Human Services

Governor's Executive Budget Program Measures

Human Services Support

Online applications submitted through COMPASS

The number of applications submitted online through COMPASS has continued to increase year over year, and that is the desired trend. Every online application reflects a cost avoidance in postage and printing.

Percentage of all applications submitted online through COMPASS

The percentage of applications submitted on-line through COMPASS has dropped slightly after a spike due to COVID-19 and office closures the previous year. The hope is that this percentage remains high as these applications are received (and therefore processed) faster.

Percentage of all COMPASS users who are also using the mobile application

Clients comfortable using COMPASS are most likely to transition to the use of the mobile application. Increased usage of the mobile app offers several cost avoidance measures. Printing and postage can be saved through document uploads and Call Center traffic decreased through checking card balances.

Average number of days to process an application - MA/NH/Waiver, TANF, & SNAP

This is the average number of days it takes to make an eligibility determination on applications for Medicaid coverage, nursing home coverage, and community-based long-term care services. The goal is to timely process an application. There needs to be a balance between getting benefits quickly to eligible recipients and ensuring accuracy in the determination.

This is the average number of days it takes to make an eligibility determination for Temporary Assistance for Needy Families. The goal is to timely process applications. There needs to be a balance between getting benefits quickly to eligible recipients and ensuring accuracy in the determination.

This is the average number of days it takes to make an eligibility determination for Supplemental Nutrition Assistance program. The goal is to timely process an application. There needs to be a balance between getting benefits quickly to eligible recipients and ensuring accuracy in the determination.

Medical Assistance and Health Care Delivery

Persons participating in Medical Assistance (MA) (monthly average) - total, adults (ages 21 and older), & children (under age 21)

This measure is the sum of the monthly average of persons who are enrolled in Medical Assistance. Individuals determined eligible receive physical and behavioral health services through the Medical Assistance (called Medicaid at the federal level) program.

This measure represents the monthly average of adults that are enrolled in Medical Assistance (MA). These adults receive both physical and behavioral health services through the MA program. Most of these adults receive these services through the mandatory HealthChoices managed care program, though some do receive MA coverage through the fee-for-service program.

This measure represents the monthly average of children that are enrolled in Medical Assistance (MA). These children receive both physical and behavioral health services through the MA program. Most of these children receive these services through the mandatory HealthChoices managed care program, though some do receive MA coverage through the fee-for-service program.

Newly Medicaid-eligible adults receiving enhanced federal match under the Affordable Care Act (ACA) (monthly average)

This measure represents the number of adults who are enrolled in Medical Assistance (MA) due to Pennsylvania's expansion of Medicaid eligibility pursuant to the Affordable Care Act, which makes MA benefits available to individuals with incomes higher than traditionally eligible MA recipients. These adults receive both physical and behavioral health services through the MA program. Most of these adults receive these services through the mandatory HealthChoices managed care programs, though some are enrolled in the fee-for-service program.

Emergency room utilization per 1,000 member-months

This measure summarizes utilization of ambulatory care per 1000 member-months for Emergency Department (ED) visits, which represents a rate per 1000 individuals enrolled in HealthChoices in a given month. This is not an inverted measure, so a lower rate is better. The HealthChoices weighted average for this measure has been trending downward, signifying lower ED utilization, which is seen as a positive outcome for HealthChoices enrollees, but the recent large decrease in this rate is due to the COVID-19 public health emergency.

Inpatient utilization (total discharges per 1,000 member-months)

This measure summarizes utilization of acute inpatient care and services for total inpatient stays (including stays related to maternity, surgery, and medicine) per 1000 member-months, which represents a rate per 1000 individuals enrolled in HealthChoices in a given month. Over the last three years, the HealthChoices weighted average for this measure has been trending slightly downward, meaning that HealthChoices enrollees are being hospitalized slightly less, but the recent large decrease in this rate is due to COVID-19 public health emergency.

Percentage of children from birth to 15 months visiting a physician six or more times in the past year

This measure shows the percentage of children who turned 15 months old during the measurement year (January 1st – December 31st) who had six or more well-child visits with a PCP during their first 15 months of life. Overall, the HealthChoices weighted average for this measure has been steadily increasing which is a positive to ensure proactive care for children, but the recent large decrease in this rate is due to the COVID-19 public health emergency.

