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Philadelphia’s Population Health Approach

Dr. Arthur C. Evans, Commissioner

Kimberly Torguson, Director of Communications

BackgroundPhiladelphia’s Department of Behavioral Health and Intellectual disAbility Services

• Administrator for public mental health and addiction service system• Safety Net for 1.5 Million people (capitated for 600K Medicaid recipients)

• Substance use, mental health and intellectual disability services• Children, adult and family services• 200+ providers, full continuum of services• Medicaid managed by the city

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Current Challenges

Clinical Fiscal System

Traditional Treatment Model

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CommunityLife

In this model, clinical care is viewed as one of many resources needed for successful integration into the community.

Recovery Oriented System of Care

Severe Mental Illness

Diagnosable Mental Disorder

Everyone Else

5%

20%

75%

Current Treatment Approach

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Factors that Influence Health Status

HEALTHCARE

LIFESTYLE• Smoking• Obesity• Stress• Nutrition• Blood Pressure• Alcohol• Drug Use

ENVIRONMENT

HUMAN BIOLOGY

10%

19%

20%

51%

Diagnosed

At Risk

Healthy

Population Health Approach

Effective & Efficient Clinical Care

Mitigate Risk &Early Intervention

Keeping People Healthy

PeopleGoal

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Evolution of a SystemEvolution of a System

1st Wave2nd Wave

3rd WaveGetting people into the

community

Helping people to be part of the community

Promoting healthy communities

• De‐institutionalization• Expanding Network of 

Providers• Creating Medicaid 

managed care entity (CBH)• Creating the Dept. & a 

single payor system

• Systematic implementation of a recovery‐oriented system of care

• Promoting recovery, resilience, and self‐determination as a framework for the system

• Creating Learning Organization

• Promoting health & wellness for the population

• Single unifying framework for all services and populations

• Reaching everyone• Efficiency and 

effectiveness• Addressing social 

determinants

System Evolution

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1. Working upstream (Earlier Intervention)

2. Broad set of strategies

3. Working with at risk & healthy  populations 

4. Deliver health promotion interventions

5. Working in non‐treatment settings

6. Health activation approaches 

and empowering others

7. Working at the community level of analysis

7 Conceptual Shifts We needed for a Population Health Approach

Our Population Health Approaches Aim to:

Focus on Prevention and Early

Intervention

Reduce Stigma

Increase Community

Inclusion

Reduce Health Disparities

Boost Mental Health Literacy

Improve Outcomes

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Example: Evidence‐based Practices

• Trauma Initiative – Prolonged Exposure (PE)

• Philadelphia Alliance for Child Trauma Services (PACTS) – Trauma Focused CBT (TF‐CBT) and Child Family Traumatic Stress Intervention (CFTSI)

• Dialectical Behavior Therapy (DBT)

• Ecosystemic Structural Family Therapy (ESFT)

• Partners for Change Outcomes  Management System (PCOMS)

• Beating the Blues

Our EBP Initiatives

500+ THERAPISTS at 60+ PROGRAMS

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Free, Supportive, Comprehensive and Not diagnostic –‘Check‐up from the Neck Up’

Example: In‐person Community Screening Events

Example: Healthy Minds Philly

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• BEyond Expectation Series• Building Brotherhood Mural•Workshops• Town halls

Example: Engaging Males of Color Initiative

First Aiders Trained

Example: Mental Health First Aid

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Example: Porch Light Program

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Example: Porch Light Program

Arthur C. Evans J

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“It gave addiction

and recovery a real voice.”

– Michael

Coming Together…

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Thank you!

DBHIDS.org  ●Healthymindsphilly.org