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R. Benjamin Wiley has led the Greater Erie Community Action Committee (GECAC) in Erie, Pennsylvania, since 1969, creating a wide range of human services programs. His passion for education is reflected in the GECAC Learning Center, which offers numerous training and educational programs for residents of all ages, and in the GECAC Community Charter School for at-risk children. (SV)

Describes a two-year (1983-1985) systems study of the human services provided adolescents aged 10-17 and their families in one rural Pennsylvania community. Describes teacher/student survey, human services utilization survey, case reviews, and development of community-based advocacy plan. Discusses study's impact on local human services network and resultant changes. (LFL)

A project to sponsor town meetings in Cambria County, Pennsylvania, to permit residents in isolated areas to express their concerns about delivery of human services and to make contact with others with similar concerns, is described. The description includes the project's rationale, purpose and goals, format, and evaluation. (KR)

The Balanced Service System specifies functions required to eliminate mental disabilities and environments in which services can be provided. The model was tested in western Pennsylvania. Although the number of agencies serving the mentally ill doubled between 1960 and 1976, relative availability of each service component remained stable. (Author/BEF)

A comprehensive, whole-person approach to individuals' health care can be achieved by aligning, integrating, and coordinating health services with other human services. HealthChoices, Pennsylvania's managed Medicaid program, delegates responsibility for Medicaid-funded behavioral health service management to individual counties or multicounty collaboratives. County administrators' programmatic and fiscal oversight of Medicaid-funded services allows them to create synergies between behavioral health and other human service delivery systems and to set priorities on the basis of local needs. This model supports access to community-based care, integration of general medical and behavioral health services, and programs that address social determinants of health. [ABSTRACT FROM AUTHOR]

The article discusses the legal issues on child abuse cases in Pennsylvania, particularly on whether a perpetrator who entered the Accelerated Rehabilitative Disposition (ARD) program should be given the right to be heard. Also cited are the case J.F. v. Department of Human Services (DHS) in which the court ruled that suspects are entitled to administrative hearing regarding a founded report and the laws used in the case like he state's Domestic Relations statute.

Energy efficiency and conservation (EE&C) programming operates through a complex network of governments, utilities, not-for-profits, and human service organizations. The function of these networks and how clients are potentially disadvantaged by ineffectiveness and inefficiency is unclear. This study uses EE&C programming in Pennsylvania to understand the related collaborative governance challenges. It demonstrates the benefit of collaborative governance theory for identifying barriers and opportunities to EE&C network function and draws from experts within the network to identify each. It concludes with future research directions and the policy implications of mistrust and loose coordination within EE&C networks. • Energy efficiency and conservation (EE&C) programs are now ubiquitous across different levels of government. • Effective EE&C program implementation requires significant collaboration among public and private actors. • Collaborative challenges include the system context, principled engagement, shared motivation, and capacity for joint action. • Collaborative opportunities include regulation, resources, and implementation. [ABSTRACT FROM AUTHOR]

