Full Text
2016 Statewide Aggregate Specialty Mental Health Services Performance Dashboard Department of Health Care Services 2016 Medi-Cal Specialty Mental Health Performance Dashboard Pursuant to the requirements of the 1915(b) Specialty Mental Health Services (SMHS) Waiver Special Terms and Conditions the SMHS Performance Dashboard makes available to the public data on SMHS provided to Medi-Cal eligible beneficiaries by Mental Health Plans (MHPs) and their contracted organizational providers. To protect patient privacy, all data is published in accordance with the DHCS Public Aggregate Reporting Guidelines. Following publication of the statewide aggregate SMHS Performance Dashboard, DHCS will produce county-specific MHP SMHS Performance Dashboards. These dashboards will be published on the DHCS and MHP websites beginning January 2017. Producing state-level and county- specific dashboards will make information on the performance of California’s SMHS readily available to the public and meets the requirements and intention of the 1915(b) SMHS Waiver Special Terms and Conditions. The statewide aggregate SMHS Performance Dashboard includes two sets of charts and tables that include demographics of children and youth, and adult and older adult populations by age, gender, race, and ethnicity. The first set of charts and tables focus on demographics and service utilization of children and youth age 0 through 20 and the second set focuses on the same data elements for adults age 21 and older. All reports are based on approved claims data for SMHS provided to Medi-Cal eligible beneficiaries. The charts and tables also include service utilization data that is displayed by dollar amount and units of service. Two types of penetration rate information are provided and categorized by demographic characteristics. Additionally, tables include a point-in-time “snapshot” of populations entering, exiting, and continuing services over a two-year period. Time-to-step-down tables provide data covering the past four years of the time-to-step-down services following inpatient discharge. The 2016 SMHS Performance Dashboard includes trend information by displaying information for fiscal years 2011-12, 2012-13, 2013-14, and 2014-15. Subsequent Performance Dashboards will also include updated and additional information as new fiscal year data becomes available. Notations on the chart and tables define measures used, such as the penetration rate, or explain anomalies in the data. Areas where data is suppressed in order to comply with Public Aggregate Reporting Guidelines, to prevent the release of patient health information, is also noted. 1 ---PAGE BREAK--- 2016 Performance Outcomes System Children and Youth Reports 2 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Statewide as of August 3, 2016 SFY Unique Count Receiving SMHS* Year-Over-Year Percentage Change Unique Count of Medi-Cal Eligibles Year-Over-Year Percentage Change FY 11-12 228,815 4,775,304 FY 12-13 246,752 7.8% 5,476,043 14.7% FY 13-14 263,909 7.0% 6,037,115 10.2% FY 14-15 266,915 1.1% 6,352,757 5.2% Compound Annual Growth Rate SFY** 5.3% 10.0% *SMHS = Specialty Mental Health Services. See Measures Catalog for more detailed information. **SFY = State Fiscal Year which is July 1 through June 30. 