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00:12 - Hi, I'm Lisa Schaefer, Executive Director.

00:15 - Welcome to County Connections,

00:17 - a show spotlighting county governments involvement in your everyday life.

00:21 - We're here today to talk about two of county's top legislative priorities

00:25 - for 2024, spotlighting mental health issues in mental health funding

00:29 - and our juvenile detention capacity crisis.

00:32 - Joining me in the studio here today is Northampton County Commissioner

00:36 - Laurie Vargo.

00:37 - HEFFNER Laurie, thanks so much for being with us today.

00:40 - Thanks for having me.

00:41 - You know, I think

00:41 - you have a really unique perspective when we talk about mental health issues

00:44 - because you're not only a commissioner, but you're also a mental health provider.

00:47 - So can you tell us a little bit about what you're seeing

00:50 - in terms of mental health needs among our Pennsylvania residents?

00:53 - Sure.

00:54 - I'm currently employed as a

00:56 - psychotherapist at St Luke's University Health Network. And

01:02 - the changes that

01:03 - have occurred in mental health over the past few years, post COVID

01:06 - and then over the span of my career, which is much longer than COVID,

01:10 - are so incredible.

01:13 - We have such long waiting lists for service.

01:18 - We have

01:20 - so many more constituents that need care and want care.

01:24 - And it's sometimes difficult to fill the need.

01:27 - I'm blessed in my organization that we have a full continuum of care

01:31 - and that sort of parallels what the counties provide because counties

01:35 - also have a full continuum of services, starting from early intervention,

01:40 - ages 3 to 5 and then on up to the aging.

01:43 - But all of those constituents in different capacities need services,

01:47 - and counties are required to provide all of those.

01:51 - So recently

01:54 - it's just been more difficult with more and more constituents

01:58 - needing the services, less people able to provide them.

02:01 - It's creating longer wait times and then gaps in service.

02:06 - So when you're seeing those longer wait times that need for services,

02:09 - what happens to those people?

02:11 - What where do we see that that come out?

02:13 - And we see it in our jails?

02:15 - Do we see in emergency rooms?

02:17 - What's happening to those folks? They can't get services.

02:19 - I think a couple of different things happen.

02:22 - I think some folks

02:25 - and that with more emergency room

02:27 - visits in crisis and then have wait times for like the continued services,

02:32 - I think some folks end up in inpatient because they weren't seen soon enough.

02:37 - And so we didn't take care of it when it was a small problem.

02:41 - And now it's a more serious or more

02:44 - critical care issue.

02:48 - Some folks who are seriously and persistently mentally ill may end up

02:52 - in some of the criminal justice systems because they're not getting the care.

02:56 - They're not in the continuum.

02:58 - Sometimes it's an accessibility or an affordability issue.

03:01 - And so they may end up

03:04 - in a situation where they commit a crime or they get picked up

03:08 - for loitering or something, or even if they're just off their meds

03:12 - and they're off balance and they're perceived as having a problem,

03:16 - or once they get that adjustment made, they're back to functioning citizens.

03:21 - But in the meantime, the jails are getting more and more filled

03:25 - with people who have persistent mental illness issues.

03:30 - You mentioned

03:31 - a few months ago the county responsibility to provide mental health services.

03:35 - So prior to this current fiscal year, counties hadn't seen an increase in state

03:40 - funding for mental health services for about 15 years.

03:44 - This year we saw an increase in about 20 million.

03:47 - Did that help? Does that move the needle?

03:49 - What comes next?

03:51 - I think it supports what we're doing, but I don't think it moves

03:56 - the needle very far, far because we're so far behind

04:00 - that that's not going to help us catch up.

04:06 - I also think that,

04:09 - again, it's not like we're

04:10 - just going to take care of X problem, okay?

04:13 - We're going to fund all the children.

04:16 - Well, that's great.

04:17 - What about everybody else?

04:19 - We're going to fund schools.

04:20 - I know $100 million was given to schools last year, and that's great.

04:25 - But then what happens when those children go home from school?

04:28 - What happens if they have a family member who has the illness?

04:31 - What if part of what identified them in the school is somebody else's

04:35 - concerns in the family?

04:36 - So the immediate need gets met and they get a little bit of an

04:40 - intervention, but they don't get a big intervention.

04:42 - So I think more money is needed to fill and maintain

04:46 - the services that have already been set up in the structure

04:49 - because the structure has been there for a long time.

04:51 - It's just that we can't keep filling the needs

04:55 - if we don't have the funds and also

04:57 - if we don't have the people to provide the services.

05:00 - So what you're saying is we need a big picture.

