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2 State News Briefs 3 Director’s Viewpoint 4 Across the Nation 5 Legislative Affairs
7 Mental Health Headlines 8 Conferences & Trainings 9 Drug & Alcohol Action 12 MR Report
14 On the Autism Spectrum 16 Children’s Corner 18 Committee Reports 20 Calendar
Provider Newso c t o b e r 2 0 0 7
E P c PA N e W S
An informational newsletter compiled by the Pennsylvania Community Providers Association for the MH, MR, and D&A communities
e I N S I D e
conference Features New resources
The association conference features two new resources this year for all guests — a printed and
bound compendium of primary handouts for workshops accom-panied by a CD-ROM of those handouts and additional reference materials from speakers. All conference guests will receive both the printed compendium and CD-ROM on site at the registration booth. “Managing workshop materials is always challenging at an event this size,” noted Kris Ericson, conference coordinator. “The efforts of the committee to secure additional sponsors is what makes this possible. We will be anxious for feedback from our guests about the value of this resource to them.”
PCPA celebrates its 35th anniversary during the 2007 conference, which begins October 16 at Seven Springs Mountain Resort. All conference activities and scheduled meals are included in the price of registration. The 2007 event features 67 work-shops including an afternoon with the Office of Developmental Programs, the first Children’s State Policy Makers Roundtable, and the PCPA Legislative Forum. Join colleagues at the premier state conference for mental health, drug and alcohol, mental retardation, and children’s leaders. Registration information is available on the association web site at www.paproviders.org by accessing any of several links to the conference section. Secure, online registration is available for those paying fees by credit card. Questions about the conference should be directed to Kris Ericson ([email protected]). f
conference opportunity to Speak With State officialsThe PCPA Training & Conference Committee has dedicated space at conference this year for state officials to share information and answer questions. A special invi-tation has been extended to state officials encour-aging them to partici-pate. Thursday, October 18, has been targeted for this new activity. The room will be open from 8:30 a.m. – 12:00 p.m. and 2:00 – 5:00 p.m. Announcements will be made during the confer-ence and participants will be encouraged to stop by to speak with state officials about pressing issues and con-cerns. If well received, the committee will con-sider this for an annual activity. f
P r o V I D e r N e W S october 2007
Provider News
executive DirectorGeorge J. Kimes
Deputy DirectorLynn Cooper
Policy SpecialistsLinda Drummond, MPAConnell O'Brien, MEd Betty Simmonds
Director of Legislative AffairsMelissa DiSanto Simmons
technical & conference Services coordinatorKris Ericson, PhD
Membership & Marketing coordinatorSteve Neidlinger
Administrative Assistant Cindy Lloyd
SecretaryTieanna BortzErin Asbury ©2007. This newsletter is written by the Pennsylvania Community Providers Associ-ation (PCPA) for the mental health, mental retardation, and addictive disease com-munities. This informational newsletter is published monthly. Deadline for publication is the third Friday of every month.
Pennsylvania community Providers AssociationBldg 3, Ste 2002101 N Front StHarrisburg, PA 17110
717-364-3280—Phone717-364-3287—Fax
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Notes From the oMHSAS Advisory committee
E S tAt e Ne W S br I e F S
Many issues were discussed during the Office of Mental Health and Substance Abuse Services (OMHSAS) Advisory Committee September meeting. A committee was formed to draft a resource
manual for behavioral health and aging services. PCPA staff will partici-pate. The October 18 Behavioral Health and Aging Forum is full. Sabrina Tillman-Boyd, OMHSAS, discussed Centers for Medicare and Medicaid Services (CMS) proposed regulations for rehabilitative services. OMHSAS and PCPA will share comments for submission to CMS. She also dis-cussed requirements for tamper-resistant prescription pads for Medical Assistance prescriptions. Expansion of a pilot community integration project conducted by OMHSAS and the University of Pennsylvania was reviewed. Revised county plan guidelines will require inclusion of the memorandum of understanding signed by county/joinder Office of Mental Health/Mental Retardation and Aging Services administrators. The Older Adult Advisory Committee formed a subcommittee to review county plans and practices. Dan Hoy, OMHSAS, discussed the Money Follows the Person grant to move older adults from state hospitals to the community. Ray Prushnok, Department of Aging, provided background and updates on the assisted living legislation and development of regu-lations. An overview of guardianship was provided.
OMHSAS is working to develop Centers of Innovation based upon evidence-based and promising practices. A task force will convene to develop this project. The Pennsylvania Psychiatry Leadership Council and OMHSAS will develop Centers of Excellence and Innovation in Public Psychiatry to train psychiatrists who are interested in practic-ing public service psychiatry in underserved areas of Pennsylvania. The use of Community Support Plans for individuals transitioning from state hospitals was discussed. It was noted that resistance is sometimes encountered from state hospital and county staff to moving individu-
als to community living arrangements. Education and outreach will continue to support transition to community integration.
The Children’s Committee discussed development of the Youth and Family Institute. Concerns were voiced about transition-age youth who are incar-cerated with needs for planning and services that must be addressed. A handout on use of reinvestment funds was distributed. Please contact Betty Simmonds ([email protected]) with questions about the advisory committee meeting. f
ProVIDer MeMberKeystone rural Health centerKelly Goshen, Director of Behavioral HealthChambersburg
bUSINeSS MeMberessential LearningPatrick Tully Senior Vice President Business DevelopmentCoppell, TX
E N e W M e M b e r S
P r o V I D e r N e W S october 2007 3 F
E D I r e c t o r ’ S V I e W P o I N t
George J. Kimes
This column represents my opinion, not necessarily that of the association.
Almost two years ago PCPA, in conjunction with partner Dr. Paul Lefkovitz, Behavioral
Pathways Systems (BPS), rolled out the benchmarking initiative at our annual conference. Since then over 75 organi-zations have signed up to participate. Data submission is again underway and opportunities exist for additional agen-cies to join this exciting project.
There are important changes to the proj-ect. Several new benchmarks, suggested by members, have been added. Data submission is easier with a more feature-laden web site, operating on a more pow-erful server platform. We have now added “drug and alcohol (D&A) provider” as a separate provider type, allowing more appropriate comparisons. Additionally, you can now compare your agency to similar agencies by Department of Public Welfare region. A simpler to read report is also new this year.
Participating members have been anx-ious to learn how their agencies compare to others both in Pennsylvania and across the country. Wouldn’t you like to know how your “Net Days of Accounts Receivable” compare to others? Other data such as “Staff Retention” and “Access to Service” have been useful measures for many participants. The project began out of a concern about pro-ductivity measurements. Data on produc-tivity is now available to participants.
In addition to the useful comparative data provided in the project, process benchmarking exercises have helped identify several “best” or “promising” practices. A recent special session for D&A providers focused on the problem
of high no-show rates for D&A clients. Comparing the methods used by top per-formers (lower no-show rates) to those with high no-show rates, providers were guided toward activities believed to reduce no-show rates. A similar exercise focusing on no-shows for initial appoint-ments will be featured in a benchmark-ing session at this year’s conference.
It is not too late to join this exciting project. If you are attending confer-ence, select the session from 3:15–5:15 p.m. on Tuesday, October 16. If you can’t attend that session, stop by the PCPA booth in Exhibit Hall and pick up bench-marking materials. Additionally, feel free to contact either Steve Neidlinger ([email protected]) or me for more information.
There are at least three reasons why your agency should be a part of the bench-marking project.