Percentage of persons ages 2 to 20 receiving at least one dental visit during the measurement year

This measure displays the percentage of members 2 to 20 years of age who had at least one dental visit as of December 31 of the measurement year. A member must have had one or more dental visits with a dental practitioner within the calendar year. Overall, the HealthChoices weighted average has been trending upwards, indicating that more children are receiving dental care, but the recent large decrease in this rate is due to the COVID-19 public health emergency.

Percentage of persons ages 18 to 75 with diabetes (type 1 and type 2) who had Hemoglobin A1c poor control (>9%) (Note: a lower rate equals better performance)

This measure shows the percentage of members 18 to 75 years of age with diabetes (type 1 and type 2) who had a Hemoglobin A1c (HbA1c) testing and HbA1c poor control (>9.0%). This is not an inverted measure, so a lower rate is better. Overall, the HealthChoices weighted average for HbA1c Test has been steady, and the weighted average for HbA1c Poor Control >9.0% has been trending downward, indicating that more HealthChoices members are getting their blood sugar levels under control. However, there has been a recent increase in this rate is due to the COVID-19 public health emergency.

One-way trips provided by the Medical Assistance Transportation Program (MATP)

This measure shows the number of one-way trips provided by the Medical Assistance Transportation Program (MATP), shown in thousands, at an annual unduplicated count. Taking a consumer from their pick-up location to their medical appointment location is considered a one-way trip. Taking a consumer home from a medical appointment is considered a separate one-way trip. Trending has shown a steady increase in the number of trips.

Cost per Medical Assistance Transportation Program (MATP) trip

This measure shows the average cost per MATP trip. The cost per trip includes the administrative costs and transportation costs and is calculated by multiplying the each county's per trip rate bye the number of trips in that county, then adding these amounts for all counties, then dividing by the total number of trips completed. DHS is currently experiencing an increase in the cost per trip due to the guidelines established for the continuing public health emergency decreasing the utilization of Shared Ride trips and instead encouraging consumers to seek reimbursement for personal vehicle usage at a higher rate.

Recipients enrolled in Medical Assistance for Workers with Disabilities (MAWD) program (monthly average)

Medical Assistance for Workers with Disabilities (MAWD) is an eligibility category for Medical Assistance and provides physical and behavioral health medical coverage. Individuals must be working and many pay a premium for their coverage. This program provides critical health care coverage that supports persons with disabilities and allows them to participate in the workforce. For those reasons, we would like to see these numbers grow.

Children's Health Insurance Program (CHIP) enrollment (monthly average)

This measure represents the monthly average of children that are enrolled in the Children's Health Insurance Program (CHIP). CHIP provides health care coverage to children 19 years of age and younger. The total population has decreased since April 2020 due to the COVID-19 public health emergency because as families' income decreases, they become eligible for Medical Assistance. However, even though the total population is decreasing, CHIP continues to enroll approximately 3,000 new children each month. DHS runs annual marketing campaigns to educate Pennsylvanians on CHIP coverage.

Percentage of CHIP-enrolled two-year-olds with one or more capillary or venous blood tests for lead prior to their second birthday

This measure represents the percentage of those children who received a blood lead test prior to turning two, with a higher percentage representing more children receiving the screening. The Children's Health Insurance Program (CHIP) weighted average has been trending up over the past three years (increasing by more than 5 percentage points in calendar years 2019 and 2020), but there is still room for increased rates of blood lead testing. The goal for CHIP is to see an increase of 5 percent per year.

Percentage of CHIP-enrolled children ages 3 to 19 receiving a well-child visit with a PCP

This measure represents the percentage of those children who were seen by a primary care physician for a well child visit, with a higher percentage indicating that more children are receiving well child visits. The Children's Health Insurance Program (CHIP) weighted average has fluctuated in the low-mid 60 percent range for the past few years. The goal for CHIP is to see an increase frequency of well-care visits by 1.5 percentage points per year over the next three years.

Percentage of CHIP-enrolled children ages 2 to 19 receiving an annual dental visit

This measure represents the percentage of those children who received a dental visit during the measurement year. A higher percentage indicates that more children are being seen by a dentist each year. This percentage overall has been steady, but there was a significant drop in fiscal year 2020-21 due to the COVID-19 public health emergency. CHIP's goal is to increase the percentage of children going to the dentist each year.

CHIP-enrolled children ages <1 to 19 utilizing an ED (visits per 1,000 member-months)

This measure summarizes utilization of ambulatory care per 1000 member-months for emergency department visits, which represents a rate per 1000 individuals enrolled in the Children's Health Insurance Program (CHIP) in a given month. This is not an inverted measure, so a lower rate is better. The CHIP weighted average has shown notable trends over the past three years, though the large drop in fiscal year 2020-21 was due to the COVID-19 public health emergency. The goal for CHIP is to see reduction of unnecessary overutilization of emergency department visits by 2.2 percent each year over the next three years.