05:02 - Look at the mental health system, not just one piece of it or another.

05:06 - I think so.

05:07 - I think the way I like to look at it is it's a continuum of care.

05:11 - You can't just treat Lisa with depression.

05:15 - You have to look at if there's a child that has some

05:19 - some needs, if there's somebody in school, if there's young adults or teenagers

05:24 - with transitional issues, are there veterans with problems?

05:29 - Are there people who are just in crisis but they could use some other companion

05:32 - services?

05:33 - AM I dealing with the spouse or a parent and am I dealing with an aging person?

05:38 - So there's so much more to treat.

05:42 - And I think counties are well-poised to do that.

05:45 - Like I said, the funding needs to be there and I know that agencies have it

05:49 - and we contract with a lot of agencies too.

05:52 - But if they don't get the funding they need,

05:53 - they can't stay open to be able to offer those things that we need.

05:59 - So when you look toward your own county, so you're kind of merging

06:02 - your your personal, your day life and you and your commissioner life.

06:06 - You know,

06:06 - you mentioned a lot of different services in a lot of different needs just now.

06:10 - How would your county be able to use an increase in funding if that was to happen?

06:15 - I'm sure that it would keep

06:18 - most of the services that we have in place.

06:20 - It would probably allow us to increase the numbers of people we serve

06:24 - and hopefully get those wait times shorter

06:28 - so that they're not waiting as long to get into the system.

06:32 - I know that one thing our county is specifically doing

06:34 - and we may touch on this.

06:36 - I think we did touch on this.

06:38 - We've opened a long term residential treatment center

06:43 - that is going to be doing assessments for court competency.

06:48 - So some of those folks with mental illness can be assessed prior

06:52 - to getting into jail or in lieu of jail so that we could see if they really did

06:57 - commit a crime or if was it a mental health issue.

07:01 - So I think more programing like that coming into fruition

07:04 - would be really helpful.

07:05 - And I'm excited that we finally have that.

07:08 - Because I guess, you know, the jail setting isn't really conducive

07:12 - to someone who has a mental health issue, to them getting the best treatment

07:16 - to improving their condition.

07:18 - So being able to provide those services and maybe divert them

07:22 - if they if the situation is warranted, can help improve outcomes for everybody.

07:26 - Absolutely.

07:27 - And if, again, there were these outpatient programs or community based programs

07:31 - where people could go and get their psychiatric needs met,

07:35 - get some counseling, be part of some groups,

07:37 - get some social work services to to meet some of their housing needs

07:42 - or their food needs, then maybe they wouldn't end up

07:45 - in the criminal justice system because most of them don't belong there.

07:49 - The other thing is, when they get into the criminal justice system, it costs a lot

07:53 - because they're getting services that they haven't had while they were not there.

07:57 - Especially when I think about folks that have gone without medication

08:01 - for such a long time.

08:03 - They get into the criminal justice system,

08:05 - they get medicated, they get back up to a functioning level.

08:09 - And then when they're released,

08:10 - they don't have access to continue with those medications.

08:14 - So they'll just been back in the system again.

08:17 - So it

08:18 - sounds like, you know, an increase in funding could really have a significant

08:21 - return on investment for counties, for communities and for people.

08:26 - I believe so.

08:27 - And I guess mental health,

08:31 - mental illness, it's not a crime.

08:34 - More and more people have it, I think,

08:37 - you know, I guess I wouldn't even try to come up with a statistic.

08:41 - There are a number.

08:42 - I just know in my experience, you'd be surprised at how many people

08:46 - have something like this in their family or something like that within themselves.

08:50 - And I think that it cuts across all continuance,

08:54 - all economic levels,

08:57 - all social levels.

08:58 - I think it absolutely would provide a return on investment, and I think

09:03 - it would help support the greater goals of people in Pennsylvania overall.

09:08 - If we started to treat these things more seriously and put the funds in the system.

09:13 - So if you had a final message to about the need for mental health funding

09:18 - and the work that the counties are doing, what would that be for our viewers.

09:22 - That mental health

09:25 - services are needed continuously,

09:27 - that this money is not an entitlement, it's not something

09:31 - that should be seen as a problem that's going to go away.

09:35 - But the more that we can address it and even start to address it

09:38 - at a prevention level,

09:39 - we can make it better for most citizens across the state of Pennsylvania.

09:44 - And that's really all that we all want to be able to make lives better.

09:47 - That's what I think.

09:48 - That's why I've been doing it for as long as I have.

09:51 - All right.

09:51 - Thank you for your time here

09:52 - with us today, for sharing your experience as a provider and as a commissioner.

