Report run on August 3, 201 - DHCS Homepage...2017/08/29 · White Other Unknown 0% 2% 4% 48% 34%...

Performance Outcomes System Report run on August 3, 2017

Background Three reports will be created during each new reporting period. The reports that will be produced are as follows: statewide aggregate data; population-based county groups; and county-specific data. These reports help meet the intent of the Legislature, as stated in Welfare and Institutions Code Section 14707.5, to develop a performance outcomes system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services that will improve outcomes at the individual, program, and system levels and inform fiscal decision-making related to the purchase of services. This reporting effort is part of the implementation of a performance outcomes system for Medi- Cal Specialty Mental Health Services (SMHS) for children and youth.

Since 2012 DHCS has worked with several groups of stakeholders to create a structure for reporting, to develop the Performance Measurement Paradigm, and to develop 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

Purpose and Overview These county-specific reports provide updated information on the initial indicators that were developed for the Performance Outcomes System and reported on at the statewide aggregate level in February 2015; they help establish a foundation for on-going reporting. DHCS plans to move to annual reporting of this data for the Performance Outcomes System.

The first series of charts and tables focus on the demographics of children and youth under 21 who are receiving SMH' based on approved claims for Medi-Cal eligible beneficiaries. Specifically, this includes demographics tables of this population by age, gender, and race/ethnicity. Two types of penetration information are provided. Both penetration rates tables are also broken out by demographic characteristics. Utilization of services data are shown in terms of dollars, as well as by service, in time increments. The snapshot table provides a point-in-time view of children/youth 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 step-down services following inpatient discharge.

Where possible, the reports provide trend information by displaying information for four Fiscal Years (FY). A FY is from July 1st to June 30th.

Utilization of services reports are shown in terms of dollars, as well as by service in time increments. The snapshot report provides a point-in-time view of children arriving, exiting, and continuing services over a two-year period. The final report provides a view over the past four years of the time to step-down services (i.e., time to next contact after an inpatient discharge). Note: The time to step-down report has a change in methodology from the first report produced in February 2015. In the initial report only outpatient services provided at least one day after the inpatient discharge were included in the calculations. On subsequent reports, any outpatient service that occurs on or after the inpatient discharge is included in the analysis.

Definitions Population - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were:

• Age 20 or younger 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 12/13 through FY 15/16. • Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 12/13 through FY15/16.

Page 1 of 14

http://www.dhcs.ca.gov/provgovpart/pos/Pages/default.aspx

Performance Outcomes System Report run on August 3, 2017

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 foundat: http://www.dhcs.ca.gov/provgovpart/pos/Pages/Performance-Outcomes-System-Reports-and-Measures-Catalog.aspx

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, 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, this data is represented as follows: 1) Data that is missing is indicated as "-" 2) Data that has been suppressed due to privacy concerns is indicated as "^".

Report Interpretation

*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 make comparison between the POS penetration rates and the EQRO penetration rates not appropriate or useful. The POS methodology for calculating penetrationrates 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 youth who received X number of SMHS (1 or 5 for POS) in a FY and dividing that by the total number of Medi-Cal eligible youth 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 children and youth's movement through the SMHS system. The report uses five general categories to classify if a youth is entering, exiting, continuing services, or a combination of these categories (e.g., arriving and exiting). Eventually the snapshot data will be used along with measures of service effectiveness to identify whether youth 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 reported on in the time to step-down services report includes data from Short Doyle/Medi-Cal II claims data and fee-for-service data. In the futurethis report will incorporate other outpatient and inpatient Medi-Cal SMHS' billed through the Managed Care healthcare delivery systems. 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 off of the county of the hospital the patient is discharged from and whom has been attributed the time to next service in days used in the calculations for this indicator.

Please contact [email protected] for any questions regarding this report.

Page 2 of 14

Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal YearStanislaus County as of August 3, 2017

SFYUnique Count

Receiving SMHS*

Year-Over-Year

Percentage Change

Unique Count of

Medi-Cal Eligibles

Year-Over-Year

Percentage Change

FY 12-13 4,070 96,422

FY 13-14 4,255 4.5% 104,200 8.1%

FY 14-15 4,267 0.3% 109,135 4.7%

FY 15-16 4,148 -2.8% 114,056 4.5%

Compound

Annual Growth

Rate SFY**

0.6% 5.8%

*SMHS = Specialty Mental Health Services. See Measures Catalog for more detailed information.

