Commonwealth of Pennsylvania Department of Public Welfare

Office of Mental Health & Substance Abuse Services Bureau of Community & Hospital Operations

Pennsylvania State Hospital System Length-of- Stay, Demographics &

Diagnoses Report For 2009

Prepared by: Betsy Zimmerman Bureau of Community & Hospital Operations

Completed: February 24, 2010 Email: bezimmerma@state.pa.us

Background

The information contained in this report is taken from the statewide Patient Census Information System (PCIS). PCIS is a Mapper-based database application that is a repository of information about past and present consumers of service in the state hospital system. The medical records staff at each of the hospitals and the restoration center is continually updating this system as new information becomes available. The PCIS database collects highly sensitive information on any person served in the hospital system including home addresses, marital status, service area and all diagnostic data.

On January 2003, several changes to the PCIS went into effect that amounted to the first major revision in the way diagnostic information is recorded. PCIS was updated to accommodate the new reporting requirements of the National Association of State Mental Health Program Directors (NASMHPD) Performance Measurement System (PMS) that the state hospitals started using on January 1, 2003. One of the three reporting requirements for this system is the submission of a patient “Episode” file, on a monthly basis, that reports diagnostic and demographic information. It also provides information on consumer admissions, discharges, leaves and legal status. It does not contain any identifier such as names, SSN, MA or other sensitive identification numbers except for the hospital consumer identification number. The major aspect of this change expanded the number of psychiatric and medical diagnosis fields up to seventeen and created five dedicated fields for recording a substance use diagnosis. This change affected the state hospitals and the restoration center and provides a status report or “snap-shot” of information on the last day of each month.

The creation of the monthly Episode file is an automated process produced by the Department of Public Welfare, Office of Information Services and the Bureau of Applications Development staff. Using their expertise and assistance, the Episode file data is exported out of PCIS and into a MS Access table form where it is downloaded by Allentown State Hospital (ASH). ASH makes further changes to the file including the removal of South Mountain data before it is uploaded to the NASMHPD Research Institute (NRI) in Alexandria, Virginia. Data quality checks on the information are done during each step of the process.

This monthly Episode file, that contains the original, monthly data for all OMHSAS facilities, is the basis for the information contained in this report. This data is refreshed monthly, usually by the tenth, for the prior month’s diagnostic and demographic history.

Purpose The purpose of this report is to provide the reader with an overview of lengths-of-stays, demographic and diagnosis information, as it exists on the last day of the month for all Office of Mental Health and Substance Abuse Services (OMHSAS) facilities. There is no personal or protected patient information in this report as it contains only counts by hospital and type of care. It is issued every six months and prior year reports are stored in the State Hospital Document Library that is located on the Allentown State Hospital server.

Acknowledgements Much work went into creating a user-friendly way of retrieving data and running reports using PCIS data. I want to acknowledge the Medical Records staff at each facility for their continuing efforts to assure that reliable data are entered into the PCIS system. I also want to recognize the work of DPW Bureau of Applications Development staff for their work on creating the conversion file for the NRI system. Finally, I want to thank William Steinmetz for creating the report functions that enabled all of the information contained in this report to be presented in a manageable and hopefully useable form.

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Table of Contents

Table Table Description Page 1 Facility Census by Level-of-Care and Month for Calendar Year 2009 4 2 Length-Of-Residence by Facility and Level-of-Care on December 31, 2009 5 3 Length-Of-Residence for People with an Axis I Diagnosis of Schizophrenia

& Related Psychotic Disorders on December 31, 2009 5

4 Number of Admissions by Facility, All Levels of Care for Calendar Year 2009 6 5 Number of Discharges by Facility, All Levels of Care for Calendar Year 2009 6 6 Length of Stay for People Discharged During Calendar Year 2009 6 7 Race and Gender of People Discharged During Calendar Year 2009 6 8 County of Origin for People Discharged During Calendar Year 2009 7 9 County of Origin for People Admitted During Calendar Year 2009 8

10 Age of People Served by the Hospital System on December 31, 2009 9 11 Gender of People Served by the Hospital System on December 31, 2009 9 12 Race/Ethnic Origin of People Served by the Hospital System on December 31, 2009 9 13 County of Origin for People Served by the Hospital System on December 31, 2009 10 14 Axis I Dx of People Served by the State Hospital System on December 31, 2009 11 15 People with a Dx of Mental Retardation Served by the Hospital System on December 31, 2009 11 16 Substance Use Dx of People Served by the State Hospital System on December 31, 2009 12 17 Medical Diagnoses of People Served by the State Hospital System on December 31, 2009 13 18 People with any Criminal History Served in the Civil Hospitals on December 31, 2009 13 19 Commitment Code/Status of People Served in the Hospital System on December 31, 2009 14