3 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Statewide as of August 3, 2016 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 11-12 1,492 0.7% 6,037 2.6% 32,017 14.0% 111,224 48.6% 62,745 27.4% 3,164 1.4% 12,136 5.3% FY 12-13 1,472 0.6% 6,688 2.7% 32,082 13.0% 123,163 49.9% 64,142 26.0% 4,298 1.7% 14,907 6.0% FY 13-14 1,478 0.6% 7,699 2.9% 31,631 12.0% 134,109 50.8% 65,847 25.0% 5,458 2.1% 17,687 6.7% FY 14-15 1,440 0.5% 8,795 3.3% 30,374 11.4% 135,952 50.9% 66,224 24.8% 6,015 2.3% 18,115 6.8% 4 ---PAGE BREAK--- - - - - - Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Statewide as of August 3, 2016 Fiscal Year Children 0 5 Count Children 0 5 % Children 6 11 Count Children 6 11 % Children 12 17 Count Children 12-17 % Youth 18-20 Count Youth 18-20 % FY 11-12 31,836 13.9% 78,479 34.3% 95,376 41.7% 23,124 10.1% FY 12-13 31,604 12.8% 84,686 34.3% 102,337 41.5% 28,125 11.4% FY 13-14 32,513 12.3% 90,328 34.2% 110,738 42.0% 30,330 11.5% FY 14-15 33,050 12.4% 90,003 33.7% 111,313 41.7% 32,549 12.2% 5 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth by Fiscal Year Statewide as of August 3, 2016 Fiscal Year Female Count Female % Male Count Male % FY 11-12 97,835 42.8% 130,980 57.2% FY 12-13 106,516 43.2% 140,236 56.8% FY 13-14 116,012 44.0% 147,897 56.0% FY 14-15 119,396 44.7% 147,519 55.3% 6 ---PAGE BREAK--- Penetration Rates* Report: Children and Youth With At Least One SMHS Visit** Statewide as of August 3, 2016 FY 11-12 FY 12-13 FY 13-14 FY 14-15 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 228,815 4,775,304 4.8% 246,752 5,476,043 4.5% 263,909 6,037,115 4.4% 266,915 6,352,757 4.2% Children 0-5 31,836 1,768,421 1.8% 31,604 1,845,768 1.7% 32,513 1,889,031 1.7% 33,050 1,899,764 1.7% Children 6-11 78,479 1,287,544 6.1% 84,686 1,582,876 5.4% 90,328 1,759,965 5.1% 90,003 1,838,788 4.9% Children 12-17 95,376 1,134,157 8.4% 102,337 1,388,448 7.4% 110,738 1,556,844 7.1% 111,313 1,622,677 6.9% Youth 18-20 23,124 585,182 4.0% 28,125 658,951 4.3% 30,330 831,275 3.6% 32,549 991,528 3.3% Alaskan Native or American Indian 1,492 20,046 7.4% 1,472 20,670 7.1% 1,478 21,976 6.7% 1,440 22,848 6.3% Asian or Pacific Islander 6,037 343,039 1.8% 6,688 434,825 1.5% 7,699 518,060 1.5% 8,795 560,523 1.6% Black 32,017 420,454 7.6% 32,082 436,927 7.3% 31,631 451,612 7.0% 30,374 463,333 6.6% Hispanic 111,224 2,807,069 4.0% 123,163 3,217,490 3.8% 134,109 3,450,311 3.9% 135,952 3,573,360 3.8% White 62,745 737,572 8.5% 64,142 820,886 7.8% 65,847 939,222 7.0% 66,224 1,001,776 6.6% Other 3,164 121,838 2.6% 4,298 167,395 2.6% 5,458 213,647 2.6% 6,015 237,756 2.5% Unknown 12,136 325,286 3.7% 14,907 377,850 3.9% 17,687 442,287 4.0% 18,115 493,161 3.7% Female 97,835 2,366,827 4.1% 106,516 2,711,146 3.9% 116,012 2,981,430 3.9% 119,396 3,133,356 3.8% Male 130,980 2,408,477 5.4% 140,236 2,764,897 5.1% 147,897 3,055,685 4.8% 147,519 3,219,401 4.6% *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 day in the Fiscal Year. 7 ---PAGE BREAK--- Penetration Rates* Report: Children and Youth With Five or More SMHS Visits** Statewide as of August 3, 2016 FY 11-12 FY 12-13 FY 13-14 FY 14-15 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 175,884 4,775,304 3.7% 189,431 5,476,043 3.5% 202,785 6,037,115 3.4% 203,992 6,352,757 3.2% Children 0-5 21,729 1,768,421 1.2% 21,417 1,845,768 1.2% 21,687 1,889,031 1.1% 22,063 1,899,764 1.2% Children 6-11 62,629 1,287,544 4.9% 67,345 