**SFY = State Fiscal Year which is July 1 through June 30.

^ Data has been suppressed to protect patient privacy.

4,070 4,255 4,267 4,148

0

1,000

2,000

3,000

4,000

5,000

FY 12-13 FY 13-14 FY 14-15 FY 15-16

Unique Count of Children and Youth Receiving SMHS

Page 3 of 14


Fiscal

Year

Alaskan

Native or

American

Indian Count

Alaskan

Native or

American

Indian %

Asian or

Pacific

Islander

Count

Asian or

Pacific

Islander %

Black Count Black % Hispanic

Count Hispanic % White Count White % Other Count Other %

Unknown

Count Unknown %

FY 12-13 11 0.3% 73 1.8% 185 4.5% 1,879 46.2% 1,517 37.3% 17 0.4% 388 9.5%

FY 13-14 13 0.3% 72 1.7% 179 4.2% 2,039 47.9% 1,501 35.3% 17 0.4% 434 10.2%

FY 14-15 ^ ^ 61 1.4% 184 4.3% 2,059 48.3% 1,509 35.4% ^ ^ 430 10.1%

FY 15-16 11 0.3% 66 1.6% 161 3.9% 2,005 48.3% 1,393 33.6% 14 0.3% 498 12.0%

*FY 13-14 claims are estimated to be 95% complete as of January 1, 2015.

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.


0% 2%

5%

46%37%

0%10%

Fiscal Year 12-13 Race Distribution

Alaskan Native or AmericanIndianAsian or Pacific Islander

Black

Hispanic

White

Other

Unknown

0%2% 4%

48%35%

0%10%



Black

Hispanic

White

Other

Unknown

^1%4%

48%35%

^10%



Black

Hispanic

White

Other

Unknown

0%2% 4%

48%34%

0%12%



Black

Hispanic

White

Other

Unknown

CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES.

Page 4 of 14


Fiscal

Year

Children 0-2

Count Children 0-2 %

Children 3-5


Children 6-11


Children 12-17


Youth 18-20

Count Youth 18-20 %

FY 12-13 78 1.9% 394 9.7% 1,625 39.9% 1,579 38.8% 394 9.7%

FY 13-14 76 1.8% 352 8.3% 1,624 38.2% 1,740 40.9% 463 10.9%

FY 14-15 70 1.6% 366 8.6% 1,617 37.9% 1,739 40.8% 475 11.1%

FY 15-16 72 1.7% 444 10.7% 1,534 37.0% 1,639 39.5% 459 11.1%

*FY 13-14 claims are estimated to be 95% complete as of January 1, 2015.

2%

10%

40%39%

10%

Fiscal Year 12-13 Age Group Distribution

Children 0-2

Children 3-5

Children 6-11

Children 12-17

Youth 18-20

2%

8%

38%41%

11%


Children 0-2

Children 3-5

Children 6-11

Children 12-17

Youth 18-20

2%

9%

38%41%

11%


Children 0-2

Children 3-5

Children 6-11

Children 12-17

Youth 18-20

2%

11%

37%40%

11%


Children 0-2

Children 3-5

Children 6-11

Children 12-17

Youth 18-20

Page 5 of 14


Fiscal

Year

Female

Count Female %

Male

Count Male %

FY 12-13 1,722 42.3% 2,348 57.7%

FY 13-14 1,838 43.2% 2,417 56.8%

FY 14-15 1,894 44.4% 2,373 55.6%

FY 15-16 1,819 43.9% 2,329 56.1%

42.3%

57.7%

Fiscal Year 12-13 Gender Distribution

Female Male

43.2%

56.8%


Female Male

44.4%

55.6%


Female Male

43.9%

56.1%


Female Male

Page 6 of 14

Penetration Rates* Report: Children and Youth with At Least One SMHS Visit** Stanislaus County as of August 3, 2017