Health system data incompletely capture the social risk factors for drug overdose. This study aimed to improve the accuracy of a machine-learning algorithm to predict opioid overdose risk by integrating human services and criminal justice data with health claims data to capture the social determinants of overdose risk. This prognostic study included Medicaid beneficiaries (n = 237,259) in Allegheny County, Pennsylvania enrolled between 2015 and 2018, randomly divided into training, testing, and validation samples. We measured 290 potential predictors (239 derived from Medicaid claims data) in 30-day periods, beginning with the first observed Medicaid enrollment date during the study period. Using a gradient boosting machine, we predicted a composite outcome (i.e., fatal or nonfatal opioid overdose constructed using medical examiner and claims data) in the subsequent month. We compared prediction performance between a Medicaid claims only model to one integrating human services and criminal justice data with Medicaid claims (i.e., integrated model) using several metrics (e.g., C-statistic, number needed to evaluate [NNE] to identify one overdose). Beneficiaries were stratified into risk-score decile subgroups. The samples (training = 79,087, testing = 79,086, validation = 79,086) had similar characteristics (age = 38±18 years, female = 56%, white = 48%, having at least one overdose = 1.7% during study period). Using the validation sample, the integrated model slightly improved on the Medicaid claims only model (C-statistic = 0.885; 95%CI = 0.877–0.892 vs. C-statistic = 0.871; 95%CI = 0.863–0.878), with small corresponding improvements in the NNE and positive predictive value. Nine of the top 30 most important predictors in the integrated model were human services and criminal justice variables. Using the integrated model, approximately 70% of individuals with overdoses were members of the top risk decile (overdose rates in the subsequent month = 47/10,000 beneficiaries). Few individuals in the bottom 9 deciles had overdose episodes (0-12/10,000). Machine-learning algorithms integrating claims and social service and criminal justice data modestly improved opioid overdose prediction among Medicaid beneficiaries for a large U.S. county heavily affected by the opioid crisis. [ABSTRACT FROM AUTHOR]

In this paper, I conduct a case study on the Allegheny Family Screening Tool (AFST), a risk assessment tool used by child protection services in Allegheny County, Pennsylvania. First, I will review the implementation, use, and impact of the AFST on screening decisions from both a technical and ethical standpoint. Then, I will consider a point of contention in the public debate surrounding the tool: a charge of discrimination against certain groups by the tool. I argue that the tool is not wrongfully discriminatory by offering conditions for wrongful discrimination and applying it to the context surrounding a child welfare decision.security to the U.S., but rather have avoided military development for other normative or institutional reasons. And it suggests that scholars should look to paradigms other than realism to explain the behavior of these and other security outliers. [ABSTRACT FROM AUTHOR]

With an increasing need for social innovations that rely on cross-sector partnerships, traditional ways of managing and leading human service nonprofits are undergoing rapid changes. Utilizing a qualitative, grounded theory approach, with data collected from a sample of nonprofit leaders of human service organizations in Pennsylvania, USA (n = 31), the research findings identify clear characteristics of leadership that support undertaking social innovations. Respondents characterized leadership orientation and responsibilities in relation to the demands of blending across sectors and roles within organizations. Findings from this study provide key insights into areas of leadership development that may lead to effective partnerships and stakeholder engagement to better support social innovations. [ABSTRACT FROM AUTHOR]

Objectives. To improve public health surveillance and response by using spatial optimization. Methods. We identified cases of suspected nonfatal opioid overdose events in which naloxone was administered from April 2013 through December 2016 treated by the city of Pittsburgh, Pennsylvania, Bureau of Emergency Medical Services. We used spatial modeling to identify areas hardest hit to spatially optimize naloxone distribution among pharmacies in Pittsburgh. Results. We identified 3182 opioid overdose events with our classification approach, which generated spatial patterns of opioid overdoses within Pittsburgh. We then used overdose location to spatially optimize accessibility to naloxone via pharmacies in the city. Only 24 pharmacies offered naloxone at the time, and only 3 matched with our optimized solution. Conclusions. Our methodology rapidly identified communities hardest hit by the opioid epidemic with standard public health data. Naloxone accessibility can be optimized with established location-allocation approaches. Public Health Implications. Our methodology can be easily implemented by public health departments for automated surveillance of the opioid epidemic and has the flexibility to optimize a variety of intervention strategies. [ABSTRACT FROM AUTHOR]