It’s free! Thanks to a grant from the Office of Mental Health and Substance Abuse Services, this service that would normally cost several thousand dollars is available to you at no cost.
It’s easy! Online reporting is simple and problems or questions are addressed quickly with timely support.
It’s effective! The information you receive from this initiative will improve your agency and will provide our indus-try with invaluable information to make a difference when we advocate with state officials.
George J. Kimes, Executive [email protected] f
Free, easy, effective
E P r o V I D e r N e W S 4 october 2007
PCPA has previously reported on federal requirements for use of tamper-resistant pre-scription pads for Medical Assistance (MA) prescriptions. The Department of Public Welfare (DPW) issued MA Bulletin 99-07-16, Tamper-Resistant Prescription Pads, (www.dpw.state.pa.us/General/Bulletins/003673169.aspx?BulletinId=4095) with an issue date of September 27 and effective date October 1, to provide guidance for Pennsylvania on use of tamper-resistant prescription pads. Tamper-resistant pads are required October 1 for MA prescriptions paid through the Fee-for-Service program, whether as a primary or secondary payer. This includes prescriptions for those receiving services through HealthChoices man-aged care organizations if prescriptions are
E A c r o S S t H e N At I o N
paid through the Fee-for-Service program. The requirement does not apply to prescriptions presented for payment in the managed care delivery system. Nor does it apply to electronic, verbal, or faxed prescriptions. An attachment to the bulletin (www.dpw.state.pa.us/General/Bulletins/003673169.aspx?AttachmentId=4093) provides a list of approved tamper-resistant prescription pad printers and suppliers.
The DPW Office of Medical Assistance Programs has posted Frequently Asked Questions and Answers Regarding Tamper-Resistant Prescription Pads (FAQ) on the Pharmacy Services web page (www.dpw.state.pa.us/Health/MAPharmProg). Please contact Betty Simmonds (betty@ paproviders.org) with further questions. f
The Department of Public Welfare (DPW) issued an updated Medical Assistance (MA) bulletin on employee education about false claims recovery provisions of the Deficit Reduction Act (DRA) of 2005. MA Bulletin 99-07-13 reminds providers of respon-sibilities for employee edu-cation about false claims as required by section 6032 of the DRA, notifies them that the deadline for submitting attestations of compliance was changed to September 30, and provides a revised attestation form. These provi-sions of the DRA are appli-cable to entities that receive or make payment of at least $5 million annually in MA payments. This bulletin refer-ences MA Bulletin 99-07-01, False Claims Act Provisions
of Deficit Reduction Act of 2005 Employee Education About False Claims Recovery (www.dpw.state.pa.us/General/Bulletins/003673169.aspx?BulletinDetailId=4044) that provided guidance for providers on compliance with section 6032 of the DRA.
The updated bulletin stresses that patient pay amounts and payment from managed care organizations do not count toward the $5 mil-lion threshold established. Covered entities must dis-tribute written policies and procedures to contractors or agents that perform billing or coding functions, furnish or authorize the furnishing of MA health care items or ser-vices on behalf of the entity, or are involved in monitor-
ing of health care provided by the entity. The Centers for Medicare and Medicaid Services (CMS) required DPW to change the original deadline for submission of attestations of compliance with the DRA from December 1 to September 30. The ear-lier attestation statement was changed to incorporate CMS guidance. Subsequent annual submission of attesta-tions is required by December 31 of each year for covered entities. Entities that have already submitted the initial attestation need not submit the revised form, although they may do so if they choose. MA Bulletin 99-07-13 is avail-able at www.dpw.state.pa.us/General/Bulletins/003673169.aspx?BulletinDetailId=4091. f
DrA Attestation of compliance Due
Deadline Arrives for tamper-resistant Prescription Pads
P r o V I D e r N e W S october 2007 5 F
E L e G I S L A t I V e A F F A I r S
For additional information on legislative issues, contact the PA Community Providers Association office at 717-364-3280 or [email protected]. For copies of bills, call your local legislator, the House Document Room 717-787-5320 or visit the General Assembly’s Electronic Bill Room at www.legis.state.pa.us.
Member Help Needed on Dedicated Alcohol tax A PCPA legislative initiative for the 2007/08 session is to achieve passage of the dedicated alcohol tax (House Bill 1032 and Senate Bill 870). While a number of legislators in both chambers have signed on as co-sponsors of the bills, PCPA and its supporters would like to see more legislative co-sponsors by year’s end. PCPA is developing a list of legislators that have not yet co-sponsored the bill in their respective chamber and will match them with PCPA members for interaction. The association will provide information with the member to be shared with the designated legislator(s). The member will also be asked to find additional support from colleagues to assist in contacting the designated legislator(s).
The dedicated alcohol tax legislation seeks to have the existing tax on wine and spirits, often referred to as the Johnstown Flood Tax or The Emergency Tax, redirected and dedicated to fund existing drug and alco-hol treatment services. The current tax is 18 percent and generates over $200 million annually. Some opponents of the tax have discussed the commonwealth eliminating the tax or dedicating it to other purposes, but PCPA and supporters believe this tax should instead be dedicated to existing state-funded drug and alcohol treatment services. The plan is revenue neutral in the first year and would generate an additional $10 million annually in subsequent years. For example, if the initiative had passed when initially proposed three years ago it would have generated an estimated $30+ million in additional funds for drug and alcohol treat-ment services. Statistics bear out the notion that this tax would not be an undue burden on Pennsylvania’s citizens. Case in point: 65 percent of Pennsylvanians drink alcohol; of those, 20 percent of the drinkers con-sume 80 percent of the alcohol.
Drug and alcohol treatment services must have a more secure funding source than the annual allocations of the commonwealth’s General Fund. Consider that Pennsylvania is working to make wine and liquor more accessible by opening stores on Sundays and expanding sales within grocery stores, border stores, and super stores. The state legislature voted to lower the alcohol level for Driving Under the Influence (DUI) to .08 percent, which has resulted in increased DUIs, increased costs to local communities, and an increased need for treatment. Many in Pennsylvania have seen the value of drug courts yet such judicial insti-tutions lack the proper funding to support needed expansion. f
bowl to Support the PAcThe GRI© Network’s annual bowl-ing tournament continues to grow! Members are highly encour-aged to pre-register teams of three (the team members need not be from the same organization) or to remit one’s own name and team assignments will be made. Time to bowl is available Tuesday and Wednesday evenings from 5:00 p.m. – 9:00 p.m. The bowling final will be held Thursday evening at 5:00 p.m. (the two final teams will be announced during Thursday’s Awards Luncheon). Contact Melissa DiSanto Simmons at [email protected] to register your team today! f
PCPA thanks
for their support of GRI conference activities.