1,582,876 4.3% 72,104 1,759,965 4.1% 71,497 1,838,788 3.9% Children 12-17 75,906 1,134,157 6.7% 81,153 1,388,448 5.8% 87,781 1,556,844 5.6% 88,340 1,622,677 5.4% Youth 18-20 15,620 585,182 2.7% 19,703 658,951 3.0% 21,213 831,275 2.6% 22,092 991,528 2.2% Alaskan Native or American Indian 1,127 20,046 5.6% 1,110 20,670 5.4% 1,087 21,976 4.9% 1,067 22,848 4.7% Asian or Pacific Islander 4,590 343,039 1.3% 5,153 434,825 1.2% 5,872 518,060 1.1% 6,758 560,523 1.2% Black 24,850 420,454 5.9% 24,864 436,927 5.7% 24,397 451,612 5.4% 23,354 463,333 5.0% Hispanic 84,368 2,807,069 3.0% 93,953 3,217,490 2.9% 102,482 3,450,311 3.0% 103,287 3,573,360 2.9% White 48,943 737,572 6.6% 48,943 820,886 6.0% 50,832 939,222 5.4% 50,912 1,001,776 5.1% Other 2,438 121,838 2.0% 3,266 167,395 2.0% 4,222 213,647 2.0% 4,570 237,756 1.9% Unknown 9,568 325,286 2.9% 11,769 377,850 3.1% 13,893 442,287 3.1% 14,044 493,161 2.8% Female 74,330 2,366,827 3.1% 81,016 2,711,146 3.0% 88,211 2,981,430 3.0% 90,189 3,133,356 2.9% Male 101,554 2,408,477 4.2% 108,602 2,764,897 3.9% 114,574 3,055,685 3.7% 113,803 3,219,401 3.5% *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 five SMHS that were claimed through the Short-Doyle/ Medi-Cal claiming system on at least five or more different days in the Fiscal Year. 8 ---PAGE BREAK--- Utilization Report*: Approved Specialty Mental Health Services for Children and Youth Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year** Statewide as of August 3, 2016 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) Health Facility (Days) FY 11-12 5,902.68 $ 0 0 432 1,856 5,483 317 306 14 526 415 7 12 9 13 70 14 FY 12-13 6,347.31 $ 825 215 394 1,795 5,227 307 294 15 502 443 7 13 9 19 91 15 FY 13-14 6,368.06 $ 1,970 1,434 367 1,725 5,116 306 305 16 516 457 8 14 8 18 101 15 FY 14-15 6,417.44 $ 2,418 1,655 368 1,698 4,906 314 299 16 528 520 7 15 8 20 95 13 MEAN 6,258.87 $ 1,738 1,101 390 1,768 5,183 311 301 15 518 459 7 14 8 18 89 14 Fiscal Year SDMC Total Clients IHBS Clients ICC Clients Case Management/ Brokerage Clients Mental Health Services Clients Therapeutic Behavioral Services Clients Medication Support Services Clients Crisis Intervention Clients Crisis Stabilization Clients Full Day Treatment Intensive Clients Full Day Rehabilitation Clients Hospital Inpatient Clients Hospital Inpatient Admin Clients Fee for Service Inpatient Clients Crisis Residential Treatment Services Clients Adult Residential Treatment Services Clients Health Facility Clients FY 11-12 228,799 - - 94,666 213,710 7,327 73,153 16,821 6,843 2,439 1,835 1,938 129 9,475 239 100 620 FY 12-13 246,748 110 179 96,628 231,416 7,983 77,965 17,704 8,530 1,900 2,006 2,085 161 10,530 283 125 781 FY 13-14 263,906 5,310 6,707 101,551 246,991 8,079 81,640 19,417 10,019 1,557 1,771 2,182 141 12,346 376 126 837 FY 14-15 266,912 7,822 10,162 99,584 248,699 8,136 80,309 20,545 11,912 675 1,405 2,351 186 13,112 454 100 953 *The graphs are color coded so that those reported in the same unit of analysis minutes) are colored similarly. Please note that 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. 