Performance Outcomes Adult Specialty Mental Health Services Report Report Date February 12, 2019 Background This report measures the effectiveness of adult specialty mental health services. It models reports developed to measure Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services as mandated by Welfare and Institutions Code Section 14707.5. The intent of these reports is to improve outcomes at the individual, program, and system levels and inform fiscal decision-making related to the purchase of services. Since 2012 DHCS has worked with several groups of stakeholders to create a structure for reporting, to develop a Performance Measurement Paradigm, and to design indicators and measures. The Performance Outcomes System will be used to evaluate the domains of access, engagement, service appropriateness to need, service effectiveness, linkages, cost effectiveness and satisfaction. Further information on the Performance Measures System implementation is available on the DHCS website. Documents posted include the relevant legislation, plans submitted to the Legislature, and handouts for meetings with the Stakeholder Advisory Committee back to the first meeting in 2012. To obtain this information go to: http://www.dhcs.ca.gov/provgovpart/pos/Pages/default.aspx. Overview Three reports will be provided: statewide aggregate data; population-based county groups; and county-specific data. These aggregate reports provide adult information on the initial indicators that were developed for the Performance Outcomes System. DHCS plans to move to annual reporting of these data for the Performance Outcomes System. The first series of charts and tables focus on the demographics of adults 21* and older who are receiving SMHS based on approved claims for Medi-Cal eligible beneficiaries. Specifically, this includes demographics tables of this population by age, gender, and race/ethnicity. Utilization of services reports are shown in terms of dollars, as well as by service in time increments. Two types of penetration information are provided; both penetration rate tables are also broken out by demographic characteristics. The snapshot table provides a point-in- time view of adults arriving, exiting, and continuing services over a two-year period. The time-to-step-down table provides a view over the past four years of the time to stepdown services following inpatient discharge. Where possible, the reports provide trend information by displaying information for Fiscal Years (FY) 14/15, 15/16, 16/17, and 17/18. Definitions *Population - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were: • Age 21 or older during the approved date of service on the claim. Data Sources - ▪Short-Doyle/Medi-Cal II (SD/MC II) claims with dates of service in FY 14/15 through FY 17/18. ▪Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 14/15 through FY 17/18. 1 of 14
Transcript
Performance Outcomes Adult Specialty Mental Health Services Report Report Date February 12, 2019
Background This report measures the effectiveness of adult specialty mental health services. It models reports developed to measure Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services as mandated by Welfare and Institutions Code Section 14707.5. The intent of these reports is to improve outcomes at the individual, program, and system levels and inform fiscal decision-making related to the purchase of services.
Since 2012 DHCS has worked with several groups of stakeholders to create a structure for reporting, to develop a Performance Measurement Paradigm, and to design indicators and measures. The Performance Outcomes System will be used to evaluate the domains of access, engagement, service appropriateness to need, service effectiveness, linkages, cost effectiveness and satisfaction. Further information on the Performance Measures System implementation is available on the DHCS website. Documents posted include the relevant legislation, plans submitted to the Legislature, and handouts for meetings with the Stakeholder Advisory Committee back to the first meeting in 2012. To obtain this information go to: http://www.dhcs.ca.gov/provgovpart/pos/Pages/default.aspx.
Overview Three reports will be provided: statewide aggregate data; population-based county groups; and county-specific data. These aggregate reports provide adult information on the initial indicators that were developed for the Performance Outcomes System. DHCS plans to move to annual reporting of these data for the Performance Outcomes System.
The first series of charts and tables focus on the demographics of adults 21* and older who are receiving SMHS based on approved claims for Medi-Cal eligible beneficiaries. Specifically, this includes demographics tables of this population by age, gender, and race/ethnicity. Utilization of services reports are shown in terms of dollars, as well as by service in time increments. Two types of penetration information are provided; both penetration rate tables are also broken out by demographic characteristics. The snapshot table provides a point-in-time view of adults arriving, exiting, and continuing services over a two-year period. The time-to-step-down table provides a view over the past four years of the time to stepdown services following inpatient discharge.
Where possible, the reports provide trend information by displaying information for Fiscal Years (FY) 14/15, 15/16, 16/17, and 17/18.
Definitions *Population - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were:• Age 21 or older during the approved date of service on the claim.