CHIP-enrolled children ages <1 to 19 with an acute inpatient discharge (discharges per 1,000 member-months)

This measure summarizes utilization of acute inpatient care and services for total inpatient stays per 1000 member-months, which represents a rate per 1000 individuals enrolled in the Children's Health Insurance Program (CHIP) in a given month. This measure identifies all acute inpatient discharges during the calendar year. Overall, the average for this measure has remained steady, though there was a large decrease in fiscal year 2020-21 due to the COVID-19 public health emergency.

Long-Term Living

Number of Long-Term Living recipients receiving institutional care (monthly average)

The number of participants in a nursing facility paid for through fee-for-service, based on the second six months of the state fiscal year. Community HealthChoices (CHC) was implemented in three phases in January 2018, January 2019, and January 2020 (halfway through the state fiscal year). Each zone roll-out would result in a decrease in this number as participants are moved into CHC.

Community HealthChoices - Recipients receiving institutional care (monthly average)

The number of participants in a nursing facility enrolled in Community HealthChoices (CHC), based on the second six months of the state fiscal year. CHC was implemented in three phases in January 2018, January 2019, and January 2020. Each zone roll-out would result in an increase in this number as participants are moved into CHC.

Number of Long-Term Living recipients receiving home and community-based waiver services (OBRA Waiver and Act 150) (monthly average)

The number of participants receiving home and community-based waiver services (HCBS) in fee-for-service, based on the second six months of the state fiscal year. Community HealthChoices (CHC) was implemented in three phases in January 2018, January 2019, and January 2020 (halfway through the state fiscal year). Each zone roll-out would result in a decrease in this number as participants are moved into CHC.

Community HealthChoices - Recipients receiving home and community-based waiver services (monthly average)

The number of participants enrolled in Community HealthChoices (CHC) receiving home and community-based services (HCBS), based on the second six months of the state fiscal year. Community HealthChoices (CHC) was implemented in three phases in January 2018, January 2019, and January 2020 (halfway through the state fiscal year). Each zone roll-out would result in an increase in this number as participants are moved into CHC.

Percentage of Long-Term Living recipients receiving institutional care (monthly average)

The percentage of long-term services and supports (LTSS) participants being served in a nursing facility, based on the second six months of the state fiscal year. The waiver population continues to grow, and as a result, this number continues to decrease. The goal is to serve fewer individuals in a nursing home and allow individuals to receive long-term care supports in their community.

Percentage of Long-Term Living and Community HealthChoices recipients receiving services in the community (monthly average)

The percentage of LTSS participants being served in the community, based on the second six months of the state fiscal year. The waiver population continues to grow, and as a result, this number continues to increase. The goal is to serve fewer individuals in a nursing home and allow individuals to receive long term care supports in their community. Since the implementation of CHC, there has been an increase in the percentage of persons receiving long term supports in their homes and communities.

Persons with developmental disabilities served in the OBRA waiver (monthly average)

The number of participants enrolled in OBRA (a home and community-based program to help people disabilities live in their community and remain as independent as possible, named for the Omnibus Budget Reconciliation Act of 1987), based on the second six months of the state fiscal year. As Community HealthChoices (CHC) was rolled out, OBRA participants who are nursing facility clinically eligible and older than 21 would become eligible for CHC.

Recipients receiving services through the LIFE program (monthly average)

The average monthly number of participants in the LIFE (Living Independence For the Elderly) program, a managed care program that provides a comprehensive, all-inclusive package of medical and supportive services. The program is known nationally as the Program of All-Inclusive Care for the Elderly (PACE). Overall, LIFE is seeing an increase in enrollments and LIFE enrollment would not directly be impacted by the Community HealthChoices roll-out.

Income Maintenance

Persons receiving cash assistance (monthly average)

Temporary Assistance for Needy Families (TANF) cash assistance helps low-income families meet essential needs. Eligibility is based on defined requirements.

Persons receiving State Supplemental Grants (monthly average)

Formerly very low income people, seniors, and people with disabilities who receive Supplemental Security Income benefits approved and authorized by the Social Security Administration were also eligible to receive a supplemental payment provided by our state in order to make up for cost of living differences between Pennsylvania and other states. In addition, the state covers medical benefits for this population through partially subsidized federal dollars. The number of these grants given is gradually trending lower.