Children and

Youth with 1 or

more SMHS

Visits

Certified Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1 or

more SMHS

Visits

Certified Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1 or

more SMHS

Visits

Certified Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1 or

more SMHS

Visits

Certified Eligible

Children and

Youth

Penetration

Rate

All 4,070 96,422 4.2% 4,255 104,200 4.1% 4,267 109,135 3.9% 4,148 114,056 3.6%

Children 0-2 78 16,455 0.5% 76 16,848 0.5% 70 17,256 0.4% 72 17,386 0.4%

Children 3-5 394 16,107 2.4% 352 16,426 2.1% 366 16,703 2.2% 444 17,008 2.6%

Children 6-11 1,625 29,206 5.6% 1,624 31,838 5.1% 1,617 33,358 4.8% 1,534 34,902 4.4%

Children 12-17 1,579 24,479 6.5% 1,740 27,114 6.4% 1,739 28,535 6.1% 1,639 30,775 5.3%

Youth 18-20 394 10,175 3.9% 463 11,974 3.9% 475 13,283 3.6% 459 13,985 3.3%

Alaskan Native or American Indian 11 180 6.1% 13 166 7.8% ^ 165 ^ 11 169 6.5%

Asian or Pacific Islander 73 4,084 1.8% 72 4,598 1.6% 61 4,766 1.3% 66 4,988 1.3%

Black 185 3,213 5.8% 179 3,291 5.4% 184 3,344 5.5% 161 3,345 4.8%

Hispanic 1,879 57,021 3.3% 2,039 61,206 3.3% 2,059 63,969 3.2% 2,005 67,341 3.0%

White 1,517 23,966 6.3% 1,501 25,368 5.9% 1,509 26,317 5.7% 1,393 26,002 5.4%

Other 17 523 3.3% 17 578 2.9% ^ 556 ^ 14 467 3.0%

Unknown 388 7,435 5.2% 434 8,993 4.8% 430 10,018 4.3% 498 11,744 4.2%

Female 1,722 47,277 3.6% 1,838 51,173 3.6% 1,894 53,646 3.5% 1,819 55,971 3.2%

Male 2,348 49,145 4.8% 2,417 53,027 4.6% 2,373 55,489 4.3% 2,329 58,085 4.0%

*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.

**Children and Youth that have received 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.


Page 7 of 14

FY 12-13 FY 13-14 FY 14-15 FY 15-16

0.5% 0.5% 0.4% 0.4%

2.4% 2.1% 2.2% 2.6%

5.6%5.1% 4.8% 4.4%

6.5% 6.4% 6.1%5.3%

3.9% 3.9% 3.6% 3.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 16,455)

FY 13-14(n= 16,848)

FY 14-15(n= 17,256)

FY 15-16(n= 17,386)

FY 12-13(n= 16,107)

FY 13-14(n= 16,426)

FY 14-15(n= 16,703)

FY 15-16(n= 17,008)

FY 12-13(n= 29,206)

FY 13-14(n= 31,838)

FY 14-15(n= 33,358)

FY 15-16(n= 34,902)

FY 12-13(n= 24,479)

FY 13-14(n= 27,114)

FY 14-15(n= 28,535)

FY 15-16(n= 30,775)

FY 12-13(n= 10,175)

FY 13-14(n= 11,974)

FY 14-15(n= 13,283)

FY 15-16(n= 13,985)

Children 0-2 Children 3-5 Children 6-11 Children 12-17 Youth 18-20

Penetration Rates by AgeChildren and Youth With At Least One SMHS Visit**, By Fiscal Year

Penetration Rates* Report: Children and Youth with At Least One SMHS Visit** Stanislaus County as of August 3, 2017


**Children and Youth that have received 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.


Page 8 of 14

6.1%

7.8%

^

6.5%

1.8% 1.6% 1.3% 1.3%

5.8% 5.4% 5.5%4.8%

3.3% 3.3% 3.2% 3.0%

6.3% 5.9% 5.7% 5.4%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 180)

FY 13-14(n= 166)

FY 14-15(n= 165)

FY 15-16(n= 169)

FY 12-13(n= 4,084)

FY 13-14(n= 4,598)

FY 14-15(n= 4,766)

FY 15-16(n= 4,988)

FY 12-13(n= 3,213)

FY 13-14(n= 3,291)

FY 14-15(n= 3,344)

FY 15-16(n= 3,345)

FY 12-13(n= 57,021)

FY 13-14(n= 61,206)