Thank You
The 2008 Government Relations Institute (GRI©) applica-tions will be available soon. Applications are sent to every PCPA member contact person; however, if individuals would like to receive an application directly, please contact Melissa DiSanto Simmons, director of legislative affairs
([email protected]). Please note that this year’s class will begin in December due to Ms. Simmons’ maternity leave. f
E P r o V I D e r N e W S 6 october 2007
E L eG I SL At I V e A F FA Ir S
Parity Advances at the Federal LevelThe US Congress is working on long-overdue federal parity legislation. This federal legislation, by providing parity for the treatment of mental illness and substance use disorders, assures a more fair and equitable system of health care. The leg-islation requires that health insurance plans recognize the need for parity and provide coverage in a manner equitable to other health conditions. Two bills are being considered, House Resolution 1424 and Senate Bill 558. S 558 passed the Senate via unanimous consent on September 18. It has been sent to the House for consideration where it was referred to the House Education and Labor Committee. There had been concerns with S 558, fearing that it did not provide the needed protections for state legislation such as Act 106 that give greater coverage for behavioral health services. PCPA supports the updated Senate bill with the amend-ment made and the removal of preemption language. There is no provision in the bill that would preempt Act 106. In fact, it is the bill’s intent to act as a floor of parity protection upon which stronger state laws will rest. On September 19, the House Ways and Means Health Subcommittee favorably reported out HR 1424, the “Paul Wellstone Mental Health and Addiction Equity Act of 2007,” by a vote of 10 to 3. The full House Ways and Means Committee was scheduled to review HR 1424 on September 26 as Provider News went to press. The House Energy and Commerce Committee, which also has jurisdiction over HR 1424, is tentatively scheduled to consider the bill the first week of October. Text and status of HR 1424 and S 558 can be found at http://thomas.loc.gov. f
Attend Legislative WorkshopsThe GRI Alumni Network and Legislative Affairs Committee have worked to make this year’s legislative forum a true recognition of PCPA’s legislative strides and accomplishments during the association’s 35 years. The forum, moderated by Peter L. DeCoursey of Capitolwire.com, will include Sens. Jake Corman and Jay Costa, Jr. as well as Reps. Kathy Manderino and Mark Longietti (a freshman legislator). Other legislators have been invited and PCPA continues work to confirm their participation.
If members are interested in discovering how they and their organizations can become more involved in statewide and local legislative activities, or how they can develop grassroots networks and information within their respective organiza-tions, consider attending W21: Public Advocacy: Getting Your Agency Out in Front. This conference workshop, hosted by Stephen Christian-Michaels (former LAC co-chair and current PCPA president), Melissa DiSanto Simmons (PCPA’s director of legislative affairs), Jane Miller (a GRI© alumna with Mercy Behavioral Health), and Tom Bach (of Turtle Creek Valley MH/MR) encourages participants to take the lead in developing public advocacy within their organizations. f
PcPA continues call for Auction DonationsThe Pennsylvania Community Providers Political Action Committee’s (PCP PAC) Silent Auction, a staple of the con-ference Exhibit Hall, still needs your help! Raising funds through the auction allows the PAC to continue to build throughout the year. If your organization has not yet donated an item to the Silent Auction, access the auction donation form on PCPA’s web site today! It is located in both the Annual Conference and Legislative Affairs sections of the site. Please notify Melissa DiSanto Simmons of intended donations immediately. Please contact Ms. Simmons with any questions (melissa@ paproviders.org or 717-364-3280). She will be on maternity leave during this time but will access electronic and voice mail messages regularly.
Auction winners will be announced during the Ice Cream Social in Exhibit Hall on Wednesday afternoon. If you will not be present in the hall at that time and you are a potential winner, see Ms. Simmons prior to the close of the auction or have a designee ready (including making sure the designee has your tickets, if applicable).
And remember…the PACPot will also make an appearance in Exhibit Hall so be sure to have some cash on hand! The pot winner will be announced during Thursday’s awards luncheon. f
P r o V I D e r N e W S october 2007 7 F
erney Updates Advisory committeeOffice of Mental Health and Substance Abuse Services (OMHSAS) Deputy Secretary Joan Erney highlighted issues of interest during the September OMHSAS Advisory Committee meeting. She discussed the closure of Mayview State Hospital. Many Mayview residents have complex physical health care needs that must be addressed in the community. Optimally, individuals will not be discharged to nursing facili-ties, but instead will live in community placements with appropriate behavioral and physical health services supports. The OMHSAS plan to privatize forensic ser-vices was reviewed. Rep. Frankel is introducing legislation to establish a housing trust and support for community services from the sale of the Mayview property. In Allegheny County individuals discharged from closing personal care homes will take their personal care home supplemental funding with them to community living arrangements. An opportunity for the Apprise Medicare insurance counsel-ing program to address mental health needs of older adults was reviewed. Erney reviewed a bill on “assisted outpatient services” that would change the existing Mental Health Procedures Act.
Erney reviewed budget initiatives. The three percent cost-of-living adjustment (COLA) for base, Community Hospital Integration Project Program (CHIPP), and BHSI funds was passed. A new methodology was applied to the base funds COLA to address past inequities in allocations due to population changes and other fac-tors. The methodology addresses poverty level, change in census, and past utiliza-tion. Both Allegheny and Philadelphia counties received significant reductions in allocations. Other counties had lesser variation and increases. Two hundred indi-viduals will be discharged from the state hospital system through CHIPP. Respite care services for 2,000 families were funded, as was the behavioral HealthChoices expansion to all counties and matching funding for adult outpatient services in an alternative setting (long term structured residence). Funding was restored for psy-chiatric services in eastern Pennsylvania. This is the last year for BHSI intergov-ernmental transfer funding. The atypical antipsychotic pharmaceutical portion of the Special Pharmaceutical Benefits Program (SPBP) is transferred from the Office of Medical Assistance Programs to OMHSAS on October 1. OMHSAS is considering the addition of buprenorphine to SPBP.
Each county will be required to provide a housing plan with county plan submis-sions. Fiscal year 2008/09 plans that were submitted to OMHSAS this spring identi-fied housing as the top unmet need for counties. Many requests for new funding for consumer or peer-run services and for psychiatric rehabilitation services were submitted. Revised county plan guidelines will be issued soon. f
E M e N tA L H e A Lt H H e A D L I N e SInformation Available on Mental Health Advance Directives Sue Walther, executive direc-tor, Mental Health Association in Pennsylvania (MHA-PA), discussed mental health advance directives in a pre-sentation to the Behavioral Health and Aging Coalition of Central Pennsylvania. In the almost three years since Act 194 of 2004 was signed MHA-PA, the Pennsylvania Mental Health Consumers’ Association, providers, and others have provided informa-tion and assistance to many individuals in developing advance directives. Education, outreach, and assistance are still needed. MHA-PA has booklets available to assist individuals with developing an advance directive. A separate Guide for Agents is available to assist individuals in under-standing the role of the agent and determining whether this is a role that they could fulfill. Materials are avail-able online or can be obtained from MHA-PA (www.mhapa.org/resources/MHAD.htm). An online Provider Frequently Asked Questions document is also available. f
The Office of Mental Health and Substance Abuse Services (OMHSAS) Pennsylvania Medicaid Funded Peer Support Services manual is available in electronic for-mat from PCPA. This manual was distributed during the three technical assistance sessions on peer support services presented by OMHSAS in July. The manual pro-vides useful background information about the value
and development of peer support services in recov-ery. It includes copies of OMHSAS’ guidance on peer support services, including information on provider enrollment and billing for services. Interested PCPA members should contact Betty Simmonds ([email protected]) for a copy. f
oMHSAS Peer Support Services Manual Available
E P r o V I D e r N e W S 8 october 2007
October 5. If You Don’t Feed the Staff, They’ll Eat the Consumers: Dealing With Heat in the Kitchen. Hemlock GS Council Office. Harrisburg, PA. For more information or to register contact Riverside Professional Development (877-238-3660 or [email protected]).
October 8. Bucks County Family Caregiver Expo. Radisson Hotel Philadelphia Northeast, Trevose, PA. For more information contact Lifetime Expos and Events (215-968-4593 or www.lifetimeexpos.com).