3

Acu

tal N

umbe

r

8,000

7,000

6,000

5,000

4,000

3,000

2,000

1,000

0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

6,678 6,421

6,079 5,920 5,692

5,356 5,032 5,066 5,017 4,994

4,550

3,799 3,821 3,884

3,360 3,205 2,928

2,692 2,377 2,309 2,285 2,284

2,023 1,946 1,764 1,772

Filled Complement Census-All Levels of Care

Overview of the Pennsylvania State Hospital System

Table 1 2009 Facility End-of-Month Census

Civil Forensic LTC Act-21 System

Month ALL CLA DAN NOR TOR WAR WER Total NOR TOR WAR Total SMRC TOR Total Dec-08 173 221 159 264 229 168 208 1422 114 46 27 187 134 22 1765 Jan-09 174 215 157 262 221 166 210 1405 115 45 25 185 134 22 1746 Feb-09 174 220 158 260 216 161 209 1398 114 45 25 184 133 22 1737 Mar-09 174 217 159 259 214 153 213 1389 119 62 26 207 133 23 1752 Apr-09 173 221 163 263 213 151 214 1398 115 59 23 197 133 23 1751

May-09 172 219 156 253 214 158 215 1387 121 59 23 203 134 23 1747 Jun-09 173 218 164 246 214 161 218 1394 121 63 26 210 134 23 1761 Jul-09 167 217 160 252 214 164 218 1392 118 63 26 207 136 23 1758

Aug-09 171 218 161 250 216 162 215 1393 124 62 26 212 134 24 1763 Sep-09 170 218 170 251 214 168 218 1409 128 60 28 216 135 24 1784 Oct-09 169 218 169 246 217 165 218 1402 129 59 25 213 135 24 1774

Nov-09 171 217 172 240 210 160 215 1385 129 60 27 216 134 25 1760 Dec-09 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

Hospital System Census & Staff 1997-2009 All Levels of Care

Note: The 3,821 complement number in the above chart includes fulltime workers at the seven civil hospitals, three forensic centers, the Act-21 program at Torrance and South Mountain on December 31, 2009.

Data Point: Since 1997 the number of people served in the hospital system, all levels of care, has declined by 46%. During this same span the number of fulltime staff working in the state hospitals has decreased 57%.

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Table 2 Length-of Residence for People Served in the State Hospital System on December 31, 2009

Civil Forensic LTC Act-21 System

%Date All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total On 12/31/2009 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

< 6 Months LOR 30 44 48 26 56 56 28 288 51 46 16 113 13 3 417 24% < 12 Months LOR 43 67 68 41 75 82 49 425 83 49 19 151 22 4 602 34%

< 2 Years LOR 63 88 93 72 130 101 75 622 107 55 19 181 44 10 857 49% 2+ Years LOR 110 131 83 170 83 60 140 777 24 0 7 31 91 16 915 52% 5+ Years LOR 70 84 29 102 51 33 59 428 12 0 6 18 50 0 496 28%

10+ Years LOR 45 51 23 64 32 27 43 285 10 0 4 14 32 0 331 19% 15+ Years LOR 27 29 18 39 16 21 32 182 5 0 4 9 15 0 206 12% 20+ Years LOR 19 18 14 23 12 16 20 122 3 0 0 3 9 0 134 8% 25+ Years LOR 12 10 9 12 8 10 12 73 0 0 0 0 7 0 80 5% 30+ Years LOR 5 3 5 5 7 4 7 36 0 0 0 0 3 0 39 2% 40+ Years LOR 0 2 3 4 1 1 4 15 0 0 0 0 1 0 16 1% 50+ Years LOR 0 1 1 2 1 5 0 0 0 0 0 0 5 0%

% 2+ Years LOR 64% 60% 47% 70% 39% 37% 65% 56% 18% 0% 27% 15% 67% 62% 52%

Table 3 Length-Of- Residence for People with an Axis I Diagnosis of Schizophrenia & Related Psychotic Disorders for All Levels of Care on December 31, 2009

Civil Forensic LTC Act-21 System Date All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total

On 12/31/2009 173 219 176 242 213 161 2151 1399 131 55 26 212 135 26 1772 < 6 Months LOR 23 29 33 17 35 31 22 190 60 35 10 105 5 0 300

< 12 Months LOR 33 44 50 30 48 49 40 294 77 40 10 127 11 0 432 < 2 Years LOR 44 57 72 58 88 64 56 439 22 0 4 26 20 0 485 2+ Years LOR 73 98 69 146 59 51 115 611 11 0 4 15 34 1 661 5+ Years LOR 48 66 24 89 43 27 46 343 9 0 3 12 13 0 368

