DHS has set five goals to guide us and our partners in serving our community well. We aim for our network for human services to improve access to care, prevent overuse of coercive services, prevent harm, increase economic security and ensure quality.

What is this report about?

DHS can reach our goals more quickly if we devote time and attention to several big, bold initiatives that will make our systems and our organization work better for everyone we serve. This document outlines our key initiatives in 2024—which are in addition to our core work of running effective systems of care for people.

County human services includes programs from over 300 community-based agencies and is delivered by social workers, peers, and outreach staff working all throughout the county. These staff run out-of-school-time programs, answer hotlines, investigate reports of potential harm to children and vulnerable adults, deliver meals to seniors and run Senior Centers, make home visits to families with newborns, and do the administrative work that makes our human services run efficiently.

What is this report about?

This report highlights the 2023 accomplishments that stood out. There are many, many other achievements that people told us about. We chose the ones that made the biggest difference.

What are the takeaways

To improve access to care, DHS and its partners

• Improved responsiveness of our two main helplines, Allegheny Link and 211. For the Allegheny Link, this led to a 13% increase in number of callers served and a 70% reduction in wait time. For 211, the reduction in wait time also was 70%.
• Expanded availability of behavioral health care, including a fellowship program that increased staff by more than 100 and a new drug and alcohol treatment model that led to a 60% increase in case management services for youth.
• Expanded the reach of our programs and the number of people served, including expansion of the Hello Baby program countywide and increased meal service to older adults.
• Directed more of our services to those in greatest need, including connecting more high-need older adults to personal care services and prioritizing the highest need people for mental health housing supports.

To prevent harm, DHS and its partners

• Launched the Community Violence Reduction Initiative. Read more about that here.
• Created safe spaces for people who are experiencing homelessness, including decentralizing shelter and increasing capacity and the creation of a Code Blue shelter during emergency weather.
• Improved health outcomes, including helping older adults as they transition from the hospitals, reducing readmissions by 50%, implementing an evidence-based model for people with intellectual disabilities or autism and expanding medication assisted treatment in the Allegheny County Jail.

To prevent overuse of coercive services

• Reduced the number of case openings in child welfare by 47% and reduced the number of home removals
  by 23% (2023 compared to 2020).
• Expanded support for people in crisis, including by adding 15 providers of informal mental health services,
  supporting respite services delivered by peers, and adding a mobile response team for crises in Downtown
  Pittsburgh.
• Expanded the Law Enforcement Assisted Diversion (LEAD) program to 11 communities. This program
  provides police with alternatives to arrest and incarceration.
• Launched a legal support, connection and intervention program to reduce recidivism for people with
  intellectual disabilities or autism who are at risk of arrest and jail.

To increase economic security

• Increase direct cash assistance and services including making transportation more affordable for 14,000 low-oncome individuals, provide assistance for over 900 older adults who are caring for children, increase payments for kin/relatives caring for children, and provision of cash assistance to over 1,000 youth involved with child welfare or homeless services.
• Making housing more stable by preventing evictions through mediation, legal presentation and rental assistance, making it easier for homeowners to apply for the Whole Home Repairs program, and partnering to secure a $50 million federal grant through the Choice Neighborhoods program.

What is this dashboard about?

Allegheny County DHS sends text messages to county residents for a variety of reasons, including increasing awareness of services, providing timely reminders, and gathering feedback after a service experience.  In addition, DHS uses this information to help evaluate and monitor programs it delivers.  This dashboard displays information about these outreach and engagement efforts, including the subject and purpose of these and the rates of engagement.  Data on DHS’s texting efforts are available from November 2017 to the present.

What data is available?

The dashboard allows users to examine DHS text messaging as a whole as well as drill down to individual text campaigns.  It allows users to understand the purpose of each campaign, the number of messages sent and the demographics of the people being contacted by each campaign.  DHS collects this information through Community Connect Labs (CCL), DHS’s texting software, and information is updated daily. Click here for a more detailed report on DHS’s texting outreach from 2018-2022.

The Allegheny County Department of Human Services (DHS) conducted a study of the involuntary hospitalization program in the county. Involuntary hospitalizations occur when an individual undergoing a psychiatric episode is deemed to be a clear and present danger to themselves or others.  The specific section that governs the intake process of an individual is Section 302 of the Mental Health Procedures Act (MHPA), and for that reason the entire program is sometimes called the 302 program.

Evaluations occur in a hospital setting. Following an upheld commitment individuals can initially be detained for up to 120 hours, with the potential for extensions. The county seeks to understand the system in detail and improve outcomes among individuals who go through this process.

What is this report about?

