In 2022, staff at the Urban Institute partnered with the Allegheny County DHS and the Western Pennsylvania Regional Data Center (WPRDC) to pilot synthetic data generation at the local level, to help understand the unique challenges that might face state and local governments in generating synthetic data. Each record in the synthetic dataset represents a simulated individual, or record, who received at least one service from the Allegheny County DHS in 2021. The synthetic data were designed such that records aggregated by service represent the original data. Read more here about synthetic data.

Why create a synthetic dataset?

The Department of Human Services (DHS) in Allegheny County, Pennsylvania, serves one in five residents of the county every year through child welfare services, behavioral health services, aging services, developmental support services, homeless and housing supports, and family strengthening and youth supports. In the process, data are collected about these services and the population using them. These data are integrated at the individual level to allow for better care coordination, operational improvements, and program evaluation. Because of the dataset’s sensitive nature, it cannot be widely shared at an individual level, so synthetic data are used in the real dataset’s place—allowing the data to be publicly shared and helping stakeholders, including researchers, service providers, and members of the public, understand these populations better.

The Allegheny County Department of Human Services (DHS) engages clients and others who interact with DHS programs in a variety of ways: regular roundtables/cabinets (e.g., Children’s Cabinet); town halls and community forums; social media (e.g., Facebook and LinkedIn); and the Director’s Action Line (DAL). In 2018, DHS expanded its public engagement strategy to include SMS text messaging (texting), a tool that is convenient for recipients and allows DHS to scale up communication with clients and other Allegheny County residents.

What is this report about?

This data brief describes DHS’s texting outreach from 2018 to 2022.  This brief outlines the different distribution paths and mechanisms that DHS uses for text outreach, and characterizes the number and content of text messages sent, the demographics of the text recipients, and the impact of DHS’s text outreach thus far.

What are the takeaways?

• From 2018 through 2022, DHS sent 832,038 text messages to 151,707 phone numbers.  Over the same time period, DHS received 193,283 messages in response from 19,185 phone numbers.
• The content type of the text messages sent over this time period can be categorized as follows: program outreach (48%), data collection (44%), alerts (7%), and public policy updates (1%).
• The subject of the text messages sent over this time period are diverse, but a disproportionate share (72%) are about transportation, due to the extensive use of text messaging for outreach and data collection in relation to the Allegheny County Discounted Fares Pilot program.
• In 2021, 74% of text messages were related to one of the following initiatives: COVID-19 rental assistance, the Older Youth Pandemic Relief program, or information about free tax preparation services.
• In 2022, 88% of text messages were related to one of the following initiatives: the Allegheny County Discounted Fares program, the SNAP fresh access program, or recruitment and outreach for paid research opportunities with university partners.
• Text messaging has allowed DHS to connect clients to resources at scale, and to elicit feedback from clients who would likely never otherwise have the time or opportunity to share their feedback.  Examples of this described in the brief include text outreach associated with the Older Youth Pandemic Relief program, and text message surveys sent to clients who use Family Center services.

How is this report being used?

The county is interested in innovative and effective ways to outreach and engage with clients.  We believe that text messaging is one way to do this at scale.  The county is using the information presented in this report to inform overall strategy about how we best engage and use client feedback information to improve programs and increase overall access to social services.

At the Allegheny County Department of Human Services (DHS), we work with more than 400 community organizations to keep children and older adults safe from abuse and neglect, connect them to effective mental health and substance use treatment, provide housing for those without shelter and more. As stewards of more than $1 billion in public funding, we constantly scrutinize the programs and services we fund to ensure that they are most effectively helping clients make measurable progress toward their goals. We pay close attention to the data, including client feedback and surveys, and use these data to determine when it’s in clients’ best interest to modify existing programs or launch new ones. Recently, we have been increasing our commitment to the use of randomized pilots to measure the effectiveness of various strategies and determine how to make the best use of available resources. In keeping with our values of transparency and the appropriate use of data for decision-making, we want to share our thinking behind the use of pilots as an effective tool to further the Department’s goals and values while improving client outcomes.

What are randomized pilots?

