Other Reports

The Impact of Medicaid Expansion (May 2017)

While plans for repealing and replacing the Patient Protection and Affordable Care Act (often referred to as the Affordable Care Act or ACA) have not been successful to date, the fate of Medicaid expansion remains uncertain. What is certain, however, are the positive effects that have been observed in states that have implemented Medicaid expansion. Benefits of this policy have been associated with an increase of insured Americans; improved access to and increased utilization of essential health care treatment; and sizeable cost savings for state and local governments. In addition, in the midst of a national opioid epidemic, states that have expanded Medicaid are better positioned to address the crisis.

The report highlights the impact of Medicaid expansion on behavioral health care overall, and specifically for Allegheny County’s HealthChoices Behavioral Health Program over an 18-month time period. Potential consequences of eliminating Medicaid expansion are also discussed.

Allegheny County Community Treatment Teams A Review of 2014 Key Outcomes (February 2016)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who have very complex needs but have not benefited from other traditional services.

Throughout 2014, various trainings, technical assistance, and quality improvement activities were undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, Allegheny HealthChoices, Inc. (AHCI), and the providers to assure high-quality CTT services. In the enclosed report, AHCI reports on how CTTs are following the Assertive Community Treatment (ACT) evidence-based practice as evaluated by national and local outcome measures.

PSH 2015 Update (August 2016)

One of the most urgent needs of people with serious mental illness is quality, affordable, permanent housing. Since 2006, the Allegheny County Office of Behavioral Health’s Permanent Supportive Housing (PSH) program has assisted people with serious mental illness to find, get and keep apartments by combining rental subsidies with community-based housing supports.

In the PSH 2015 Update report, Allegheny HealthChoices, Inc. (AHCI) provides an update of demographic information and outcomes for people who found housing through the PSH program. This report focuses on housing tenure, psychiatric hospitalizations, and use of behavioral health services while people are in PSH.

The Value of Engagement in SUD Treatment (July 2016)

Ensuring that people receive sufficient substance use disorder (SUD) treatment is important given the increase in the number of people with opioid addictions over the past few years. People who continue SUD treatment for 90 days or longer tend to use fewer acute services and have better outcomes than those who do not remain in treatment for at least 90 days.

Given the above, the purpose of The Value of Engagement in Substance Use Disorder (SUD) Treatment report is to provide demographic information and behavioral health service use for people in Allegheny County who remained engaged in SUD treatment for 90 days or longer in comparison to those who did not, highlighting notable changes. Information regarding current Allegheny County initiatives to address engagement in treatment is provided as well.

Topaz: A Recovery Story (June 2016)

The approaches to behavioral health treatment have evolved over time. The attached report demonstrates this through the story of one person who is part of the Allegheny County HealthChoices program. It features her personal experiences with institutional and community-based approaches to care from 1999 to 2015.

A Comparative Analysis of National Behavioral Health Standards and Allegheny County’s Performance (August 2015)

The Healthcare Effectiveness Data and Information Set (HEDIS) measures are used by a majority of health plans in the United States. These widely-used measures allow health plans to compare themselves to national benchmarks. As such, Allegheny HealthChoices, Inc. (AHCI) developed the attached fact sheet, A Comparative Analysis of National Behavioral Health Standards and Allegheny County’s Performance.

This fact sheet was prepared to communicate Allegheny County’s performance in the following areas compared to other Medicaid plans across the country: Follow-Up after Hospitalization for Mental Illness, and Follow-Up Care for Children Prescribed Attention-deficit/hyperactivity disorder (ADHD) Medication. An analysis of these HEDIS measures in comparison to Allegheny County’s performance can help identify areas in need of quality improvement.

Mayview Five Year Report (April 2015)

Beginning in July 2005, representatives of behavioral health authorities in the region (Allegheny, Beaver, Greene, Lawrence and Washington counties) worked together to develop a plan for supporting people discharged from Mayview State Hospital (MSH) in their communities. With the official closure of MSH in 2008, the region has been operating without a state hospital for over five years.

Mayview Five Year Report Summary

Access to Medication-Assisted Treatment for Alcohol Use Disorders in Allegheny County: 2013 (January 2015)

The “Access to Medication-Assisted Treatment for Alcohol Use Disorders in Allegheny County: 2013″ report is designed to help system stakeholders understand the utilization of medication-assisted treatment (MAT) among people who received substance use disorder treatment for alcohol use disorders in the County in 2013.