10+ Years LOR 30 40 20 57 27 21 31 226 4 0 3 7 10 0 243 15+ Years LOR 17 22 17 36 14 15 24 145 2 0 0 2 6 0 153 20+ Years LOR 12 15 14 21 11 12 16 101 1 0 0 1 3 0 105 25+ Years LOR 8 8 9 11 7 8 10 61 0 0 0 0 2 0 63 30+ Years LOR 3 3 5 4 7 3 5 30 0 0 0 0 0 0 30 40+ Years LOR 0 2 3 3 1 1 4 14 0 0 0 0 0 0 14 50+ Years LOR 0 1 1 2 0 0 1 5 0 0 0 0 0 0 5

Data Point - On December 31, 2009, people with an Axis 1diagnosis of Schizophrenia and related psychotic disorders accounted for 65% of those served in the hospital system. This percentage increases to 79% of the population with people who have 25 or more year’s length-of-residence.

Defining Length-Of-Residence (LOR) - For the purpose of this report, hospital length-of-residence is expressed in the amount of time a person is continually served, without separation, within a specific OMHSAS facility. The database expresses length-of-residence in days, which is then auto calculated to years for this report. It should also be noted that when a facility is closed (i.e. Woodville, Dixmont, Somerset, Harrisburg, Haverford, Philadelphia, Retreat, Mayview) or a person was transferred, his/her admission date was reset to the date of the transfer to the new facility.

Defining Length-of-Stay (LOS) - A hospital length-of-stay refers to the amount of time, usually expressed in days, between the date of a person’s hospital admission and their discharge.

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State Hospital System Discharge & Admission History Calendar Year 2009

Table 4 Number of Admissions by Facility

Civil Forensic LTC Act-21 System

Admissions All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Jan-Dec 2009 59 106 106 47 110 146 61 635 158 216 69 443 28 4 1110

Table 5 Number of Discharges by Facility

Civil Forensic LTC Act-21 System

Discharges All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Jan-Dec 2009 59 108 89 73 129 152 54 664 137 204 71 412 27 0 1103

Deceased 2 4 1 13 4 5 2 31 1 0 0 1 23 0 55 Discharges 57 104 88 60 125 147 52 633 136 204 71 411 4 0 1048

Note: “Discharged” includes people who may have been transferred from one facility or level of care to another.

Table 6 Length-of-Stay for People Discharged During 2009

Civil Forensic LTC Act-21 System

Discharged not Deceased All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total

Total 2009 Discharges 57 104 88 60 125 147 52 633 136 204 71 411 4 0 1048 < 6 Months LOS 20 39 43 9 37 84 11 243 100 191 63 354 3 0 600

< 12 Months LOS 30 68 65 20 76 114 23 396 123 202 69 394 3 0 793 < 2 Years LOS 41 83 74 32 104 135 38 507 136 204 70 410 4 0 921 2+ Years LOS 16 21 14 28 21 12 14 126 0 0 1 1 0 0 127 5+ Years LOS 5 10 2 15 9 3 6 50 0 0 1 1 4 0 55

10+ Years LOS 2 5 1 7 5 1 2 23 0 0 0 0 4 0 27 15+ Years LOS 1 3 1 4 1 0 2 12 0 0 0 0 4 0 16 20+ Years LOS 1 2 0 3 1 0 1 8 0 0 0 0 4 0 8 25+ Years LOS 0 2 0 2 1 0 1 6 0 0 0 0 0 0 6 30+ Years LOS 0 1 0 2 1 0 0 4 0 0 0 0 0 0 4 40+ Years LOS 0 0 0 1 1 0 0 2 0 0 0 0 0 0 2 50+ Years LOS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Table 7 Race & Gender of People Discharged During 2009

Civil Forensic LTC Act-21 System

Race & Gender All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Total 2009 Discharges 59 108 89 73 129 152 54 664 137 204 71 412 27 0 1103 Amer Indian/Alaskan 0 0 0 0 0 0 1 1 0 1 0 1 0 0 2 Asian/Pacific Islander 1 1 1 0 0 0 2 5 2 2 0 4 0 0 9 Black/Africian Amer 6 9 12 31 17 12 4 91 66 77 19 162 6 0 259

Hispanic 6 4 3 1 4 9 6 33 15 3 4 22 0 0 55 White 46 94 76 39 110 136 38 539 54 118 48 220 21 0 780

Other/Not Identified 0 0 0 0 1 0 0 1 0 3 0 3 0 0 4 Men 26 62 48 44 69 84 36 369 104 149 71 324 15 0 708

Women 33 46 41 29 60 68 18 295 33 55 0 88 12 0 395

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Table 8 County (Base Service Unit) of Origin for People Discharged During 2009

