We invite you to explore this page and its resources to learn about two data driven models—the Allegheny Housing Assessment (AHA) and the Mental Health Allegheny Housing Assessment (MH-AHA). These are decision support tools that the Allegheny County Department of Human Services (DHS) uses to improve equity and transparency in how we prioritize placement—and ultimately improve outcomes—in housing and mental health residential services.

Allegheny Housing Assessment (AHA)

Permanent Supportive Housing (PSH) and Rapid Rehousing (RRH) are two long-term housing programs operated by Allegheny County’s Continuum of Care (CoC). Because referrals for placement in these programs exceed capacity every year, we have to prioritize for placement those who are at highest need and would benefit from it the most.

The Allegheny Housing Assessment (AHA) is a tool that uses administrative data to support decision making in this prioritization process. It is a significant improvement from the previous method of prioritization, which required the use of a lengthy questionnaire that was time-consuming to administer, distressing to applicants and unreliable. In August 2020, DHS implemented the Allegheny Housing Assessment (AHA), a model developed by a team led by Dr. Rhema Vaithianathan and partners at the Centre for Social Data Analytics↗. This model has been shown to improve equity in the allocation of housing resources. As part of DHS’s commitment to continued quality assurance, it was updated in 2025.

Mental Health Allegheny Housing Assessment (MH-AHA)

Mental Health Residential (MH-Res) programs are a high-demand resource that require prioritization and waitlist management. The purpose of the Mental Health Allegheny Housing Assessment (MH-AHA) is to identify people who are at the highest risk of future mental health inpatient stays and repeated ER visits and thus most in need of MH-Res services. This model offers a low-cost and data-driven way to assess individuals in Allegheny County for their level of need to help prioritize this limited resource. 

Questions or Feedback?

We welcome your questions and suggestions. To share feedback, email us at  DHSResearch@alleghenycounty.us. If you’d like to stay informed, consider  signing up for our newsletter. To learn how to use DHS data in your research, please visit our Requesting Data page. Thank you for your time and interest. Your engagement helps shape and improve how we share data that matters.

We invite you to explore this page to understand how Allegheny County is using settlement funds to address the opioid epidemic.

 

In 2021 and 2022, states and localities reached historic settlements with manufacturers and distributors of opioids, as well as pharmacy chains and a consulting firm, for their roles in the opioid epidemic. As a result of these settlements, Allegheny County will receive annual payments in varying amounts, every December, through at least 2038.

Two major objectives guide Allegheny County’s use of opioid settlement funds:

• reducing fatal overdoses
• reducing the harms from opioid use disorder

The flexible nature of the settlement funds compared to other funding streams strengthens Allegheny County’s ability to:

• provide stability for effective existing programs, especially when other funding is uncertain or inadequate
• expand effective services and build capacity—such as covering upfront operational costs—that Medicaid or other healthcare funding does not cover
• support emerging strategies and fund innovative solutions aimed at addressing the opioid epidemic

Dashboard and Reports

The dashboard and reports—housed on this page—track the use of settlement funds and document the outcomes of the investments.

1. 1. 2024 Opioid Settlement Fund Report (Published 2025): describes the County’s strategy to address the opioid epidemic and the programmatic investments made with opioid settlement dollars in 2024.
   2. Opioid Settlement Community Listening Sessions Findings: reports the results and findings from community listening sessions held in 2024. Community priorities for opioid settlement spending included: expanding treatment access, reducing harm and stigma, improving housing stability and investing in family strengthening supports and services.
   3. Opioid Settlement Dashboard (2022-Present): displays an interactive dashboard that tracks Allegheny County’s spending of opioid settlement funds across different programs and priorities.

Previous:

1. 1. 2023 Opioid Settlement Fund Report (Published 2024): details how Allegheny County used it’s first installment of opioid settlement funds.