A 2013 Update on Allegheny County Community Treatment Team Key Outcomes (October 2014)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who often also have co-occurring substance abuse disorders. CTTs in Allegheny County follow the Assertive Community Treatment (ACT) model, an evidence-based practice. In this report, Allegheny HealthChoices, Inc. (AHCI) summarizes the evidence-based and local outcomes for people using CTT services. The report also summarizes the range of quality improvement activities undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, AHCI, and the providers to assure high-quality CTT services.

Access to Medication-Assisted Treatment for Opioid-related Disorders in Allegheny County: 2013 (September 2014)

This report is designed to help system stakeholders understand medication-assisted treatment (MAT) and its availability for people with opioid-related disorders in the County in 2013.

A 2013 Update on the Permanent Supportive Housing Program in Allegheny County (June 2014)

This report provides an update of demographic information and outcomes for people who found housing through the PSH program. This report focuses on housing tenure, psychiatric hospitalizations, and use of behavioral health services while people are in PSH.

Access to Medication-Assisted Treatment for Opioid-related Disorders in Allegheny County: 2012 (May 2014)

This report is designed to help system stakeholders understand medication-assisted treatment (MAT) and its availability for people with opioid-related disorders in the County.

A 2012 Update on Allegheny County Community Treatment Team Key Outcomes (April 2014)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who often also have co-occurring substance abuse disorders. CTTs in Allegheny County follow the Assertive Community Treatment (ACT) model, an evidence-based practice. In this report, Allegheny HealthChoices, Inc. (AHCI) summarizes the evidence-based and local outcomes for people using CTT services. The report also summarizes the range of quality improvement activities undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, AHCI, and the providers to assure high-quality CTT services.

RTF Fact Sheet (February 2014)

Residential treatment facilities (RTFs) are places where youth live for a period of time to receive behavioral health treatment for severe emotional and behavioral problems. As one of the most intensive services youth can receive, the analysis of trends and patterns is of critical importance. Allegheny HealthChoices developed this fact sheet titled, “Residential Treatment Facility (RTF) Services for Allegheny County Youth,” to provide a profile of youth receiving RTF services in Allegheny County and to see if this population had any patterns regarding service utilization and/or demographic characteristics.

Rehab and Recovery in Allegheny County (September 2013)

The attached Allegheny HealthChoices, Inc. (AHCI) report provides information about the utilization of short-term residential rehabilitation treatment services (often called “rehab”) in 2012. As part of its role to build system capacity and encourage data-driven decision making, AHCI developed this report to help treatment system stakeholders gain a better understanding of rehab and addiction recovery.

2011 Allegheny County Community Treatment Teams: Fidelity and Outcomes Report

An Analysis on the Elimination of the General Assistance Category of Aid (July 2013)

Youth Using Behavioral Health Services (December 2012)

Addressing the specific needs of youth across multiple life domains as they transition from the children’s behavioral health treatment system to the adult treatment system is critically important. Allegheny HealthChoices developed this report to provide a profile of youth transitioning from the child to adult service systems and to see if this population had any patterns regarding utilization or demographic characteristics that could predict future service use. An analysis on this population provides a better understanding of how service use can indicate areas for intervention to improve the continuity of care for youth during this transition period.

AHCI Factsheet regarding Inpatient Readmission Rates and Average Length of Stay Over Time (November 2012)

The attached Allegheny HealthChoices, Inc. (AHCI) fact sheet provides longitudinal information on Allegheny County’s HealthChoices behavioral health inpatient readmission rates and average length of stay. From 2000 to 2012, these benchmarks were evaluated to see how they have been trending before and after the closure of Mayview State Hospital.

2011 Allegheny County Community Treatment Teams: Fidelity and Outcomes Report (April 2012)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who often also have co-occurring substance abuse disorders. CTTs in Allegheny County follow the Assertive Community Treatment (ACT) model, which differs from traditional services in many ways: CTTs provide a wide range of treatment and rehabilitation services (rather than referring people to other services); contact with the people they serve is more frequent; most services occur in the community; and the multidisciplinary staff share responsibilities. In this report, AHCI reports on how CTTs are following the ACT evidence-based practice, as measured by fidelity reviews conducted in 2011. The report also includes outcomes for people using CTT services during 2011 and the training, technical assistance, and quality improvement activities undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, AHCI, and the providers to assure high-quality CTT services.