Civil Forensic LTC Act-21 System

2009 Discharges All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Allegheny 7 7 113 1 114 N 121

Armstrong/Indiana 6 6 0 o 6 Beaver 0 1 1 1

Bedford/Somerset 5 5 2 2 D 7 Berks 18 18 12 12 i 30 Blair 19 19 1 1 s 20

Bradford/Sullivan 4 4 1 1 c 5 Bucks 7 7 15 15 h 22 Butler 13 13 4 4 a 17

Cambria 13 13 1 2 3 r 16 Cameron/Elk 1 1 2 1 3 g 4

Carbon/Monroe/Pike 11 17 28 6 6 e 34 Centre 4 4 1 1 s 5

Chester 6 6 7 2 9 15 Clarion 5 5 0 i 5

Clearfield/Jefferson 18 18 1 3 4 n 22 Col/Mont/Sny/Union 1 13 14 1 2 3 1 18

Crawford 9 9 2 2 C 11 Cumberland/Perry 1 1 13 13 Y 14

Dauphin 11 11 1 13 14 25 Delaware 8 8 21 21 2 29

Elk 4 4 2 2 6 Erie 1 28 29 1 13 14 0 43

Fayette 1 13 14 3 3 0 17 Forest/Warren 16 16 1 4 5 9 21

Franklin/Fulton 8 8 2 2 10 Green 0 1 1 1

Hunt/Miff/Juniata 5 5 1 1 2 7 Indiana 3

Lacka/Susqueh 25 25 5 1 6 31 Lancaster 1 18 19 12 12 1 32 Lawrence 1 1 3 3 4 Lebanon 11 11 0 11

Lehigh 30 30 4 4 34 Luzerne/Wyoming 48 1 49 3 1 4 1 54 Lycoming/Clinton 9 1 10 1 3 4 14

McKean 9 9 0 9 Mercer 42 42 1 11 12 54

Montgomery 1 1 14 16 9 3 12 24 40 Northampton 15 15 4 5 9 24

Northumberland 13 13 0 13 Out Of State 1 3 2 6 0 6 Philadelphia 1 25 26 34 1 35 1 62

Potter 1 1 1 1 2 Schuylkill 1 1 20 22 0 22

Tioga 3 3 0 3 Venago 11 11 4 4 15

Washington 0 3 3 3 Wayne 2 2 1 2 3 5

Westmoreland 41 41 11 11 52 York/Adams 5 5 1 17 18 23 Facility Total 57 104 88 60 125 147 52 633 136 204 71 411 4 0 1048

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Act-Civil LTC 21 System

2009 Admissions All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Adams 2 2 2

Allegheny 3 3 118 1 119 2 124 Armstrong 5 5 0 5 Beaver 1 1 1 Bedford 3 3 1 1 4 Berks 18 18 11 11 1 30 Blair 17 17 0 17 Bradford 5 5 1 1 6 Bucks 11 11 11 11 22 Butler 13 13 3 3 16 Cambria 16 16 1 2 3 19

Cameron 1 1 0 1 Carbon 5 5 10 2 2 12 Centre 5 5 1 1 6 Chester 4 4 14 2 16 1 21

Clarion 5 5 0 5 Clearfield 1 22 23 2 2 25

Clinton 4 4 1 1 5 Colombia 7 7 0 7

Crawford 5 5 3 3 8 Cumberland 2 2 9 9 2 13

Dauphin 18 18 1 17 18 1 37 Delaware 5 5 25 25 2 1 33

Elk 1 1 2 2 3 Erie 31 31 1 13 14 45 Fayette 11 11 7 7 18 Franklin 8 8 2 2 10 Greene 2 2 2 Indiana 3 3 0 3 Jefferson 1 1 1 Juniata 1 1 1 Lackawanna 20 20 3 1 4 24 Lancaster 20 20 7 7 1 28

Lawrence 2 2 2 Lebanon 11 11 2 2 1 14 Lehigh 30 30 10 10 1 41 Luzerne 51 2 53 3 3 1 57 Lycoming 12 1 13 1 2 3 1 17 McKean 10 10 10 10 20

Mercer 42 42 0 42 Mifflin 3 3 1 1 1 5 Monroe 7 12 19 2 2 1 22

Montgomery 1 15 16 16 3 15 34 50 Montour 2 1 3 0 1 4

Northampton 16 1 17 3 5 8 1 26 Northumberland 13 13 0 1 14 Out Of State 3 1 4 0 1 5 Perry 2 2 2 Philadelphia 1 11 12 45 45 3 60 Potter 2 2 1 1 2 4 Schuylkill 1 21 22 0 22 Snyder 1 1 1 2 3 4 Somerset 2 2 0 1 3 Susquehanna 2 2 0 2