October 11. Bullying in Prison. Comfort Inn. Harrisburg, PA. For more information or to reg-ister contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
October 11 – 12. Overview of Substance Abuse. Eagleville Hospital. Eagleville, PA. For more information or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
October 12. Motivational Enhancement Therapy. Allegheny General Hospital. Pittsburgh, PA. For more information or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
October 16. Family Caregiver/Professional Education Conference. Holiday Inn Harrisburg West. Mechanicsburg, PA. For more information contact Erica Hood at 717-651-5020.
October 16 – 19. Uniting…Service, Integrity, Passion. Celebrating 35 Years. The 2007 PCPA Conference. Seven Springs Mountain Resort. Champion, PA. Information at www.paproviders.org.
October 19. Family Caregiver/Professional Education Conference. Holiday Inn Green Tree. Pittsburgh, PA. For more information or to receive a brochure contact Lois Lutz 412-261-5040.
October 19. Clinical Supervision. Eagleville Hospital. Eagleville, PA. For more informa-tion or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
October 22. Spiritual Nature of Addiction Treatment. Comfort Inn. Harrisburg, PA. For more information or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
November 2. Ethics Revisited. Eagleville Hospital. Eagleville, PA. For more informa-tion or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
November 2. Basics of Clinical Supervision. Gateway Rehabilitation Center. Aliquippa, PA. For more information or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
November 8 – 9. Overview of Substance Abuse. Comfort Inn. Harrisburg, PA. For more infor-mation or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
November 12. Ethics for Drug and Alcohol Professionals. Allegheny General Hospital. Pittsburgh, PA. For more information or to reg-ister contact Pennsylvania Certification Board (717-540-4455 or [email protected]).
November 14 – 16. Which Way Out? The Sequential Intercept Model — A Framework for Decriminalizing Mental Illness. Station Square Sheraton Hotel. Pittsburgh, PA. For more information access The Center for Continuing Education in Health Sciences at https://ccehs.upmc.edu/courses/brochure_1236.pdf.
November 15 – 16. Co-Occurring Disorders. Eagleville Hospital. Eagleville, PA. For more information or to register contact Pennsylvania Certification Board (717-540-4455 or [email protected]). f
E c o N F e r e N c e S & t r A I N I N G S
P r o V I D e r N e W S october 2007 9 F
A process benchmarking exer-cise was sponsored by the Drug and Alcohol (D&A) Committee in efforts to address high no-show rates among D&A clients. Process benchmarking systematically con-trasts the methods used by top performers with others. The meth-ods that distinguish top perform-ers from others may be regarded as potential “best practices.” In this exercise, the approaches used by organizations with the lowest no-show rates were contrasted with others. Dr. Paul Lefkovitz, PCPA’s benchmarking partner, helped guide this exercise.
An online survey gathered data from participating organizations. The survey requested the organi-zation’s no-show rate among D&A clients and presented 37 questions about organizational practices and characteristics potentially related to no-shows. Thirty-two usable survey responses were analyzed. Eleven dimensions were identified as potential ”best practices” in that they differentiated top per-formers from the other organiza-tions. These dimensions included:
E Providing waiting room ameni-ties such as coffee and snacks for D&A clients.
E Compensating D&A counselors on an incentive basis (incentive basis is defined as a payment system that involves less or no pay for non-productive hours).
E Hosting an Alcoholics Anonymous (AA) or other D&A support group onsite.
E Presence of a waiting list for D&A services (requires interpretation).
bDAP Liability Pilot Projects — Information NeededThe Bureau of Drug and Alcohol Programs (BDAP) has been working for several years on a new set of liability and abatement requirements. The original liability and abate-ment requirements drafted and distributed in July 2006 were eliminated in response to concerns expressed by the field. After redrafting require-ments, BDAP wisely decided to field test the revised require-ments in pilot projects for three months before finalizing them. Implementation of the pilots began in July. A number of PCPA members are in the pilot project and some have reported problems with the projects. However, those concerns have not reached BDAP. The primary complaint reported is that in some cases the co-pay has increased and the provider has, not surprisingly, had no luck collecting it from the cli-ent. The inability to collect the co-pay has resulted in a reduced rate to the provider. All members in the pilot proj-ects are strongly encouraged to contact Lynn Cooper at the association with both positive and negative feedback. This is an important opportunity that cannot be missed. Once these requirements are adopted they will likely be in place for many years. BDAP announced that they are considering a three- month extension of the pilot project period. f
E D & A A c t I o N
E Communicating no-show rates to scheduling staff.
E Maintaining low turnover of D&A counselors.
E Not being a larger, multi-service agency with a broader continuum of care.
E Requiring AA or other self-help group attendance with writ-ten confirmation of D&A client attendance.
E Requiring AA or other self-help group attendance of D&A clients.
E Having scheduling staff discuss the importance of follow-through when the initial appointment is made with clients.
E Sending appointment reminder cards or letters to clients for ongoing appointments.
Some practices yielded very high levels of endorsement from both top performing and comparison groups. These may be best thought of as “common practices.” Even though they did not differentiate between top performers and the others, these tactics would be worth considering for organizations not already prac-ticing them. They include:
E Requiring that counselors see-ing D&A clients have special-ized training, experience, or certification.
E Using motivational interview-ing (as defined by Miller and Rollnick).
E Maintaining a flexible policy for those that feel they cannot meet the co-payment.
For a copy of the entire final report contact Lynn Cooper ([email protected]) at the association. f
D&A benchmarking exercise completed
E P r o V I D e r N e W S 10 october 2007
D&A training Problems reportedPCPA held an August conference call to discuss problems encountered with drug and alcohol (D&A) training programs. A number of issues were iden-tified. The most significant concerns expressed included access problems and high costs. A number of activities are underway to assist members. PCPA will submit criteria for online training to be considered by Drug and Alcohol Licensing to meet D&A licensing requirements. The work group identified a number of courses believed to be suitable for online train-ing such as, HIV/STDs, Confidentiality, Addictions 101, and Ethics. A September meeting with the Bureau of Drug and Alcohol Programs (BDAP) to discuss concerns that relate to BDAP-sponsored training and explore the role PCPA can play in helping to address the concerns was scheduled as Provider News went to press. Some members have reported that they believe that the “mini-regional” trainings are too costly and not conve-nient for providers. PCPA will request a number of changes such as more advance notice of trainings, wider distribution of training announce-ments, and a recommendation to increase the opportunities for clinical supervision training. PCPA will also discuss the need for more training on co-occurring services with the Office of Mental Health and Substance Abuse Services. For more information contact Lynn Cooper (lynn@ paproviders.org) at the association. f
Addictions curriculum for NursesThe Northeast Addictions Technology Transfer Center (NeATTC), in col-laboration with the University of Pittsburgh School of Nursing, began development of an 11-module curriculum encompassing basic addiction information relevant for nursing practice and simulated experience in Screening and Brief Intervention (SBI.) In September the NeATTC piloted a section of the curriculum with a two-hour classroom experience and one hour of SBI simulation for junior year nursing students. The in-class experience will be complemented by three-week clinical rotations at three healthcare sites using SBI as part of the statewide Pennsylvania Screening, Brief Intervention, Referral and Treatment Program. Moving forward, the NeATTC will continue to work with the nursing school to per-manently integrate an addictions/SBI component, a full clinical SBI simu-lation experience for all students, and more SBI clinical rotation into the baccalaureate nursing curriculum. f
IretA Hires New Scientific coordinator The Institute for Research, Education, and Training in Addictions (IRETA) welcomed Eric Hulsey as scientific coordinator. Hulsey is finishing his PhD at the University of Pittsburgh Graduate School of Public Health. Prior to returning to pursue his degree, he worked as a family therapist for several non-profit organizations. PCPA members looking for someone to evaluate agency programs may be able to be helped by Hulsey. He can be reached at [email protected]. f
Mercy opens Adolescent IoPThe Mercy Behavioral Health Adolescent Intensive Outpatient Program (A-IOP) is a four-week, highly structured treatment program designed for adolescents experiencing substance use disorders and emotional or behav-ioral problems, family conflicts, or school-related difficulties. The program is available to adolescents that need more than one or two outpatient visits per week with a psychiatrist or thera-pist, or as a step-down program from inpatient or partial hospitalization. Features of the program include:
E six hours per week of group therapy based on the Chestnut Health System model (a SAMHSA/NREPP Model Program),
E required family sessions,
E required individual therapy sessions,
E a recovery-oriented approach, and a
E certificate granted upon successful completion of the program.