Connecting People to Substance Abuse Services in Allegheny County: First Year Utilization of the Engagement Center (October 2011)

The Engagement Center has been providing engagement, assessment, and referral services to people experiencing a crisis primarily resulting from substance use since July of 2010. This report summarizes characteristics and service use history of people who have been assessed at the Engagement Center during its first year of operation. This report also examines how many people accessed substance abuse treatment services paid for by Allegheny County and Community Care Behavioral Health immediately following contact with the Engagement Center.

Outcomes and Regional System Development for the Mayview State Hospital Service Area (June 2011)

This report covers consumer outcomes and regional system changes occurring in the two years since the closure of Mayview State Hospital. Overall, consumer outcomes have been positive, and the regional behavioral health system has invested in community-based treatment and supports to benefit not only people discharged from Mayview as part of the closure but all people with serious mental illness in the five-county region.

2010 CTT Outcomes Summary Report (March 2011)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who often also have co-occurring substance abuse disorders. CTTs in Allegheny County follow the Assertive Community Treatment (ACT) model, which differs from traditional services in many ways: CTTs provide a wide range of treatment and rehabilitation services (rather than referring people to other services); contact with the people they serve is more frequent; most services occur in the community; and the multidisciplinary staff share responsibilities.

In this report, Allegheny HealthChoices, Inc. (AHCI) summarizes the outcomes for people using CTT services during 2010. The report also summarizes the quality improvement activities undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, AHCI, and the providers to assure high-quality CTT services.

Permanent Supportive Housing Program Report (December 2010)

One of the most urgent needs of people with serious mental illness is quality, affordable, permanent housing. Since 2006, the Allegheny County Office of Behavioral Health’s (OBH) Permanent Supportive Housing (PSH) program has offered new housing opportunities to people with serious mental illness. This report provides a summary of outcomes for people in the PSH program. The newsletter focuses on housing tenure, psychiatric hospitalizations, and use of behavioral health services while people are in PSH.

Building Recovery-Oriented Services (August 2010)

While most stakeholders in the Allegheny County behavioral health system believe that recovery is the goal of behavioral health treatment, many providers face challenges in operationalizing the principles of recovery within their own organizations and practices. To encourage providers to continue (or begin) to develop and use services and supports that are recovery-focused in their day-to-day operations, this report discusses the experience of one outpatient community mental health provider that successfully undertook the implementation of an intensive, recovery-focused promising practice pilot.

The report discusses the pilot project at Turtle Creek Valley MH/MR mainly from an operations perspective – describing the planning, partnerships, collaboration, outcomes, and evaluation components of project management. The report concludes with resources and concrete action steps providers can take to move their organizations further towards providing recovery-focused services and supports.

Older Adults and Substance Use Disorders (July 2010)

Older adults who abuse or are dependent on alcohol or prescription or illegal drugs are at greater risk for developing other health problems, including illness, injury, and co-occurring mental health disorders. This report provides an overview of how substance use disorders impact older adults, as well as an analysis of the population of older adults in Allegheny County who access substance use treatment funded through Medical Assistance.

It Still Pays to Work (June 2010)

Work can be an important part of a fulfilling life. For individuals who receive mental health services, work can also be an important part of a journey toward recovery. Allegheny HealthChoices, Inc. (AHCI), working with a number of regional stakeholders, developed It Pays to Work: Are You Ready to Cash In? as a resource to help people understand the wide variety of employment support programs available in the region, as well as how working can affect cash and health benefits. AHCI is redistributing this booklet, as well as a supplement that provides updated 2010 information. With the right support, people can address potential barriers to employment and find fulfilling work. AHCI hopes the It Pays to Work: Are You Ready to Cash In? booklet will inspire individuals to consider or reconsider employment as part of their recovery journey.

Click to view the supplemental booklet.

BHRS Brief Treatment Report (May 2010)

Brief Treatment is a form of BHRS in which services are delivered by a single master’s level clinician. This type of BHRS is especially useful in serving children and families with less intensive treatment needs, children who are transitioning down from more intensive levels of care, and children who are new to behavioral health services. This report provides an overview of Brief Treatment, an analysis of how and why utilization of the model has increased, and recommendations regarding the Brief Treatment service model. The report includes descriptions of the programmatic specifications of Brief Treatment (e.g. the authorization process, clinical staff, and treatment approaches), as well as description of the populations of children and families who may benefit from Brief Treatment.