Tioga 3 3 1 1 4 Union 1 1 0 1 Venago 10 10 3 3 13

Warren 14 14 2 2 16 Washington 1 1 7 7 8 Wayne 2 2 1 1 3 6 Westmoreland 32 32 15 15 47

Wyoming 4 4 1 1 5 York 7 12 19 2 15 17 3 1 40

Facility Total 59 106 106 47 110 146 61 635 158 216 69 443 28 4 1110

Table 9 County of Origin for People Admitted During 2009

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Table 10 Age of People Served by the Hospital System on December 31, 2009 Civil Forensic LTC Act-21 System

On 6/30/09 All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Census 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

<21 1 4 2 2 4 6 6 25 6 3 2 11 0 1 37 >21 172 215 174 240 209 155 209 1374 125 52 24 201 135 25 1735

20-29 14 32 13 30 36 21 26 172 30 13 2 45 2 26 245 30-39 20 19 19 26 24 20 28 156 24 12 6 42 1 0 199 40-49 34 43 32 67 44 32 39 291 35 11 5 51 12 0 354 50-59 57 62 61 67 60 51 66 424 31 13 7 51 19 0 494 60-69 34 40 37 32 40 25 34 242 7 3 2 12 37 0 291 70-79 11 18 9 15 5 9 17 84 1 0 1 2 34 0 120 80-89 2 3 3 4 2 2 0 16 0 1 1 2 26 0 44 90-99 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

65+ 23 34 28 34 23 17 33 192 3 1 2 6 84 0 282 % Age 65+ 13% 16% 16% 14% 11% 11% 15% 14% 2% 2% 8% 3% 62% 0% 16%

Table 11 Gender of People Served by the Hospital System on December 31, 2009 Civil Forensic LTC Act-21 System

On 12/31/09 All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Census 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

Men 103 140 96 159 125 97 127 847 115 44 26 185 73 26 1131 Women 70 79 80 83 88 64 88 552 16 11 0 27 62 0 641 % Men 60% 64% 55% 66% 59% 60% 59% 61% 88% 80% 100% 87% 54% 100% 64%

% Women 40% 36% 45% 34% 41% 40% 41% 39% 12% 20% 0% 13% 46% 0% 36% Data Point – Overall, men represented 64% of the people served in the hospital system on December 31, 2009.

Table 12 Race/Ethnic Origin of People Served by the Hospital System on December 31, 2009 Civil Forensic LTC Act-21 System

Racial Distribution All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total 12/31/09 Census 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

Amer Indian/Alaskan 0 0 0 0 0 2 0 2 1 0 0 1 0 0 3 Asian/Pacific Islander 4 1 0 4 2 0 4 15 1 0 0 1 0 1 17 Black/Africian Amer 12 3 18 93 24 19 22 191 69 19 5 93 28 1 313

Hispanic 14 3 2 7 0 3 17 46 10 2 0 12 9 1 68 White 143 212 156 138 186 136 172 1143 50 33 21 104 98 23 1368

Other/Not Identified 0 0 0 0 1 1 0 2 0 1 0 1 0 0 3 % Non White 17% 3% 11% 43% 13% 16% 20% 18% 62% 40% 19% 51% 27% 12% 23%

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Table 13 County of Origin for People Served in the Hospital System on December 31, 2009 Civil Forensic LTC Act-21 System

