Pennsylvania’s Evidence-Based Intervention Programs

Sustainability and Impact

OMHSAS Children’s Bureau of Behavioral Health Services

August 16, 2012Presentation to OMHSAS Children’s Advisory Committee

Pennsylvania’s Evidence-Based Intervention Programs

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The Evidence-based Prevention and Intervention Support Center (EPISCenter) is a project of the Prevention Research Center, College of Health and Human Development and Penn State University with funding and support from the Pennsylvania Commission on Crime and Delinquency (PCCD) and the Pennsylvania Department of Public Welfare (DPW) as a component of the Resource Center for Evidence-Based Prevention and Intervention Programs and Practices

www.episcenter.psu.edu

EPISCenter

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Collects quarterly Performance Measure data for evidence based programs provided in Pennsylvania that are funded through Special Grant funds from OCYF, PCCD grants, or Medical Assistance. (MTFC, MST, & FFT)

Provides technical assistance to providers and communities.

Facilitates regular networking meetings for each program to discuss timely issues.

EPISCenter

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Multidimensional Treatment Foster Care (MTFC)

Multisystemic Therapy (MST)Functional Family Therapy (FFT)

Pennsylvania Evidence Based ServicesReviewed…

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Multidimensional Treatment Foster Care (MTFC) is a treatment alternative to group, residential treatment and/or incarceration for youth who have problems with chronic disruptive behavior.

Multisystemic Therapy (MST) is an alternative to out of home placement provided to youth with significant externalizing behaviors, with the primary treatment population being delinquent youth and chronic or violent juvenile offenders.

Functional Family Therapy (FFT) is an intensive, short-term family therapy model provided to youth who present with externalizing behaviors ranging from oppositional, defiant, and disruptive behaviors (i.e., at risk for delinquency) to serious, chronic criminal offenses.

MTFC, FFT and MST Definitions

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SustainabilityFFT Sites

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SustainabilityMST Teams

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SustainabilityMTFC Teams

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On average, sites that close do so around the 3-year mark.

The top reasons for closure:Not enough referrals (low need in

community or other barriers/disincentives to referring)

Financial (related to program census and unique aspects of EBI implementation)

For maps of active programs, visit:www.episcenter.psu.edu/emaps

Sustainability

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Population Served

Total Number of

Youth Served

Total Number of Caregivers

Served

Percent of New

Admissions at Imminent

Risk of Placement**

FFT 2,027 2,027 8%

MST 3,121 4,209 62%

MTFC 81 6449%

July 2010-Dec. 2011

**More recent data suggest that the percent of youth at risk of placement may be 10-20% higher than reported here.

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Outcomes Data…

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FFTA total of 1,646 youth were discharged from July 2010-Dec.

2011. 1,483 youth who had the opportunity to complete FFT (i.e.,

were not administratively withdrawn): 66% were successfully discharged (completed FFT with positive

outcome). 34% were unsuccessfully discharged. Of these youth, 24% were

placed out-of-home.

Average length of stay: 4.0 months for successful cases 2.9 months for unsuccessful cases

Program Outcomes

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MST A total of 2,571 youth were discharged.

2,313 youth who had the opportunity to complete MST (i.e., were not administratively withdrawn): 76% were successfully discharged (completed MST and met

all 3 Ultimate Outcomes)24% were unsuccessfully discharged. Of these youth, 54%

were placed out of home.

The average length of stay:4.1 months for successful cases3.4 months for unsuccessful cases

Program Outcomes

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MTFCA total of 41 youth were discharged from July 2010-Dec.

2011.

36 youth had an opportunity to complete MTFC (i.e., were not administratively withdrawn): 58% were successfully discharged (met treatment goals,

completed MTFC point & level system, discharged to a lower level of care).

42% were unsuccessfully discharged. Of these youth, 80% were placed in a more restrictive setting.

The average length of stay:8.0 months for successful cases3.4 months for unsuccessful cases

Program Outcomes

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The number of EBI programs and the number of Pennsylvania counties implementing an EBI have grown steadily over the past 7 years.

Across all placement types (Juvenile Justice, C&Y, M.A.-funded) there have been decreases in the numbers and rates of placement.

As a whole, counties implementing EBIs have shown substantial decreases in placement rates while counties without EBIs have shown no change or even increases.

Impact on Placement Rates

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8 counties that did not have any EBI from 2006-2010 were compared to 11 counties that began the implementation of their first EBI between 2007 and 2009. Placement rates were totaled across the counties in each group. Group 1, Counties without an EBI 2006-2010:

Bedford, Carbon, Franklin, Fulton, Lebanon, Schuylkill, Somerset, and Susquehanna

Group 2, Counties beginning implementation 2007-2009: Allegheny, Berks, Cameron, Clarion, Elk, Forest, Lackawanna, McKean, Monroe, Pike, and Potter

Impact on County Placement Rates

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Impact on Placement Rates

2005 2006 2007 2008 2009 20107.00

7.50

8.00

8.50

9.00

9.50

10.00

10.50

11.00

10.54 10.58

9.07

9.7610.05

10.5310.84 10.69

9.89

8.70

7.79 7.78

No EBI during 6-year period

Adopted EBI in '07, '08, or '09

Juvenile Court Placement Rates: A comparison of counties with and

without an EBI

Plac

emen

t as

a Pe

rcen

t of

Dis

posi

tions

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Impact on Placement Rates

2006 2007 2008 2009 2010 201125

27

29

31

33

35

37

39

30.88

29.48

32.55 31.99

35.56

37.9

35.336.13

32.36 32.3832.38 31.98

No EBI during 6-year period

Adopted EBI in '07, '08, or '09

Perc

ent o

f You

th In

Car

e, A

ges

10-1

7,

In a

Res

tric

tive

Plac

emen

t as

of M

arch

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Children & Youth Placements: A comparison of counties with and without

an EBI

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Cost Savings…

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Program Benefit Cost per Youth (2010$)

Youth Discharged(2010)

Estimated Economic Benefit (crime reduction)

FFT $57,341 1,646 $94,383,286

MST $22,096 2,571 $56,808,816

MTFC $33,047 41 $1,354,927

Cost Savings

Pennsylvania’s immediate savings related toreduced placement costs = approximately $2.4 Million

Youth Discharged July 2010-December 2011

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Questions

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OutcomesEBI Programs Outcomes Summary, July 2010-

Dec. 2011FAQ about INSPIRE

Placement Trends & Program LocationsElectronic MapsYouth Placements & Placement Rates in PA

Additional Resources

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Special Thanks to the EPISCenter, for allowing us to use the Evidence-based Intervention Programs Outcome Summary. For a full copy of this report please visit the EPISCenter at http://www.episcenter.psu.edu/resources/PRCmainresearch/researchreports

Website: http://www.episcenter.psu.edu Email: episcenter@psu.eduLiz Campbell, Intervention Programs

Coordinator: ecampbell@episcenter.org, 717-233-1350

Acknowledgements