Key Takeaways

1. Decrease in fatal overdoses: There was a 35% decline in fatal overdoses from January to August 2024 compared to the same period in 2023 (301 compared to 466).
2. Decline in wastewater levels for norfentanyl and xylazine:
   1. The concentration of norfentanyl (a proxy for fentanyl) in wastewater dropped by more than 60% from March 2024 through the end of December 2024.
   2. The concentration of xylazine (a drug often used in veterinary medicine as a sedative) in wastewater levels had a sharp decline over the course of 2024, falling over 80%.
3. Expansion of treatment in jail: The total count of individuals receiving any medication for opioid use disorder (MOUD) in the jail more than doubled from 2023-2024—from 889 to 1,800.
4. Growth of mobile and telehealth treatment access:
   1. Mobile units operated by Prevention Point Pittsburgh (PPP) served 600 patients in high need communities at no cost.
   2. Telemedicine services offered by the UPMC Bridge Clinic—a fast turnaround MOUD prescribing service—had over 2,000 encounters in 2024, and most patients accessed medication within two hours of their telehealth visit.
5. Support for community-led solutions: In 2024, Allegheny County dedicated nearly $1 million in settlement funds to support initiatives led, designed or operated by highly impacted communities.
6. Investments in harm reduction strategies: In 2024, syringe services reached 700 new visitors and 3,000 returning visitors. The service program collected approximately 40 cubic feet of medical waste each month by collecting used supplies (e.g., needles, syringes) from visitors—supporting safe handling and disposal of medical waste in the community.
7. Direction from the community: 2024 settlement investments reflected community input from the listening sessions—demonstrating Allegheny County’s commitment in shared decision-making.

How the County Uses this Information

Allegheny County uses the dashboard and reports to ensure it uses opioid settlement funds responsibly, equitably and effectively. Specifically, the County uses this information to:

1. Monitor trends and outcomes in overdoses, treatment access and disparities across populations.
2. Fill service gaps by directing funds to under-funded effective programs and by financing programs prioritized or endorsed by the community.
3. Invest in evidence-based supports and services that support the improvement of current programs, the piloting of new initiatives and the design of innovative solutions.
4. Drive continuous improvement efforts that strengthen partnerships and improve coordination across Allegheny County.
5. Share insights and lessons learned with other communities and jurisdictions looking to pursue similar efforts.
6. Strengthen public trust through advancing transparency in use of funds.

What’s Next

For 2025-2026, Allegheny County plans to use opioid settlement funds to:

1. Expand access to low-barrier, high-quality, evidence-based MOUD and recovery support services.
2. Continue to support treatment in the Allegheny County Jail, including continuity of care post-release.
3. Increase services in highly impacted communities—improving mobile units for MOUD distribution and wound care, strengthening harm reduction services and enhancing targeted interventions for people at highest risk.
4. Upgrade supportive housing by investing in recovery housing and permanent supportive housing for people with opioid use disorder.

Allegheny County has also issued a funding opportunity called the Open Solicitation for Programs that Prevent or Treat Opioid Addiction Under the Guidelines of the Opioid Settlement Fund. Through this Request for Proposals (RFP), Allegheny County seeks additional ideas from the community on how to improve outcomes for groups disproportionately or hardest impacted by the opioid epidemic, particularly the Black community, people who are currently or recently incarcerated, individuals experiencing homelessness, people who inject drugs, and people with chronic pain or disabilities.

 

Questions or Feedback?

We welcome your questions and suggestions. To share feedback, you can reach us at DHSResearch@alleghenycounty.us. If you’d like to stay informed, consider signing up for our newsletter. To learn how to use DHS data in your research, please visit our Requesting Data page. Thank you for your time and interest. Your engagement helps shape and improve how we share data that matters.

The Allegheny County Department of Human Services (DHS) partnered with Pittsburgh Regional Transit (PRT) to launch a new transportation assistance program in November 2022 called the Discounted Fares Pilot. This program offered free and reduced-price PRT rides for county residents ages 18 to 64 who receive Supplemental Nutrition Assistance Program (SNAP) benefits, along with their 6- to 17-year-old children. The fare discounts were allocated using a lottery. Each household in the pilot was randomly assigned to one of three groups, each with equal probability. One group received unlimited free PRT trips, a second group received a 50% discount on all PRT trips, and a third group received no discount. The fare discounts lasted 16 to 19 months for the free-fare and half-fare groups.