When we ask, Was this program effective?, We want to know if client outcomes are better for program participants when compared to the outcomes of others not involved in the program. There are various ways to make this comparison. For example, we can compare client status before and after the program or we can compare their outcomes to clients who chose to not participate in the program. The weakness of both of these approaches is their reliance on the assumption that the groups are similar, i.e., on average, they would have performed the same if neither had received the intervention. Thus, we are left wondering, “How can we distinguish the program impact from the effects of time or characteristics of the participants?” Randomized pilots solve this problem by breaking the link between characteristics that could drive differences between groups and the program itself. In a randomized pilot, participants are assigned to different programs or policies randomly, based on the equivalent of a coin flip. These methods are standard practice in medical and drug trials to measure the effectiveness of health interventions with confidence; in recent years, they have become more popular with governments entities, nonprofit organizations and businesses.

Why start with a pilot?

Many organizations have highlighted the value of randomization (see here and here for examples). Rather than rehash their points, we expand upon three DHS core values that are supported by the use of pilots.

• Accountability and Transparency: Too often, the performance of government-led initiatives or strategies are unclear, making it impossible to measure progress or demand accountability. Change, if it does occur, is not based on credible data nor connected to measurable outcomes. Without clear information, program continuation or termination may be based on subjective decisions that might be inaccurate. In contrast, DHS wants to be held accountable and to ensure that we are funding programs that measurably improve the outcomes of the clients who rely on us for critical support, services and resources. We seek to provide clear feedback to ourselves and our stakeholders, demonstrating either that our investments are producing their intended outcome(s) and that money is being spent effectively or that the program needs to be modified or even ended. Randomized pilots promote this accountability and transparency because they are simple to understand, analyze and report on.
• Betting boldly: Pilots allow us to bet on new, unproven or controversial solutions without committing to expensive or unproven investments that don’t produce results. By getting clear data on performance of new interventions, we can make informed decisions that are in the best interest of those we serve. At DHS, pilots will never be used to generate a known answer to a question or to withhold resources for an intervention clients would otherwise be entitled to receive (e.g., publicly funded childcare subsidies).
• Continuous improvement: Given the complexity and range of the problems we face—from the opioid epidemic to community violence—we need to use every tool at our disposal to make progress. In government, as in any endeavor, it is hard to improve without feedback. Pilots are a key part of a continuous quality improvement cycle that starts with asking whether programs are effective and how they could be better. They guard against poor decision-making by providing data on an initial investments before making longer term decisions about funding and large-scale program launches.

Pilot ethics

Earning and keeping clients’ trust is essential for our work. In line with our strategic initiatives, work on algorithms and funding decisions, we will continue to strive for transparency and community engagement as we develop pilots and report on their results and ultimate funding decisions. Our commitment to transparency and
protections for clients includes:

• Seeking participants’ informed consent for sharing data and voluntary participation in all pilots.
• Targeting studies to individuals and neighborhoods that can benefit from the solution.
• Compensating clients for completing surveys and other forms of participation.
• Protecting participants’ data—study data will always be reported only in aggregate form, protecting the individual identity of all participants.

When partnering with outside academics who propose to analyze and report on the implementation and outcomes of a pilot, they will be asked to submit their analysis plan to their institutions’ Institutional Review Board (IRB), thus minimizing the risk of unintended negative outcomes and ensuring informed consent. In any case, when we implement and analyze the results of a pilot to inform decisions about launching the program, we commit to publishing the results and decisions on our website. We welcome suggestions about potential interventions where a randomized pilot can increase our understanding of the specific intervention and of the kind of interventions community members are interested in testing (contact us at DHS-Research@alleghenycounty.us). Randomized pilots have the potential to increase our data-informed program decisions and improve the quality and relevance of program strategies; they will also challenge us to make the best use of our resources. We look forward to the challenge and hope you’ll join us as we expand this continuous quality improvement strategy. We’ll update this website as we begin new pilots and report on interim and final results.

The Latinx population of Allegheny County is growing fast. It is important to understand this community’s demographics, geographic locations, and how our social, health and human services systems are and are not meeting their needs so we can strengthen families and advance the health and wellness that are crucial to supporting the local Latinx community.

What is the Latinx needs assessment?

In early 2020 the Latinx community asked Allegheny County Department of Human Services (DHS) to commission a community needs assessment. DHS issued a Request for Proposals (RFP) in August 2020, and a review committee selected Metis Associates as the successful proposer. The RFP is available here. Award details and the successful proposal is available here.

The assessment, which was conducted between January and September 2021, was a collaboration between Metis Associates, a research firm from New York; MonWin, an urban planning firm in Pittsburgh; and several community researchers. The assessment includes interviews with community leaders and service providers, focus groups with community members, and a review of public and administrative data sources.