On 12/31/2009 All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Adams 0 1 1 1 Allegheny 24 24 28 28 3 1 53 Armstrong 12 12 0 12 Beaver 1 1 Bedford 5 5 0 5 Berks 61 61 6 6 5 1 73 Blair 25 25 2 2 27 Bradford 11 11 1 1 12 Bucks 42 42 7 7 1 50 Butler 17 17 0 1 18 Cambria 20 20 0 2 22 Carbon 8 5 13 0 1 14 Centre 5 5 0 5 Chester 11 11 9 9 4 24 Clarion 4 4 0 4 Clearfield 2 25 27 2 2 29 Clinton 5 5 0 5 Colombia 7 7 1 1 8 Crawford 6 6 3 3 9 Cumberland 16 1 1 18 2 2 9 29 Dauphin 37 1 2 40 5 5 11 56 Delaware 36 36 21 21 5 2 64 Elk 2 2 3 3 5 Erie 52 52 0 1 3 56 Fayette 16 16 5 5 1 22 Forest 1 1 0 1 Franklin 6 6 0 6 12 Fulton 1 1 2 0 2 Greene 1 1 1 1 2 Huntington 4 4 0 1 1 6 Indiana 9 9 0 9 Jefferson 1 1 Lackawanna 61 61 1 1 2 2 66 Lancaster 66 66 5 5 7 1 79 Lawrence 1 1 0 1 Lebanon 31 31 4 4 2 4 41 Lehigh 107 4 111 10 10 8 1 130 Luzerne 105 3 1 109 4 4 2 2 117 Lycoming 19 19 0 6 25 McKean 11 11 1 1 12 Mercer 1 32 33 3 3 36 Mifflin 7 7 0 1 8 Monroe 7 7 14 0 1 15 Montgomery 58 58 13 6 19 4 81 Montour 1 1 0 3 4 Northampton 50 1 1 52 1 1 4 57 Northumberland 18 18 0 18 Out Of State 1 5 6 0 1 7 Perry 1 1 1 1 Philadelphia 85 85 49 49 13 147 Pike 1 2 3 0 1 4 Potter 3 3 1 1 4 Schuylkill 33 1 34 0 3 37 Snyder 1 1 1 1 2 Somerset 6 6 0 13 19 Susquehanna 2 2 0 2 Tioga 10 10 1 1 11 Union 1 1 0 1 Venago 13 13 0 1 14 Warren 11 11 2 2 2 15 Washington 2 2 3 3 5 Wayne 11 11 0 4 2 17 Westmoreland 67 67 3 3 70 Wyoming 5 5 0 5 York 9 2 53 64 1 4 5 8 1 79 Totals 173 219 176 242 213 161 215 1399 131 55 26 212 135 26 1772

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Table 14 Axis I Diagnosis of People Served by the State Hospital System on December 31, 2009 Civil Forensic LTC Act-21System

On 12/31/2009 All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Additional Codes Focus of Treatment 1 2 3 0 2 5

Adjustment Disorders 1 1 2 2 2 2 6 1 9 Anxiety Disorders 2 2 3 1 8 0 1 9

Delirium, Dementia and Amnestic 22 4 1 6 1 6 8 48 1 1 57 106

Diseases of the Nervous System & Sense Organs 47 23 56 65 65 23 69 348 8 2 4 14 63 425 Early Onset Disorders 1 1 1 1 2 2 8 1 1 1 2 12

Factitious Disorders 0 0 0 Impulse Control Disorders Not Classified 13 3 2 5 4 13 40 4 4 2 46 Mental Disorders/General Medical Cond 1 4 1 3 9 1 1 10

Mood Disorders 25 38 25 21 37 33 17 196 23 11 7 41 9 1 247 Other Conditions/Focus of Clinical Attention 1 1 2 0 2 4

Other Psychosis 0 0 0 Personality Disorders 7 1 2 8 18 1 1 3 1 23

Schizophrenia/Psychotic Disorders 117 155 141 204 147 115 171 1050 99 40 14 153 54 1 1258 Sexual and Other Gender Identify Disorders 2 3 5 0 18 23

Symptoms, Signs and Ill-Defined Symptoms 35 48 59 67 43 61 77 390 8 5 7 20 63 473 Total 255 290 290 370 320 243 359 2127 144 62 36 242 258 23 2650

% with Schizophrenia/Psychotic Disorders 46% 53% 49% 55% 46% 47% 48% 49% 69% 65% 39% 63% 21% 4% 47%

Table 15 People with a Diagnosis of MR/DD Served by the Hospital System on December 31, 2009

Civil Forensic LTC Act-21 System All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total

12/31/2009 12 13 0 23 15 8 24 95 11 3 3 17 15 2 129 6/30/2009 13 18 8 20 18 12 24 113 12 4 1 17 14 2 146

12/31/2008 15 23 10 21 16 18 23 126 13 4 1 18 14 1 159 6/30/2008 17 27 9 19 14 16 22 124 13 2 15 10 2 151

12/31/2007 17 28 11 18 15 15 19 123 11 2 13 9 1 146 6/30/2007 17 28 12 20 17 19 18 131 10 2 12 11 1 155

12/31/2006 17 27 11 16 15 15 22 123 9 4 13 11 147 6/30/2006 16 27 11 17 16 15 24 126 6 4 10 11 147

12/31/2005 15 26 15 17 16 17 29 135 4 3 7 9 151 6/30/2005 12 29 15 18 14 18 22 128 7 4 11 11 150

12/31/2004 13 27 15 18 12 20 18 123 6 3 9 11 143

Percentage of People with MR/DD Dx on 12/31/2009 Civil Forensic LTC Act-21 System

All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total Dx MR/DD 7% 6% 0% 10% 7% 5% 11% 7% 8% 5% 12% 8% 11% 8% 7%

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Table 16 Substance Use Diagnosis of People Served by the State Hospital System on December 31, 2009