Key Takeaways

1. The Pilot began with strong enrollment—over 14,000 people. A total of 9,544 adults and 4,928 children enrolled in the Pilot during the three-month open enrollment period. The majority of adult participants were female (72%) and Black (59%). Participants reported taking an average of ten PRT trips per week and spending an average of nearly $30 on public transportation per week at the time they enrolled in the Pilot.
2. Free fares increased public transit ridership. On average, participants in the free-fare group took 1.48 more trips per week—a 43% increase—compared to those who paid regular price for their trips. In contrast, transit usage among participants who received half-priced fares was not statistically different from those who paid regular price for their trips.
3. Fare discounts eased financial hardships. Near the end of the discount period—around 15 months into the pilot program—recipients of free fares reported spending $17.09 less per week on public transit compared to participants who paid full price for their transit usage. Participants paying half-priced fares reported spending $5.64 less per week on public transportation than participants who paid full price for each ride.
4. Among participants who began the study without a job, free fares led to meaningful gains in employment and income. Over the first year and a half of the program, unemployed individuals who received free transit were 6% more likely to secure paid work than those who paid full price. Free-fare recipients also earned nearly $2,850 more—a 28% increase in earnings—compared to participants who covered their own transit costs. These findings suggest free public transit can increase financial stability and employment opportunities for low-income residents in Allegheny County.
5. The short duration of the fare discounts may have limited their impact on other social and educational outcomes. The study found small and statistically insignificant impacts on healthcare utilization and criminal justice involvement (including appearances in court). Fare discounts had no detectable impact on school attendance among children who attend Pittsburgh Public Schools.

How DHS Uses This Information

DHS has used the results from this pilot to inform the design and implementation of a longer-term program called AlleghenyGo, which offers a 50% PRT discount for working-age county SNAP beneficiaries and their children. Click here to learn more about AlleghenyGo.

Past Reports and Resources

1. Evaluation of First Year of Pilot Program – Interim Results (May 2024)
2. Research and Evaluation Plan for Pilot Program (2022)

Questions or Feedback?

We welcome your questions and suggestions. To share feedback, you can reach us at DHSResearch@alleghenycounty.us. If you’d like to stay informed, consider signing up for our newsletter. To learn how to use DHS data in your research, please visit our Requesting Data page. Thank you for your time and interest. Your engagement helps shape and improve how we share data that matters.

Statement from Allegheny County DHS: Improving outcomes for people with serious mental illness 

July 15, 2025

“A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization,” released this week, showcases the unique data and analytic capacity of Allegheny County Department of Human Services and presents the first causal evidence around psychiatric hospitalizations produced anywhere in the country.   

The research raises critical and difficult questions about how best to support individuals living with serious mental illness (SMI), particularly during times of crisis. The findings underscore what we have long recognized: that the current system does not always produce the outcomes we intend, and that we must invest in new models of care.  

Allegheny County DHS is committed to improving outcomes and reducing adverse events—such as overdose, suicide, and justice involvement—among individuals with SMI. 

Our efforts to improve outcomes for people include: 

• We launched the Alternative Response program, an initiative in which behavioral health first responders can now answer human service and behavioral health 9-1-1 calls instead of law enforcement in 11 municipalities and two police departments, with the hopes that individuals can get safely to community based behavioral health care, instead of hospital where appropriate.  

• We are deploying crisis response teams in key geographic areas, including downtown Pittsburgh, to meet people where they are in crisis and work together with a multidisciplinary team to engage frequently with them and offer low-barrier connection to care for complex needs. 

• We will introduce a new street-based treatment program to engage, stabilize, and treat individuals with SMI who are experiencing unsheltered homelessness. This model will use targeted, persistent engagement to build trust and therapeutic relationships to support long-term recovery. 

• We recently launched the Mobile Competency Restoration and Support Team (MCRST), allowing individuals with SMI involved in the criminal justice system to begin competency restoration in the community—reducing long jail stays while waiting for placement in a state hospital. 

• We are launching a peer-led, short-term respite overnight program that operates 24 hours/day in a home-like environment. It will be staffed by certified peer specialists, who will provide non-clinical crisis support based on specialized training and their own personal recovery experience. 

• Earlier this month, DHS assumed responsibility for managing access to key community-based mental health services that are critical for promoting stability. Using consistent tools and criteria, we will proactively identify individuals in need, facilitate timely connections to care, and help clients step down to lower levels of support while ensuring access to additional human services where appropriate. 

• We will expand the supply of supportive housing for people with SMI and co-occurring SMI and substance use disorders. We aim to add 300 supportive housing beds this year, and we recently issued a solicitation to increase our Long-Term Structured Residences (LTSR) bed supply. 

• We are expanding core behavioral health services, including mobile medication teams that assist with medication education and adherence, and integrated dual-diagnosis teams for individuals with both SMI and substance use disorders. 