Background and aims Uncertainty about optimal treatment duration for buprenorphine opioid agonist therapy may lead to substantial variation in provider and payer decision-making regarding treatment course. We aimed to identify distinct trajectories of buprenorphine use and examine outcomes associated with these trajectories to guide health system interventions regarding treatment length. Design Retrospective cohort study. Setting US Pennsylvania Medicaid. Patients A total of 10 945 enrollees aged 18-64 years initiating buprenorphine treatment between 2007 and 2012. Measurements Group-based trajectory models were used to identify trajectories based on monthly proportion of days covered with buprenorphine in the 12 months post-treatment initiation. We used separate multivariable Cox proportional hazard models to examine associations between trajectories and time to first all-cause hospitalization and emergency department (ED) visit within 12 months after the first-year treatment. Findings Six trajectories [Bayesian information criterion (BIC) = −86 246.70] were identified: 24.9% discontinued buprenorphine < 3 months, 18.7% discontinued between 3 and 5 months, 12.4% discontinued between 5 and 8 months, 13.3% discontinued > 8 months, 9.5% refilled intermittently and 21.2% refilled persistently for 12 months. Persistent refill trajectories were associated with an 18% lower risk of all-cause hospitalizations [hazard ratio (HR) = 0.82, 95% confidence interval (CI) = 0.70-0.95] and 14% lower risk of ED visits (HR = 0.86, 95% CI = 0.78-0.95) in the subsequent year, compared with those discontinuing between 3 and 5 months. Conclusions Six distinct buprenorphine treatment trajectories were identified in this population-based low-income Medicaid cohort in Pennsylvania, USA. There appears to be an association between persistent use of buprenorphine for 12 months and lower risk of all-cause hospitalizations/emergency department visits. [ABSTRACT FROM AUTHOR]

The article discusses the role of legal advocacy as a catalyst for change in relation to the housing policies in the city of Philadelphia, Pennsylvania as of March 2013, focusing on the work of the Regional Housing Legal Services and Community Legal Services groups in Pennsylvania on behalf of domestic violence victims in landlord-tenant matters. The U.S. Violence Against Women Act of 2005 and city ordinances are addressed, along with federally-subsidized housing in America.

Abstract: A sample of 301 Philadelphia adolescents were assessed for substance use and place-based social network quality, a weighted variable based upon risky and protective behaviors of alters. The network measure was anchored in routine locations identified as safe, risky, important, or favorite. Results show young females'' (13–16) substance use was strongly associated with their place-based social networks compared to older females (17–20) and compared to young and older males. Younger females'' protective networks reduced their likelihood of substance use compared to females with risky networks (OR=.94, CI=.89–.99, p <.05), while young males experienced no protective network effects. Older females'' protective networks reduced the likelihood of substance use compared to those with risky networks (OR=.96, CI=.93–.99, p <.005). Older males'' protective networks also reduced their likelihood of substance use (OR=.86, CI=.74–.99, p <.05). Results highlight the varying affects of place, gender, and age on adolescent social network protection and associated risk for substance use. [Copyright &y& Elsevier]

Objective: Adolescents, elderly persons, African Americans, and rural residents with bipolar disorder are less likely than their middle-aged, white, urban counterparts to be diagnosed, receive adequate treatment, remain in treatment once identified, and have positive outcomes. The Bipolar Disorder Center for Pennsylvanians (BDCP) study was designed to address these disparities. This report highlights the methods used to recruit, screen, and enroll a cohort of difficult-to-recruit individuals with bipolar disorder. Methods: Study sites included three specialty clinics for bipolar disorder in a university setting and a rural behavioral health clinic. Study operations were standardized, and all study personnel were trained in study procedures. Several strategies were used for recruitment. Results: It was possible to introduce the identical assessment and screening protocol in settings regardless of whether they had a history of implementing research protocols. This protocol was also able to be used across the age spectrum, in urban and rural areas, and in a racially diverse cohort of participants. Across the four sites 515 individuals with bipolar disorder were enrolled as a result of these methods (69 African Americans and 446 non-African Americans). Although clinical characteristics at study entry did not differ appreciably between African Americans and non-African Americans, the pathways into treatment differed significantly. Conclusions: Rigorous recruitment and assessment procedures can be successfully introduced in different settings and with different patient cohorts, thus facilitating access to high-quality treatment for individuals who frequently do not receive appropriate care for bipolar disorder. [ABSTRACT FROM AUTHOR]