Data Sources - ▪Short-Doyle/Medi-Cal II (SD/MC II) claims with dates of service in FY 14/15 through FY 17/18.▪Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 14/15 through FY 17/18.
Performance Outcomes Adult Specialty Mental Health Services Report Report Date February 12, 2019
Additional Information The Measures Catalog is the companion document for these reports and provides the methodology and definitions for the measures. Each measure is defined and the numerator and denominator used to develop the metrics are provided with relevant notes and additional references. The Measures Catalog may be found at: http://www.dhcs.ca.gov/services/MH/Documents/MedCCC/Library/POSMeasuresCatalog_Sept15Reporting_Final_1.11.15.pdf
Note on Privacy: The Health Insurance Portability and Accountability Act (HIPAA) and Code of Federal Regulations (CFR) 42 rules protect most individually identifiable health information in any form or medium; whether electronic, on paper, or oral. DHCS has strict rules in place to protect the identification of individuals in public reports. A “Public Aggregate Reporting – DHCS Business Reports” process has been established to maintain confidentiality of client Personal Information. The Performance Outcomes System complies with Federal and State privacy laws. Thus, the POS must appropriately and accurately de-identify data for public reporting. Due to privacy concerns, some cells in this report may have been suppressed to comply with state and federal rules. When necessary, these data are represented as follows: 1) Data that are missing is indicated as "-" 2) Data that have been suppressed due to privacy concerns is indicated as "^".
Report Highlights
*County-specific findings may be interpreted alongside the POS statewide and population-based report findings.
*The penetration rates reported here were calculated using a different methodology than that used by the External Quality Review Organization (EQRO). The differences in methodology makes comparison between the POS penetration rates and the EQRO penetration rates not appropriate nor useful. The POS methodology for calculating penetration rates was selected because it is easier to compute, more straightforward to interpret, and is in use by other states and counties. For the POS, the penetration rate is calculated by taking the total number of adults who received a number of SMHS (1 or 5 for POS) in a FY and dividing that by the total number of Medi-Cal eligible adults for that FY. This methodology results in lower penetration rates as compared to the EQRO rates, but it does so across the board so that all counties and the state will be similarly impacted.
*The snapshot report provides a point-in-time look at adults' movement through the SMHS system. The report uses five general categories to classify if an adult is entering, exiting, continuing services, or a combination of these categories (e.g., arriving and exiting). As of now, this report only classifies adults and their service usage for FY 14/15 through FY17/18. Eventually the snapshot data will be used along with measures of service effectiveness to identify whether adults are improving as a result of receiving services from the time they first arrived in the system to when they exit the system. This methodology was adapted from the California Mental Health and Substance Use System Needs Assessment (2012). More information on the original methodology can be found here: http://www.dhcs.ca.gov/provgovpart/pos/Pages/Performance-Outcomes-System-Reports-and-Measures-Catalog.aspx
*The psychiatric emergency services/hospital data measured in the time to step-down services report relies solely on claims data from Short Doyle/Medi-Cal II. Currently, the number of days is capped at 365 days (to mitigate the impact of extreme statistical anomalies) when calculating the mean and max for time between discharge and step down service. This methodology will be updated in the next reporting cycle. Additionally, county specific and population-based reports are based on the county of fiscal responsibility for the patient who receives step-down services.
Please contact [email protected] for any questions regarding this report.
Please note: This report uses the Medi-Cal Eligibility Data System to obtain race/ethnicity data. CDSS uses Child Welfare Services/Case Management System to obtain race/ethnicity data. For more information, please refer to the Measures Catalog.
^ Data has been suppressed to protect patient privacy.