FY 14-15(n= 63,969)

FY 15-16(n= 67,341)

FY 12-13(n= 23,966)

FY 13-14(n= 25,368)

FY 14-15(n= 26,317)

FY 15-16(n= 26,002)

Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White

Penetration Rates by RaceChildren and Youth With At Least One SMHS Visit**, By Fiscal Year

3.6% 3.6% 3.5% 3.2%

4.8% 4.6% 4.3% 4.0%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 47,277)

FY 13-14(n= 51,173)

FY 14-15(n= 53,646)

FY 15-16(n= 55,971)

FY 12-13(n= 49,145)

FY 13-14(n= 53,027)

FY 14-15(n= 55,489)

FY 15-16(n= 58,085)

Female Male

Penetration Rates by GenderChildren and Youth With At Least One SMHS Visit**, By Fiscal Year

Penetration Rates* Report: Children and Youth with Five or More SMHS Visits**Stanislaus County as of August 3, 2017

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

All 2,708 96,422 2.8% 2,765 104,200 2.7% 2,766 109,135 2.5% 2,685 114,056 2.4%

Children 0-2 ^ 16,455 ^ 12 16,848 0.1% 13 17,256 0.1% ^ 17,386 ^

Children 3-5 186 16,107 1.2% 168 16,426 1.0% 192 16,703 1.1% 203 17,008 1.2%

Children 6-11 1,129 29,206 3.9% 1,134 31,838 3.6% 1,111 33,358 3.3% 1,070 34,902 3.1%

Children 12-17 1,156 24,479 4.7% 1,190 27,114 4.4% 1,199 28,535 4.2% 1,145 30,775 3.7%

Youth 18-20 ^ 10,175 ^ 261 11,974 2.2% 251 13,283 1.9% ^ 13,985 ^

Alaskan Native or American Indian ^ 180 ^ ^ 166 ^ ^ 165 ^ ^ 169 ^

Asian or Pacific Islander 49 4,084 1.2% 42 4,598 0.9% 38 4,766 0.8% 40 4,988 0.8%

Black 113 3,213 3.5% 109 3,291 3.3% 112 3,344 3.3% 107 3,345 3.2%

Hispanic 1,266 57,021 2.2% 1,318 61,206 2.2% 1,307 63,969 2.0% 1,222 67,341 1.8%

White 1,000 23,966 4.2% 983 25,368 3.9% 1,003 26,317 3.8% 957 26,002 3.7%

Other ^ 523 ^ ^ 578 ^ ^ 556 ^ ^ 467 ^

Unknown 263 7,435 3.5% 301 8,993 3.3% 291 10,018 2.9% 342 11,744 2.9%

Female 1,107 47,277 2.3% 1,160 51,173 2.3% 1,202 53,646 2.2% 1,149 55,971 2.1%

Male 1,601 49,145 3.3% 1,605 53,027 3.0% 1,564 55,489 2.8% 1,536 58,085 2.6%


**Children and Youth that 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 12-13 FY 13-14 FY 14-15 FY 15-16

^ 0.1% 0.1% ^

1.2% 1.0% 1.1% 1.2%

3.9% 3.6% 3.3% 3.1%

4.7% 4.4% 4.2%3.7%

^

2.2% 1.9%

^0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 16,455)

FY 13-14(n= 16,848)

FY 14-15(n= 17,256)

FY 15-16(n= 17,386)

FY 12-13(n= 16,107)

FY 13-14(n= 16,426)

FY 14-15(n= 16,703)

FY 15-16(n= 17,008)

FY 12-13(n= 29,206)

FY 13-14(n= 31,838)

FY 14-15(n= 33,358)

FY 15-16(n= 34,902)

FY 12-13(n= 24,479)

FY 13-14(n= 27,114)

FY 14-15(n= 28,535)

FY 15-16(n= 30,775)

FY 12-13(n= 10,175)

FY 13-14(n= 11,974)

FY 14-15(n= 13,283)

FY 15-16(n= 13,985)

Children 0-2 Children 3-5 Children 6-11 Children 12-17 Youth 18-20

Penetration Rates by AgeChildren and Youth With Five or More SMHS Visits**, By Fiscal Year