Full Report (12 pages)

Executive Summary (2 pages)

Toward Recovery and Hope – Executive Summary of the Mayview Lessons Learned White Paper (March 2010)

Toward Recovery and Hope – Mayview Lessons Learned White Paper (March 2010)

Toward Recovery and Hope – Consumer Brochure (March 2010)

Crisis Services Newsletter (February 2010)

A behavioral health crisis is a significant event or feeling of instability in a person’s life that causes them to feel that they are unable to manage on their own. In an effective behavioral health care system, a variety of crisis services – telephone, mobile, walk-in, and residential – should be available to help people when they experience a crisis. This newsletter describes the role crisis services play within the Allegheny County community and behavioral health care system, with a detailed look at the development and utilization of services offered through the re:solve Crisis Network. The re:solve Crisis Network began providing services in July 2008 and offers a comprehensive array of crisis response services that are immediately available to all residents of Allegheny County, regardless of age, insurance status, or previous involvement with behavioral health services.

Outcomes for People on Allegheny County Community Treatment Teams (Winter 2010)

Community Treatment Teams (CTTs) provide services to people with serious mental illness who often also have co-occurring substance abuse disorders. CTTs in Allegheny County follow the Assertive Community Treatment (ACT) model, an evidence-based practice. In this report, Allegheny HealthChoices, Inc. (AHCI) summarizes the outcomes for people using CTT services since 2001. The report also summarizes the range of quality improvement activities undertaken by the Allegheny County Office of Behavioral Health, Community Care Behavioral Health, AHCI, and the providers to assure high-quality CTT services.

Detoxification Services (Summer 2009)

For many people with substance abuse problems, their addiction is a chronic illness similar to Type II diabetes, asthma or hypertension. Some individuals with a serious addiction may need detoxification services to help them manage their withdrawal symptoms from drug or alcohol abuse as a starting point in the recovery process. Connecting people to treatment and rehabilitation services after people leave detox is an important goal shared by detox providers.

The goal of this report is to better understand who accesses publicly funded detox services, their access to treatment services before and after detox, and their involvement with the criminal justice system. The data in this report supports national research showing that addiction is often a chronic disorder. People can recover from chronic addiction—however, most will need long term treatment and support. Publicly funded treatment services are an essential safety net to help people move towards recovery.

Supported Employment (Summer 2009)

For many people with mental illness, employment is a key part of their recovery. Research shows that individuals with serious mental illness want to work and can do well in competitive employment positions. Supported Employment is an evidence-based practice which helps people with severe mental illness find, get, and keep competitive employment positions in their communities. This report explains the principles of the Supported Employment model and compares it to other vocational service models. It also provides information about local and state efforts to increase the use of the Supported Employment model and resources for additional information. Please share this report with others in your organization that may benefit from learning more about these topics.

Permanent Supportive Housing Report (July 2009)

For many people with mental illness, stable housing can play a key part in their recovery. Since 2006, the Allegheny County Office of Behavioral Health’s (OBH) Permanent Supportive Housing (PSH) program has offered new housing opportunities to people with serious mental illness. OBH developed the PSH program for people with serious mental illness living in OBH-funded residential programs. This report explains the principles of permanent supportive housing and the progress made to help people find and keep permanent supportive housing. The report also provides information on program costs compared to residential and inpatient settings, program sustainability, and an update on the development of new housing units. Please share this report with others in your organization that may benefit from learning more about these topics.

Trauma-informed Care Report (Spring 2009)

Many children and adults receiving mental health or substance abuse services have experienced trauma in their lives. Better addressing trauma within the behavioral health system is a priority at the local, state and national levels. This report includes information on trauma and its impact, how providers can develop trauma-informed services, and resources about trauma. Personal stories of several individuals who have recovered from trauma are also featured.

MRSAP Discharge Report (January 2009)

Mayview State Hospital closed on December 29, 2008. Over the last several years, the five counties in the Mayview service area, Mayview State Hospital, and the Department of Public Welfare (DPW) have developed a recovery-oriented community support planning (CSP) process for people being discharged. These efforts have been coordinated by Allegheny HealthChoices, Inc. (AHCI). This report describes the demographics, and preliminary data related to housing stability, use of services and supports, and time spent living in the community, of the people who were discharged as part of the hospital closure.

