Overview
The Franklin/Fulton County Mental Health (MH) program provides services to Franklin and Fulton county adults with severe and persistent mental illness and children who have a mental health diagnosis or who are at risk of developing a mental illness.
Diagnoses for Mental Health
To be in the Adult Priority Group and potentially qualify for county funding for mental health services, a person must be 18+ years old (or age 22+ if in special education) and must have a diagnosis of the following:
- Major depressive disorder
- Schizophrenia
- Schizophreniform disorder
- Schizoaffective disorder
- Bipolar I disorder
- Bipolar II disorder
- Mood disorder
- Psychotic disorder
- Borderline personality disorder
County-Provided Services
Emergency Delegate
Both Keystone Crisis Intervention Services and the emergency delegate are available 24/7/365. The primary role of the emergency delegate is to determine whether criteria for danger to self or others is met as per the Mental Health Procedures Act. If yes, then the petition is completed and the person is transported to the nearest Emergency Department by law enforcement for evaluation and potential admission.
Additionally, the emergency delegate can provide information on community based resources to individuals and family members/friends of individuals who are experiencing serious and possibly life threatening challenges in their lives.
Franklin/Fulton County Crisis Intervention Team (CIT)
The South Central Region Crisis Intervention Team (CIT) is based on the nationally recognized Memphis Police Department CIT program and is an innovative program of police-based crisis intervention involving law enforcement, mental health and advocacy partnerships (MHA). CIT is a pre-jail diversion program that directs individuals with mental illness away from the criminal justice system and into treatment where they can be better served.
Programs offered:
- 40-hours of specialized training to intervene more effectively in crisis situations involving people with serious mental illness and drug and alcohol issues.
- Officers learn to recognize the signs of psychiatric distress and how to de-escalate a crisis—avoiding officer and individual injuries/deaths, and tragedy for the community.
- Community liaisons are mental health professionals embedded in the Chambersburg, Greencastle, Washington Township and Waynesboro police departments.
- The liaisons are able to work with community members to engage in service systems instead of engaging with the criminal justice system, when applicable.
For more information about any of the services listed above, call 717-264-5387 or email CIT@franklincountypa.gov.
Program Functions
Program functions consist of duties such as contract preparation, program/contract monitoring, program development and education and resource sharing.
Staff coordinates programmatic and fiscal management of the local intellectual and developmental disabilities service delivery system. Related activities include planning, development/expansion of services, contracting with provider agencies, monitoring of the services provided including evaluating program effectiveness and efficiency.
Tasks include, but are not limited to:
Contract Preparation
Franklin/Fulton MH/IDD/EI operates on a July 1-June 30 fiscal year. Contracts are prepared on an annual basis with the combined involvement of program specialists, fiscal staff and agency personnel. Similarly mid-year amendments are prepared with the mutual collaboration of the aforementioned individuals.
Program/Contract Monitoring
This annual process involves one or more of the program specialists. During the on-site visit, staff receives a tour of the facility, speaks with program staff and reviews a variety of documents, including the agency’s policies and procedures, staff training log, fire drill log, etc. Additionally, program participant charts are reviewed (as appropriate) to assure that all documentation is completed and updated. Along with the review of charts, contract requirements are reviewed to assure providers are meeting the expectations of their contract and completing reports required by the county and/or state. Brief conversations with program participants are sometimes included to get a broader perspective of the program. A summary report of findings is prepared and provided to the agency afterwards.
Program Development
As service gaps are identified through a variety of means and as funding becomes available, staff and various stakeholders determine if new programs can be developed or existing programs expanded to ensure that individuals are receiving the services they need to support their ongoing recovery.
Education and Resource Sharing
Staff welcomes phone calls inquiring about available local mental health services. Staff is also available to provide training on a wide variety of topics to agency staff, staff from other county departments, civic organizations, etc. upon request. Staff participates in numerous community health fairs and similar functions to show representation and provide information and resources to those who attend.
PATH
Projects for Assistance in Transition from Homelessness (PATH) can assist with:
- Payment of security deposit for a new residence
- Payment of one month of back rent to prevent eviction.
- PATH cannot assist with payment if more than one month of back rent is owed.