• We will test the use of financial incentives to support adherence to long-acting injectable antipsychotic medications, where clinically recommended – which can increase medication adherence and reduce adverse outcomes such as inpatient hospitalization and involuntary commitment.   

• We are working with inpatient providers to reexamine physician training related to evaluating involuntary commitment petitions. Physicians with more training and experience are often more circumspect in their choice to hospitalize, and facilitating knowledge sharing across disciplines may improve results. At the same time, we are exploring data-informed tools to improve decision-making.  

• We are exploring the implementation of Assisted Outpatient Treatment (AOT) in Allegheny County as one component of a broader, community-centered behavioral health system. Many clients deteriorate in community until friends, family, law enforcement, or providers become so concerned about their and others’ welfare that they file a petition. These clients often struggle to connect with behavioral health services. We are exploring AOT as a tool to engage with people sooner and help them remain stable in community as well as be a diversion from involuntary inpatient hospitalization.  

 

It is important to underscore: every day, people are working across the behavioral health system to help people find safety, support and recovery – and in many cases, people are indeed getting help they need. At the same time, we recognize that we must always strive to do better, particularly to help people who are still struggling despite what our current system has to offer. We are committed to learning from data — being transparent about what the research tells us and using it to accelerate our improvement efforts – and listening to those most affected and their families to guide solutions that will lead to greater safety, stability, and recovery. 

What are these reports about?

DHS’s Strategic Initiatives are bold, transformative efforts designed to improve the effectiveness of human services for everyone. These reports describe innovative strategies aimed at supporting the people of Allegheny County and detail featured accomplishments that have strengthened essential systems in the County.  

2025 Strategic Initiatives

Strategic initiatives featured in the 2025 report include expanding caregiver support, improving access to key programs for individuals with serious mental illness and developing crisis support for families involved in the child welfare system. View the 2025 Strategic Initiatives report here.

2024 Accomplishments

During 2024, DHS and its partners made significant progress toward achieving several goals by focusing on annual Strategic Initiatives. The 2024 Accomplishments report features several accomplishments, including the launch of Allegheny Go, an increase in the number of people transitioning from shelter to permanent housing, reduced wait times for Allegheny Link, improved access to support for seniors and fewer law enforcement encounters.

Previous Reports:

• 2024 Goals and Key Initiatives
• 2023 Goals and Key Initiatives
• 2019-2020 Strategic Initiatives

 

The Allegheny County Department of Human Services (DHS) engages clients and others who interact with DHS programs in a variety of ways: regular roundtables/cabinets (e.g., Children’s Cabinet); town halls and community forums; social media (e.g., Facebook and LinkedIn); and the Director’s Action Line (DAL). In 2018, DHS expanded its public engagement strategy to include SMS text messaging (texting), a tool that is convenient for recipients and allows DHS to scale up communication with clients and other Allegheny County residents.

How does DHS use text outreach? 

DHS uses text outreach in a variety of ways, including collecting feedback after a service touchpoint, increasing program engagement, recruiting for paid research opportunities, and providing timely alerts. Text messaging has allowed DHS to connect clients to resources at scale, and to solicit feedback from clients who would likely never otherwise have the time or opportunity to share their feedback.

What data is available?

The data brief provides more information about the communication strategy and descriptive analytics from 2018 to 2022. The interactive dashboard, which is updated daily, allows users to drill down to individual text campaigns to understand the purpose, the number of messages sent, and the demographics of people who were contacted.

Terms and Conditions

This service is used by the Allegheny County Department of Human Services to send you notifications about publicly funded services. You can cancel this service at any time. Just text “STOP” to 987987. After you send the message “STOP” to us, we will send you a reply message to confirm that you have been unsubscribed. After this, you will no longer receive messages from us. If you want to join again, just text “START” to 987987, and we will start sending messages to you again. If at any time you forget what keywords are supported, just text “HELP” to 987987 After you send the message “HELP” to us, we will respond with information about the program. Message frequency varies. Carriers are not liable for delayed or undelivered messages. As always, Message and Data Rates May Apply for any messages sent to you from us and to us from you. If you have any questions about your text plan or data plan, it is best to contact your wireless provider. For all questions about the services provided by this short code, you can contact us at DHS-Research@alleghenycounty.us

Please view our Privacy Policy here

Pittsburgh-Allegheny County is one of eight sites participating in the Community Choice Demonstration (CCD) – a large-scale, multi-site randomized controlled trial to test the efficacy of offering housing mobility-related services to families with children in the Housing Choice Voucher (HCV) program. The CCD builds on prior research showing that growing up in lower-poverty neighborhoods increases children’s academic achievement, long-term earnings as adults, and selected improved health outcomes for children and adults.