Persons receiving Supplemental Nutrition Assistance Program (SNAP) benefits (monthly average)

The Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, provides a monthly benefit to help people purchase groceries. SNAP eligibility is based on income and household size. SNAP is the nation's most important anti-hunger program, providing nine meals for every meal provided by a Feeding America food bank. SNAP primarily helps children, people with disabilities, and seniors. SNAP enrollments are currently increasing due to the COVID-19 pandemic.

Households receiving energy cash payments

The Low Income Home Energy Assistance Program (LIHEAP) helps qualifying households pay home heating costs. This is measured by totaling the number of households to which a cash grant was issued. Energy cash payments have been declining in recent years; the decrease in grants is consistent with many LIHEAP programs across the country. This downward trend may be related to a generally stronger economy and milder weather during the heating season.

Households receiving energy crisis payments

Energy crisis payments available through the Low Income Home Energy Assistance Program (LIHEAP) are grants issued to prevent loss of heat or re-establish heat after it has been lost. A household is eligible to receive multiple crisis payments within a program year, up to the maximum crisis amount. This measure is calculated by totaling the number of households to which at least one crisis grant was issued. Crisis payment needs vary each year based on the costs of fuel, the weather, and if the LIHEAP program provided any supplemental payments to the households.

TANF recipients enrolled in employment and training programs (monthly average)

This measures the monthly number of adults who receive Temporary Assistance for Needy Families (TANF) and are enrolled in employment and training programs. Due to disruptions caused by COVID-19, program participation is projected to remain near current levels and then return to the declining trend it had been following prior to COVID-19.

TANF recipients obtaining employment

This measures those individuals who receive Temporary Assistance for Needy Families (TANF) who obtain employment. TANF recipients obtaining employment reflects a goal in the program to improve clients' lives. An increase in this figure would be positive, but must be considered alongside the overall decline in the TANF population. As most TANF recipients are children, there is a smaller pool of adults that can obtain employment to increase this number.

Mental Health and Substance Abuse Services

Persons receiving mental health inpatient and outpatient services from non-Medical Assistance funding (unduplicated)

This measure includes any individual that received at least one county base-funded mental health services (non-MA) during the specified fiscal year. This measure tracks the number of individuals receiving services through county base-funded mental health (MH). The number of individuals receiving county base-funded MH services has overall decreased in recent years due in part to Pennsylvania accepting the Medicaid expansion beginning in January 2015.

Persons receiving services through Medical Assistance expenditures (fee-for-service and HealthChoices) (unduplicated)

This measure includes any individual that received at least one mental health Medical Assistance (MA) service through either fee-for-service or HealthChoices during the specified year. The number of individuals is increasing due in part to Pennsylvania's Medicaid expansion that began in January 2015 and increased need for medically-necessary behavioral health services for individuals eligible for MA.

Percentage of patients discharged from a psychiatric inpatient setting who have follow-up service seven days from discharge (ages 21 to 64)

This measure tracks individuals discharged from psychiatric inpatient hospitalization services who then received a qualifying follow-up behavioral health services within seven days of the discharge. This performance measure is important as follow up after hospitalization is a key measure that reduces readmission rates for psychiatric hospitalizations and it is considered best practice to have follow up with community-based services from an intensive inpatient hospitalization service. The current target goal is 65 percent follow up after hospitalization rates.

Number of individuals on Medical Assistance with a substance use disorder

This number represents the number of individuals on Medical Assistance (MA) who have a substance use disorder diagnosis. Since MA provides substance use treatment, it is an important resource for those with this diagnosis. With the recent opioid epidemic, there has been an increase of individuals with a substance use disorder.

Non-hospital detoxification and rehabilitation clients

This is a measure that is an unduplicated count of individuals that have received a non-hospital detoxification and/or rehabilitation service. This measure tracks the use of non-hospital residential services which are a less intensive service than inpatient treatment. This measure continues to increase due in part to Pennsylvania accepting the Medicaid expansion beginning in January 2015.

Percentage of patients discharged from a substance use disorder hospital setting who have follow-up services seven days from discharge (ages 21 to 64)

This measure tracks individuals discharged from substance use disorder inpatient hospitalization services who then received a follow-up behavioral health service within seven days of the discharge. This performance measure is important as follow up after hospitalization is a key measure that reduces readmission rates for hospitalizations and it is considered best practice to have follow up with community-based services from an intensive inpatient hospitalization service. The current target goal is 75 percent follow up after hospitalization rates. The trend often fluctuates due to the low number of individuals that receive substance use disorder inpatient hospitalization services.