Qualifications:
- Documentation of a serious mental illness
- Documentation of sufficient income to maintain rent on residence
- Homeless or at imminent risk of homelessness
Services In The Community
Outpatient Mental Health Services
Outpatient therapy is a level of care with the least amount of restriction. The therapy can be individual or group, structured or not.
Traditional outpatient therapy is individual sessions with a therapist at his or her office. There are some occasions when an individual may bring a partner or family member to the session; however, the focus remains on the identified individual.
It is important that a person in outpatient therapy be able to maintain a degree of safety outside of the session. At times a higher or more restrictive level of care may be required to ensure the safety of the client.
Individuals may also see a psychiatrist for medication management as necessary.
Agencies that provide outpatient mental health services
Case Management Services
A mental health case manager coordinates a variety of community services, monitors the services and serves as an advocate for the individual receiving services, their family and friends. It is the case manager’s role to locate resources and assist the individual in getting access to needed services.
A case manager provides assistance in identifying an individual’s needs, goals, strengths, abilities and preferences in treatment and recovery. The case manager also monitors the effectiveness of services to ensure they are of benefit. All residents having a diagnosis of a serious mental health illness qualify for these services regardless of their ability to pay. After the need for services is established, financial liability is determined (if appropriate). Case managers then assist individuals in applying for any benefits available to help pay for the cost of services.
Mental health case management levels of care include Utilization Management (UM), Administrative Case Management (ACM) and Blended Case Management (BCM), which is a combination of the former Resource Coordination (RC) and Intensive Case Management (ICM).
- UM – Utilization Management is basic case management services for individuals who are stable in their mental illness and only need assistance with completing various documentation.
- ACM – Administrative Case Managers work with individuals who are stable in their mental illness. Therefore, the caseloads are rather large and staff has minimal contact with their individuals.
- BCM – Blended Case Management is for individuals involved in several community-based services whose mental illness is not as stable and who would benefit from a higher level of consistent support. These case managers are trained to work with individuals for a longer period of time and provide the appropriate amount of assistance based on the needs of the individual at any given time. This contributes to greater continuity of care since the case manager can adjust the level of support without needing to transfer the individual to a different case manager.
Agencies that provide case management services:
TrueNorth Wellness Services provides administrative case management services for individuals who reside in Fulton County and refer individuals to SAM should a higher level of case management be warranted.
Representative Payee
A representative payee is an individual or organization (agency) appointed by the Social Security Administration (SSA) to receive Social Security and/or SSI benefits for someone who cannot manage or direct someone else to manage his or her money. The main responsibilities of a payee are to use the benefits to pay for the current and foreseeable needs of the beneficiary and properly save any benefits not needed to meet current needs. A payee must also keep records of expenses. When SSA requests a report, a payee must provide an accounting to SSA of how benefits were used or saved.
Agencies that provide Representative Payee services:
Residential Programs
Community Residential Rehabilitation (CRR)/Group Home
The full-care CRR site offers supervision and support to consumers on a 24-hour basis and is intended to address the need for intense psychosocial skills training within a structured residential setting. Staff assists the consumers by monitoring medications, assisting with daily living and interpersonal skills development, and generally aiding consumers in making the often-difficult transition of community living.
Supported Living
TrueNorth Wellness Services provides 18 apartments. The adults live independently but have access to support staff 24/7. The support staff assist with teaching traditional activities of daily living such as household maintenance, money management, medication management, health management, nutrition and cooking skill development, etc. Community integration skills, such as accessing transportation, employment, grocery stores, pharmacy, etc., are also developed.
New Visions, Inc. also provides residential supported living apartments in Chambersburg and Waynesboro areas.
Specialized Community Residence (SCR)
The Keystone Specialized Community Residence is an eight-bed facility for adults with serious and persistent mental illness. Per the state-issued license, this program operates under personal care home regulations. An LPN is part of the staff complement and is on site during the day shift.
Additionally, the residential program staff is trained to work with this segment of the population. These two components allow it to be referred to as a specialized residence. The presence of the LPN on staff allows this program to admit individuals with psychiatric and physical/medical conditions which would not be appropriate for facilities without representation by this discipline on staff. Each resident has his or her own bedroom and shares various common areas within this facility.