Working Toward Wellness: Addressing the physical health of people with serious mental illness (November 2008)

One of the most serious issues facing the behavioral health field is addressing the burden of co-occurring chronic medical conditions for people with mental illness and/or substance abuse. Physical health issues hinder recovery and shorten lives; on average, people with serious mental illness die 25 years earlier than the general population. In this report, Allegheny HealthChoices, Inc. (AHCI) provides an overview of the risk factors common for people with serious mental illness and a description of the barriers faced by providers in delivering coordinated care. The report also includes ways people with serious mental illness, providers, and policy makes can begin to make an impact.

Housing As Home Newsletter (September 2008)

One of the most urgent needs of people with serious mental illness is quality, affordable, and permanent housing. In 2005, the Allegheny County Office of Behavioral Health (OBH) developed the “Housing as Home” permanent supportive housing strategic plan to help address this need. The goal of the plan is to use over $5 million to help 220-240 people currently living in a state hospital or OBH-funded residential program to move into permanent supportive housing (PSH) within three to five years. In this newsletter, Allegheny HealthChoices, Inc. (AHCI) summarizes the plan components and the progress made by Transitional Services, Inc. (TSI) in implementing the plan to date. The report also includes frequently asked questions and features descriptions of two people living in permanent supportive housing.

Using Motivational Interviewing In Substance Abuse Treatment (June 2008)

Figuring out how to motivate people to reduce or stop their substance abuse is an enormous challenge for clinicians. Research has found motivational interviewing (MI) to be a highly effective counseling method for enhancing a person’s internal motivation for behavior change. Through helping people explore and resolve their ambivalence around change, people can ultimately commit to changing their substance use patterns. In the enclosed report, Allegheny HealthChoices, Inc. (AHCI) summarizes the principles of MI with the help of several local experts and practitioners. The report also includes resources for clinicians and agencies for getting started with MI.

Family Focused Solution Based Services (January 2008)

Families involved in the Children, Youth and Families (CYF) and/or Juvenile Probation Office (JPO) systems often have complex service needs, including mental health treatment needs. In 2005, Family Focused Solution Based Services (FFSBS) were introduced into the Allegheny County HealthChoices system to meet the complex needs of these families. FFSBS staff can provide one-on-one mental health and family therapy, crisis stabilization, and case management services. However, FFSBS staff can also help parents and children improve communication skills, learn ways to resolve conflict, deal with behavioral challenges, and establish appropriate parent / child roles and boundaries. There are several features of FFSBS that make it unique within the Allegheny County HealthChoices system. AHCI’s report on Family Focused Solution Based Services describes the unique features of this service and illustrates how it has helped a variety of families in Allegheny County.

Substance Abuse Treatment Services (June 2007)

Substance abuse is a serious health and social problem in the United States. It is costly —for individuals and society—causing health problems, deaths, loss of productivity, underemployment, crime, and family instability. However, while people with severe substance abuse may need treatment and support over a long period of time and may have several relapses, recovery is possible. The attached report, Substance Abuse Treatment Services, provides an overview of local trends in substance use, treatment services available in the HealthChoices program, and service use patterns for adults and adolescents in the HealthChoices program. This report is the first in an occasional series on substance abuse treatment.

Mayview Regional Service Area Plan (MRSAP) Summary Report: Phase 2 Consumer and Family Assessment Results (May 2007)

The five counties in the Mayview service area, Allegheny, Beaver, Greene, Lawrence and Washington, are working together in partnership with the Department of Public Welfare to strengthen their community behavioral health systems. To ensure consumers discharged from Mayview State Hospital receive the services and supports they want and need, a consumer-focused assessment and community support plan (CSP) process has been developed. Consumer and Family Satisfaction Teams (CFSTs, or CART in Allegheny County) conduct interviews with consumers in the state hospital to help determine what each person thinks he or she will need and want upon discharge. CFSTs also interview family members. These assessments are the basis for developing a community support plan to help individuals transition from Mayview to the community. Allegheny HealthChoices, Inc. (AHCI) recently completed the enclosed report summarizing the peer and family assessment responses for the 52 Mayview residents selected to participate in Phase 2 of this project. For more information on the Mayview project, please visit www.mayview-sap.org.