Persons receiving methadone maintenance services

This measure tracks included individuals that received at least one methadone maintenance service in the specified year. This measure indicates individuals that are being engaged in treatment for substance use disorder needs and specifically for individuals that use opioids. The measure continues to increase with the possibility of the reduced stigma of opioid use disorder.

Persons receiving Behavioral Health services through Medical Assistance expenditures

This measure is the number of unique individuals that received at least one behavioral health service that includes both Medical Assistance (MA) fee-for-service and HealthChoices mental health and/or substance use disorder services. Individuals that received both services will only be counted once. This number provides an accurate depiction of how many individuals are receiving behavioral health services through MA.

Utilization rate of Behavioral Health services

This measure includes the number of unique individuals that received at least one behavioral service that is calculated against the average number of recipients throughout the reporting year. This metric is important to know for network adequacy and provider networks.

Total persons served in state hospitals

This measure calculates the number of individuals in a psychiatric or civil level of care that were in one of the DHS-operated state mental health hospitals for at least one day during the specified reporting year. Individuals in a Pennsylvania mental health hospital are individuals who would have difficulty functioning in the community.

Average cost per person in state hospital population

The average cost per person in the state hospital system. Maintaining services within the Pennsylvania mental health hospital is costly and this measure demonstrates the amount per person. The average cost per person has increased over this time period due to increased health care and labor costs.

Percentage of adults readmitted to state hospitals within 180 days of discharge

The percent is calculated by the number of admissions in a specified reporting year that had a separate state hospital discharge within 180 days of the admission. Readmission rates indicate when an individual who was discharged and returned was not prepared to return to the community. The trend fluctuates due to the low numbers of admissions and therefore readmissions that occur within the reporting year.

Percentage of persons in state hospitals with stay longer than two years

The measure looks at all individuals active to the civil and forensic state hospital levels of care during the fiscal year that includes every individual that was discharged during the year and active at the end of the fiscal year that have had length of stay that is equal to or greater than two years. State hospitals typically have longer length of stays and this measure allows the Office of Mental Health and Substance Abuse Services (OMHSAS) to track those that have stays beyond two years for the purpose of policy changes to reduce the number of individuals staying in a Pennsylvania state hospital for two years or greater. The goal is to decrease this percentage by the state hospital system working with various PA counties to discharge individuals who may be able to get similar treatment in the community.

Intellectual Disabilities

Number of persons receiving autism services

This measure is the total number of adults with autism enrolled in the Adult Autism Waiver or the Adult Community Autism Program at any time during the fiscal year. This measure has a flat trend line and is anticipated to remain flat. For administrative efficiencies, the Office of Developmental Programs (ODP) expanded eligibility to include autism in the Consolidated, Person/Family-Directed Services, and Community Living Waivers beginning in 2017. Growth in availability of services for people with autism will be seen in that program.

Number of persons receiving intellectual disability services

This measure is the total number of people enrolled in intellectual disability/autism (ID/A) services at any time during the fiscal year. All individuals calculated in this measure receive, at a minimum, targeted supports management. The majority receive home and community-based services through base or waiver funding. This measure overall is trending up and is likely to continue to do so. Prevalence data for ID/A indicates that only about a quarter of the population of people potentially eligible are known to ODP.

Persons receiving intellectual disability services during fiscal year: Home and Community Services (Waiver and Base services) (unduplicated)

This measure is the total number of people enrolled in non-institutional (non-intermediate care facility) intellectual disability and autism (ID/A) services at any time during the fiscal year. All individuals calculated in this measure receive, at a minimum, targeted supports management. This measure overall is trending up and is likely to continue to do so. Home and community services are generally preferred to services in intermediate care facilities.

Persons receiving Consolidated Waiver services during fiscal year: Home and Community Services (unduplicated)

This measure is the total number of people with an intellectual disability or autism (ID/A) enrolled in the consolidated home and community-based services (HCBS) at any time during the fiscal year. The majority of individuals in this program live in licensed community homes receiving intensive 24/7 support. This measure overall is trending up and is likely to continue to do so. Home and community services are generally preferred to services in intermediate care facilities and are less costly.