The article discusses a study comparing the Cooperative Extension System (CES) educators' perception of community readiness, knowledge of prevention science and experience with community collaborations with that of the perceptions of community human service professionals. Participants of the study include CES educators and human service professionals in 28 communities within Pennsylvania and Iowa that are involved in Promoting School-Community-University Partnerships to Enhance Resilience (PROSPER) program. Results of the comparison show that CES educators and human service professionals share similar perceptions regarding community readiness for prevention programs as well as having similar involvement, success and effectiveness in community collaborations.

Nonprofit managers often report difficulties in hiring and retaining top-quality professional staff members. The goals of this study were to assess the seriousness of the problems and to identify some best practices that can be used by nonprofit managers. The study focused on small and mid-sized nonprofits in the human service and community development fields in Allegheny County, Pennsylvania. Although the problems identified were not of crisis proportion, organizations faced particular difficulties in hiring and retaining staff members in information technology and development. Use of contemporary recruitment techniques, including the Internet, was surprisingly limited, but some organizations had creative approaches to retaining valued employees. [ABSTRACT FROM AUTHOR]

Describes models of citizenship services offered by the Jewish community in Philadelphia, Pennsylvania. Impact of welfare reform in expanding citizenship services; Models of service since 1996; Assistance to the disabled and homebound elderly.

Discusses impending study of Pennsylvania's Voluntary Benefits Program (VBP) and the latest grants designed to help consumers, the elderly, physically disabled and minorities in select states in the United States to obtain access to health care and long-term care. Legal status of the VBP and its likely impact on statewide efforts to increase voluntary organ donation.

The pattern of human service facilities in Philadelphia affects and is affected by the distribution of poor, nonworking households who use those facilities. Spatial linkages arise because clients need to be close to support facilities. Service providers seek to locate facilities in areas most accessible to potential users. Minimal cash incomes of service-dependent households and budget limitations of service agencies constrain service-dependents and facilities to Philadelphia's oldest and most deteriorated neighborhoods. Ghettoization of the nonworking poor and their support services in the inner city is most likely detrimental to the service-dependent themselves and in addition acts as a barrier to urban revitalization. [ABSTRACT FROM AUTHOR]

The article focuses on the public assistance caseload explosion during the late 1960's which occurred during a period of economic prosperity and low unemployment. But it is argued that the most plausible explanation for the dramatic rise in the public assistance caseload can be found in changes in the statutory provisions governing public assistance cash benefits and in certain policies of the Pennsylvania Department of Public Welfare. Those with the institutional view hold that in a modern, complex, and industrialized society the economy and family will always be inadequate to provide for the public welfare of all citizens. A highly dynamic economy is constantly reordering the work force, making many workers obsolete or marginal for long periods. Technological change, lack of training, support for the disabled, and increasingly long life for the aged, also create relatively permanent dependent groups. Events such as those depicted here are commonly misunderstood as evidence of the ineffectiveness of public organizations. The call is out for the introduction of improved management practices.

Project Outreach was a specially designed crisis intervention program funded by the National Institute of Mental Health following the devastating 1972 Agnes flood disaster in the Wyoming Valley of northeastern Pennsylvania. The project was in operation for 32 months and employed 60 individuals primarily specially trained, indigenous nonprofessionals. Utilizing a neighborhood canvassing effort, Human Service Counselors encountered individuals with a wide range of problems ranging in severity and difficulty from those requiring limited assistance from community resources to those involving the need for direct mental health services. Over 25,000 client contacts were made. The project demonstrated that a cadre of local residents can be recruited, selected, and trained within a very short period of time to provide crisis intervention services to disaster victims. Further, Project Outreach has shown that an active, community-based, outreach/case-finding effort can be a highly effective approach in dealing with the problems of disaster victims. [ABSTRACT FROM AUTHOR]