Mobile Medication Services (May 2007)

Mobile Medication Services were developed to address the needs of individuals whose difficulties taking psychiatric medications placed them at risk for frequent inpatient admissions or placement into restrictive living arrangements. Introduced into the Allegheny County HealthChoices program in late 2005, Mobile Medication Services are designed to provide consumers with community-based, team-delivered medication administration and monitoring services. Most importantly, Mobile Medication Services are designed to provide consumers with the opportunity to develop a variety of medication management skills and thereby facilitate their journeys toward recovery. This short report provides an overview of Mobile Medication Services, an analysis of short-term consumer outcomes, and several brief case studies.

Housing As Home Newsletter (October 2006)

The Allegheny County Office of Behavioral Health (OBH), in conjunction with consumers, family members, providers, and housing advocates, has created a Permanent Supportive Housing Strategic Plan. The Plan provides a blueprint for developing 220-240 units of permanent supportive housing within three to five years for people with mental illness or co-occurring mental illness and substance abuse. We recently completed the attached second edition of the Housing as Home newsletter. It provides an update on our progress implementing the plan, including information on the agencies that are leading this effort.

Peer Support: Consumers Helping Consumers (August 2006)

People with mental illness have supported each other in their recovery journeys for many years. Because consumers share common experiences, they have a unique opportunity to learn from, teach, and support each other. This newsletter, Peer Support: Consumers Helping Consumers, provides an overview of peer support. The report describes peer support and research supporting the benefits of peer support. It also outlines Pennsylvania’s Office of Mental Health and Substance Abuse Services’ (OMHSAS) plan for implementing state-wide peer support services, paid for with Medicaid funds, in the fall of 2006. Most importantly, AHCI staff visited many programs and interviewed consumers who have benefited from peer support and consumers who work as peer staff. Their personal stories illustrate the value and importance of peer support to consumers, providers, and to the mental health system as a whole.

BHRS Brief Treatment Report (April 2006)

Behavioral Health Rehabilitation Services (BHRS) provide comprehensive treatment to children and adolescents diagnosed with a serious emotional or behavioral disorder. To address the treatment needs of children who would benefit from a less intensive form of BHRS treatment, Allegheny County BHRS providers and Community Care developed and implemented a BHRS “brief” treatment model. In addition to describing how the resulting BHRS Brief Treatment model differs from traditional BHRS, this report presents an overview of the demographic characteristics, diagnostic characteristics, and HealthChoices service utilization patterns of children who received BHRS Brief Treatment during the first 18 months of the model’s implementation (January 1, 2004 – June 30, 2005).

Full Report (20 pages)

Newsletter Version (2 pages)

Housing Plan Newsletter (November 2005)

The Allegheny County Office of Behavioral Health (OBH), in conjunction with consumers, family members, providers, and housing advocates, has created a Permanent Supportive Housing Strategic Plan. The Plan provides a blueprint for developing 220-240 units of permanent supportive housing within two to three years for people with mental illness or co-occurring mental illness and substance abuse. The Housing as Home newsletter summarizes the OBH Strategic Plan. It provides a definition of permanent supportive housing, explains the various strategies/components outlined in the OBH Plan, and discusses the results of the housing preferences survey that were used in the development of the Plan.

Housing Preferences Survey Report (November 2005)

The Allegheny County Office of Behavioral Health and Allegheny HealthChoices, Inc. (AHCI) teamed with the Consumer Action & Response Team (CART) in 2005 to conduct a survey of the housing needs and preferences of consumers in Allegheny County. The Housing Preferences Survey Report summarizes the results of this survey and includes findings related to preferences on housing type, housing location, and community supports. The report features survey input from consumers in Mayview State Hospital, consumers living in non-hospital residential programs, and residential program staff. Results of the survey were used to inform the development of the Allegheny County Permanent Supportive Housing Strategic Plan.

Community Treatment Teams in Allegheny County: Service Use and Outcomes (October 2005)

Community Treatment Teams (CTTs) provide community-based, comprehensive, and intensive mental health and addiction treatment to persons with serious and persistent mental illnesses in Allegheny County. This report includes all consumers enrolled on the four Allegheny County Community Treatment Teams from the inception of the teams through March of 2005. This report covers three areas: CTT consumer characteristics, services used by CTT consumers and consumer outcomes over time. In addition to data analysis, the report includes input from the teams.