Long-Term Structured Residence (LTSR)
Through a contractual agreement with Dauphin County Department of Mental Health/Autism/Developmental Programs for bed availability for up to two persons at a time in this 16-bed locked facility, residents of Franklin and Fulton counties are provided with long-term residential services. Residents of this facility are involuntarily committed and may live in this program for as long as is determined to be appropriate by the treatment team.
Individuals who are considered to be appropriate for this program include: persons being discharged from long-term inpatient psychiatric treatment (such as Danville State Hospital) and individuals who are at risk for commitment to either of these long-term inpatient facilities.
Residents of this facility receive case management services through Service Access and Management (SAM).
Family-Based Mental Health Services
Family-Based Mental Health Services (FBMHS) are designed to provide community-based therapy and support services to children and adolescents with emotional and behavioral problems. FBMHS provides therapy in a family’s home by utilizing a two-person team who are under the supervision of a program director.
The goal of the program is to enhance parents’ feelings of empowerment and self-efficiency so they can help themselves and their children become psychologically and financially self-sufficient. The function of FBMHS is to assist families with maintaining their child in the home rather than in a psychiatric or residential facility.
Family members are encouraged to actively participate in assessment, treatment planning, development of treatment goals, and ongoing review of progress. The child, family and FBMHS team work together to develop a plan that is individualized and designed to fit each family’s unique situation.
All services are designed to better circumstances, empower families and prevent out-of-home placement.
Agencies that provide Family-Based Mental Health Services:
Social Rehabilitation
Social Rehabilitation (SR) programs assist persons with mental illness with learning social skills and acquiring supports needed to live in the community.
The goal is for the person with a psychiatric disability to build skills and access the supports needed to function as actively and independently in the community as possible.
Social Rehabilitation is directed at helping persons with mental illness gain or regain practical skills needed to live and socialize in the community. Social Rehabilitation programs provide learning opportunities in areas such as daily and community living skills, healthy diet, personal hygiene, cooking, shopping, budgeting, housekeeping, and use of transportation.
Respite
Respite care is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home.
Respite programs provide planned short-term and time-limited breaks for families and other unpaid caregivers of children with behavioral health issues and/or developmental delays in order to support and maintain the primary caregiving relationship. Respite also provides a positive experience for the person receiving care.
Even though many families take great joy in providing care to their loved ones so that they can remain at home, the physical, emotional and financial consequences for the family caregiver can be overwhelming without some support, such as respite. Respite provides a break for the family caregiver, which may prove beneficial to the health of the caregiver. Respite has been shown to help sustain family caregiver health and wellbeing, avoid or delay out-of-home placements, and reduce the likelihood of abuse and neglect.
Student Assistance Program
Student Assistance Program (SAP) is a process using techniques to mobilize school resources to remove barriers to learning. This service is available for elementary, middle and high school students. The core of the program is a professionally trained team, including school staff and the Mental Health Professional (MHP) from community alcohol and drug and mental health agencies. SAP team members are trained to identify problems, determine whether or not the presenting problem lies within the responsibility of the school, and to make recommendations to assist the student and the parent.
When the problem lies beyond the scope of the school, the SAP team will assist the parent and student so they may access services within the community. The MHP is able to complete a screening for the student’s presenting issues and then assist with making referrals to access services and/or support.
Referrals include outpatient counseling, school-based counseling, psychological/psychiatric evaluations, case management, group counseling, support groups, food banks, assistive technology, coping skills training, etc. The MHP will offer continued support and follow up with the student and his or her family to ensure successful linkage to services.
Crisis Intervention Services
This program provides a 24-hours a day, seven days a week telephone, walk-in or mobile crisis intervention service. The crisis staff provide intervention, assessment, brief counseling and disposition/referral services to individuals presenting themselves in a mental health or substance abuse crisis situation.
Agencies that provide crisis intervention services:
Certified Peer Specialist Program
The Peer Support Services (PSS) program seeks to provide one-to-one support to youth/young adults (14-17 years of age) and adults with mental illness in a way that helps each person achieve his or her full potential. The Peer Support Services program is voluntary. Peer specialists meet with their peers in public environments convenient and familiar to peers. Essentially, it is service provision provided for individuals with mental illness by individuals with mental illness. The peer specialists receive extensive training initially (and receive certification) and then ongoing training thereafter.