09:56 - We'll be back in just a few moments to talk more about the juvenile detention

10:00 - capacity with Clinton County Commissioner Jeff Snyder.

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10:36 - Welcome back to County Connections, where we're here

10:38 - talking about county's top priorities for 2024.

10:42 - Next up, we're going to talk about the juvenile detention capacity crisis.

10:45 - And joining me in the studio is Clinton County Commissioner Jeff

10:48 - Snyder, who also chairs Keycaps Courts and Corrections Committee.

10:51 - Welcome, Jeff. Thanks for having me.

10:53 - So juvenile detention capacity crisis, that's a mouthful.

10:57 - So let's try to break it down a little bit for

10:59 - for the folks who are watching this show.

11:01 - What responsibility do counties have for juveniles who are involved

11:05 - with the criminal justice system?

11:06 - Once juveniles get involved in the criminal justice system, it comes

11:10 - back to the counties are responsible for delivering all the services

11:14 - that they need in a timely fashion for a community based

11:20 - services for all of their needs.

11:23 - And that comes to

11:26 - housing them in a safe environment.

11:29 - So is that we mean by juvenile detention?

11:31 - Is housing them?

11:32 - That's part of it, yes.

11:34 - So so what else do we need to know about juvenile detention?

11:37 - Juvenile detention includes the services that they need

11:40 - while they're there, and that may be mental health services.

11:44 - And unfortunately,

11:46 - too many times today, we have juveniles that have

11:50 - physical and or drug related issues

11:54 - that come to detention centers that we have to deal with.

11:58 - So we're talking about a capacity crisis.

12:00 - What does that mean?

12:02 - Well, it started back in 2016 to 2021.

12:07 - We have had 16 detention facilities that have ceased operation in Pennsylvania.

12:13 - And as of last month, Pennsylvania had

12:16 - 513 licensed detention center beds,

12:20 - but only 366 of them are operational

12:24 - because of staff shortages.

12:27 - Meanwhile, the average length of stay

12:31 - rose from 17 days

12:33 - in 2018 to 27 days in 2022.

12:38 - And there's been a significant increase in the cost of wages

12:42 - for staffing and liability and insurance costs.

12:46 - That has also led to the decline in the amount of shelters

12:52 - that have been able to remain open.

12:56 - So those are a lot of numbers.

12:57 - You just gave us about what's going on, what makes this a crisis?

13:02 - Well, because of the number of beds

13:05 - we have more juveniles needing

13:08 - those beds than we have the bed capacity.

13:11 - So counties are having to send youth out of state.

13:15 - And because of that, there's additional costs to the counties for that.

13:20 - But it's not just the cost that causes a burden to the families.

13:23 - Now we have additional costs to the families for travel,

13:27 - and then it causes more additional mental stress, not only for the use,

13:32 - but the to the family to have to travel out of state

13:36 - and unfortunately, we've heard

13:39 - anywhere from costs from 500 to $5000

13:42 - a day, depending on what that child may need

13:46 - for services for out of state expenses, for costs per day.

13:53 - So how is your

13:54 - county currently handling that crisis with how you dealing with these challenges?

13:58 - We have met with the Department

14:02 - of of Human Services

14:06 - and had some conversations with them today.

14:10 - We met with other commissioners and people at the Capitol

14:14 - to talk about this issue being a crisis.

14:17 - And we've asked the state for a partnership

14:20 - in helping us deal with this crisis, because it needs to be resolved.

14:24 - We need to find a way to deliver the services

14:28 - that are needed so that we can

14:31 - have a holistic approach to deal with this, to provide the services

14:35 - that are needed to every county

14:38 - so that we can keep our youth more local

14:42 - and return the number of beds needed

14:47 - for the number of youth

14:49 - in the full Commonwealth.

14:53 - What does that look like?

14:54 - Is that funding?

14:54 - Is that other resources?

14:56 - What what do you need to make that happen?

14:58 - Funding is a big part of it, absolutely.

15:00 - But also, there are so many restrictions and requirements

15:04 - for staffing and that has to be looked at

15:09 - just the whole gamut of what is required to staff.

15:15 - A facility needs to be looked at.

15:17 - And certainly I'm no expert and that's

15:20 - why we're looking out to other

15:23 - agencies to help us look at

15:25 - what needs to be done to correct the situation.

15:30 - What happens if it's not corrected?

15:32 - Well, we're going to have a real problem

15:36 - because we really have to work together with the state and local and community

15:40 - providers, stakeholders to broaden the community based treatment programs.

15:46 - If we don't,

15:48 - Lisa,

15:50 - unfortunately,

15:52 - what is our youth going to do then?