What is this report about? 

This Rapid Cycle Evaluation is the first report assessing the early implementation of the Demonstration and capturing the initial impact and costs of comprehensive mobility-related services (CMRS). The report provides preliminary findings on the locational outcomes for 596 HCV families with children who enrolled in the first 8 months of the 6-year Demonstration through March 2023. This is the first of a series of reports expected over the next eight years detailing progress of the Demonstration, which began in August of 2022 and ends in October 2028.

What are the takeaways?

An analysis of 12 months of data indicates that the Demonstration is having a statistically significant, positive impact on moves to low-poverty, high opportunity areas. Almost 24% of HCV families with children who received CMRS moved to an opportunity area, compared to 4% percent of HCV families in the control group. The offer of CMRS resulted in a nearly 20 percentage point increase in the share of families moving to an opportunity area within 12 months of study enrollment.

In May 2022, Allegheny County assembled a taskforce of leaders to reduce intimate partner violence (IPV) through improved coordination, information sharing, training, and implementation of interventions that target both those who use violence and those who are victims or survivors of it.

Historically, the County’s understanding of IPV has been based on national data, which, though useful, fails to capture local nuances that lend greater insight into specific community needs. The county published a report and dashboard to provide more local context to problems of IPV in Allegheny County by describing trends in demographics, human services involvement, and criminal histories among victims and perpetrators of intimate partner homicides (IPH). The report covers January 2017 through September 2022. The dashboard includes more recent information and is updated annually.

The analysis point to a disproportionate impact on individuals who are disadvantaged not only by their gender identity, but also by systemic racial and socioeconomic inequalities. Though IPV has traditionally been framed as an issue related to gender alone, a more intersectional understanding of risk and impact can better inform strategies for effective prevention and mitigation.

Key Findings from Report

• There were 45 victims (43 incidents) of IPV and IPV-spillover homicides from January 2017 through September 2022.
• The demographic trends among individuals involved in IPH are similar to those of overall homicides: victims and perpetrators are disproportionately Black, young (aged 25-34) and living in high-need areas. Black women represent the highest proportion of victims (37%, n=16), while Black men constitute the highest proportion of perpetrators (56%, n=23).
• Unlike homicides at large, IPH victimization disproportionately impacts women: 63% of victims of IPH are women.  While IPH accounted for roughly 7% of all homicides from January 2017 through September 2022, they made up 30% of all homicides with female victims.
• Both victims and perpetrators of IPH had high rates of involvement in human services.  74% of perpetrators had prior involvement with child welfare, publicly funded behavioral health, or homeless and housing systems.
• 58% of victims had prior involvement with child welfare, publicly funded behavioral health, or homeless and housing systems.
• Across all gender, race and role categories, about 53% of individuals involved in IPH – 47 of 88 – had criminal justice involvement at some point prior to the homicide incident: 63% of perpetrators (27 of 43) and 44% of victims (20 of 45). Among perpetrators with criminal justice involvement, both Black and White men had higher rates of involvement than either Black or White women.
• Roughly 24% of all IPV perpetrators had indicators of IPV history in either the criminal courts or child protection system. This is likely an undercount of true IPV history, as data limitations, legal restrictions and underreporting make identification of non-fatal IPV in the data difficult. Among those with domestic violence related criminal cases, the majority occurred in the 18 months prior to the homicide incident.

Read more about the county’s IPV work here.

 

 

From May through August 2024, Allegheny County Department of Human Services (DHS) engaged in a comprehensive needs assessment. The purpose of the assessment was to determine how DHS can best address the needs of individuals and families living in poverty and promote stability and economic security using Community Service Block Grant (CSBG) funds and other flexible funding across the agency. The assessment included collection and analysis of qualitative and quantitative data from community members and service providers.

Read the new report here.

What are the takeaways?