Adolescents in the program may have been hospitalized, although prior hospitalization is not required for pro-gram participation. Adolescents not making desired progress in other less intensive treatment settings may also benefit from the program. Teens and parents must be capable of actively participating in treatment. The A-IOP is designed to help teens learn new skills and develop more positive atti-tudes to eliminate substance abuse/dependence, improve social relation-ships, and function in a healthier manner with families, schools, and in the community. For more informa-tion contact Victor Barbetti, PhD, unit manager (412-261-5071 or [email protected]).
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IretA Hosts National recovery InitiativeThe Institute for Research, Education, and Training in Addictions (IRETA) will spearhead an initiative to advance recovery issues in research by gathering leaders in recovery to advance this issue at a national level. On September 20, at the request of the White House Office of Faith-Based and Community Services, Dr. Michael Flaherty traveled to Washington, DC to dis-cuss a recovery research agenda. Among attendees were John Walters, direc-tor, Office of National Drug Control Policy, and Dr. H. Westley Clark, director, Center for Substance Abuse Treatment. f
IretA receives New Attc GrantPCPA is pleased to report that the Institute for Research, Education, and Training in Addictions (IRETA) has received a new five-year Addictions Technology Transfer Center (ATTC) grant award. Previously the grant was for Pennsylvania, New York, and New Jersey. The new grant will focus on Pennsylvania and New York. PCPA looks forward to partnering with IRETA to bring science to service. f
Addictions treatment brochure UpdatedAn update to IRETA’s popular brochure, Addictions Treatment: When Knowing the Facts Can Help, is now available. Originally published in 2003 in response to the addictions treatment budget crisis in the state, the brochure was instrumental in helping restore treatment funding in Pennsylvania. The updated version addresses issues surrounding changing views in the field such as the need for a cost-effective continuum of care. The updated resource can be useful in informing policy makers about the importance and effectiveness of substance use disorder treatment and can form the basis for local, state, and national advocacy efforts. f
Promoting Awareness of Motivational IncentivesThe National Institute on Drug Abuse (NIDA) blending product, Promoting Awareness of Motivational Incentives (PAMI), is available for download at http://pami.nattc.org. The PAMI Blending Team developed the tools con-tained in this package to build awareness of Motivational Incentives (MI) as a science-based therapeutic strategy within the addiction treatment field. MI, also referred to as contingency management, is a form of behavioral therapy based on Skinner’s operant conditioning principles. Positive rewards increase client retention in treatment programs, a strong predictor of posi-tive treatment outcomes, when compared to counseling alone. The products in this package illustrate positive outcomes and lessons learned from the NIDA Clinical Trials Network study and the Motivational Incentives for Enhanced Drug Abuse Recovery study. f
clinical training for opioid treatmentThe Institute for Research, Education, and Training in Addictions (IRETA) is working with doctors and nurses to organize a special continuing education opportunity titled Patient Safety in Opioid Addiction Treatment — A Best Practice Update on May 16, 2008. This one-day clinical train-ing event is planned to appeal to practitioners working in opioid maintenance treatment across the commonwealth, encouraging them to collaborate and to participate in didactic and interactive discussion that will facilitate mentoring and networking. The goal is to provide a best practice update that will assist opioid maintenance practitioners including physicians, nurses, nurse practitioners, and physician assistants in their recognition and understanding of evidence-based guidelines for safe and effective medication-assisted treatment for opioid dependence. For more infor-mation contact Kris Pond at [email protected]. f
SbIrt training in PittsburghOn October 19 the Institute for Research, Education, and Training in Addictions (IRETA) will offer a free one-day Screening and Brief Intervention Training (SBIRT) for trauma and primary care provid-ers in Pittsburgh at the Pittsburgh Hilton Downtown. Attendees will learn how to screen patients and provide brief interventions for alco-hol problems. For more information contact Wayne Shipley ([email protected]) or visit www.ireta.org/sbirt/trainings.htm. f
E D & A A c t I o N
E P r o V I D e r N e W S 12 october 2007
E M e N t A L r e t A r D A t I o N r e P o r t
elwyn Dental clinicElwyn, a non-profit organization in southeastern Pennsylvania, provides a variety of services to individuals with special needs. Many of these services are provided in Media, but Elwyn also offers support programs in schools, community, workplaces, and individual homes in Delaware, New Jersey, and California. Currently, over 12,000 children and adults are offered support in residential, educational, rehabilitation, vocation, and employment services.
