is struggling to keep up with referrals to C&Y. 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. C&Y 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.) C&Y 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 service outcomes the county expects to achieve as a result
of the child welfare services funded through the Human Services Block Grant with a
27
primary focus on FY 2015-16. Explain how service outcomes will be measured and the
frequency of measurement. Please choose outcomes from the following 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 if
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
All Child Welfare
Services in 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
28
Family Group Decision Making (FGDM)
Program
Name:
Family Group Decision Making (FGDM)
Status Enter Y or N
Continuation from 2015-2015 Y
New implementation for 2015-2016 N
Funded and delivered services in
2014-2015 but not renewing in
2015-2016
N
Requesting funds for 2015-2016 (new, continuing or expanding) Y New Continuing Expanding
X
14-15 15-16
Target Population Children & family members Children & family members
# of Referrals 30* 35
# Successfully completing
program 18* 30
Cost per year $47,469 $59,349
Per Diem Cost/Program
funded amount $47,469 $59,349
Name of provider FCCYS FCCYS
*Note that numbers are for 7/1/14-5/12/15 • 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.
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.
29
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.
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.
DRUG and ALCOHOL SERVICES
This section should describe the entire substance abuse system available to county
residents incorporating all supports and services 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.
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.
Waiting list issues:
All 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 through the
drug and alcohol program in fiscal year 2014-2015. FFDA projects that 419 individuals
30
will receive level of care assessments. Level of care assessments are completed by
contracted outpatient providers or FFDA Case Management staff.
Coordination with the county human services 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 implemented a program titled “Feed The Good Wolf.” This
program identifies individuals in need of treatment at the “street” level and coordinates
services accordingly.
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 four
offenders with addictions issues who are sentenced to restrictive intermediate
punishment. Funding for this program is provided through a grant from the Pennsylvania
Commission on Crime and Delinquency.
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,
31
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 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
32
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 treatment for
offenders with addictions leaving the Jail without a home plan. This program is funded
through a grant from PCCD through Franklin County CJAB.
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
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.
Racial/Ethnic/Linguistic minorities
If indicated, minorities 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.
Recovery–Oriented Services
Describe the current recovery support services available in the county and any
proposed recovery support services being developed to enhance the existing system.
Address any challenges in moving toward a recovery-oriented system of care in the
county.
Individuals in need of recovery support services receive information about local
Narcotics Anonymous, Alcoholics Anonymous, Al-Anon, and Alateen meetings. This
information is provided by inpatient providers at discharge, outpatient providers at
admission, or by Case Management staff at FFDA. All individuals are encouraged to
seek a sponsor through these 12-step programs to aid them in their recovery.
33
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 will be applying 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 DEVELOPMENT FUND (HSDF)/HUMAN SERVICES AND
SUPPORTS:
The Human Services Development Fund will continue to be essential part of the block
grant that allows Franklin County the flexibility to provide for specialized services
throughout the fiscal year.
Estimated / Actual Individuals
served in FY 14-15
Projected Individuals to be
served in FY 15-16 Adult Services 0 0
Aging Services 0 0
Generic Services 3,676 3,732
Specialized Services 1,152 0
Adult Services:
Describe the services provided, the changes proposed for the current year, and the
estimated expenditures for each service provided.
Franklin County implemented the adult protective services program in the beginning of
fiscal year 12/13. This program has provided disabled consumers ages 19-59 access to
protective services. Effective April 1, 2015 these services were contracted by the State
to another provider, however the County will continue to receive the reports of need and
ensure that they are communicated to the contracted entity
Franklin County executed the PA Link to Aging and Disability Resources (LINK) in
February 2011. Designed to streamline access to long term supports and services, the
initiative is part of the nationwide effort to re-structure services and supports for older
adults, persons with disabilities, family members and care providers. The objective is to
34
“link” disability and aging providers together to share information and to increase access
to services to these groups easier. The LINK Coordinator refers the consumer to the
agency or agencies that best fits their particular needs.
These programs are not funded by the Block Grant.
