Priority Setting for Philadelphia's Next Behavioral Health Commissioner

By Joe Pyle & Cherie Brummans

After almost six years of service as commissioner and deputy commissioner of the Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), Dr. Jill Bowen stepped down on April 15, 2024. With the mayor’s desire to improve access to treatment in Kensington and beyond, the change of leadership for the $1.7 billion department is absolutely critical. Philadelphia is simultaneously experiencing countless challenges‭, ‬including gun violence‭, an ‬overdose epidemic, rising rates of ‬suicide‭, ‬homelessness‭, ‬and pervasive exposure to traumatic stress among children‭. Communities are vulnerable and strong leadership is critical to our collective resilience. 

As we look toward the future of behavioral health, intellectual disabilities and autism services in Philadelphia, the new commissioner must be ready to tackle complex problems so that all Philadelphians can achieve optimal health and wellness. The Scattergood Foundation and Alliance for Community Service Providers hope that new leadership for DBHIDS will embrace:

Data-driven decision-making. The new commissioner must evaluate the existing provider network to understand accessibility of treatment options and quality of care. They should draw on existing Community Behavioral Health (CBH) data and other sources examining social determinants of health—the conditions in places where people live, learn, work, and play that impact wide-ranging health outcomes—to better understand the risks, and how we can use existing community assets to meet needs. Utilizing data effectively and disaggregating data by race and ethnicity can help DBHIDS allocate funds wisely and equitably across all communities. 

Focusing on greater accountability. The need for oversight was laid out in a July 2021 report by the City Controller. The new commissioner should seek the initiation and expansion of pay-for-performance and value-based purchasing models, in which providers can receive incentive payments for high-quality and cost-efficient services. In addition, the Department should increase transparency in data reporting and metrics as a way of elevating service quality and holding the system to the highest standards.

Additionally, the new commissioner should diversify the DBHIDS advisory board and CBH Oversight Board to engage people who use services, their family members, behavioral and physical health providers, city and private employers, workforce development agencies, and academic and community partners.

Collaborating across systems. The new commissioner must work with the new Mayor to break down silos. They should allocate staff time toward coordination, and create strategic data sharing across all Health and Human Services Departments, the Police Department, the School District, etc.

Investing  in the workforce. Quality treatment begins with a well-trained, highly skilled, and diverse workforce that can address the evolving needs of Philadelphians. Solutions must include augmenting pay for providers through immediate and increasing rates and long-term strategies for sustainable payment methodologies within CBH. Diversity is critical in building a culturally and linguistically accessible workforce, especially for individuals from oppressed and marginalized identities. 

Peer specialists are vital assets to the workforce, but remain underutilized. These positions should be valued, paid a living wage, and have equal opportunities for advancement.There are many opportunities to embed peer specialists outside of DBHIDS, ‬as seen in the Same Day Pay programs and others.

Strengthening prevention, well-being, and recovery supports. The new commissioner must build upon these efforts to strengthen assets for all Philadelphians. Including but not limited to:

• Pursuing ongoing coordination for crisis services and linkages to support networks to harness the national momentum, attention, and funding support for the 988 crisis line in Philadelphia.
• ‬Enhancing access to and supporting effective services for individuals with substance use disorders‭, ‬including identifying places and spaces where they can‭ ‬be served. Continuing to support and expand unique programs that promote collective and individual recovery like Mural Arts‭, ‬First Person Arts‭. 
• Maximizing the use of innovation and technology to support individuals through home and community based services whenever possible‭.‬

The Scattergood Foundation and the Alliance of Community Service Providers remain steadfast in our commitment to partnering with DBHIDS, the Mayor’s Office, providers, and the community to implement these recommendations for the well-being of all Philadelphians.

Joe Pyle is the President of the Scattergood Foundation. Cherie Brummans is the Executive Director of the Alliance of  Community Service Providers.