Civil Forensic LTC Act-21 System Diag# DSM IV Description All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total 291.2 Alcoholic Dementia Oth 1 2 2 5 1 1 6 291.81 Alcohol Withdrawal 1 1 0 1 292.84 Drug Induced Depressive Syndrom 2 2 1 1 3

292.9 Drug Induced Mental Disorder Unspec 1 1 0 1

303.90 Oth/unspec Alcohol Dep Unspec 4 8 2 5 4 5 28 3 2 5 33 303.93 Alcohol Dep Oth In Remiss 4 3 10 2 19 2 2 21 304.00 Opioid Dependence Unspec 1 3 1 1 6 1 1 7 304.03 Opioid Dependence Remiss 1 2 3 1 1 4 304.10 Barbiturate Depend Unspec 1 1 2 0 2 304.13 Barbiturate Depend Remiss 1 1 0 1 304.20 Cocaine Depend Unspec 1 1 1 2 2 7 1 1 8 304.23 Cocaine Depend Remiss 1 2 1 4 1 1 5 304.30 Cannabis Depend Unspec 1 1 5 1 1 9 1 3 1 5 14 304.33 Cannabis Depend Remiss 1 2 3 1 7 1 1 8 304.40 Amphetamine Depend Unspec 1 1 2 0 2 304.50 Hallucinogen Dep Unspec 1 1 0 1 304.53 Hallucinogen Dep Remiss 1 1 2 0 2 304.60 Drug Depend Oth Unspec 1 1 1 3 0 3 304.80 Combination Drug Dep Oth, Unspe 4 5 2 2 13 26 8 8 34 304.83 Comb Drug Dep Oth, Remiss 1 1 8 1 11 3 3 1 15 304.90 Unspec Drug Depend Unspec 6 1 7 0 7 304.93 Drug Depend Unspec Remiss 3 3 0 1 4 305.00 Alcohol Abuse Unspec 5 14 17 16 12 33 35 132 15 7 5 27 159 305.01 Alcohol Abuse Continuous 1 1 2 1 1 3 305.02 Alcohol Abuse Episodic 6 1 7 0 7 305.03 Alcohol Abuse Remiss 29 2 3 14 2 7 57 3 3 1 61 305.1 Tobacco Use Disorder 69 17 35 17 61 45 100 344 2 2 4 2 350 305.20 Cannabis Abuse Unspec 1 3 7 1 9 15 17 53 4 8 2 14 67 305.22 Cannabis Abuse Episodic 3 3 0 1 4 305.23 Cannabis Abuse Remiss 15 3 1 19 0 19 305.30 Hallucinogen Abuse Unspec 2 2 0 1 3 305.33 Hallucinogen Abuse Remiss 2 2 4 0 4 305.40 Barbiturate Abuse Unspec 1 1 0 1 305.50 Opioid Abuse Unspec 1 3 4 3 3 7 305.53 Opioid Abuse Remiss 4 1 2 7 1 1 8 305.60 Cocaine Abuse Unspec 1 1 2 1 3 6 3 17 2 3 5 22 305.62 Cocaine Abuse Episodic 1 1 0 1 305.63 Cocaine Abuse Remiss 9 2 1 1 13 0 13 305.70 Amphetamine Abuse Unspec 5 5 0 5 305.73 Amphetamine Abuse Remiss 1 1 2 0 2 305.90 Drug Abuse Oth Unspec 3 3 14 33 9 14 40 116 17 3 1 21 137 305.91 Drug Abuse Oth Continuous 1 1 0 1 2 305.92 Drug Abuse Oth Episodic 1 1 0 1 305.93 Drug Abuse Oth In Remiss 5 2 12 2 2 23 1 1 24 305.93 Drug Abuse Nec-In Remiss 0 1 1 V71.09 Observ-Mental Cond Nec 1 1 0 1

Totals 161 49 105 70 208 104 258 955 47 45 18 110 0 9 1074 % with Tobacco Use Disorder 43% 35% 33% 24% 29% 43% 39% 36% 0% 4% 11% 4% 0% 22% 33%

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Table 17 Medical Diagnoses of People Served by the State Hospital System on December 31, 2009

Civil Forensic LTC Act-21 System Medical Diagnosis by Major Group All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total