Persons receiving Person/Family Directed Supports Waiver services during fiscal year: Home and Community Services (unduplicated)

This measure is the total number of people with an intellectual disability or autism (ID/A) enrolled in the Person/Family-Directed Services Waiver any time during the fiscal year. Individuals in this program live in private homes, typically with family. Services are aimed at supporting family to continue to care for the individual, building independent living and employment skills. This program offers a very modest service package and trends flat and likely to continue trending flat.

Persons receiving Community Living Waiver services during fiscal year: Home and Community Services (unduplicated)

This measure is the total number of people with an intellectual disability or autism (ID/A) enrolled in the community living home and community-based services waiver at any time during the fiscal year. Individuals in this program live in private homes, typically with family. Services are aimed at supporting family to continue to care for the individual, supported independent living, community engagement, and employment. This program offers a moderate service package and is trending upward and likely to continue trending upward.

Persons receiving Base services during fiscal year: Home and Community Services (unduplicated)

This measure is the total number of people with ID/A enrolled in base or supports coordination services only during the year. Approximately half the individuals in this category are on the waiting list for services in a home and community-based waiver. This measure is trending flat and likely to continue trending flat as both overall ODP enrollment grows but the corresponding home and community-based waiver programs also grow.

Number of individuals receiving services who reside in a private home (not in a provider-controlled setting)

This measure is the total number of people with an intellectual disability or autism that do not reside in an intermediate care facility or licensed or unlicensed residential home during the year. The majority of individuals live with family and receive support through a home and community-based services waiver or base funding. This measure overall is trending up and likely to continue to trend up as the overall enrollment in ODP grows, and generally services are cost effective and people prefer these settings.

Private intermediate care facilities for persons with intellectual disabilities (ICFs/ID)

This measure is the total number of people with an intellectual disability that received services in a private intermediate care facility (ICF) during the year. The goal is for this measure to trend down as generally people prefer home and community-based services an ICF providers downsize facilities and transition people to community services.

State centers

This measure is the total number of people with an intellectual disability that received services in a state center (publicly-operated intermediate care facility) during the year. This measure is trending down and likely to continue trending down. There are few admissions and census has been declining due to deaths (average resident age is 62) and transfers to home and community-based settings. ODP announced a 36-month closure plan for two of the four state centers in 2019.

Number of people moving from private ICFs/ID and state centers into the community

This measure is the total number of people with an intellectual disability that transition from an intermediate care facility (ICF), public or private, to a community waiver during the year. Community services are a cost effective alternative to institutional settings with better quality of life outcomes. This measure is trending up and likely to continue trending up. ODP announced a 36-month closure for two of the four public ICFs in 2019. There are also planned transfers from private ICFs to community programs.

Consolidated Waiver services

This measure is calculated by dividing total expenditures for the Consolidated Waiver by total number of people enrolled in the waiver during the year. This program is for people with an intellectual disability or autism (ID/A) with intensive needs, the majority of whom use 24/7 residential services. The average cost per person is trending up and likely to continue trending up as the enrolled population presents with increasing acuity and people with lower acuity can be served in other ODP waivers.

Person/Family Directed Supports Waiver services

This measure is calculated by dividing total expenditures for the Person/Family-Directed Services Waiver by total number of people enrolled in the waiver during the year. Individuals in this program live in private homes, typically with family. Services are aimed at supporting the family to continue to care for the individual, building independent living and employment skills. The average cost is trending upward.

Community Living Waiver services

This measure is calculated by dividing total expenditures for the Community Living Waiver by total number of people enrolled in the waiver during the year. Individuals in this program live in private homes, typically with family. Services are aimed at supporting family to continue to care for the individual, supported independent living, community engagement and employment. The average cost is trending upward.

Autism services

This measure is calculated by dividing total expenditures for the Adult Autism Waiver by total number of people enrolled in the waiver during the year. Individuals in this program predominantly live in private homes. Services are aimed at providing behavioral support, building independent living and employment skills. The average cost is trending upward.

Number of persons receiving intellectual disability services with an employment goal and receiving employment services

This measure is calculated by subtracting from the total number of people who have identified employment as a goal in their individual plan people who do not receive any employment services from ODP. ODP has a comprehensive Employment First plan which includes training, technical assistance, and service design to incentivize employment. This measure is trending up and likely to continue trending up given the comprehensive plan to increase employment for people with disabilities.

Number of persons receiving intellectual disability services with competitive, integrated employment

This measure is calculated by totaling the number of people from all ODP programs that have competitive integrated employment during the year. ODP has a comprehensive Employment First plan which includes efforts such as training, technical assistance, and service design to incentivize employment.