1%
20%
7%
20%32%
7%
13%
Fiscal Year 14-15 Race Distribution
Alaskan Native or AmericanIndianAsian or Pacific Islander
Black
Hispanic
White
Other
Unknown
1%
19%
6%
21%32%
8%
13%
Fiscal Year 15-16 Race Distribution
Alaskan Native or AmericanIndianAsian or Pacific Islander
Black
Hispanic
White
Other
Unknown
1%
19%
6%
21%32%
9%
13%
Fiscal Year 16-17 Race Distribution
Alaskan Native or AmericanIndianAsian or Pacific Islander
Black
Hispanic
White
Other
Unknown
1%
19%
6%
22%31%
9%
12%
Fiscal Year 17-18 Race Distribution
Alaskan Native or AmericanIndianAsian or Pacific Islander
Black
Hispanic
White
Other
Unknown
Page 4 of 14
Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal YearSanta Clara County as of February 12, 2019
Fiscal
Year
Adults 21-44
Count Adults 21-44 %
Adults 45-64
Count Adults 45-64 %
Adults 65+
Count Adults 65+ %
FY 14-15 5,276 46.5% 5,130 45.2% 938 8.3%
FY 15-16 5,663 48.2% 5,104 43.4% 981 8.4%
FY 16-17 5,613 48.8% 4,900 42.6% 980 8.5%
FY 17-18 5,603 49.7% 4,700 41.7% 962 8.5%
46.5%
45.2%
8.3%
Fiscal Year 14-15 Age Group Distribution
Adults 21-44
Adults 45-64
Adults 65+
48.2%
43.4%
8.4%
Fiscal Year 15-16 Age Group Distribution
Adults 21-44
Adults 45-64
Adults 65+
48.8%
42.6%
8.5%
Fiscal Year 16-17 Age Group Distribution
Adults 21-44
Adults 45-64
Adults 65+
49.7%
41.7%
8.5%
Fiscal Year 17-18 Age Group Distribution
Adults 21-44
Adults 45-64
Adults 65+
Page 5 of 14
Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal YearSanta Clara County as of February 12, 2019
Fiscal
Year
Female
Count Female %
Male
Count Male %
FY 14-15 5,857 51.6% 5,487 48.4%
FY 15-16 5,970 50.8% 5,778 49.2%
FY 16-17 5,671 49.3% 5,822 50.7%
FY 17-18 5,644 50.1% 5,621 49.9%
51.6%
48.4%
Fiscal Year 14-15 Gender Distribution
Female Male50.8%
49.2%
Fiscal Year 15-16 Gender Distribution
Female Male
49.3%
50.7%
Fiscal Year 16-17 Gender Distribution
Female Male50.1%
49.9%
Fiscal Year 17-18 Gender Distribution
Female Male
Page 6 of 14
Penetration Rates* Report: Adults With At Least One SMHS Visit** Santa Clara County as of February 12, 2019
*Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the Short-Doyle/Medi-Cal claiming system. This does not include non-specialty mental health services provided in Medi-Cal Managed Care system.
**Adults and Older Adults at least one SMHS that was claimed through the Short-Doyle/ Medi-Cal claiming system on at least one (1) day in the Fiscal Year.
^ Data has been suppressed to protect patient privacy. Page 7 of 14
FY 14-15 FY 15-16 FY 16-17 FY 17-18
4.7% 4.6% 4.6%4.8%
6.2%5.9%
5.6% 5.7%
1.6% 1.6% 1.5% 1.5%
0%
1%
2%
3%
4%
5%
6%
7%
FY 14-15(n= 112,076)
FY 15-16(n= 122,224)
FY 16-17(n= 123,313)
FY 17-18(n= 116,582)
FY 14-15(n= 82,268)
FY 15-16(n= 87,058)
FY 16-17(n= 87,163)
FY 17-18(n= 82,477)
FY 14-15(n= 59,430)
FY 15-16(n= 62,432)
FY 16-17(n= 64,911)
FY 17-18(n= 64,702)
Adults 21-44 Adults 45-64 Adults 65+
Penetration Rates by AgeAdults With At Least One SMHS Visit**, By Fiscal Year
Penetration Rates* Report: Adults With At Least One SMHS Visit** Santa Clara County as of February 12, 2019
*Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the Short-Doyle/Medi-Cal claiming system. This does not include non-specialty mental health services provided in Medi-Cal Managed Care system.
**Adults and Older Adults at least one SMHS that was claimed through the Short-Doyle/ Medi-Cal claiming system on at least one (1) day in the Fiscal Year.
^ Data has been suppressed to protect patient privacy.