Penetration Rates* Report: Children and Youth with Five or More SMHS Visits**Stanislaus County as of August 3, 2017


**Children and Youth that 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.


Page 10 of 14

^ ^ ^ ^1.2% 0.9% 0.8% 0.8%

3.5% 3.3% 3.3% 3.2%2.2% 2.2% 2.0% 1.8%

4.2% 3.9% 3.8% 3.7%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 180)

FY 13-14(n= 166)

FY 14-15(n= 165)

FY 15-16(n= 169)

FY 12-13(n= 4,084)

FY 13-14(n= 4,598)

FY 14-15(n= 4,766)

FY 15-16(n= 4,988)

FY 12-13(n= 3,213)

FY 13-14(n= 3,291)

FY 14-15(n= 3,344)

FY 15-16(n= 3,345)

FY 12-13(n= 57,021)

FY 13-14(n= 61,206)

FY 14-15(n= 63,969)

FY 15-16(n= 67,341)

FY 12-13(n= 23,966)

FY 13-14(n= 25,368)

FY 14-15(n= 26,317)

FY 15-16(n= 26,002)

Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White

Penetration Rates by RaceChildren and Youth With Five or More SMHS Visits**, By Fiscal Year

2.3% 2.3% 2.2% 2.1%

3.3% 3.0% 2.8% 2.6%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 47,277)

FY 13-14(n= 51,173)

FY 14-15(n= 53,646)

FY 15-16(n= 55,971)

FY 12-13(n= 49,145)

FY 13-14(n= 53,027)

FY 14-15(n= 55,489)

FY 15-16(n= 58,085)

Female Male

Penetration Rates by GenderChildren and Youth With Five or More SMHS Visits**, By Fiscal Year

Utilization Report*: Approved Specialty Mental Health Services for Children and Youth

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal YearStanislaus County as of August 3, 2017

Fiscal Year SDMC Total

Approved

IHBS

(Minutes)

ICC

(Minutes)

Case

Management/

Brokerage

(Minutes)

Mental Health

Services

(Minutes)

Therapeutic

Behavioral

Services

(Minutes)

Medication

Support Services

(Minutes)

Crisis

Intervention

(Minutes)

Crisis

Stabilization

(Hours)

Full Day

Treatment

Intensive

(Hours)

Full Day

Rehabilitation

(Hours)

Hospital

Inpatient (Days)

Hospital

Inpatient Admin

(Days)

Fee for Service

Inpatient (Days)

Crisis Residential

Treatment

Services (Days)

Adult Residential

Treatment

Services (Days)

Psychiatric

Health Facility

(Days)

FY 12-13 3,812.38$ 0 0 341 1,224 4,366 159 221 12 473 114 29 0 6 9 0 16

FY 13-14 3,868.12$ 115 636 311 1,266 4,124 170 227 12 102 545 3 0 7 0 0 7

FY 14-15 4,297.06$ 1,317 798 384 1,287 3,676 194 263 24 831 685 0 0 5 0 0 4

FY 15-16 4,587.69$ 1,899 1,006 327 1,268 2,573 180 256 15 678 537 0 0 7 0 0 6

MEAN 4,141.31$ 1,110 813 341 1,261 3,685 176 242 16 521 470 16 0 6 9 0 8

*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.


Page 11 of 14

$3,812.38 $3,868.12

$4,297.06 $4,587.69

$-

$500.00

$1,000.00

$1,500.00

$2,000.00

$2,500.00

$3,000.00

$3,500.00

$4,000.00

$4,500.00

$5,000.00

FY 12-13(n = 4,070)

FY 13-14(n = 4,255)

FY 14-15(n = 4,267)

FY 15-16(n = 4,148)

Total Approved Per Unique Beneficiary By Service Fiscal Year

0115

1,317

1,899

-

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

FY 12-13(n = )

FY 13-14(n = ^)

FY 14-15(n = ^)

FY 15-16(n = 69)

IHBS Minutes Per Unique BeneficiaryBy Service Fiscal Year

0

636

798

1,006

-

200

400

600

800

1,000

1,200

FY 12-13(n = )

FY 13-14(n = ^)

FY 14-15(n = ^)

FY 15-16(n = 89)