• Despite a decrease in the overall poverty rate, there remain deep disparities in poverty by demographic groups. Black people, women with children and people with less than a high school diploma experience poverty at twice to three times Allegheny County’s rate.
• Finding job opportunities was the number one challenge reported by survey respondents seeking employment. Additional barriers to employment include transportation and resumé/application preparation.
• Workforce participant engagement for those receiving SNAP and TANF (i.e., those with low income, for whom relevant data are available) increased from 2021 to 2022, possibly explained by COVID-related participation extensions. The demand for job readiness/training programs among this population, particularly for SNAP recipients who are female and Black, is expected to increase further as SNAP work requirement waivers expire in 2025.

Allegheny County residents face significant challenges in accessing behavioral health services, an issue highlighted by recent studies and surveys. Notably, a Countywide survey revealed that 42.7% of respondents believe improving access to mental health care, particularly for young people, should be a priority. This finding is supported by research from the University of Pittsburgh, which documented long wait times for appointments and challenges in connecting with providers. These issues stem from a critical shortage of behavioral health professionals and are compounded by time-consuming provider search processes.

In response, the Allegheny County Department of Human Services (DHS), along with Community Care Behavioral Health (CCBH), the County’s behavioral health managed care organization, are pursuing a series of investments and initiatives aimed at addressing these barriers and increasing service availability.

To improve access and reduce wait times, DHS and CCBH are focusing on:

• Creating visibility into appointment availability so clients and providers spend less time searching for services.
• Supporting the behavioral health workforce through loan repayment and cohort-based training programs to increase the number of providers.
• Investing in community-based mental health supports to offer additional options outside the traditional system.
• Expanding access to proven treatments like medication-assisted therapy for opioid addiction, cognitive behavioral therapy and group therapy.
• Augmenting clinical decision-making to ensure those who need help most get it quickly

The Allegheny County Department of Human Services (DHS) funds programs to assist young adults who are transitioning out of the child welfare system (also known as transition-aged youth) to secure employment, education, housing, behavioral health services, financial advice and more. Despite these service offerings, transition-aged youth have higher rates of homelessness, substance use, mental health challenges and incarceration, as well as lower rates of high school graduation compared with people who were not involved with the child welfare system. While targeted services are important, some human service needs result from poverty, which can be mitigated by providing direct financial assistance.

What is this report about?

In the summer of 2023, DHS launched a direct cash support program called Cash Assistance for Allegheny Young Adults (CAAYA), which provided a one-time payment of $4,000 to young adults, ages 18 through 22, with a history in the child welfare system, who were experiencing homelessness or were young parents who had an open case with Allegheny County’s child welfare office. In this report, we present a mixed-methods approach to evaluating the impact of CAAYA, including longitudinal surveying, a quasi-experimental analysis of administrative data in the Allegheny County Data Warehouse, and semi-structured interviews with cash recipients.

What are the takeaways?

• CAAYA recipients demonstrated significant financial need. At the launch of the program, only 35% reported being currently employed and only 29% reported being in school either full-time or part-time. Those who had some form of formal employment in the 12 months before the program had mean annual earnings of $10,174. Twenty-eight percent had one or more children.
• CAAYA recipients also lacked financial support within their community. Two-thirds of recipients reported not knowing anyone who would lend them $500 in a time of crisis.
• Overall, the program encouraged about 100 individuals to open a bank account. Seventy-five percent (n = 774) of recipients chose to receive the money via bank account transfer and 25% via a virtual gift card.
• Recipients used the cash assistance quickly. On average, $2,769 of the $4,000 was spent within the first month.
• Car-related expenses ranked as the number one item for planned expenditures, and there was a 41% relative increase in car ownership three months after receiving the money.
• The program improved self-reported well-being after receiving financial assistance, but the effects faded in the subsequent months.
• CAAYA recipients increased their use of mental health outpatient therapy by 7% compared to a control group of individuals who were narrowly ineligible for the program. There was no change in utilization of crisis and inpatient services. In contrast to self-reported well-being, the program’s impact on usage of outpatient mental health services persisted for at least eight months after receiving funds.

How is this report being used?

As a result of this program, we are exploring additional opportunities to leverage cash assistance with this population to increase engagement in holistic supports and services. We are also considering longer-term programs with more frequent, smaller payments to targeted populations.  For future programs, we hope to receive state waivers for the impact of cash assistance on public benefits, especially if a program is designed to include ongoing payments.