15:54 - There's no place to put them.

15:55 - It's it's already illegal to put youth in

15:59 - and to incarcerate them in adult settings.

16:03 - So we have to resolve this.

16:06 - There's no other place to deal with our youth

16:09 - unless we address this issue.

16:14 - And if the issue can be resolved, know if if we can get some place,

16:17 - we can find these beds and bring these youth closer to home.

16:20 - Find them the services they need.

16:22 - What does that mean to these these youth?

16:23 - What does it mean to their families?

16:26 - It means stability.

16:28 - It means knowing that their problems are going to be dealt with

16:33 - locally and that

16:37 - they know where these services are going to be delivered.

16:41 - We've talked about partnering with the state.

16:42 - You talk about some other stakeholders.

16:45 - Are we hearing about counties trying to work together or are we hearing

16:48 - about some local solutions that are happening out there?

16:50 - And are there models that we can lean on?

16:53 - Fortunately, my county, we're lucky.

16:57 - I guess we are in a partnership with four other counties.

17:01 - Five counties own a detention center, but it's not without problems.

17:06 - We have staffing issues, so

17:10 - we have a model and we are out there

17:15 - working with their counties.

17:18 - And and when we're all not all those beds are used by the member counties,

17:23 - then other counties can use those empty beds on a per diem basis.

17:28 - But there still seems

17:31 - to be some issues with staffing,

17:35 - and it's a model, but it needs some improvement.

17:40 - But again, we can use that as a model for other counties to look at.

17:45 - It's there and we're willing to share what we have with other counties

17:50 - if they like to come and look at Central

17:53 - Counties Youth Program.

17:56 - That sounds like at least a good model.

17:57 - Of course, as you said, still needs support, still needs funding

17:59 - and partnerships.

18:01 - You know, we talk about this being a crisis.

18:02 - Has it been a sudden crisis? Has this been coming on for a while?

18:05 - How did we get here?

18:06 - Well, I think we go out here because

18:10 - it's started back in 2006, as I said.

18:13 - And it's just been a steady decline.

18:18 - And now we're at a crisis situation.

18:21 - And I guess the million dollar question is,

18:27 - why did it take a crisis to get everyone's attention?

18:31 - Well, we are at a crisis right now at this point.

18:34 - So now we've got to

18:37 - pull together the state, county, other agencies to

18:40 - to fix it and bring all the stakeholders together to make it happen.

18:46 - You know,

18:46 - the residents of your county, the residents across Pennsylvania,

18:50 - they probably don't all have youth members of their family, people

18:54 - they know who are involved in the juvenile justice system.

18:57 - So so why should

18:58 - why should this be an issue that that everyone cares about in Pennsylvania?

19:02 - Why should your other residents who might not have those interactions

19:06 - pay attention?

19:07 - Well,

19:09 - I think that when you're talking

19:11 - about the youth of your community, it is a community issue and and

19:18 - it affects everyone sooner or later.

19:21 - And it's a community issue.

19:23 - And I think that people do need to pay attention to it,

19:29 - especially in your smaller, rural counties.

19:31 - Everybody knows everybody.

19:33 - So I think it is a community issue and people do pay attention.

19:37 - So any last words for our viewers about this, about this issue?

19:42 - Well, I think just to say that

19:45 - we're working on it, we realize it is a crisis.

19:48 - And I think that we had a good day in Harrisburg today.

19:53 - I think that our representatives that we had an opportunity

19:56 - to speak to today and their staff listened to us.

20:00 - And it was a good day, the day in Harrisburg.

20:03 - Good.

20:04 - Well, counties certainly are looking for that partnership with the state.

20:07 - We're getting that message out there and trying to make life a little bit

20:11 - better for all of our residents who are out there in our counties.

20:15 - Absolutely.

20:17 - Thank you,

20:17 - Commissioner Snyder, for joining us here on County Connections will conclude with

20:21 - just a few remarks from Capps president, Berks County Commissioner Michael Rivera.

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21:27 - I'm here with Berks County Commissioner Michael Rivera, who's serving

21:31 - as president of the County Commissioners Association of Pennsylvania for 2024.

21:35 - Michael, congratulations on being in the leadership for this year

21:38 - and thanks for everything that you do for counties.

21:41 - You know, we've been talking about our legislative priorities here on this show.

21:45 - Talk to us all about how these priorities are decided, who comes up with these.

21:49 - Okay.

21:50 - So first of all, let me thank you for the job that you do.

21:53 - It's a pleasure to serve as president this year, and I'm looking forward to it.

21:57 - So the these are the priorities are set by the members of CAP.

