CITY OF PHILADELPHIA
BEHAVIORAL HEALTH SYSTEM

A Brief History

TIMELINE: CREATION OF THE BEHAVIORAL HEALTH SYSTEM

1986	The Office of Mental Health is awarded the Robert Wood Johnson Grant to explore the feasibility of a unified system and to develop a broad range of services for people with mental illnesses. In the subsequent years, OMH develops new program initiatives, analyzes Medicaid data, and meets regularly with the provider community to conceptualize a unified system.
1990	Philadelphia State Hospital closes and OMH, in conjunction with consumer/family groups, providers, and advocates, successfully lobbies the State to transfer $60 million from the hospital closure to the City for the development of new services for people formerly institutionalized. This is the first step in realizing a unified system and represents the integration of two of the three funding streams.
1992	The Department of Public Health and its two departments, the Office of Mental Health and the Office of Addiction Services, initiate discussions with the Pennsylvania Department of Public Welfare about the City managing the Medicaid behavioral health dollars. Staff is hired to lead a managed care initiative.
1994	Community Behavioral Health is incorporated in anticipation that the City will eventually manage the Medicaid dollars. Pennsylvania issues an RFP, HealthChoices, which requires Medicaid recipients living in Philadelphia and the surrounding counties to enroll in managed care plans. In the proposed RFP, the State would contract with HMOs which would be responsible for both the physical health services as well as the behavioral health services. HMOs would then subcontract out the behavioral health services to behavioral health managed care organizations.
1995/ 1996	Philadelphia begins discussions with the HMOs to be their subcontractor. Difficulties are encountered. The City changes its strategy and in conjunction with advocacy groups, providers, consumers, and the surrounding counties covered by HealthChoices persuades the State to separate physical health care from behavioral health and give each county the right to implement the behavioral health contract directly by establishing its own managed care organization or subcontracting with a private sector behavioral health organization.
1997	Philadelphia is awarded the Medicaid behavioral health managed care contract. The Behavioral Health System becomes operational - the Health Department oversees Community Behavioral Health, Office of Mental Health, Office of Addiction Services, and infrastructures are established which ensure coordination between clinical and fiscal staff of each component.
1998	After its first year of operation, the Pennsylvania Department of Public Welfare favorably evaluates both CBH and the City's implementation of a unified system of care, noting that "CBH's senior management demonstrated a solid understanding of the need to balance service to consumers with fiscal responsibility."
1999	Philadelphia's Behavioral Health System receives national recognition and a $100,000 grant for its unique approach as winner of the 1999 Innovations in American Government Award. The award showcases programs that have taken a fresh approach to a problem in government. Philadelphia's Behavioral Health System competed for the award with more than 1600 other local, state and federal governments, and distinguished itself as a leading example of a government agency tackling a tough situation.