For other local governments or providers who are considering cash assistance programs, we hope this report serves as a resource for program design and evaluation. Local governments should note that the success of the CAAYA program would not have been possible without our partner organizations. Trust in government significantly impacts the accessibility of services, particularly for marginalized communities. When first hearing about the cash assistance, many individuals who were eligible to receive the money thought that it was a scam. This skepticism was eased by having multiple trusted intermediaries ensure that it was a real program and that they should apply.

The 2008 Act 33 Amendment to the Pennsylvania Child Protective Services law requires state and local reviews of all child fatalities and near fatalities that result from suspected child abuse. In response, the Allegheny County Department of Human Services (DHS) conducts a comprehensive and multidisciplinary review of child fatalities and near fatalities in cases where there is suspicion of child abuse or neglect. These reviews are a component of DHS’s continuous quality improvement process.

What is this report about?

This report covers child fatalities and near fatalities (critical incidents) in Allegheny County reviewed in 2022 and 2023 with a focus on drug ingestions, which have been a growing cause of these critical incidents. The increase in child ingestions and fatalities has been a nationwide trend in recent years and has worsened amidst the nation’s opioid epidemic. The County seeks to understand how these incidents happen and the circumstances surrounding them so that it can develop strategies to minimize them.

What are the takeaways?

• There were 50 critical incidents that occurred during 2022 and 2023. Forty percent (20) of these incidents were the result of unintentional drug ingestion. Unintentional ingestion comprised one-third of the 2022 incidents, rising to nearly one-half in 2023. The number of ingestion-related incidents has been rising year-over-year since 2019 and has been the primary cause of the County’s fatalities and near fatalities since 2022, surpassing blunt force or penetrating trauma and abusive head trauma.
• In 18 of the 20 ingestion cases, at least one of the substances ingested was an opioid. Eighty-six percent of the near fatal and 100% of the fatal ingestions involved opioids.
• The majority (70%) of ingestions occurred in children below the age of three. 40% of victims of ingestions were between one and two years of age compared to 27% of victims of non-ingestion fatalities and near fatalities. This age group are especially at risk for unintentional ingestion as they begin to gain mobility, which increases the likelihood of coming into contact with substances.
• Only 4 (20%) families of ingestion-related critical incidents had active child welfare involvement at the time of the incident, though three quarters (15) of families had a history of child welfare involvement prior to the ingestion incident.
• Sixty-six percent of alleged perpetrators in ingestion cases had received publicly funded substance use disorder services prior to the critical incident.  However, there was a reduction in engagement with these services within a year (43%) and within a month (36%) prior to the critical incident.
• Of the known alleged perpetrators in ingestion cases, 41% had utilized medication for opioid use disorder (MOUD) at some point before the critical incident. There was a steady decrease in MOUD use leading up to the critical incident with 31% using MOUD within the year and 13% within the month prior to the critical incident. 

How is this report being used?

Allegheny County is taking an active role in addressing the ramifications of the opioid epidemic and the rising trend of unintentional ingestions. This includes enhanced training for Child welfare staff and access to naloxone, lockboxes and fentanyl test strips for caseworkers to provide to clients. The County, through its opioid settlement funds, has expanded convenient access to MOUD and evidence-based treatment (e.g., mobile medication, telemedicine prescribing, and incentives for abstinence from stimulants and opioids) and launched a Countywide marketing campaign in April 2024 warning about the dangers of opioid ingestions and the safety of administering naloxone to children. In addition, it has invested in preventative programming like residential substance use disorder treatment that allows families to reside together during a person’s treatment and in the Hello Baby approach, a collaboration which is designed for parents with newborns to improve family outcomes and maximize child and family well-being, safety and security.

Other information

Explore updated annual data and prior reports here.

Read about how Allegheny County responded to an 82% increase in reports of need to Older Adult Protective Services.

Click here to read more information about older adult protective services and access real-time data.

Since 2016, the Allegheny County Department of Human Services (DHS) in Pennsylvania has utilized the Allegheny Family Screening Tool (AFST), which assists child welfare call screening caseworkers in their assessment of general protective service (GPS) referrals regarding potential child maltreatment.

What is this report about?

This report reviews the research evidence on algorithms in child welfare, specifically focusing on the causal impacts of the AFST and comparable predictive risk models (PRMs). It begins by summarizing the influence of these tools on child welfare decisions. The report then explores the discrepancies between perceived and actual effects of these models, highlighting the importance of bridging the gap between perception and reality to alleviate concerns and maximize the effectiveness of these tools.

What are the takeaways?