This report describes individuals who went through the involuntary hospitalization program from 2015-2022. The analysis profiles the individuals including their characteristics such as diagnosis, their usage of mental and behavioral health services, and their outcomes post release. 

What are the takeaways?

• Involuntary hospitalizations are common, affecting over 3,700 residents each year. The most common source of referrals occur from friend / family (43%), police officers (19%), and physicians (14%).
• Individuals who are involuntarily hospitalized have poor outcomes upon release—within 5 years of their first evaluation, fully 20% of the population has died, a rate that is higher than that for clients exiting jail, enrolling in homeless shelters, or receiving food assistance (SNAP) as well as the rate for individuals with severe mental illness (SMI) diagnoses.
• We find worse outcomes among 302 individuals with a pre-existing substance use disorder (SUD)— 5% of those with SUD 18–50 years of age die within two years of intake, compared to 2.5% of the 18–50-year-olds without SUD. Of those with SUD, eighty percent (60%) of the mortality rate is attributable to drug overdose.
• We found similarly elevated risks for other adverse outcomes. Over 23% were charged with a crime within 5 years of release, and 60% used an emergency department (ED) within one year of release.
• Statistical methods can distinguish between riskier and less risky clients with high fidelity at the moment of the 302 evaluation.
• Those petitioned for involuntary commitment were disproportionately Black, although petition-upheld rates are similar across race. A similar picture emerges for gender—men were more likely to be petitioned, but upheld rates at the point of exam were similar for men and women.

How is this report being used?

The report serves as an initial analysis into the involuntary hospitalization process. The county is using this analysis, as well as planned subsequent ones that look at the impact of an involuntary hospitalization on a person’s outcomes, and input from clinicians and community members to develop recommendations to improve care for this vulnerable population. Ultimately the county is looking to improve both the process and the outcomes for individuals who experience an involuntary hospitalization.

Making good, informed decisions about how to allocate limited resources is an ever-evolving process. The Allegheny County Department of Human Services (DHS) strives to make the most equitable decisions when allocating scarce resources for individuals and families in need. Housing is a critical resource for which demand far exceeds supply; thus, DHS is dedicated to making sure that those most at need have priority for the housing services that are available. Since 2017, DHS has developed predictive risk models that utilize administrative data to assign a risk score that is used to determine the appropriate course of action. Two of these models were developed to support prioritization of housing resources.

Allegheny Housing Assessment (AHA)

In 2020, DHS launched the Allegheny Housing Assessment (AHA), a decision support tool designed to help prioritize admissions to supportive housing services for individuals or families experiencing homelessness. The AHA forms the infrastructure for DHS’s coordinated entry system for those in a housing crisis.

The tool uses administrative data from Allegheny County’s data warehouse to predict the likelihood of three types of events occurring in a person’s life if they remain unhoused over the next 12 months: 1) a mental health inpatient stay, 2) a jail booking and 3) frequent use (4 or more visits) of hospital emergency rooms.  These events serve as indicators of harm if a person remains unhoused. The AHA assigns a risk score that is used as part of the housing prioritization process; it is far more objective and unbiased than earlier assessment tools and it doesn’t require the time or trauma associated with asking sensitive questions at the time of housing crisis.

Mental Health – Allegheny Housing Assessment (MH-AHA)

After a couple of years of experience with the AHA, DHS leadership realized that a similar tool could help prioritize admissions to residential services for individuals with a diagnosis of serious and persistent mental illness. Using the AHA as a starting point, the team developed the Mental Health – Allegheny Housing Assessment (MH-AHA) and launched it in February 2023.

Similar to the AHA, the MH-AHA utilizes administrative data from Allegheny County’s data warehouse to predict the likelihood of two potential types of adverse events that may occur in an individual’s life if they do not receive adequate support for their MH condition over the next 12 months: 1) a mental health inpatient stay and 2) frequent use [4 or more visits] of hospital emergency departments. These events serve as indicators of harm and are things we would like to prevent. The MH-AHA assigns a risk score that is used as part of the prioritization process. Individuals who are not eligible or who do not receive a risk score likely to lead to a placement in the near future will be introduced to other supportive services options instead of waiting a long time on a waiting list for a placement that might not occur.

By prioritizing those most in need of MH residential services, the MH-AHA will simplify the referral process, decrease uncertainty and reduce wait times. In addition, it will help Allegheny County document unmet MH residential needs created by the gap between limited MH residential resources and the number of high-risk eligible individuals. An external impact evaluation by researchers at Stanford will document progress toward these goals.

