Next Steps

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Next StepsNext Steps

The EBP Initiative in Pennsylvania is now more than a decade old. An infrastructure to support the initiative, the Resource Center for Evidence-Based Prevention and Intervention Programs and Practices, has been in place for over 4 years. Pennsylvania has seen a positive impact from its investment in EBIs, as illustrated by outcome data showing good outcomes for the families served, a steady reduction in placements over the past several years, and money saved by diverting youth from placement and future reduction in crime. At the same time, there are significant challenges to program sustainability. Improvements that focus on key barriers and are informed by lessons learned will help to promote program sustainability and maximize public health impact.

1.

Take concrete and proactive steps to address the challenges faced by the programs, with the support and involvement of key stakeholders at the state level. The challenges facing EBI programs are interrelated in complex ways and would be most effectively addressed through collaboration between state leaders and providers to identify creative and systemic solutions. A best practice guide from the state, outlining policies and processes for effectively supporting EBIs and integrating information from multiple systems (e.g., child welfare, juvenile justice, mental health), could be highly beneficial to local communities. Appendix A outlines a number of possibilities for addressing the current challenges.

2.

Create avenues for continuing to educate a broad audience of county leaders about the benefits associated with EBIs and the role counties play in ensuring implementation is a success. This includes sharing the lessons learned over the past decade with communities. While many counties are “on board” with EBIs, others have been slower to respond or are misinformed. Counties that have developed successful ways of supporting their EBIs and have seen the fruits of their labor in terms of decreased placement rates have much to share with counties that are newer to EBI implementation or in which providers are struggling. Similarly, in some counties Behavioral Health-Managed Care Organizations have developed ways to support and collaborate with EBIs – from expediting M.A. authorization to attending clinical trainings to learn more about the models – which could be shared. Next steps should include:

3.

Collect and disseminate more information about the long-term outcomes associated with EBIs in Pennsylvania. Policy makers and funders are very interested in knowing what impact EBIs have over the long-term. The INSPIRE system, deployed in the spring of 2011, makes available to providers and to the state more reliable, valid, and consistent data about EBI utilization and outcomes. The system provides a way for programs to track and report follow-up data, but at this time few programs are consistently collecting data beyond the point of discharge, in part due to limited resources at the provider level. A multi-pronged approach would be most successful and could consist of a written policy around expectations for data collection, small grants to incentivize data collection, and training for providers around how to most effectively follow-up with clients.

  • An “EBI Forum,” similar to the one held in 2010, to share best practices and educate counties regarding their critical role in supporting EBIs.
  • Continued sharing of information through the EPISCenter newsletter for county leadership and BH-MCOs, which should focus on some of these key challenges and how counties can help.
  • Targeted TA from a team of state partners to counties that continue to place high numbers of youth, yet are underutilizing existing EBIs.

4.

Identify communities that are interested in adopting an EBI and counties where additional service capacity is needed, and provide technical assistance from the earliest stages of planning. It has become clear that planning can play a pivotal role in the successful implementation of a program. The EPISCenter is available to provide technical assistance not only to existing EBI providers, but also to communities considering adoption of an EBI. When communities have reached out for assistance, the EPISCenter has been able to answer questions, clarify misconceptions, and provide information not only about the models being considered but also about specific considerations for successful implementation in Pennsylvania, based on experience working with EBI providers across the Commonwealth. A protocol for identifying communities in the early stages of planning would enable us to provide this support on a larger scale. Furthermore, the electronic maps developed by the EPISCenter are helping us to identify communities where placement rates are high, yet the availability EBIs is low. These counties would likely benefit from targeted outreach and planning assistance.

By proactively addressing the current challenges facing EBIs and continuing to support communities with effective implementation, Pennsylvania can continue to experience the benefits of EBI implementation: positive outcomes for youth, responsible use of taxpayer dollars, and reducing the flow of youth into the adult criminal justice system.

Download Next Steps(Written in December 2012)

 

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