Aging Services:
Describe the services provided, the changes proposed for the current year, and the
estimated expenditures for each service provided.
The County’s Human Services Program Specialist coordinates with local community
agencies to provide trainings at the local senior center. Topics included but not limited
to; technology, health and wellness, nutrition, etc. Informational trainings are also
provided by local agencies in regards to what services are available to our aging
population within the County of Franklin.
This service is not funded by the Block Grant.
Generic Services:
Describe the services provided, the changes proposed for the current year, and the
estimated expenditures for each service provided.
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.
Estimated HSBG Expenditures for Generic Services: $106,239
Specialized Services:
35
Describe the services provided, the changes proposed for the current year, and the
estimated expenditures for each service provided.
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 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
36
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.
The above programs tie into several categorical programs but best fit into the Human
Services Development Fund due to flexibility and affordability.
Estimated HSBG Expenditures for Specialized Services: $0.00 unless funding becomes
available within the fiscal year to provide the programs listed above.
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
If you plan to utilize HSDF funding for other human services, please provide a brief
description of the use and amount of the funding.
None anticipated.
37
Appendix A: Signatures
Appendix B: Minutes
38
Appendix C: Human Services Block Grant Proposed Budget and Service Recipients
County:
HSBG HSBG PLANNED NON-BLOCK OTHER
ESTIMATED ALLOCATION EXPENDITURES GRANT COUNTY PLANNED
CLIENTS (STATE AND FEDERAL) (STATE AND FEDERAL) EXPENDITURES MATCH EXPENDITURES
MENTAL HEALTH SERVICES
ACT and CTT
Administrator's Office 652,559 6,686
Administrative Management 287 273,420 7,263
Adult Developmental Training
Children's Evidence Based Practices
Children's Psychosocial Rehab
Community Employment 119 298,739 8,126
Community Residential Services 53 1,470,108 38,318
Community Services 492 323,250 8,520
Consumer Driven Services
Crisis Intervention 1,920 273,162 7,430
Emergency Services 168 37,898 1,031
Facility Based Vocational Rehab 31 66,696 1,814
Family Based Services 3 23,081 628
Family Support Services 15 4,024 109
Housing Support 31 52,421 49,485 1,426
Other
Outpatient 401 282,570 5,340
Partial Hospitalization
Peer Support 15 44,625 1,214
Psychiatric Inpatient Hospitalization 2 45,317 1,233
Psychiatric Rehabilitation 10 77,652 2,112
Social Rehab 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 0
39
INTELLECTUAL DISABILITIES SERVICES
Admin Office 571,466
Case Management 70 50,409
Community Residential Services 4 38,840
Community Based Services 250 314,471 46,500
Other
TOTAL ID SERVICES 324 975,186 975,186 0 46,500 0
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 0
CHILDREN & YOUTH SERVICES
Evidence Based Services 35 59,439
Promising Practice
Alternatives to Truancy
Housing
TOTAL C & Y SERVICES 35 59,439 59,439 0 0
DRUG AND ALCOHOL SERVICES
Inpatient non hospital 69 182,107
Inpatient Hospital
Partial Hospitalization
Outpatient/IOP 80 44,462
Medication Assisted Therapy 3 23,400
Recovery Support Services
Case/Care Management
Other Intervention
Prevention
TOTAL DRUG AND ALCOHOL SERVICES 152 290,526 249,969 0 0
40
HUMAN SERVICES AND SUPPORTS
Adult Services
Aging Services
Generic Services 3,732 71,506
Specialized Services
Children and Youth Services
Interagency Coordination 13,097
TOTAL HUMAN SERVICES AND SUPPORTS 3,732 95,968 84,603 0 0
COUNTY BLOCK GRANT
ADMINISTRATION 0
56,719 0
GRAND TOTAL 8,612 5,993,719 5,993,719 49,485 152,259 0
41
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, Drug and Alcohol Director)
• 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)
*denotes Leadership Team Members
42
Appendix E: Overview of 2015-2017 Quality Management Plan
Outcome Objective for 2015-2017 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.
43
44