Human Services

Youth served in Youth Development Center (YDC) and Youth Forestry Camp (YFC) facilities

This measure reports the youth receiving services in youth development center and youth forestry camp facilities in order to develop skills and attitudes that will enable them to become responsible, productive members of society. Pennsylvania’s juvenile justice system is designed to minimize institutionalization except when confinement in a treatment environment is necessary for youth who pose a threat to themselves or others. Recent trends show a decline in youth served due to a decrease in admissions during the COVID-19 pandemic.

Percentage of youth in work experience

This measure shows the percent of all youth receiving services in youth development center and youth forestry camp system facilities who were enrolled in an approved work training program. Participation in these programs provides youth the opportunity to develop vocational skills and earn wages to make reparation to victims and pay court costs in preparation for their return to society. Trends continue to show that approximately 35 to 40 percent of youth are enrolled in these programs.

Annual number of children receiving child welfare services at home (unduplicated)

This measure represents the number of children receiving in-home child welfare services via a county children and youth agency during the fiscal year. The child welfare system works to allow children to remain safely in their own homes and communities through the provision of services to prevent abuse and placement of children out of the home.

Community-based placements

This measure shows the total number of children in the child welfare system whose last placement setting was a group home (but not institution), foster care (kinship, non-relative, and pre-adoptive), or supervised independent living (other). When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible.

Group homes: Community residential programs

This measure shows the total number of children in the child welfare system served in out-of-home placement during the state fiscal year whose most recent placement setting was a group home. When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible, minimizing the use of congregate care settings.

Foster care: Community residential programs

This measure shows the total number of children in the child welfare system served in out-of-home placement during the state fiscal year whose most recent placement setting was foster care. When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible, minimizing the use of congregate care settings.

Other: Community residential programs

This measure shows the total number of children in the child welfare system served in out-of-home placement during the state fiscal year whose most recent placement setting was supervised independent living. When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible, minimizing the use of congregate care settings.

Annual recipients of in-state institutional care programs (unduplicated)

This measure is the total number of children served in foster care during the state fiscal year whose most recent placement setting was an in-state institution. When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible, minimizing use of institutional placements when possible.

Children in out-of-state programs

This measure is the total number of children served in foster care during the state fiscal year whose most recent placement setting was an out-of-state institution. When children cannot remain safely in their homes, the goal is to place them in the most family-like setting as possible within their local community.

Percentage of children reunited with parents or primary caregiver within 12 months of placement

This measure reflects the percent of children removed from the home for the first time who are reunified with their parent/caretaker within 12 months of the removal. When children cannot remain safely in their homes and must enter out-of-home care, the goal is to work to return them home as soon as safely possible.

Percentage of children not returning to care within 12 months of discharge to parents or primary caregivers

This measure reflects the percent of children who are reunified with their parent/caretaker and who do not re-enter foster care within 12 months of reunification. When children are placed out of the home, the county child welfare agency works to provide the services necessary to support a permanent and lasting reunification of the child with the family.

Finalized adoptions

This measure is the number of children discharged from foster care to a finalized adoption during the year. When children in out-of-home placement cannot be safely returned to their families, adoption is the preferred alternative for establishing a permanent family for children.

Children reaching permanency outside of adoption

This measure is the number of children discharged from foster care to a permanent home (excluding adoption) during the year which may include reunification, discharge from care to relatives, or a guardianship arrangement. One of the main goals of the child welfare system is to ensure children achieve permanency so they can remain in stable living arrangements and have life-long supportive connections.

Investigations of reported child abuse

This measure is the number of investigations of child abuse (known as child protective services reports) conducted by county children and youth agencies or the Office of Children, Youth, and Families (OCYF) regional office. Investigating reports of suspected abuse is one of the main responsibilities of the county child welfare agencies and critical to ensuring child safety. There has been a decrease in reports received due to the impact of COVID-19 and school closures because teachers and school staff are among the largest reporters of potential abuse or neglect. Training was provided to help teachers and school staff identify potential abuse or neglect in a virtual environment.

Percentage of child abuse investigations substantiated

This measure represents the percent of investigations of child abuse conducted by county children and youth agencies or the OCYF regional office which are substantiated. Substantiated reports are those in which through investigation or court determination, child abuse was found to have occurred.