Page 8 of 14
8.3% 8.5%
7.7%
8.5%
2.4% 2.2% 2.1% 2.2%
7.6%7.1%
6.6%7.1%
3.8% 3.9% 3.7% 3.8%
7.7% 7.6% 7.5% 7.7%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
FY 14-15(n= 1,191)
FY 15-16(n= 1,223)
FY 16-17(n= 1,226)
FY 17-18(n= 1,195)
FY 14-15(n= 94,311)
FY 15-16(n= 101,768)
FY 16-17(n= 102,664)
FY 17-18(n= 96,239)
FY 14-15(n= 9,721)
FY 15-16(n= 10,198)
FY 16-17(n= 10,275)
FY 17-18(n= 9,974)
FY 14-15(n= 58,492)
FY 15-16(n= 62,596)
FY 16-17(n= 65,210)
FY 17-18(n= 65,104)
FY 14-15(n= 47,566)
FY 15-16(n= 49,404)
FY 16-17(n= 48,459)
FY 17-18(n= 44,896)
Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White
Penetration Rates by RaceAdults With At Least One SMHS Visit**, By Fiscal Year
4.1% 4.0% 3.7% 3.9%4.9% 4.8% 4.7% 4.8%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
FY 14-15(n= 141,351)
FY 15-16(n= 150,155)
FY 16-17(n= 152,194)
FY 17-18(n= 146,315)
FY 14-15(n= 112,423)
FY 15-16(n= 121,559)
FY 16-17(n= 123,193)
FY 17-18(n= 117,446)
Female Male
Penetration Rates by GenderAdults With At Least One SMHS Visit**, By Fiscal Year
Engagement Rates* Report: Adults with Five or More SMHS Visits**Santa Clara County as of February 12, 2019
*Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the Short-Doyle/Medi-Cal claiming system. This does not include non-specialty mental health services provided in Medi-Cal Managed Care system.
**Adults and Older Adultsthat have received at least five SMHS that were claimed through the Short-Doyle/ Medi-Cal claiming system on at least five (5) or more different days in the Fiscal Year.
^ Data has been suppressed to protect patient privacy. Page 9 of 14
FY 14-15 FY 15-16 FY 16-17 FY 17-18
3.1%2.9% 3.0% 3.1%
4.5%
3.9% 3.8% 3.9%
1.2% 1.1% 1.1% 1.0%
0%
1%
1%
2%
2%
3%
3%
4%
4%
5%
5%
FY 14-15(n= 112,076)
FY 15-16(n= 122,224)
FY 16-17(n= 123,313)
FY 17-18(n= 116,582)
FY 14-15(n= 82,268)
FY 15-16(n= 87,058)
FY 16-17(n= 87,163)
FY 17-18(n= 82,477)
FY 14-15(n= 59,430)
FY 15-16(n= 62,432)
FY 16-17(n= 64,911)
FY 17-18(n= 64,702)
Adults 21-44 Adults 45-64 Adults 65+
Engagement Rates by AgeAdults With Five or More SMHS Visits**, By Fiscal Year
Engagement Rates* Report: Adults with Five or More SMHS Visits**Santa Clara County as of February 12, 2019
*Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the Short-Doyle/Medi-Cal claiming system. This does not include non-specialty mental health services provided in Medi-Cal Managed Care system.
**Adults and Older Adultsthat have received at least five SMHS that were claimed through the Short-Doyle/ Medi-Cal claiming system on at least five (5) or more different days in the Fiscal Year.
^ Data has been suppressed to protect patient privacy.
Page 10 of 14
5.4% 5.1%4.5%
5.6%
1.6% 1.3% 1.3% 1.4%
5.3%4.8% 4.4% 4.7%
2.6% 2.6% 2.5% 2.4%
5.5% 5.2% 5.2% 5.2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
FY 14-15(n= 1,191)
FY 15-16(n= 1,223)
FY 16-17(n= 1,226)
FY 17-18(n= 1,195)
FY 14-15(n= 94,311)
FY 15-16(n= 101,768)
FY 16-17(n= 102,664)
FY 17-18(n= 96,239)
FY 14-15(n= 9,721)
FY 15-16(n= 10,198)
FY 16-17(n= 10,275)
FY 17-18(n= 9,974)
FY 14-15(n= 58,492)
FY 15-16(n= 62,596)
FY 16-17(n= 65,210)
FY 17-18(n= 65,104)
FY 14-15(n= 47,566)
FY 15-16(n= 49,404)
FY 16-17(n= 48,459)
FY 17-18(n= 44,896)
Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White
Engagement Rates by RaceAdults With Five or More SMHS Visits**, By Fiscal Year
2.9% 2.6% 2.5% 2.6%3.4% 3.1% 3.1% 3.1%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
FY 14-15(n= 141,351)
FY 15-16(n= 150,155)
FY 16-17(n= 152,194)
FY 17-18(n= 146,315)
FY 14-15(n= 112,423)
FY 15-16(n= 121,559)
FY 16-17(n= 123,193)
FY 17-18(n= 117,446)
Female Male
Engagement Rates by GenderAdults With Five or More SMHS Visits**, By Fiscal Year
Utilization Report*: Approved Specialty Mental Health Services for Adults
Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year*Santa Clara County as of February 12, 2019
*The graphs are color coded so that those reported in the same unit of analysis (e.g., minutes) are colored similarly.