Full Report (43 pages)

Newsletter Version (6 pages)

Does Race Matter? Access and Service Use for Children by Race During 2002

This series of reports is a follow-up to AHCI’s November 2003 report on factors associated with accessing services. The reports examine behavioral health service access and treatment patterns by race for children and youth eligible for Medicaid during 2002 in Allegheny County. The Surgeon General’s reports on mental health (1999 and 2001) provide the context for these reports. The analysis found racial differences in access across gender groups, age groups, service types, diagnostic patterns, and the amount of service used. Racial disparities persisted for children with histories of involvement with child welfare and juvenile justice. The series includes three reports:

  • Does Race Matter? Access and Service Use for Children by Race During 2002: This report covers the entire HealthChoices population and also includes appendices covering access and service use for specific diagnostic groups.
  • Supplemental Report on Children with Histories of Involvement with Social Services: This report provides an in-depth look at access and service use for children with histories of involvement with social services (child welfare, juvenile justice, or substitute care).
  • Does Race Matter? A Summary of AHCI Reports: This newsletter provides a summary of the two full reports above. The newsletter also includes an article on access and service use during 2003 for comparison with earlier findings. In August 2006, some updates were made to the language in the reports on children and youth with histories of involvement with social services, specifically the Office of Children, Youth and Families (CYF) and the Juvenile Probation Office (JPO). This memo summarizes these clarifications and also provides an update on enhanced data now available from CYF and JPO.

Allegheny County HealthChoices Program: Five Year Summary (March 2004)

The year 2003 marked the five-year anniversary of the HealthChoices program in Allegheny County. When the program began, stakeholders had great hopes for better access to services, quality of care, and the use of less restrictive and more community-based treatment. This five-year milestone provides an important opportunity to review how enrollment and service use have evolved over time to meet these goals. This report provides a broad overview of HealthChoices in Allegheny County since the program began in 1999. Enrollment and utilization data highlight both the changes and the stability within the system.

Community Treatment Teams: Implementation in Allegheny County Since 2002 (March 2004)

This report examines the four Community Treatment Teams in Allegheny County during the early implementation stage through the first and second quarters of 2003. The report tracks the evolution of the teams and changes in consumer outcomes over time, specifically focusing on 1) the composition of the teams, including age, gender, and race of consumer participants, 2) changes in service utilization of CTT and non-CTT services, including hospitalizations, and 3) stability and community integration, including living arrangements, employment, educational status, and utilization of natural support systems.

Demographic and Social Services Factors Associated with Behavioral Health Claims in Children and Youth 0 – 20 Years of Age (November 2003)

AHCI recently completed a study examining disparities in accessing behavioral health care for children and youth 0 – 20 years of age. AHCI examined multiple factors to determine the likelihood of different groups accessing care, including race, gender, age, HealthChoices eligibility, involvement with the Office of Children, Youth and Families, involvement with the juvenile justice system, and involvement with substitute care. The findings indicate that significant disparities exist in terms of who accessed behavioral health care within one year time period, 2001 or 2002. Caucasians, males, school-aged children (6 – 17 years), and children involved with one of the social services were all more likely to access the system. Notably, African-Americans, even when they are involved in the social service system, are still less likely to access behavioral healthcare than Caucasians.

Medicaid Benchmarking – A Comparative Report (June 2003)

In June 2002, the Substance Abuse and Mental Services Administration (SAMHSA) released a draft report titled “Medicaid Managed Behavioral Health Care Benchmarking Project”. The purpose of the study was to systematically review and compare data submitted by multiple Medicaid behavioral health programs, identify ways to improve the quality and consistency of data, and determine trends in the ways managed care program performance is measured. Allegheny HealthChoices, Inc. (AHCI) developed a report that looks at how the Allegheny HealthChoices program compares to the same industry standard measures and data reported by other Medicaid behavioral health programs. Measures include penetration rates, average length of stay, readmissions, and follow-up after discharge from inpatient services.