Number of child abuse clearances processed

This measure is the number of processed child abuse clearance applications that were submitted manually or through the online self-service portal. Clearances are used to promote child safety by verifying that those working in positions where there is contact with children do not have a history of perpetrating child abuse or committing certain crimes that would preclude them from working with children under state law. The number of processed clearances has been trending upwards recently and is expected to further increase due to the first upcoming five-year renewal period for individuals who were required for the first time to get clearances due to changes in state law enacted in 2014 as well as federally required implementation of a new consolidated clearance for child care providers.

Average number of days to process a child abuse clearance

This measure reflects the average processing time for processed clearance applications that were submitted manually or through the online self-service portal. As receipt of clearances is necessary for certain individuals to start or retain employment, under state law, the department has 14 days to process clearance requests. Processing timeframes have been improving.

Persons receiving homeless services

The Homeless Assistance Program (HAP) serves people in immediate need of shelter or to prevent homelessness for those who are in imminent danger of becoming homeless and helps them to obtain or retain shelter.

Domestic violence victims served

This measure shows the number of persons (adults and children) who received direct domestic violence services. Domestic violence is a serious social problem and has many adverse health impacts on the victims and survivors, as well as negative impacts on our communities. The number of persons served demonstrates an upward trend, with a slight dip due to the COVID-19 pandemic.

Rape crisis/sexual assault victims served

This measure shows the number of persons (adults and children) who received rape crisis/sexual assault services. Sexual violence is a widespread social problem that impacts many people. The number of persons served demonstrates an upward trend, with a dip due to the COVID-19 pandemic.

Breast cancer screening clients

This measure shows the number of clients who received screenings. Breast cancer is the most commonly diagnosed cancer in women, and early detection through screening can increase chances for survival. The number of clients served demonstrates an upward trend, with a decrease in fiscal year 2019-20 due to the COVID-19 pandemic.

Legal service clients

Pennsylvania Legal Aid Network (PLAN) measures results through the number of cases handled by each of its programs as well as the number of individuals served through education, outreach, and advocacy. Cases handled is an important measure because it demonstrates tangible outcomes for clients on critical issues like family law and housing. Both family and housing cases will continue to grow significantly because of the ongoing economic crisis caused by the pandemic.

Child Development

Total children served in subsidized child care during the last month of the fiscal year

This measure represents the number of children enrolled in the commonwealth's subsidized child care program, Child Care Works, during the month of June for each represented fiscal year. The number of children enrolled in services fluctuates throughout the fiscal year and is dependent on availability of funds. The number of children served increases when new funding initiatives intended to reduce the waitlist are included in the enacted budgets, but through the COVID-19 pandemic, there has not been a waiting list for subsidized care.

Percentage of children in subsidized child care enrolled in Keystone STARS level 3 or 4 facilities

This measure represents the percentage of children enrolled in the commonwealth's subsidized child care program, Child Care Works, who are being served in high-quality settings. The commonwealth's quality rating and improvement system, Keystone STARS, works with providers to assess and improve the quality of child care settings. It is a goal of the Office of Child Development and Early Learning (OCDEL) is to continue to grow access to quality care for families enrolled in subsidized child care.

Number of regulated facilities

This measure represents the number of regulated child care facilities in the commonwealth. While new providers open and other providers close constantly, this count has stayed relatively stable over the several years shown. If this number were to suddenly or drastically change, it would be important to understand the potential impacts on accessibility and capacity. In the latter half of fiscal year 2019-20 a number of child care facilities closed due to the COVID-19 pandemic. However, new facilities have also opened.

Percentage of regulated facilities at Keystone STARS level 3 or 4

This measure represents the percentage of regulated child care facilities that are considered high-quality. The commonwealth's quality rating and improvement system, Keystone STARS, works with providers to assess and improve the quality of child care settings. It is a goal of OCDEL to continue to grow access to quality care within the commonwealth.

Children participating in Early Intervention (EI) services

This measure represents the number of children aged 0 to 2 who received early intervention (EI) services during the fiscal year because they were experiencing or were determined to be at risk of developmental delays. As screening and referral practices are improved, this count overall continues to increase annually.

Number of children served (funded slots) in evidence-based home visiting programs

This measure represents the number of slots available for children to be served in evidence-based home visiting programs including: Maternal, Infant, Early Childhood Home Visiting (MIECHV) (federal funding), OCDEL-funded Nurse Family Partnership, Home Visiting Expansion (state funding), and Family Centers. The commonwealth contracts with providers to fund a certain number of slots utilizing all available state and federal funding. The number of slots will increase when initiatives intended to grow these programs are included in the enacted budgets.