Current Challenges

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Current ChallengesCurrent Challenges

The section Program Impact highlights the many benefits experienced by Pennsylvania from the implementation of FFT, MST, and MTFC:

  • Positive outcomes for youth and families served.
  • Many youth are able to remain in their homes, avoiding the negative trajectory associated with placement.
  • Immediate cost savings associated with diversion from placement.
  • Long-term savings associated with crime reduction.

In this section we highlight the challenges currently face EBIs, which not only pose a significant threat to sustainability but also directly impact the youth served.

Underutilization
Data from the past fiscal year, along with reports from providers, show that EBIs are being underutilized in Pennsylvania – the number of youth served is less than the capacity that currently exists.

Underutilization

Delayed Start of Services
OCYF Special Grants were initiated in order to fill funding gaps that could not be covered by Medical Assistance, including the cost of services delivered prior to M.A. authorization. In reality however, many providers report that the start of services is delayed while they await M.A. authorization for a youth. Depending on the Behavioral Health Managed Care Organization and its protocols, as well as whether a youth is covered by M.A. at the time of referral, this can take anywhere from a few days to several weeks.

Shift in Focus to Productivity & Administrative Requirements
There are undoubtedly benefits of Medical Assistance funding for EBIs. In contrast to time-limited grants, M.A. provides a reliable funding source for programs, and it has broadened the scope of youth that can be served to beyond those in the juvenile justice system. At the same time, the current funding structure for EBIs in Pennsylvania and the requirements associated with M.A. regulations create specific challenges for EBI providers.

Financial Losses
Pennsylvania has seen some improvement in EBI stability as communities have been provided clearer information about accessing Special Grant funds and some providers have been successful in negotiating rate increases with their Behavioral Health-Managed Care Organizations. However, across agencies and across the three EBIs, the majority of programs report that they are losing money. In some cases, losses are in the hundreds of thousands for a single provider. Ultimately, losses of this magnitude will result in program closures.

While Pennsylvania has created a structure of blended funding streams with the goal of funding all aspects of EBIs, in reality the process is a complicated one that directly impacts referrals and youth access to services.

Download the full text of Current Challenges(Written in December 2012)

 

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