The Implementation of Community Treatment Teams in Allegheny County (January 2003)

Community Treatment Teams (CTTs) are a service-delivery model that provides comprehensive, locally based treatment to people with serious and persistent mental illnesses. Unlike other community-based programs that provide linkage to service, CTTs provide highly individualized services directly to consumers. This report presents the principles, structure, and function of the CTT model and describes the start up period for the teams in Allegheny County. An aggregate analysis of members enrolled in a CTT is presented in terms of their demographic characteristics. The member’s HealthChoices in-plan and County base-side service utilization during the pre-implementation period are compared to their post-implementation use of services. The findings are consistent with teams in the developmental process. AHCI’s recommendations focus on areas for improvement that should occur over time as the teams are more established in the community and members develop trust with the team.

Recidivism: A Longitudinal Study of the Original Cohort (October 2002)

This is the third consecutive study of utilization patterns of HealthChoices members who were identified in the initial analysis as having one or more inpatient mental health admissions. AHCI has followed this cohort over time in an attempt to understand factors that may influence recidivism and identify the systematic impact of treatment and outreach. In addition to a comparison of service utilization, the consumer’s perspective of their historical and current status was compared to their case manager’s perspective.

Addendum to the Longitudinal Recidivism Report (January 2002)

As a result of the findings from the Recidivism Report published August 2001, AHCI, Community Care and Allegheny County attempted to identify possible contributing factors to high recidivism rates. To accomplish this, Community Care distributed surveys to Intensive Case Managers (ICMs) and Resource Coordinators (RCs) to assess their understanding consumers’ support systems, clinical treatment, functional status, and living situation. The following is a summary of the ICM’s or RC’s survey data. A similar survey is being distributed to consumers to gain their perspective.

Recidivism: A Longitudinal Study of the Original Cohort (August 2001)

Recidivism refers to consumers that are readmitted within 30 days of discharge for inpatient mental health services. It is a vital concern of stakeholders because of the clinical and financial implications. In January 2001, AHCI completed an initial report that compared consumers who were admitted frequently for inpatient and intensive non-hospital services with consumers who had one or two admissions. This second report is part of a longitudinal study of the same group of people from the original study from July 2, 2000 through March 2001 to determine any changes in readmissions, demographics, and other utilization data. This report illustrates those findings. Of particular note are changes/trends in inpatient utilization, average lengths of stay, utilization of out patient services, and issues related to housing and life stressors.

Dual Diagnosis Report (August 2001)

The needs of people with dual diagnosis, a co-occurring mental health and substance abuse disorder, far exceed a blend of some mental health and substance abuse services. This report shows that individuals with a dual diagnosis access services differently that people with only a mental illness or substance abuse diagnosis. Related issues such as identification, engagement, a comprehensive treatment plan, and reporting and tracking abilities are address in the report.

Involuntary Admission of HealthChoices Members (March 2001)

Most admissions for mental health services occur on a voluntary basis, however, in Allegheny County the rate of involuntary admission exceeds the state average. The focus of this report is to evaluate HealthChoices consumers and the utilization patterns of individuals that are involuntarily admitted. The analysis period was based on admission authorized and claims paid for services during the second quarter of 2000.

Recidivism (January 2001)

Recidivism refers to consumers that are readmitted within 30 days of discharge for impatient mental health services. It is a vital concern of stakeholders because of the clinical and financial implications. This report examines some of the issues surrounding recidivism by analyzing and characterizing three population groups. The three groups are stratified by the frequency at which persons are admitted during the 12-month time period of July 1, 1999 to June 30, 2000.

Consumers with Serious and Persistent Mental Illness (October 2000)

This report focuses on consumers with serious and persistent mental illness (SPMI) from January 1, 1999 through June 30, 2000. AHCI analyzed the service mix consumers received prior to and after HealthChoices mandatory enrollment to determine if/how theHealthChoices program had effected service delivery patterns.

Behavioral Health Rehabilitation Services for Children and Adolescents (BHRSCA) (August 2000)

This report focuses on children and adolescents who received behavioral health rehabilitation services through the HealthChoices program during the first and second quarters of 2000. Services to children with behavioral health needs continue to be a concern of stakeholders, and AHCI chose to study this group in relation to BHRSCA services to more fully examine what this population looks like in terms of demographic characteristics, service utilization, involuntary commitments, recidivism, and average length of stay.

High Cost Users of Services (July 2000)

This report focuses on consumers for whom the aggregated total HealthChoices claims from January 1, 1999 through May 31, 2000 exceeds $25,000. AHCI analyzed this group by demographic characteristics and service utilization to determine if there were any trends and/or opportunities for improving service delivery.