The impacts of predictive risk models in child welfare must be compared with alternative approaches to augmenting call screening caseworker decision-making. Traditional risk assessments in child welfare have been largely manual, prone to inconsistencies, and often omit critical information. Before implementing the AFST, Allegheny County did not employ any structured risk assessment.

The main conclusions from recent research on the AFST are:

• The AFST changed the composition of investigated referrals. The introduction of the AFST decreased the probability of investigation for referrals with low risk of removal and increased the probability of investigation among referrals with high risk of removal. The introduction of the AFST also reduced the racial gap in investigation rates, particularly among higher risk referrals.
• The AFST is reducing, not increasing, racial disparities. Researchers found that the introduction of the model reduced racial disparities in investigation rates across AFST scores, although the size and precision of the reduction varied. The AFST reduced the racial disparity in investigation rates for the highest risk referrals by 83%, from 10.6% to 1.8%. The researchers estimated that the AFST reduced the Black–White gap in removal rates of screened-in referrals by 73%, from 4.3% to 1.2%.
• Screeners use the algorithm but with caution. Researchers found that call screening case workers are integrating information from the AFST effectively, aligning their decisions more closely with predicted removal risk compared with the period before the tool’s introduction. The tool is seen as a helpful source of additional information rather than a replacement for professional judgment. 

How is this report being used?

The application of algorithms to support decision-making, especially in sensitive areas like child welfare, mandates high transparency. It is critical that the complexities of predictive risk models are communicated clearly to all stakeholders to maintain trust and prevent misuse. DHS is committed to keeping the public informed about the use and impact of algorithms at the Department and draw upon current research to shape the implementation of these tools in the field.

Read more about AFST here.

What is the Community Need Index?

The Allegheny County Department of Human Services (DHS) conducts a Community Need Index (CNI) to identify specific areas that are in greater need, and face larger socioeconomic barriers, relative to others. The newest version of the CNI index ranks neighborhoods by need level by looking at:

• The percentage of families who live below the poverty line
• The percentage of unemployed or unattached males
• The percentage of those aged 25 and up without at least a Bachelor’s degree
• The percentage of single parent households
• The percentage of households without internet access
• Rate of homicide per 100,000 residents
• Rate of fatal overdoses per 100,000 residents

The researchers used a census tract level to break up the region and assess needs. Census tracts are static, relatively small subdivisions of a county.

How can I view the findings?

An interactive map allows users to view and extract data from the 2024 CNI (which uses 2022 five-year data estimates and totals). The new report focuses on all of Allegheny County, examines changes in need over time, and places emphasis on the connection between race and community need. Earlier reports are linked below.

What are the takeaways?

• In Allegheny County, we continue to find the highest levels of need in specific sections of the City of Pittsburgh (Hill District, South Hilltop, parts of the West End, Upper East End neighborhoods, Upper Northside) as well as census tracts outside the City of Pittsburgh (Mon Valley, sections of the Allegheny County River Valley, sections of Penn Hills, sections of Wilkinsburg, Stowe-Rocks).
• There are vast discrepancies between the lowest need communities, which have an average poverty rate of 2%, and the highest need communities, where the average poverty rate is 38%.
• With few exceptions, census tract-level community need is persistent over time.
• Only about one-third of Allegheny County’s Black residents live in lower-need communities. For every other racial and ethnic group in the County, the majority of residents live in lower need communities. Black communities in Allegheny County have disproportionately high levels of need, as do a number of racially mixed communities. 
• Poverty status alone does not account for where various racial and ethnic groups tend to live by level of need; poor Black and Latino families are more likely than other poor families to live in higher need communities. Even Black families above the poverty line are many times more likely than their Asian, White and Latino peers above the poverty line to live in higher need communities.

How is this report used?

The geographic dimensions of community need can help inform many aspects of DHS’s strategic planning and resource allocation decisions, such as decisions on where to locate Family Centers or new after-school programs.

Where can I go for more information?

For more information, you can read previous reports below. Or you can reach out to DHS-Research@alleghenycounty.us with any questions.

 

---

Previous reports in this series 

• 2018 update (all county)
  • 2018 Storymap
• 2014 update (suburbs)
• 2012 update (suburbs)
• 2000-2009 (suburbs)
• 2000-2012 (city)

Previous datasets in this series

• 2018 (all county)
• 2014 (suburbs)
• 2000-2012 (city)