Elwyn’s dental services are offered at the Media campus and a new program recently opened in Philadelphia. People with special needs often have dif-ficulty securing basic dental care. Physical, medical, and behavioral issues often create barriers to being served in local communities. The agency’s dental services provide comprehensive, quality care to these individuals. A full range of dental services covered by insurance include preventive, X-rays, cleanings, periodontal therapy, restorative fillings, endodontic treat-ment, extractions, crowns, and removable prosthodontics. For additional information contact Dental Services (610-891-2320 or www.elwyn.org). f
Provider Profile Phase IIThe Office of Developmental Programs (ODP) work group developing recom-mendations for Provider Profile met recently with Deputy Secretary Casey to discuss Phase II of this initiative. Phase I recommendations will be shared with service providers through an informational bulletin. Casey asked the work group to look at the possibility of using the system’s current data col-lected such as the Turnover and Vacancy Survey, Independent Monitoring for Quality, and Incident Management. A review of these items needs to include developing statistics that are meaningful to individuals and fami-lies to help in selecting their providers. Once finalized the Provider Profile would be required of providers. It will be the only profile used by providers and administrative entities (AE). AEs would also work with ODP to have a role in monitoring the accuracy of the data. f
House resolution 159 Waiting ListHouse Resolution 159 of 2007 establishes a Joint State Government Commission Advisory Committee on Community-Based Mental Retardation Services. Policy Specialist Linda Drummond represents PCPA on this com-mittee, which is developing recommendations to address the state’s mental retardation waiting list. Discussion evolved from an overview of the sys-tem’s intake system and data collection processes to the state budget issues of annual cost-of-living adjustments, funding for students graduating from special education, and wages for direct support professionals. Right-sizing the system could be addressed by reassessing the needs of those most costly to serve, state centers, and private ICFs/MR and allowing funds received from the closure and sale of state centers to be used for community services. f
Disability Programs GAo reportModernizing Federal Disability Policy is a newly released report by the US Government Accountability Office (GAO) based on a forum of research-ers, advocacy groups, academia, and federal agencies brought together to discuss what is working in over 200 federal disability programs. Forum participants addressed what is working, what needs improve-ment, strengthening partnerships and coordination, and modernizing measures of success. The report is available at www.gao.gov/ new.items/d07934sp.pdf. f
Positive behavior resourceThe American Association on Intellectual and Developmental Disabilities has revised its Positive Behavior Support Training Curriculum which can be ordered at http://bookstore.aaidd.org. This is an evidence-based tool that trains direct support staff and supervisors regarding interacting with individ-uals using principles including:
E Praise and feedback to increase target behavior,
E Positive and age-appropriate interactions,
E Identifying and teaching essen-tial skills as opposed to non-functional skills,
E How to give individual’s choices, and
E Learning when to use verbal, gesture, modeling, and physical prompts. f
P r o V I D e r N e W S october 2007 13 F
E M r r e P o r t
Property ownership bulletinThe Office of Developmental Pograms (ODP) has issued Bulletin 4300-07-05, Administrative Entity (AE) and Provider Contracts, which interprets the MH/MR Fiscal Manual, PA Code 55, Chapter 4300.87. This section relates to financing and title of real property subject to both waiver and non-waiver funding and states that the property will remain with the provider. ODP will not fund contracts in violation of Chapter 4300. Where this language exists in a current AE/provider contract, it must be removed effective July 1, 2007. Any questions should be directed to the appropriate ODP regional program manager. f
Sheltered employment researchIn a recent article published in the Journal of Vocational Rehabilitation (Volume 26, #1/2007), authors Migliore, Mank, Grossi, and Rogan note that despite national and state policies promoting integrated employment, 76 percent of adults with intellectual or developmental disabilities are served in facility-based programs. The article focuses on whether or not this gap between policy and practice is in part due to the lack of interest of adults with intellectual disabilities and their families for employment outside facility-based programs. The authors surveyed 210 adults with intellectual disabilities in 19 sheltered workshops, their respective families or caregiv-ers, and staff members in these workshops. Results show that 74 percent of adults with intellectual disabilities, 67 percent of families, and 66 percent of staff felt those they serve would prefer employment outside workshops or at least consider it as an option. The majority believed that adults with intel-lectual disabilities can perform outside workshops if support is made avail-able. The study highlighted the fact that the preference for employment outside of workshops is not associated with the severity of the disability.
Another article of interest from the Journal of Vocational Rehabilitation (Volume 24, #3/2006), “What Predicts Re-employment After Job Loss for Individuals with Mental Retardation,” studied the reasons for job loss and identifies which individuals and agency characteristics are predictors of re-employment for persons with intellectual disabilities. The most frequent reason reported for job loss included job performance problems, employee’s decision to quit, health issues, and employer layoffs. Only 38 percent of those individuals who experienced a job interruption in 2002 were success-fully re-employed in 2003. Individual and service agency characteristics including race, agency size, and use of job coach were significant predic-tors of re-employment. Copies of these articles may be ordered through the National Rehabilitation Information Center, www.naric.com. f
DM-ID Diagnostic ManualThe National Association for the Dually Diagnosed (NADD) in associ-ation with the American Psychiatric Association has developed a new diagnostic manual, Diagnostic Manual — Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability. A shorter clinical version is also available. The manuals focus on issues related to diagnosis of people with intellectual disabilities, the limitations in applying DSM-IV-TR criteria, and adaptation of the diagnostic criteria. Information on ordering is available at www.dmid.org. f
IcFs/Mr employment InitiativeThe Office of Developmental Programs is moving forward with its emphasis on supported and competitive employment for individuals served in the commu-nity. One work group is develop-ing an “Employment Manual for Intermediate Care Facilities for Persons With Mental Retardation (ICFs/MR)” to be used by direct support workers, employment spe-cialists, qualified mental retarda-tion professionals, school districts and intermediate units, and others such as the Office of Vocational Rehabilitation. This document provides information regarding existing standards, policies, and resources to assist agencies working to move individuals into employ-ment options. The draft document has been disseminated to the ICFs/MR for comment. An electronic copy is available from Linda Drummond ([email protected]). f
E P r o V I D e r N e W S 14 october 2007
E 0 N t H e A U t I S M S P e c t r U M
Autism bureau MeetingPCPA’s recent meeting with the Bureau of Autism Services provided an opportunity to learn about funding criteria, future trainings, and system development. The Autism Syndrome Disorder Task Force Report 2004 continues to be the driving force for bureau initiatives. Providers seeking financial support from the state need to offer innovative programs that show cross-systems collaboration and stakeholder involvement. Pilots funded by the bureau need to demonstrate funding resources, program sustainability, administrative capacity, use evidence-based practices, and provide outcome measures. The autism waiver application will be submitted to the Centers for Medicare and Medicaid Services. Once approved, Office of Development Programs regional offices will be used to administer the waiver, including intake. Supports coordination will be an important component and will receive extensive training. f
conference Sessions Address AutismPCPA’s 2007 conference, Uniting...Service, Integrity, Passion, at Seven Springs Mountain Resort in Champion October 16 – 19 features several presentations specific to autism:
E Glynn Chase, Dr. Gertrude A Barber National Institute, “Bringing Autism Expertise and Services to Rural Areas of Pennsylvania,”
E Karen Markle and Astrid Berry, NHS Human Services, “United We Stand: A Blended Services Design for People with Autism and Intellectual Disability,”
E Karen Markle, Carl Clark, and Sharon Greene, NHS Human Services, “Blending Behavioral Health and Education Services for Children with Autism Spectrum Disorder,” and
E Jean Ruttenberg, Lew Hemmer, and Ia Ioannidou, Center for Autism Services, “Uniting Families and Professionals: Working With Families Who Have a Child With an Autism Spectrum Diagnosis.” f
New Autism researchThe Simons Foundation’s Autism Research Initiative funds projects for a period of three years to address the causes of autism and to improve treat-ment and prevention. Rutgers University Cell and DNA Repository has received $7.8 million to establish a collection of DNA samples for autism studies. The Simons Simplex Collection will investigate autism from the standing of sporadic genetic changes that may occur in one generation which may account for a large number of cases. Many scientists feel there is a genetic cause for autism and may include several environmental factors which alter genes. This DNA analysis may direct future research and pos-sible therapies. f
early Autism DiagnosisResearchers from the Kennedy Krieger Institute have found that autism can be diagnosed close to age one for approxi-mately half of all children eventually determined to have the disorder. This early diag-nosis, allowing for early inter-vention, can greatly impact the child’s development. Parents and pediatricians should watch for the following signs of developmental delays:
E Abnormalities in initiating communication with others,
E Missed cues and opportuni-ties to share experiences with others,
E Irregularities when playing with toys, and
E Reduced variety of sounds, words, and gestures used to communicate.