Please note that (n) values listed at the bottom of each bar graph represent the actual number of children/youth that received the SMHS represented in their respective graph by Fiscal Year.
^ Data has been suppressed to protect patient privacy. Page 11 of 14
$89,648,712.64 $87,555,745.67
$141,685,354.06
$124,894,660.62
$-
$20,000,000.00
$40,000,000.00
$60,000,000.00
$80,000,000.00
$100,000,000.00
$120,000,000.00
$140,000,000.00
$160,000,000.00
FY 14-15(n = 11,344)
FY 15-16(n = 11,748)
FY 16-17(n = 11,493)
FY 17-18(n = 11,265)
Total Approved By Service Fiscal Year
5,008,509
4,680,336
4,588,6234,625,298
4,300,000
4,400,000
4,500,000
4,600,000
4,700,000
4,800,000
4,900,000
5,000,000
5,100,000
FY 14-15(n = 7,344)
FY 15-16(n = 7,729)
FY 16-17(n = 7,418)
FY 17-18(n = 7,240)
Case Management/Brokerage Minutes By Service Fiscal Year
7,728,9858,338,854
8,824,920 8,824,543
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
10,000,000
FY 14-15(n = 8,406)
FY 15-16(n = 8,615)
FY 16-17(n = 8,510)
FY 17-18(n = 8,253)
Mental Health Services Minutes By Service Fiscal Year
1,568,1051,701,108
1,892,4772,011,839
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
FY 14-15(n = 6,893)
FY 15-16(n = 7,399)
FY 16-17(n = 7,057)
FY 17-18(n = 7,021)
Medication Support Services Minutes By Service Fiscal Year
119,186
140,133
118,864
104,035
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
FY 14-15(n = 911)
FY 15-16(n = 938)
FY 16-17(n = 831)
FY 17-18(n = 743)
Crisis Intervention Minutes By Service Fiscal Year
88,072.8 88,985.083,647.3
77,661.8
-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
FY 14-15(n = 2,690)
FY 15-16(n = 2,680)
FY 16-17(n = 2,619)
FY 17-18(n = 2,594)
Crisis Stabilization HoursBy Service Fiscal Year
0 0
102
0 -
20
40
60
80
100
120
FY 14-15(n = )
FY 15-16(n = )
FY 16-17(n = ^)
FY 17-18(n = )
Full Day Treatment Intensive Hours By Service Fiscal Year
43,356
27,568
14,868
8,852
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
FY 14-15(n = 192)
FY 15-16(n = 124)
FY 16-17(n = 98)
FY 17-18(n = 83)
Full Day Rehabilitation Hours By Service Fiscal Year
6,806
3,8583,346 3,310
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
FY 14-15(n = 555)
FY 15-16(n = 409)
FY 16-17(n = 336)
FY 17-18(n = 359)
Hospital Inpatient Days By Service Fiscal Year
Utilization Report*: Approved Specialty Mental Health Services for Adults
Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year*Santa Clara County as of February 12, 2019
*The graphs are color coded so that those reported in the same unit of analysis (e.g., minutes) are colored similarly.
Please note that (n) values listed at the bottom of each bar graph represent the actual number of children/youth that received the SMHS represented in their respective graph by Fiscal Year.
^ Data has been suppressed to protect patient privacy.