ICC Minutes Per Unique Beneficiary By Service Fiscal Year

341311

384

327

-

50

100

150

200

250

300

350

400

450

FY 12-13(n = 888)

FY 13-14(n = 847)

FY 14-15(n = 848)

FY 15-16(n = 920)

Case Management/Brokerage Minutes Per Unique Beneficiary

By Service Fiscal Year1,224 1,266 1,287 1,268

-

200

400

600

800

1,000

1,200

1,400

FY 12-13(n = 3,847)

FY 13-14(n = 3,961)

FY 14-15(n = 3,922)

FY 15-16(n = 3,836)

Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year

4,366 4,124

3,676

2,573

-

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

FY 12-13(n = 77)

FY 13-14(n = 74)

FY 14-15(n = 73)

FY 15-16(n = 62)

Therapeutic Behavioral Services Minutes Per Unique Beneficiary

By Service Fiscal Year

159170

194180

-

50

100

150

200

250

FY 12-13(n = 1,101)

FY 13-14(n = 1,104)

FY 14-15(n = 1,131)

FY 15-16(n = 1,129)

Medication Support Services Minutes Per Unique Beneficiary


221 227

263 256

-

50

100

150

200

250

300

FY 12-13(n = 494)

FY 13-14(n = 599)

FY 14-15(n = 688)

FY 15-16(n = 700)

Crisis Intervention Minutes Per Unique Beneficiary By Service Fiscal Year

12.5 12.2

24.4

15.3

-

5

10

15

20

25

30

FY 12-13(n = 12)

FY 13-14(n = 23)

FY 14-15(n = 20)

FY 15-16(n = 29)

Crisis Stabilization Hours Per Unique BeneficiaryBy Service Fiscal Year

Utilization Report*: Approved Specialty Mental Health Services for Children and Youth

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal YearStanislaus County as of August 3, 2017

*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.


Page 12 of 14

473

102

831

678

-

100

200

300

400

500

600

700

800

900

FY 12-13(n = 35)

FY 13-14(n = 19)

FY 14-15(n = ^)

FY 15-16(n = ^)

Full Day Treatment Intensive Hours Per Unique BeneficiaryBy Service Fiscal Year

114

545

685

537

-

100

200

300

400

500

600

700

800

FY 12-13(n = ^)

FY 13-14(n = 32)

FY 14-15(n = ^)

FY 15-16(n = 31)

Full Day Rehabilitation Hours Per Unique Beneficiary By Service Fiscal Year

0.0 0.0 0.0 0.0 -

0

0

0

0

1

1

1

1

1

1

FY 12-13(n = )

FY 13-14(n = )

FY 14-15(n = )

FY 15-16(n = )

Adult Residential Treatment Services Days Per Unique Beneficiary

By Service Fiscal Year 16.4

7.4

4.35.5

-

2

4

6

8

10

12

14

16

18

FY 12-13(n = ^)

FY 13-14(n = ^)

FY 14-15(n = 54)

FY 15-16(n = 105)

Psychiatric Health Facility Days Per Unique BeneficiaryBy Service Fiscal Year

29

3

0 0 -

5

10

15

20

25

30

35

FY 12-13(n = ^)

FY 13-14(n = ^)

FY 14-15(n = )

FY 15-16(n = )

Hospital Inpatient Days Per Unique BeneficiaryBy Service Fiscal Year

0 0 0 0 -

0

0

0

0

1

1

1

1

1

1

FY 12-13(n = )

FY 13-14(n = )

FY 14-15(n = )

FY 15-16(n = )

Hospital Inpatient Admin Days Per Unique BeneficiaryBy Service Fiscal Year

6

7

5

7

-

1

2

3

4

5

6

7

8

FY 12-13(n = 235)

FY 13-14(n = 209)

FY 14-15(n = 219)

FY 15-16(n = 169)

Fee for Service Inpatient Days Per Unique BeneficiaryBy Service Fiscal Year

9.0

0.0 0.0 0.0 -

1

2

3

4

5

6

7

8

9

10

FY 12-13(n = ^)

FY 13-14(n = )

FY 14-15(n = )

FY 15-16(n = )

Crisis Residential Treatment Services Days Per Unique Beneficiary


Snapshot Report: Unique Count of Children and Youth Receiving SMHS

Arriving, Exiting, and with Service Continuance by Fiscal YearStanislaus County as of August 3, 2017