Published in the July issue of Archives of General Psychiatry, additional information is available at Kennedy Krieger Institute, www.kennedykrieger.org. f
P r o V I D e r N e W S october 2007 15 F
corzine enacts Autism LegislationNew Jersey Gov. Corzine has signed a package of seven bills relating to Autism Spectrum Disorders. Statistics for New Jersey indicate the incidence of this disorder is one in 95 and the national rate is estimated at one in 150 children. The legislation signed into law includes teacher training in aware-ness and instructional methods, early intervention programs, establish-ment of an autism task force, renaming the Governor’s Council for Medical Research and Treatment of Autism, funding for autism medical research and treatment, development of a registry of reported autism diagnoses, and establishment of an Asperger’s Syndrome pilot initiative. f
Speaker o’brien on Hb 1150House Speaker Dennis O’Brien provided an update on House Bill 1150 to the autism advocacy community. In his message, O’Brien noted that Sen. Donald White, chair of the Senate Insurance Committee, has asked the Pennsylvania’s Health Care Cost Containment Council to review HB 1150 to determine if it has a cost benefit. He shares his expectation that a review will show that there is a significant long-term benefit to this legislation in terms of quality of life and in long-term savings. O’Brien is asking families to provide data and information that would demonstrate:
E The extent to which the proposed benefit and the services it would pro-vide are needed by, available to, and utilized by the population.
E The extent to which insurance coverage for the proposed benefit already exists or, if no coverage exists, the extent to which this lack of coverage results in inadequate health care or financial hardship.
E The demand for the proposed benefit from the public and the source and extent of opposition to mandating the benefit. All relevant findings bearing on the social impact of the lack of the proposed benefit.
E Where the proposed benefit would mandate coverage of a particular ther-apy, the results of at least one professionally accepted, controlled trial comparing the medical consequences of the proposed therapy, alterna-tive therapies, and no therapy.
E Where the proposed benefit would mandate coverage of an additional class of practitioners, the results of at least one professionally accepted, controlled trial comparing the medical results achieved by the additional class of practitioners and those practitioners already covered by benefits.
E The results of any other relevant research. f
NHS Autism SchoolsNHS Human Services has been pro-viding behavioral health services for children with autism, perva-sive developmental disorder and Aspergers Syndrome for over ten years. In 2005, NHS opened its first school in Herminie for children and now offers similar schools in Philadelphia, Altoona, Carlisle, and State College. Additional programs are planned for Chambersburg, Reading, and York. The schools use a skill-based curriculum which concentrates on communication, social and daily living skills, aca-demic skills, and behavioral devel-opment. Students served are those that have behaviors and needs that preclude them from partici-pating in traditional mainstream activities. For additional informa-tion contact Karen Markle, direc-tor of autism services ([email protected]). f
E o N t H e A U t I S M S P e c t r U M
The future is not some place we are going, but one we are creating. The paths to it are not found but made, and the activity of making them changes both the maker and the destination.
— John Schaar
E P r o V I D e r N e W S 16 october 2007
E c H I L D r e N ’ S c o r N e r
Act Initiative UpdatesThe Alternatives to Coercive Techniques (ACT) Work Group has begun to imple-ment plans for the next phase of the ACT initiative. Last year saw a broad and enthusiastic response from members engaged in practice improvements related to the prevention and management of behavioral crisis situations and restraint reduction. Secretary Richman has directed staff to focus the next phase of this initiative on training related to specific prevention and restraint avoidance techniques and the expansion of promising trauma informed care models of practice. A work group has begun to discuss some of the predict-able but unintended effects of restraint reduction in residential settings. The group is seeking data on changes in elopements, admission criteria, staff injury, police contacts, transfer to involuntary inpatient treatment, and other changes that may be related to new crisis intervention practices. f
IcSP Announces GrantsAt the recent Integrated Children’s Service Planning (ICSP) advisory meeting it was announced that more than $2.4 million in grant funds will flow to 25 tier one counties. Funds are targeted for the development of infrastructure to support comprehensive services for children, including integrated data management systems, developing common screening and assessments pro-cesses, integrated prevention planning, and streamlining intake procedures across child serving systems. County ICSP plans for fiscal 2008/09 were due in the Department of Public Welfare (DPW) September 15. To date 35 counties have declared plans to apply as tier one counties, an increase from 27 in the prior year. An update was also provided on the MacArthur juvenile justice – mental health service integration model program project. DPW is working with the Pennsylvania Commission on Crime and Delinquency to develop a center for evidence-based practice with details on this initiative and a request for proposals expected to be announced this winter. f
children and Family Web Site enhancedThe Governor’s Commission has recently improved their web site, www.pachildren.state.pa.us. The site provides links to a variety of resources including parent guides and advocacy resources in education, health, and mental health. In response to recommendations from commission members the site was improved and now includes:
E Added search capability to allow users to instantly search for different types of information within the site,
E A section for New Recommendations that include the Commission’s Advancing Children’s Mental Health recommendations and Strengthening and Supporting Parents recommendations,
E A web link to the state budget, and
E Updated and expanded language and new resources to the links, such as the PA Health and Human Service Guide. f
early childhood behavioral Health Survey resultsThe PCPA Early Childhood Behavioral Health Work Group has been identifying service needs and promising practices for young children across the state. In July the association began conducting a brief online survey to identify agencies that serve children ages birth – five. More than 100 agen-cies/individuals completed the survey. Surveys reflected provid-ers addressing the needs of the population in all but nine counties. Self-identified service provid-ers in counties ranged from one in several counties to more than ten in six counties. Information reflected services to more than 21,000 children and families being provided by a staff complement of 1,900 along with more than 150 university interns and train-ees. The majority of services are delivered in early intervention and community mental health settings. Assessment, outpatient treatment, and Behavioral Health Rehabilitation Services were the most frequently reported. The larg-est funding source reported was Medical Assistance, closely followed by county funding through county mental retardation, mental health, early intervention, or community services grants. Fundraising and local grants were also frequently cited as a funding source. f
P r o V I D e r N e W S october 2007 17 F
E c H I L D r e N ’ S c o r N e r
Parent experiences Focus of New StudyThe University of Pennsylvania Collaborative on Community Integration (www.upennrrtc.org) is seeking stories from parents with mental illnesses about their experiences with the child welfare system, child custody issues, barriers to reunification associated with having a mental illness, and custody being used to encourage treatment compliance. This infor-mation will help the university develop training, policy, and research initiatives to increase opportunities for parents with mental illnesses to have lasting, loving relationships with their children. The collaborative is looking for mental health consumers to share stories that include a brief description of a parent/consumer mental health history and the incident that led to the removal of a child from a parent. It is important to note that the center has stated that by submitting a story the individual gives permission to use it in part or in whole in trainings, presentations, and/or policy briefs. No identifying information will be included in any use of the story. If members are aware of an individual that may wish to share experi-ences they can contact Pam Cousounis ([email protected] or at 215-746-1950). f
recommendations to Prevent Youth ViolenceMembers of the Governor’s Commission on Children and Families agree that youth violence is a problem confronting communities across the state. The commission has issued this challenge to state leaders:
Members of the Governor’s Commission for Children and Families urge state leaders to undertake a variety of actions to reduce and prevent youth violence. The Commission members are recom-mending a comprehensive approach with strategies to prevent, intervene early, intervene on the streets (after-school and com-munity-based programs) and in schools, mobilize communities, and strengthen law enforcement and gun laws. The Members sup-port a balanced approach of strategies. Members believe that the Commonwealth should support local action by community leaders to reduce youth crime.