Page 12 of 14
3,526.0 3,451.83,246.0
1,863.0
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
FY 14-15(n = 55)
FY 15-16(n = 50)
FY 16-17(n = 42)
FY 17-18(n = 32)
Adult Residential Treatment Services DaysBy Service Fiscal Year
2,562.0
2,039.2
1,472.6
48.0 -
500
1,000
1,500
2,000
2,500
3,000
FY 14-15(n = 268)
FY 15-16(n = 221)
FY 16-17(n = 133)
FY 17-18(n = 11)
Psychiatric Health Facility Days By Service Fiscal Year
4,735
5,7046,031
3,178
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
FY 14-15(n = 243)
FY 15-16(n = 233)
FY 16-17(n = 193)
FY 17-18(n = 198)
Hospital Inpatient Admin Days By Service Fiscal Year
3,067
2,1232,389 2,356
-
500
1,000
1,500
2,000
2,500
3,000
3,500
FY 14-15(n = 320)
FY 15-16(n = 283)
FY 16-17(n = 271)
FY 17-18(n = 264)
Fee for Service Inpatient Days By Service Fiscal Year
11,026.012,130.0 11,768.0
9,106.0
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
FY 14-15(n = 463)
FY 15-16(n = 477)
FY 16-17(n = 415)
FY 17-18(n = 349)
Crisis Residential Treatment Services Days By Service Fiscal Year
Snapshot Report: Unique Count of Adults Receiving SMHS
Arriving, Exiting, and with Service Continuance by Fiscal YearSanta Clara County as of February 12, 2019
Description (Please refer to the Measures Catalog for more detailed descriptions on all Performance Outcomes System measures.)
Adults that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year.
Adults receiving continuous services with no breaks in service greater than 90 days for a period of at least 2 years (>= 2 YR) or a period of 1 to 2 years (< 2 YR).
Adults that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year.
A distinct category in which Adults met both the criteria for Arrivals and Exiting above for the fiscal year.
A distinct category in which Adults had at least 2 years of Service Continuance going into the Fiscal Year and then Exited within the same Fiscal Year.
20%
17%
13%14%
34%
3%
Fiscal Year 14-15 Arrivals, Service Continuance, &
Exits Distribution
19%
17%
13%15%
34%
3%
Fiscal Year 15-16 Arrivals, Service Continuance, &
Exits Distribution
18%
18%
11%17%
33%
4%
Fiscal Year 16-17 Arrivals, Service Continuance, &
Exits Distribution
18%
18%
11%14%
35%
4%
Fiscal Year 17-18 Arrivals, Service Continuance, &
Exits Distribution
Arrivals
Service Continuance(>= 2 YR)
Service Continuance(< 2 YR)
Exiting
Arriving & Exiting
Service Continuance (>= 2 YR) & Exiting
Page 13 of 14
Time to Step Down Report: Adults Stepping Down in SMHS Services Post Inpatient Discharge*Santa Clara County as of February 12, 2019
* No Step Down is defined as no Medi-Cal eligible service was claimed through Short-Doyle/Medi-Cal after a claimed inpatient service was billed with a discharge date. This category may include data currently unavailable to DHCS, such as beneficiaries that
were moved to a community-based program or beneficiaries that were incarcerated.
910
910
0
2
4
6
8
10
12
FY 14-15 FY 15-16 FY 16-17 FY 17-18
Median Time Between Inpatient Discharge and Step Down Service in Days
34.639.0
41.838.0
0
10
20
30
40
50
FY 14-15 FY 15-16 FY 16-17 FY 17-18
Mean Time Between Inpatient Discharge and Step Down Service in Days
47.3% 44.7% 45.6% 45.1%
21.2% 19.6% 17.5% 21.4%
22.0% 22.6% 23.0% 18.3%
9.5% 13.1% 13.8% 15.1%
0%
20%
40%
60%
80%
100%
FY 14-15( 696 Unique Beneficiaries with
1,007 Total Inpatient Discharges )
FY 15-16( 546 Unique Beneficiaries with 771 Total Inpatient Discharges )
FY 16-17( 462 Unique Beneficiaries with 686 Total Inpatient Discharges )
FY 17-18( 480 Unique Beneficiaries with 676 Total Inpatient Discharges )
Percentage of Discharges by Time Between Inpatient Discharge and Step Down Service
Within 7 Days Within 8 - 30 Days 31 Days + No Step Down
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