What is the Service Utilization by Latinx Communities Data Brief?

To accompany the findings of the needs assessment, DHS conducted the following analyses to describe Latinx use of human services, publicly funded health services and involvement with the criminal justice system within Allegheny County. The analysis describes participation rates of people identifying as Latinx in 1) family and child services, 2) physical and behavioral health services, 3) aging services, 4) developmental support services, 5) income supports, 6) housing and homeless supports, and 7) criminal and juvenile justice involvement.

In September of 2020, the Allegheny County Department of Human Services (DHS) and Allegheny County Emergency Services co-convened the Crisis Response Stakeholder Group (CRSG). Comprised of over 30 stakeholders from across the crisis system including representatives from 9-1-1, law enforcement, City and County government, elected officials, foundations, provider agencies and community members, the workgroup was formed to address the overreliance on emergency services for people with behavioral health needs, as well as the racial inequities that persist throughout our crisis system.

The group met regularly to map out the current crisis system and hear from a wide variety of stakeholders, including frontline staff and people in the community. They identified gaps and opportunities within the system and developed a set of 16 recommendations, which was published in February 2021.

Where can I find more information?

Visit the DHS page related to Improving Crisis Prevention and Response.

The Allegheny County Department of Human Services (DHS) helps more than 200,000 people each year through well-established programs and innovations that advance its mission. In addition to these day-to-day programs, DHS developed a set of “strategic initiatives” to focus on in 2019 and 2020 – developed through a planning process that involved a full review of priorities across the agency. These initiatives, of course, were planned prior to the challenges of 2020, which required DHS to be flexible and respond to new and greater needs.

The report presents these initiatives and examples of how DHS has worked with our community partners to continually improve the well-being of children, youth and adults in Allegheny County.

When the COVID-19 pandemic hit Allegheny County, PA, the Department of Human Services (DHS) responded with a tireless focus on the needs of providers, staff and County residents. DHS was able to streamline processes that helped feed, educate, house, protect and serve thousands of clients and residents of the County.

A first report covers DHS’s early response to the pandemic through June 2020, including establishing remote work policies, creating daily briefings for provider staff, and providing internet capability for hundreds of families and children.

A subsequent report provides an overview of later efforts through the summer, fall and winter of 2020 and into 2021, including topics such as deployment of funding and Emergency Rental Assistance, establishment of learning hubs for school-aged children and modifications to housing for people with COVID-19.

The Allegheny County Department of Human Services (DHS) offers free tax preparation services at its downtown location for income-eligible County residents. This data brief provides a summary of DHS’s 2019 tax assistance service, the taxpayers using the service and the volunteers who were involved. Data is from participants’ tax returns with additional information self-reported by participants.

Click here to read the report.

The Allegheny Family Screening Tool (AFST) is a predictive risk model designed to improve decision-making in Allegheny County’s child welfare system. The tool utilizes hundreds of data elements to predict the likelihood that a child referred for abuse or neglect will later experience a foster care placement. The AFST provides additional information – in conjunction with clinical judgement – to assist child welfare workers making a call screening decision.

After a multi-year process that included rigorous research, community feedback, and independent ethical review, Version 1 of the AFST started being used by call screeners in August 2016. Findings from an independent impact evaluation and a commitment to continuous improvement of the tool led to a rollout of Version 2 in December 2018 that updated the algorithm, data sources, and associated policies.

View a comprehensive packet on the AFST that provides all of the County’s published research and partner evaluations to date or select from the following documents:

• Methodology of the AFST
  • • • Version 2 (April 2019)
      • Version 1 (April 2017)
• Evaluations of the AFST, Version 1
  • • • Impact Evaluation Summary and Full Impact Evaluation (April 2019)
      • Process Evaluation (January 2018)
      • Ethical Analysis and Response to Ethical Analysis (April 2017)
• Frequently-Asked Questions

Click here to access recent press coverage of the AFST.

Allegheny County Medicaid recipients are entitled to free transportation assistance to their non-emergency medical appointments. Traditionally, this transportation has been provided by paratransit vehicles for those not able to utilize public transportation or their own vehicle. The advent of ride-hailing services like Lyft and Uber has presented a new, rider-friendly option. This report describes a pilot program that tested the viability and user experience of ride-hailing services for people using medical assistance transportation.

Click here to read the report.