9 ---PAGE BREAK--- Snapshot Report: Unique Count of Children and Youth Receiving SMHS Arriving, Exiting, and with Service Continuance by Fiscal Year Statewide as of August 3, 2016 Category Description (Please refer to the Measures Catalog for more detailed descriptions on all Performance Outcomes System measures.) Arrivals Children/Youth that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year. Service Continuance 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). Exiting Children/Youth that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year. Arriving & Exiting A distinct category in which children/youth met both the criteria for Arrivals and Exiting above for the fiscal year. Service Continuance & Exiting 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. Service Fiscal Year Arrivals Count Arrivals % Service Continuance 2 YR) Count Service Continuance 2 YR) % Service Continuance 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 65,825 26.7% 21,242 8.6% 22,066 8.9% 47,977 19.4% 81,065 32.9% 8,577 3.5% 246,752 100% FY 13-14 65,197 24.7% 21,454 8.1% 23,620 9.0% 54,840 20.8% 89,579 33.9% 9,219 3.5% 263,909 100% FY 14-15 65,315 24.5% 21,246 8.0% 22,862 8.6% 56,409 21.1% 91,329 34.2% 9,754 3.7% 266,915 100% 10 ---PAGE BREAK--- Time to Step Down Report: Children and Youth Stepping Down in SMHS Services Post Inpatient Discharge Statewide as of August 3, 2016 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 11-12 8,699 59.2% 2,560 17.4% 2,321 15.8% 1,102 7.5% 0 365 30.4 3 FY 12-13 9,694 63.1% 2,427 15.8% 2,097 13.6% 1,146 7.5% 0 365 26.1 2 FY 13-14 10,764 62.1% 2,844 16.4% 2,224 12.8% 1,512 8.7% 0 365 23.7 2 FY 14-15 10,655 58.0% 3,096 16.9% 2,353 12.8% 2,268 12.3% 0 365 21.9 3 * 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. 11 ---PAGE BREAK--- 2016 Performance Outcomes System Adult Reports 12 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year SFY Unique Count Receiving SMHS* Year-Over-Year Percentage Change Unique Count of Medi-Cal Eligibles Year-Over-Year Percentage Change FY 11-12 227,705 3,435,578 FY 12-13 230,815 1.4% 3,525,620 2.6% FY 13-14 293,282 27.1% 5,642,702 60.0% FY 14-15 336,619 14.8% 7,056,451 25.1% Compound Annual Growth Rate SFY** 13.9% 27.1% *SMHS = Specialty Mental Health Services. See Measures Catalog for more detailed information. **SFY = State Fiscal Year which is July 1 through June 30. The Measures Catalog may be found at: http://www.dhcs.ca.gov/services/MH/Documents/MedCCC/Library/POSMeasuresCatalog_Sept15Reporting_Final_1.11.15.pdf 13 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year 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 11-12 1,653 0.7% 22,322 9.8% 39,397 17.3% 46,052 20.2% 91,881 40.4% 6,077 2.7% 20,323 8.9% FY 12-13 1,838 0.8% 21,430 9.3% 40,376 17.5% 47,964 20.8% 88,983 38.6% 5,925 2.6% 24,299 10.5% FY 13-14 2,227 0.8% 24,586 8.4% 49,657 16.9% 63,464 21.6% 111,031 37.9% 9,090 3.1% 33,227 11.3% FY 14-15 2,601 0.8% 27,688 8.2% 54,788 16.3% 74,294 22.1% 125,389 37.2% 12,784 3.8% 39,075 11.6% 14 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year Fiscal Year Adults 21-44 Count Adults 21-44 % Adults 45-64 Count Adults 45-64 % Adults 65+ Count Adults 65+ % FY 11-12 98,600 43.3% 113,550 49.9% 15,555 6.8% FY 12-13 100,581 43.6% 113,109 49.0% 17,125 7.4% FY 13-14 134,496 45.9% 140,667 48.0% 18,119 6.2% FY 14-15 162,885 48.4% 154,527 45.9% 19,207 5.7% 15 ---PAGE BREAK--- Demographics Report: Unique Count of Adults by Fiscal Year Fiscal Year Female Count Female % Male Count Male % FY 11-12 132,758 58.3% 94,947 41.7% FY 12-13 134,000 58.1% 96,815 