Violent youth crime is a persistent problem in Pennsylvania. Although substantially less than in the mid 1990s, the Pennsylvania Commission on Crime and Delinquency reports that there has been a recent rise of 10 percent from 2001 to 2005. In general, schools are safer than the commu-nities in which they sit, but they are not safe. Youth violence in schools continues to be a serious issue. According to the Pennsylvania Department of Education the number of reported incidents involving law enforcement increased 12 percent, fights increased 68 percent, and bullying incidents increased 32 percent. There were marked decreases in assaults on students and staff and reported sexual offenses. Along with the Commission’s chal-lenge comes a list of recommended strategies and actions. The recommen-dations for preventing youth violence are available in their entirety at www.pachildren.state.pa.us. f
Goals for Youth Suicide Prevention in PennsylvaniaThe Pennsylvania Youth Suicide Prevention Advisory Work Group was formed in 2003 to provide input on the development and monitoring of a five-year action plan. The advisory group has recently revised the goals and areas of activity. In the years ahead Pennsylvania will strive to:
E Promote awareness that youth suicide is a public health problem that is preventable;
E Develop broad-based support for youth suicide prevention;
E Develop and implement strategies to reduce the stigma associated with being a youth consumer of mental health, substance use, and suicide prevention services;
E Identify, develop, and imple-ment youth suicide prevention programs;
E Promote efforts to reduce access to lethal means and methods of self-harm;
E Implement training for recogni-tion of at-risk behavior and deliv-ery of effective treatment;
E Develop and promote effective clinical and professional practices;
E Improve access to and community linkages with mental health and substance abuse services;
E Improve reporting and portrayals of suicidal behavior, mental ill-ness, and substance abuse in the entertainment and news media;
E Promote and support research on youth suicide and prevention; and
E Improve and expand surveillance systems. f
E P r o V I D e r N e W S 18 october 2007
Provider/Mco Initiatives Featured in NovemberIn response to suggestions from members, the November 27 Children’s Committee agenda will include collaborative presen-tations by community providers and the behavioral health managed care organi-zation with which they contract. While managed care is struggling in its infancy in much of the state there are several good examples of collaborative practices that reflect the strengths and potentials of HealthChoices. Members, both provid-ers and managed care staff, will showcase and discuss some of these promising practices. f
PcPA Participates in FASD Awareness PCPA and the Fetal Alcohol Spectrum Disorder (FASD) Task Force held a rally at the State Capitol to commemorate the start of FASD Awareness Week, which began September 10. The task force is a cooperative effort between government agencies and advocacy groups, designed to educate the general public about the dangers of prenatal alcohol consump-tion. The rally featured speakers from the Bureau of Drug and Alcohol Programs, the Liquor Control Board, and other gov-ernment agencies. The most influential speaker was Kathleen Mitchell, vice presi-dent of the National Organization on Fetal Alcohol Syndrome (NOFAS). Mitchell was very candid concerning her alcohol use and her daughter, Carly, who was born with FASD. Carly, now an adult, also took the microphone and thanked everyone for coming. The day concluded with a task force meeting where the group discussed a publication of research and recom-mendations. Each agency represented on the task force detailed their efforts to publicize FASD Awareness Week. Advocate groups delivered educational materials to selected legislators. f
E coMMI t t e e r eP or t S E c H I L D r e N ’ S c o r N e r
The September Children’s Committee was preceded by two focus groups conducted by the Office of Children, Youth and Families in preparation for the federal Child and Family Service Review. The committee received reports and updates from a range of commit-tees and work groups, many of which previewed workshops and events for the October conference. Richard Gold, deputy secretary, Office of Children, Youth and Families (OCYF) met with the com-mittee and reviewed the activities of the office including develop-ment of an OCYF mission and vision statement; development of four secure residential treatment facilities; focus on evidence-based, outcome oriented county level services in the development of the 2008/09 Needs Based Budget; centralized provider profiles for children and youth services to facilitate consumer choice; expansion of the use of Family Group Decision Making to all counties; the creation of a OCYF advisory group; and the impend-ing release of a ban on prone restraints. Senior staff from OCYF reviewed several draft bulletins and special transmittals related to changes in the laws of child protective services, the review of child fatalities and near fatalities, expanded requirements for clearances in the foster care systems, and the expansion of the scope of the mandated reporter laws. Deloitte Consulting pre-sented information on the recently launched OCYF incident report-ing system and solicited feedback from members. Deloitte also provided the following information for the HCSIS Help Desk: 866-444-1264 (phone), 717-540-0960 (fax), or [email protected]. Help Desk hours are 8:00 a.m. – 5:00 p.m. Monday through Friday.
The Department of Education and the Office of Mental Health and Substance Abuse Services provided updates on several initia-tives ranging from the review of credentials needed to provide behavioral health services in schools to the pending announce-ment of the organization selected to operate the state’s Youth and Family Institute. The next meeting of the Children’s Committee is November 27. f
OCYF Deputy Secretary Richard Gold speaks with the Children’s Committee about the many initia-tives of the office.
children’s committee
P r o V I D e r N e W S october 2007 19 F
Sabrina Tillman-Boyd, OMHSAS, discussed adult outpatient treatment options with members of the committee in their September meeting.
The Drug and Alcohol Committee covered a wide range of issues in the September meeting. Reports were shared from a number of work groups, including the latest on the rate setting initiative, plans for the Pharmacotherapy Work Group, the final report for the no show benchmarking project, and the work group focusing on the training problems members are experiencing. In-depth dis-cussions took place regarding the Bureau of Drug and Alcohol Programs (BDAP) liability project and the new BDAP data system. Officials from BDAP, D&A Licensing, the Office of Mental Health and Substance Abuse Services, and the Pennsylvania Association of County Drug and Alcohol Administrators attended. A report was given on the Dedicated Alcohol Tax Initiative. Updates on many of the issues addressed at the commit-tee meeting can be found throughout this edition of Provider News. The next meeting is November 27. All interested PCPA members are encouraged to attend. Questions should be directed to Lynn Cooper at the association. f
E c o M M I t t e e r e P o r t S
Drug and Alcohol committee
Outgoing Mental Health Committee Co-chair Julie Weaver (center) receives a certificate of appreciation for her many years of leadership from current Co-chairs Kathy Yarzebinski and Jerry Skillings.
Mental Health committee
Mental Health committee
Current Drug & Alcohol Committee Chairs Jack Wozniak, far left, and Carol Nicholas, far right, present Terry McSherry and Charlie Folks with a certificate of thanks for their years of leadership to the committee.
o c t o b e r
tuesday – Friday october 16 – 19
Uniting…Service, Integrity, Passion Seven Springs, Champion, PA
tuesday , october 16 11:30 a.m. – 12:45 p.m.
Executive CommitteeSeven Springs, Champion, PAOak Room
Wednesday, october 17 5:00 – 6:30 p.m.
Children’s Steering Committee Seven Springs, Champion, PADirectors 2
N o V e M b e r
tuesday, November 13 10:00 a.m. – 12:00 p.m.
Child and Adolescent Forensic Subcommittee PCPA
tuesday, November 13 1:00 – 4:00 p.m.
Forensics Committee PCPA
Monday, November 19 2:00 – 4:00 p.m.
Legislative Affairs Committee Teleconference
tuesday, November 27 9:30 a.m. – 12:00 p.m. 9:30 a.m. – 12:30 p.m. 12:00 – 1:00 p.m. 1:00 – 4:00 p.m. 1:00 – 4:00 p.m. 3:00 – 6:00 p.m.
Mental Health CommitteeMental Retardation CommitteeExecutive CommitteeDrug & Alcohol CommitteeChildren’s CommitteeExecutive Committee Holiday Inn East, Harrisburg
Wednesday, November 28 9:00 – 10:00 a.m. 11:00 a.m. – 3:30 p.m.
Membership Committee Board Meeting Holiday Inn East, Harrisburg
E P r o V I D e r N e W S 20 october 2007
E c A L e N D A r
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