The Department of Public Welfare (DPW) oversees and
funds the Commonwealth’s mental health system, comprised of
state mental hospitals and community programs. The system served
approximately 126,000 individuals with mental illness in 2006/07,
including 3,535 individuals who received services in the state mental
hospitals.
The 2007/08 budget includes $723 million in state funds ($999 million
including federal and other) for the Mental Health Services appropriation,
which funds both the state hospitals and community programs. State
funding includes $19.4 million to expand community services to an
additional 200 persons currently residing in state hospitals and
to provide respite care for 2,000 families of children with mental
illness. It also provides for a three percent cost of living increase
for community programs.
Pennsylvania’s Mental Health System
Various state laws govern Pennsylvania’s mental health system,
beginning with the Mental Health/Mental Retardation Act of 1966
(MH/MR Act of 1966) and including the Mental Health Procedures Act
of 1976. The MH/MR Act of 1966 establishes responsibilities for
state and county government, identifies mandated services, defines
eligibility, and creates procedures for commitment to state facilities.
The Mental Health Procedures Act of 1976 further defines the procedures
for voluntary and involuntary treatment in state mental hospitals.
DPW operates the state mental hospital system, which is comprised
of eight state mental hospitals and one restoration center. All
state hospitals provide general psychiatric inpatient treatment
for adults with serious mental illness who require extended treatment.
In addition, three hospitals offer specialized treatment programs
for mentally ill adult offenders and defendants. Only adults are
in the state hospital system; children and adolescents are treated
in community-based facilities.
Pennsylvania targets community services to adults with serious mental
illnesses and to children/ adolescents with or at-risk of serious
emotional disturbances. Community mental health programs are administered
by the counties, which receive funding grants from DPW. In general,
the county MH/MR office determines a person's eligibility for service
funding, assesses the need for treatment or other services, and
makes referrals to appropriate programs. Most actual services are
delivered by local mental health providers under contract with the
county.
CHIPP
Community/Hospital Integration Program Projects (CHIPP) links community
programs to the state hospital system. The objective is to move
state hospital patients, who no longer require inpatient psychiatric
treatment, into more appropriate community-based programs.
CHIPP is designed to assure that counties have the necessary residential
and treatment services to support discharged patients. As patients
are discharged, DPW closes hospital beds and transfers state hospital
funds to the county programs.
Community services developed with CHIPP funds are not only available
to discharged patients, but also to individuals residing in the
community who would likely be hospitalized if CHIPP services were
not available. Thus, CHIPP creates additional community-based service
capacity for diversionary services that prevent unnecessary hospital
utilization, facilitating more predictable planning for future state
hospital needs.
Since its inception in 1991/92, DPW reports that 2,539 patients
have been discharged from the state hospitals through CHIPP. Moreover,
the number of admissions to the state hospitals has continuously
decreased since CHIPP began. As a result of these 2,539 discharges,
CHIPP funding has accumulated $190.3 million through June 2007 and
served a total of 12,387 people – this includes individuals
directly receiving CHIPP funds and others receiving diversionary
services.
Community Mental Health Services Services
The MH/MR Act of 1966 requires the counties to establish mental
health programs with nine mandated services, including: short-term
inpatient treatment, partial hospitalization, outpatient care, 24-hour
emergency services, rehabilitation and training, and aftercare services
for people released from state mental hospitals. The MH/MR Act of
1966 requires the counties to establish mental health programs with
nine mandated services, including: short-term inpatient treatment,
partial hospitalization, outpatient care, 24-hour emergency services,
rehabilitation and training, and aftercare services for people released
from state mental hospitals.
Inpatient psychiatric care provides short-term 24-hour evaluation,
care and treatment services to individuals in severe distress. The
treatment objective is to stabilize the crisis so that an individual
may return safely to the community. Inpatient psychiatric care provides
short-term 24-hour evaluation, care and treatment services to individuals
in severe distress. The treatment objective is to stabilize the
crisis so that an individual may return safely to the community.
Partial hospitalization services are provided daily to individuals
suffering moderate emotional or mental disorders. In partial hospitalization,
the individual resides in the community and spends the day at a
treatment center. Services include group therapy, individual therapy,
and medication management. Partial hospitalization services are
provided daily to individuals suffering moderate emotional or mental
disorders. In partial hospitalization, the individual resides in
the community and spends the day at a treatment center. Services
include group therapy, individual therapy, and medication management.
Outpatient psychiatric services are provided periodically (such
as weekly or monthly) to individuals suffering minimal to moderate
distress. Services include counseling, therapy, psychiatric evaluation,
and medication reviews. Outpatient psychiatric services are provided
periodically (such as weekly or monthly) to individuals suffering
minimal to moderate distress. Services include counseling, therapy,
psychiatric evaluation, and medication reviews.
Emergency and crisis interventions assure the safety of individuals.
These services include telephone counseling for individuals experiencing
moderate to severe distress and 24-hour intervention for people
experiencing severe emotional distress. Emergency and crisis interventions
assure the safety of individuals. These services include telephone
counseling for individuals experiencing moderate to severe distress
and 24-hour intervention for people experiencing severe emotional
distress.
Community programs also include the following services
for individuals with mental illness and their families: Community
programs also include the following services for individuals with
mental illness and their families:
Case management to assure individuals receive needed services; employment
and training programs for adults; and residential living arrangements
such as personal care homes, group homes and supervised apartments.
Case management to assure individuals receive needed services; employment
and training programs for adults; and residential living arrangements
such as personal care homes, group homes and supervised apartments.
Family support services, such as respite care and family-based mental
health services that enable families to care for their children
at home. Family support services, such as respite care and family-based
mental health services that enable families to care for their children
at home.
State funding for community mental health services
is $362.1 million in 2007/08, an increase of $24 million (or seven
percent) from 2006/07. DPW allocates funds to the county MH/MR offices
as direct grants to pay for community programs. State funding for
community mental health services is $362.1 million in 2007/08, an
increase of $24 million (or seven percent) from 2006/07. DPW allocates
funds to the county MH/MR offices as direct grants to pay for community
programs.
CHIPP ExpansionCHIPP Expansion The budget includes $18.9 million
in CHIPP funding for counties to develop additional community-based
services for 200 persons currently residing in state hospitals.
This initiative would provide community placement for people (under
age 65) who have been in the state mental hospital system for over
two years and who no longer need inpatient treatment.
Respite Services
The budget provides $500,000 in state funds for specialized respite
services for families that have children with serious emotional
disturbance. DPW estimates 2,000 families will receive an average
of twelve hours of respite service per year.
Three Percent COLA The budget includes $14.7 million in state funds
for a three percent COLA for community programs. This represents
the largest cost of living increase in more than fifteen years.
State Mental Hospitals
DPW currently operates eight state hospitals: Allentown, Clarks
Summit, Danville, Mayview, Norristown, Torrance, Warren and Wernersville.
The Restoration Center at South Mountain provides licensed skilled
nursing and intermediate long-term care services to elderly former
residents of state hospitals who require nursing home care.
With the initiative to expand community placements, the state hospital
system is expected to serve 3,415 people in 2007/08. This represents
a decrease of 160 from 2006/07.
State funding for the state hospitals is $361.5 million in 2007/08,
an increase of $14 million. Budgeted funds pay the staff, operating
expenses, and fixed assets needed by DPW to effectively run the
hospitals.
QUESTIONS AND COMMENTS
717-783-1540
Miriam A. Fox, Executive Director mfox@hacd.net
Barbara Fellencer, Communications Director
Beth Balaban, Senior Budget Analyst
http://www.hacd.net