Any Medical Diagnosis 3 4 2 31 16 123 123 72 1 73 5 201 Complications of Pregnancy, Childbirth & Puerperiu 2 2 0 2 Conditions Originating in the Perinatal Period 1 2 1 4 0 4 Congenital Anomalies 5 1 3 3 3 7 2 24 1 1 1 2 28 Delirium, Dementia and Amnestic 1 1 1 1 2 Diabetes 53 31 39 55 57 32 43 310 14 7 3 24 41 375 Diseases of the Blood and Blood Forming Organs 33 6 18 25 14 22 23 141 1 1 21 163 Diseases of the Circulatory System 125 72 85 122 97 70 111 682 31 21 7 59 158 2 901 Diseases of the Disgestive System 72 59 82 86 124 153 161 737 12 6 8 26 116 11 890 Diseases of the Genitourinary System 25 4 20 5 14 9 24 101 1 1 2 33 1 137 Diseases of the Musculoskeletal System and Connect 134 19 67 68 57 58 64 467 2 9 13 24 109 3 603 Diseases of the Nervous System and Sense Organs 60 27 72 103 77 26 98 463 8 5 4 17 82 6 568 Diseases of the Respiratory System 57 51 44 56 49 48 58 363 9 11 3 23 25 10 421 Diseases of the Skin and Subcutaneous Tissue 8 10 15 23 14 35 32 137 4 3 5 12 13 8 170 Early Onset Disorders 1 1 0 1 2 Eating Disorders 190 118 121 120 95 51 77 772 50 26 12 88 24 15 899

Endocrine Nutritional, Metabolic, Immunity 404 234 275 237 264 179 249 1842 67 47 29 143 104 14 2103 Fractures 3 1 3 1 1 9 1 1 10 Infectious and Parasitic Diseases 14 9 22 14 8 8 18 93 15 15 24 1 133 Injuries and Poisonings 5 5 12 8 12 24 14 80 3 2 5 5 90 NeoPlasams (growths) 17 1 8 3 3 4 3 39 3 1 4 10 1 54 Other Conditions/Focus of Clinical Attention 3 7 2 2 4 1 2 21 0 6 27 Substance-Related Disorders 1 1 0 6 7 Symptoms, Signs and Ill-Defined Symptoms 40 53 68 75 51 77 85 449 9 5 8 22 75 2 548 Traumatic Brain Injury 2 2 4 0 4

Percentage of People served with Diabetes 31% 14% 22% 23% 27% 20% 20% 22% 11% 13% 12% 11% 30% 0% 21%

Table 18 People with any Criminal History Served in the Civil Hospitals on December 31, 2009

Civil Hospitals Only On 12/31/2009 All Cla Dan Nor Tor War Wer Total

Census 173 219 176 242 213 161 215 1399 Number with Criminal History 58 33 59 113 96 36 73 339

Number with Felony History 16 7 17 49 24 11 24 117 Homicide/Manslaughter 0 0 1 21 0 2 2 26

Number with Sex Crime Conviction 9 0 5 16 18 7 5 42 NGRI/GBMI/Incompetent 0 1 0 8 2 2 6 16

Number Listed with Megan’s Law 2 1 2 7 1 1 0 12 Percentage with Criminal History 34% 15% 33% 44% 45% 22% 34% 24%

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Table 19 Commitment Status/Code of People Served in the Hospital System on December 31, 2009

Civil Forensic LTC Act-21 System PCIS Commitment Type as of 12/31/2009 Sec All Cla Dan Nor Tor War Wer Total Nor Tor War Total SMRC Tor Total

2300 Voluntary admission of an Adult 201 2 44 2 6 5 3 62 0 62 2400 Conver vol from Invol (302,303, 304, 305) 201 17 3 21 9 3 11 64 0 64 3500 Invol commit of voluntary in SMH 304 1 1 2 0 2 3600 Invol commit/not voluntary SMH inpatient 304 1 1 0 1 3700 Invol commit/not SMH inpatient 304 10 16 4 22 9 19 2 82 0 82 3800 Involuntary not guilty by reason of insanity NGRI 304 4 2 1 7 8 1 9 16 3900 Invol criminal commit incompetent to stand trial 304 12 1 2 15 2 3 3 8 23 4000 Extended involuntary commitment 305 144 152 163 105 183 137 164 1048 2 2 1050 4100 Extended involuntary commitment/Guilt/Mental/Ill 305 1 1 9 1 5 17 3 3 20 4200 Extended involuntary commitment/Incompetent 305 1 4 1 1 8 15 3 1 4 19 7000 Invol 60 days incompetent trial/not mentally ill 402 20 20 90 26 9 125 145 7500 Invol/convicted/ examination 405 4 4 11 1 3 15 19 7501 Invol/convicted/guilty but mentally ill 405 0 2 2 8000 Invol emerg commit/person charged/convicted 302 1 1 0 1 8200 Invol criminal commit/charged/convicted 304 8 1 2 11 14 10 3 27 38 8300 Extended involuntary charged/convicted 305 5 2 28 1 15 51 7 4 5 16 67 0 SMRC ICF 0 0 134 134 1 SMRC SNF 0 0 1 1 9900 SRTU Act21 0 0 26 26

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