Service

Fiscal Year

Arrivals

Count Arrivals %

Service

Continuance

(>= 2 YR)

Count

Service

Continuance

(>= 2 YR) %

Service

Continuance

(<2 YR) Count

Service

Continuance

(< 2 YR) %

Exiting

Count Exiting %

Arriving &

Exiting

Count

Arriving &

Exiting %

Service

Continuance

(>= 2 YR) &

Exiting Count

Service

Continuance

(>= 2 YR) and

Exiting %

Total

Count Total %

FY 12-13 1,107 27.2% 260 6.4% 288 7.1% 811 19.9% 1,446 35.5% 158 3.9% 4,070 100%

FY 13-14 1,011 23.8% 270 6.3% 376 8.8% 860 20.2% 1,576 37.0% 162 3.8% 4,255 100%

FY 14-15 1,072 25.1% 261 6.1% 331 7.8% 904 21.2% 1,530 35.9% 169 4.0% 4,267 100%

FY 15-16 1,002 24.2% 248 6.0% 323 7.8% 917 22.1% 1,451 35.0% 207 5.0% 4,148 100%


Category

Arrivals

Exiting

Service Continuance

Arriving & Exiting

Service Continuance &

Exiting

Description (Please refer to the Measures Catalog for more detailed descriptions on all Performance Outcomes System measures.)

Children/Youth that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year.

Children/Youth 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).

Children/Youth that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year.

A distinct category in which children/youth met both the criteria for Arrivals and Exiting above for the fiscal year.

A distinct category in which Children/Youth had at least 2 years of Service Continuance going into the Fiscal Year and then Exited within the same Fiscal Year.

27%

6%

7%

20%

36%

4%

Fiscal Year 12-13 Arrivals, Service Continuance, &

Exits Distribution

24%

6%

9%

20%

37%

4%


Exits Distribution

25%

6%

8%

21%

36%

4%


Exits Distribution

24%

6%

8%

22%

35%

5%


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: Children and Youth Stepping Down in SMHS Services Post Inpatient Discharge*Stanislaus County as of August 3, 2017

Service FY

Count of Inpatient

Discharges with Step

Down within 7 Days

of Discharge

Percentage of

Inpatient

Discharges with

Step Down within

7 Days of

Discharge

Count of Inpatient

Discharges with

Step Down

Between 8 and 30

Days

Percentage of

Inpatient

Discharges with

Step Down

Between 8 and 30

Days

Count of Inpatient

Discharges with a

Step Down > 30

Days from

Discharge

Percentage of

Inpatient

Discharges with a

Step Down > 30

Days from

Discharge

Count of Inpatient

Discharges with

No Step Down*

Percentage of

Inpatient

Discharges with

No Step Down*

Minimum Number

of Days between

Discharge and

Step Down

Maximum

Number of Days

between

Discharge and

Step Down

Mean Time to

Next Contact Post

Inpatient

Discharge

(Days)

Median Time to

Next Contact Post

Inpatient

Discharge

(Days)

FY 12-13 184 74.2% 20 8.1% 28 11.3% 16 6.5% 0 358 14.3 1

FY 13-14 147 68.4% 20 9.3% 32 14.9% 16 7.4% 0 331 20.6 2

FY 14-15 151 74.8% ^ ^ 22 10.9% ^ ^ 0 348 14.4 0

FY 15-16 137 76.5% ^ ^ ^ ^ 17 9.5% 0 349 14.5 0


* 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.

1

2

0 00

1

1

2

2

3

FY 12-13 FY 13-14 FY 14-15 FY 14-15

Median Time Between Inpatient Discharge and Step Down Service in Days

14.3

20.6

14.4 14.5

0

5

10

15

20

25

FY 12-13 FY 13-14 FY 14-15 FY 14-15

Mean Time Between Inpatient Discharge and Step Down Service in Days

74.2% 68.4% 74.8% 76.5%

8.1% 9.3%^ ^

11.3% 14.9% 10.9% ^6.5% 7.4% ^ 9.5%

0%

20%

40%

60%

80%

100%

FY 12-13( 170 Unique Beneficiaries with 248 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

CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES.

Page 14 of 14

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