22:03 - So not set by the C cap staff

22:05 - do not set by myself as a president or one individual.

22:08 - They're set by the membership in general.

22:11 - So we have different committees that are set up.

22:13 - These committees will meet

22:14 - and to decide on what are the needs of that particular area, so be it.

22:19 - Around the election reform, be it around veterans, be it around the emergency

22:22 - services, whatever it is, they determine what are the needs.

22:26 - And then the committee will decide which of those should be passed

22:30 - on to the general forum for to be voted on as a priority.

22:35 - And the committee submit those.

22:37 - And then in the fall conference in November,

22:39 - the membership in general votes on those on those priorities

22:44 - to see which will be the new priorities for the coming year.

22:47 - So they're set by the membership to be able to be acted on by C cap.

22:53 - And this is important because what that does, it says

22:56 - all counties are talking as one voice.

22:59 - The counties themselves set the priorities and the and the C stuff at C cap

23:04 - is then pushing those priorities forward

23:07 - with the administration and with the legislature.

23:11 - So you've mentioned the membership and you just said all counties.

23:13 - So there are 67 counties in Pennsylvania.

23:15 - How many of them are members of the association?

23:18 - So all counties are members of C cap.

23:21 - We have a C cap.

23:23 - Membership is set by law and all counties have to be members of C cap.

23:27 - So that's important to understand.

23:28 - And when we set these priorities, we're

23:31 - representing all 67 counties in the Commonwealth.

23:35 - And all counties have a voice in these.

23:37 - And all counties have a voice in these matters.

23:39 - Correct.

23:40 - So, you know, counties say, you know, here are our priorities.

23:43 - You know, I'm

23:44 - guessing we're taking those to the General Assembly where our state partners are

23:47 - are legislators working with Governor SHAPIRO in the administration.

23:50 - Why is that partnership so important?

23:53 - It's important because

23:56 - the General Assembly and the administration, they set the laws

24:01 - what counties can or can't do,

24:03 - and they provide funding for many of the jobs that the county does.

24:06 - So it's important that we have a strong relationship for them.

24:10 - It's important that they reach out to us and say,

24:13 - you know what, we're thinking about this this law.

24:16 - We're thinking about proposing this.

24:18 - What do you think?

24:19 - Is that something that counties would support?

24:21 - Is it something that would work for counties or wouldn't work for county?

24:24 - So we want to make sure that we're partnering,

24:26 - that we're working together to make sure because in the end, Lisa,

24:30 - everyone's working for the betterment of the Commonwealth and to be able

24:33 - to serve the residents of the Commonwealth in the best way possible.

24:38 - Because really those residents, they're both your constituents

24:40 - and they're the constituents of our state partners.

24:43 - Exactly. Yeah.

24:44 - So when we have that a common voice and we work together,

24:47 - we can really try to make those improvements on the ground.

24:50 - And it's really important that we have that

24:52 - unifying voice on behalf of our county government.

24:54 - Exactly. Anyone,

24:55 - the legislature and the administration to speak up as that one voice.

25:01 - Again, you know, if there's an issue where they're going to come

25:03 - is to see cap, to say, you know, what will this work for counties?

25:06 - Understanding that the counties really are

25:09 - the boots on the ground people for the commonwealth.

25:13 - We're out there doing the human services work, running

25:16 - the jails and many, many other services, running elections

25:20 - and other things that have an impact on the daily life of our residents.

25:24 - So many ways that people

25:25 - don't even realize that they interact with county government on a regular basis.

25:29 - Yes, it's interesting because when I go to to speak at different

25:32 - places, I'll say, okay, how many of you know what a commissioner does?

25:36 - Raise her hand, then I may get one hands or two hands,

25:39 - and I say, Well, how many of you know what counties do?

25:41 - And same thing, maybe one hand or two hands,

25:43 - because when in school they talk about state level

25:47 - or federal level of government,

25:48 - but very rarely do they talk about the county level of government,

25:51 - which has a bigger impact on the day to day life

25:55 - of many people, more so than the state and the federal government does.

25:58 - And that makes it so important for an association like ours

26:01 - to have that unifying voice, to be able to tell that story about what counties do.

26:04 - Yes, it does.

26:07 - I'm Lisa Shafer Schaffer,

26:08 - executive director for the County Commissioners Association of Pennsylvania.

26:11 - Thank you for joining us for county connections brought to you by C cap.

26:15 - For more information about county government or about our 2024

26:19 - priorities, please visit us at WW W Dot

26:22 - County's dot org.

26:56 - This program has been paid

26:57 - for by the sponsor and does not reflect the views of PCN.