Agencies that provide certified peer specialist services:
Community Support Program
Monthly Meetings
Community Support Program (CSP) is a group of recipients of mental health services, family members, mental health professionals and other community members who are working together to help adults with serious mental illnesses and co-occurring disorders live successfully in the community. The cornerstone of CSP is the bringing together of families, friends, professionals and other natural supports into the lives of people with mental illness.
Advocacy
Franklin and Fulton CSP members sit on advisory boards to advocate for persons with mental illness. Fulton CSP is part of a statewide coalition. Over the years, it has achieved a very positive reputation within Pennsylvania.
Community Involvement
Participants have the opportunity to make a meaningful difference in the lives of individuals with serious mental illness and those with co-occurring (mental health/intellectual disabilities or mental health/drug and alcohol) disorders by becoming involved with the Franklin and Fulton County CSP. The Leadership Academy is one of the ways that individuals get to interact with others in the community.
Support
Phone support (Warm Line – those who answer the phones receive ongoing monitoring and training) is provided to members of the local community, which allows the crisis intervention service to focus more exclusively on the individuals who are in crisis. This service provides individuals with a place they can call to speak with someone.
Inpatient Psychiatric Treatment
Inpatient behavioral health provides individualized treatment for patients in crisis. Short-term care is provided for patients with a primary behavioral health diagnosis (mental health) who are not responsive to outpatient treatment. The staff provides a round-the-clock structured and supportive environment and one-to-one supervision for patients who are at risk for harm to self or others. Patients benefit from diagnostic assessment, stabilization and individualized treatment programs.
Agencies that provide inpatient psychiatric treatment:
Supported Employment
Supported employment is employment for individuals with disabilities who are working toward competitive employment in integrated work settings. Employment is based on the individual’s interests, the availability of jobs, and transportation needs.
Support is provided by an employment specialist and is based on the needs of the individual. An employment specialist and the individual work to establish goals that are designed to provide the necessary support for the individual to be successful in employment. Support can be provided throughout the entire employment process.
Transitional Employment
Transitional employment is temporary subsidized employment that allows individuals with a disability who lack work experience, education or training an opportunity to prepare for competitive employment.
Individuals with no or limited work history are able to access job placement and receive on-the-job training and support in the “real world.” A “host” employer provides duties that a group of transitional employment individuals complete under the supervision of a job coach. The individuals receive payment from the transitional employment provider, not the “host” employer.
Vocational Rehabilitation
Sheltered employment is a workplace that provides a supportive environment where a person with a disability can acquire job skills and vocational experience.
Vocational rehabilitation is a service that provides job training to individuals with disabilities. Individuals work with a counselor who develops a service plan with the individual so he or she can reach the highest level of employability. Employment is in-house and individuals’ pay corresponds with their production.
Work adjustment training is a vocational rehabilitation program to develop an individual’s capability, including vocational, social and emotional capabilities to the optimal level. Individuals participate in this program when the outlook for attainment of competitive employment within a short period of time is likely. Individuals are assigned to a counselor and are placed in a competitive-oriented work setting during training. This program is sponsored by the Office of Vocational Rehabilitation and may last up to 16 weeks.
Supporting Individuals Transitioning to Employment Success (SITES)
Supporting Individuals Transitioning to Employment Success (SITES) serves to bridge gaps between case management, vocational rehabilitation, transitional employment and extra employment support programs by providing individuals with another “stepping stone” toward successful competitive employment within the community. The program provides individuals with more intensive guidance and support on targeted issues than is available through other programs.
When participating in other Occupational Services, Inc. (OSI) programs, time limitations due to work demands and confidentiality issues due to program locations prevent intensive, focused guidance in “soft skills” and coping strategies. For those who have not worked for an extended period of time due to severe mental health-related issues or who are coming out of institutional settings, the vocational rehabilitation and transitional employment programs may initially be intimidating or overwhelming. The SITES program provides a physical space separate from the vocational rehabilitation or transitional employment programs that is smaller and accommodates both individual and group activities.
In addition, the maximum group size is six individuals per one staff person at any given time, with a maximum program enrollment of 12. Limits to the program size allow for structured group activities to develop employment readiness skills, as well as more opportunity to receive individualized attention.