41.9% FY 13-14 162,354 55.4% 130,928 44.6% FY 14-15 179,318 53.3% 157,301 46.7% 16 ---PAGE BREAK--- Penetration Rates* Report: Adults With At Least One SMHS Visit** FY 11-12 FY 12-13 FY 13-14 FY 14-15 Adults with 1 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 1 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 1 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 1 or more SMHS Visits Certified Eligible Adults Penetration Rate All 227,705 3,435,578 6.6% 230,815 3,525,620 6.5% 293,282 5,642,702 5.2% 336,619 7,056,451 4.8% Adults 21-44 98,600 1,454,758 6.8% 100,581 1,509,629 6.7% 134,496 2,626,878 5.1% 162,885 3,515,040 4.6% Adults 45-64 113,550 962,681 11.8% 113,109 974,387 11.6% 140,667 1,930,585 7.3% 154,527 2,381,477 6.5% Adults 65+ 15,555 1,018,139 1.5% 17,125 1,041,604 1.6% 18,119 1,085,239 1.7% 19,207 1,159,934 1.7% Alaskan Native or American Indian 1,653 20,815 7.9% 1,838 21,060 8.7% 2,227 31,838 7.0% 2,601 38,616 6.7% Asian or Pacific Islander 22,322 520,041 4.3% 21,430 528,892 4.1% 24,586 895,255 2.7% 27,688 1,130,645 2.4% Black 39,397 365,964 10.8% 40,376 373,909 10.8% 49,657 562,212 8.8% 54,788 657,419 8.3% Hispanic 46,052 1,144,963 4.0% 47,964 1,190,155 4.0% 63,464 1,856,796 3.4% 74,294 2,348,111 3.2% White 91,881 973,926 9.4% 88,983 976,019 9.1% 111,031 1,567,524 7.1% 125,389 1,937,800 6.5% Other 6,077 124,253 4.9% 5,925 128,805 4.6% 9,090 252,480 3.6% 12,784 349,162 3.7% Unknown 20,323 285,616 7.1% 24,299 306,780 7.9% 33,227 476,597 7.0% 39,075 594,698 6.6% Female 132,758 2,150,142 6.2% 134,000 2,211,304 6.1% 162,354 3,259,111 5.0% 179,318 3,949,396 4.5% Male 94,947 1,285,435 7.4% 96,815 1,314,315 7.4% 130,928 2,383,591 5.5% 157,301 3,107,055 5.1% *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. Penetration rates decreased because the number of Affordable Care Act SMHS eligible beneficiaries increased markedly beginning in SFY 2013-14 while claims increased more gradually. **Adults and Older Adults that have received at least one SMHS that was claimed through the Short-Doyle/ Medi-Cal claiming system on at least one day in the Fiscal Year. 17 ---PAGE BREAK--- Penetration Rates* Report: Adults With Five or More SMHS Visits** FY 11-12 FY 12-13 FY 13-14 FY 14-15 Adults with 5 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 5 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 5 or more SMHS Visits Certified Eligible Adults Penetration Rate Adults with 5 or more SMHS Visits Certified Eligible Adults Penetration Rate All 161,425 3,435,578 4.7% 163,290 3,525,620 4.6% 197,705 5,642,702 3.5% 225,257 7,056,451 3.2% Adults 21-44 67,348 1,454,758 4.6% 67,974 1,509,629 4.5% 85,873 2,626,878 3.3% 103,254 3,515,040 2.9% Adults 45-64 83,691 962,681 8.7% 83,388 974,387 8.6% 98,992 1,930,585 5.1% 108,618 2,381,477 4.6% Adults 65+ 10,386 1,018,139 1.0% 11,928 1,041,604 1.1% 12,840 1,085,239 1.2% 13,385 1,159,934 1.2% Alaskan Native or American Indian 1,148 20,815 5.5% 1,249 21,060 5.9% 1,496 31,838 4.7% 1,666 38,616 4.3% Asian or Pacific Islander 17,375 520,041 3.3% 16,626 528,892 3.1% 18,244 895,255 2.0% 19,660 1,130,645 1.7% Black 27,221 365,964 7.4% 27,619 373,909 7.4% 32,313 562,212 5.7% 35,658 657,419 5.4% Hispanic 31,847 1,144,963 2.8% 32,959 1,190,155 2.8% 41,417 1,856,796 2.2% 48,796 2,348,111 2.1% White 64,620 973,926 6.6% 62,692 976,019 6.4% 74,559 1,567,524 4.8% 