When a child is placed in a foster home, the resulting move can also mean living in a new school district. Research has shown that unplanned school changes can lead to worse educational outcomes, such as lower test scores and graduation rates. A 2015 federal mandate, the Every Student Succeeds Act, requires that children in child welfare placements remain in their home school – unless it is determined not to be in the student’s best interest – so as to maximize a student’s stability and educational outcomes.

In response, the Allegheny County Department of Human Services took advantage of a wealth of data and strong school partnerships to develop a collaborative, child-centered process that helps children in child welfare placements maintain school stability whenever possible. The result was hundreds of students continuing to attend their home school in the 2016-17 school year.

Read the full report to learn about how DHS responded, challenges we faced, and results from the first year of implementation.

The Allegheny County Department of Human Services (DHS) continuously strives to better understand our clients’ experiences and incorporate that feedback into service planning. We recently tested satisfaction kiosks as a new way of collecting feedback. The wireless kiosks were placed in a variety of service locations and asked clients to indicate their satisfaction by pressing a button, with the results quickly and anonymously sent to DHS. Staff and clients responded positively to the pilot, and we were able to collect feedback on a range of services. Building on the success of the pilot, we are continuing to employ innovative technology to hear from the people we serve.

This series of three reports gives an overview of the kiosk pilot program and then takes a closer look at ways the kiosks are helping us better understand our clients.

Piloting Satisfaction Kiosks: Overview, Implementation and Insights
Read about how the pilot was implemented, examples of survey questions, lessons learned, and next steps for building on the success of the pilot.

Satisfaction Kiosk Findings: Clients’ Overall Satisfaction
This data brief describes the results of six different survey questions that asked DHS clients about their overall satisfaction. Some clients responded to the question, “How did you feel about the service you received today?” while others were asked to agree or disagree with statements such as, “I feel better than when I came in” and “I felt heard today by staff.”

Satisfaction Kiosk Findings: Clients’ Experience with Homelessness and Housing Services
This data brief describes the results of survey questions that were asked of some clients who visited housing and homelessness programs. Clients used kiosks to give feedback on service quality, their unmet needs, and interest in possible future programming.

In an effort to provide affirming services to LGBTQ (lesbian, gay, bisexual, transsexual, queer/questioning) communities involved with Allegheny County’s Department of Human Services (DHS), the first Department-wide LGBTQ work group began in 2009. At that time, sexual orientation and gender identity were not frequently discussed as part of DHS practice. By 2016, DHS had made great strides in affirming LGBTQ communities. Work within DHS and with community partners led to written practice guidance related to gender and sexuality, improved understanding of bias in the workplace, the creation of an LGBTQ advisory council, and improved data collection related to gender and sexuality.

This report shares DHS’s experiences from 2009 through 2016 as it worked to better understand and serve the LGBTQ communities of Allegheny County. We share our strategies, challenges and lessons learned with the hope that others can learn from them.

Click here to read the report. 

The Allegheny County Department of Human Services (DHS), in partnership with the United Way of Southwestern Pennsylvania, has been offering free tax preparation in several locations throughout the County since 2011. Thirteen trained volunteers helped 343 clients in need prepare returns last year. Collectively, these clients received a total federal refund of $519,645, at no cost to them. This brief includes demographic information about the taxpayers who received DHS tax assistance services and the overall results of the 2017 program.

Click here to read the brief. 

Allegheny County, like much of Western Pennsylvania, is in the midst of an opioid overdose epidemic and it is vitally important that County residents have access to the best and most effective treatment to support their recovery from opioid use disorders. Medication-assisted treatment, or MAT, combines medication and counseling/behavioral therapy and, when clinically appropriate, is a standard of care in the treatment of opioid use disorders. Research has proven MAT to be highly effective in improving recovery outcomes and reducing criminal behavior and risk of infectious disease.

The Allegheny County Departments of Health and Human Services, together with Allegheny HealthChoices, Inc. and Community Care Behavioral Health, issued a Joint Position Statement on Medication-Assisted Treatment for Opioid Use Disorders in Allegheny County, describing their expectations for contracted treatment providers and others who encounter or serve individuals with opioid use disorders. It states that every person entering substance use treatment for opioid use is entitled to the opportunity to learn about and consider MAT as a treatment option. It is intended to dispel ambiguity and should be understood as a clear statement in support of an effective treatment continuum that includes MAT.

Click here to view the full joint position statement.