Select from the following documents to learn more about the AHA tool:

• • • Using Predictive Risk Modeling to Prioritize Services for People Experiencing Homelessness in Allegheny County: Methodology Report for the Allegheny Housing Assessment Tool (September 2020)
    • Methodology Update (December 2020)
    • Frequently asked questions about the implementation of the Allegheny Housing Assessment tool
    • Summary of client feedback on the new housing prioritization process
    • Independent ethical/data science review of the Allegheny Housing Assessment
    • DHS’s response to the ethical review

Select from the following documents to learn more about the MH-AHA:

• • • Methodology Report for the Mental Health-Allegheny Housing Assessment Tool (November 2023)
    • Frequently asked questions about the implementation of the Mental Health-Allegheny Housing Assessment Tool

Overview: 

Beginning August 31, 2022, Allegheny County received its first payment related to the settlement of litigation against manufacturers, distributors, and associated consultants for the opioid industry. Together, the litigation settlement will yield $82 million in total payouts to Allegheny County through December 2038.

Analysis: 

The report lists the summary of the planned investments. Additional analysis and information will be added as it becomes available.  The dashboard provides additional information about the fund and the initiatives the money is supporting.

Trouble viewing the dashboard below? You can view it directly here.

What information about overdose deaths is available?

How is this data used?

Data on victims and potential risk factors can help County government and other stakeholders implement evidence-based strategies to address the ongoing opioid epidemic. The reports, maps and dataset are provided in an effort to inform and stimulate discussion about substance use treatment and prevention.

---

Related materials

Previous reports about accidental overdose

• 2015-2016 data
• 2008-2014 data

Dataset

• Overdose deaths by Allegheny County municipality: 2008-2014

Maps

• Cumulative County Overdose Deaths: 2008-2017 (interactive heat map)
• County Overdose Deaths: 2015-2016 (static heat map)
• By Pittsburgh City Council District: 2015-2016, 2008-2014
• By Allegheny County Council District: 2008-2014
• By Allegheny County Municipality: 2015-2016, 2008-2014
• By Pittsburgh Neighborhood: 2015-2016

Throughout the United States, people experiencing behavioral health challenges are overrepresented in the criminal justice system and Allegheny County is no exception. To better understand the state of our current system and to learn more about promising approaches in other jurisdictions, Allegheny County sought an independent evaluator to conduct a study. From among a number of proposers, the county selected researchers from the University of Pittsburgh who interviewed dozens of stakeholders, analyzed justice system data, examined models from other jurisdictions, and solicited feedback through a series of workshops.

Click on the links above to learn more about the researchers’ findings and recommendations:

One way that Allegheny County promotes the provision of high quality behavioral health services is through value-based contracting (VBC), which pays providers of behavioral health services based on quality of care rather than quantity of care. This type of contracting can reduce system costs while also providing financial incentives for high-performing providers. The Pennsylvania Department of Human Services (PA DHS) has implemented a series of VBC requirements for the Medicaid-funded behavioral health program statewide. This report outlines these requirements, highlights Allegheny County’s various VBC initiatives, and discusses next steps.

Click here to read the report.

The dashboard below displays information about Allegheny County suicides since 2002. View trends in yearly suicides, demographics of people who died by suicide, and locations within the county. The data is updated monthly.

A related data brief is also available.

Problems viewing the dashboard? You can view it directly here.

---

Related materials

• Data brief: 2008-2017 data

Suicide rates have been rising in nearly every state in the U.S. in recent years, and in Pennsylvania and Allegheny County, suicide rates are higher than the nation’s. This data brief explores Allegheny County suicide trends since 2008 as well as demographics, causes of death, and publicly funded service usage of those who died.

Click here to view the data brief.

Click here to view a related interactive dashboard.

The dashboard below provides information on licensed substance use disorder and mental health treatment providers in Allegheny County as of August 2018.

Trouble viewing the dashboard? You can view it directly here.

In 2016, the Allegheny County Jail began offering naloxone, a life-saving medication that rapidly reverses opioid overdose, to people exiting the jail. Since then, the jail has distributed over a thousand naloxone kits. This data brief describes the naloxone distribution program and provides information on the people who received naloxone, including their demographics, the communities they lived in after leaving jail, and how many died of an overdose following their release from jail.

Click here to read the data brief.

People struggling with unhealthy drug or alcohol use sometimes face challenges when it comes to accessing treatment. Research has found that lack of insurance, unfamiliarity with treatment options, a shortage of available treatment slots, and concern that treatment will not work can all contribute to a person hesitating to seek help.

The Allegheny County Department of Human Services wanted to learn more about the barriers that people face when accessing publicly funded treatment in our region, so we interviewed more than 60 consumers, family members, and staff who had experience with the treatment system. Using a human-centered design approach, we summarized the information from the interviews into insights and then used the insights to ask “how-might-we” questions related to future system improvements.

Read the full report here.