83,578 1,937,800 4.3% Other 4,372 124,253 3.5% 4,200 128,805 3.3% 5,930 252,480 2.3% 8,058 349,162 2.3% Unknown 14,842 285,616 5.2% 17,945 306,780 5.8% 23,746 476,597 5.0% 27,841 594,698 4.7% Female 92,712 2,150,142 4.3% 93,109 2,211,304 4.2% 108,919 3,259,111 3.3% 120,352 3,949,396 3.0% Male 68,713 1,285,435 5.3% 70,181 1,314,315 5.3% 88,786 2,383,591 3.7% 104,905 3,107,055 3.4% *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. Penetration rates decreased because the number of Affordable Care Act SMHS eligible beneficiaries increased markedly beginning in SFY 2013-14 while claims increased more gradually. **Adults and Older Adults that have received at least five SMHS that were claimed through the Short-Doyle/ Medi-Cal claiming system on at least five or more different days in the Fiscal Year. 18 ---PAGE BREAK--- Utilization Report*: Approved Specialty Mental Health Services for Adults Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year** Fiscal Year SDMC Total Approved Case Management/ Brokerage (Minutes) Mental Health 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) Health Facility (Days) FY 11-12 3,963 499 933 302 234 21 119 335 8 16 15 18 81 11 FY 12-13 4,600 443 840 282 236 23 336 288 8 15 15 19 87 13 FY 13-14 4,342 401 771 263 227 23 375 254 7 16 12 17 87 12 FY 14-15 4,826 407 792 278 231 24 0 244 7 19 12 17 89 11 MEAN $ 4,432.51 437 834 281 232 23 277 280 8 17 13 18 86 12 *The graphs are color coded so that those reported in the same unit of analysis minutes) are colored similarly. Please note that values listed at the bottom of each bar graph represent the actual number of Adults and Older Adults that received the SMHS represented in their respective graph by Fiscal Year. 19 ---PAGE BREAK--- Snapshot Report: Unique Count of Adults Receiving SMHS Arriving, Exiting, and with Service Continuance by Fiscal Year Category Description (Please refer to the Measures Catalog for more detailed descriptions on all Performance Outcomes System measures.) Arrivals Adults that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year. Service Continuance 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). Exiting Adults that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year. Arriving & Exiting A distinct category in which adults met both the criteria for Arrivals and Exiting above for the fiscal year. Service Continuance & Exiting 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. Service Fiscal Year Arrivals Count Arrivals % Service Continuance 2 YR) Count Service Continuance 2 YR) % Service Continuance 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 41,605 18.0% 45,543 19.7% 30,891 13.4% 34,660 15.0% 72,650 31.5% 5,466 2.4% 230,815 100% FY 13-14 72,687 24.8% 45,263 15.4% 30,239 10.3% 36,582 12.5% 102,554 35.0% 5,955 2.0% 293,280 100% FY 14-15 59,939 17.8% 43,229 12.8% 43,401 12.9% 54,763 16.3% 128,467 38.2% 6,796 2.0% 336,595 100% 20 ---PAGE BREAK--- Time to Step Down Report: Adults Stepping Down in SMHS Services Post Inpatient Discharge 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 11-12 20,500 42.4% 9,949 20.6% 14,259 29.5% 3,634 7.5% 0 365 55.6 10 FY 12-13 13,532 44.0% 5,537 18.0% 8,820 28.7% 2,881 9.4% 0 365 57.4 8 FY 13-14 14,020 43.7% 5,416 16.9% 8,645 27.0% 3,992 12.4% 0 365 53.0 8 FY 14-15 16,575 39.5% 7,133 17.0% 10,411 24.8% 7,896 18.8% 0 365 44.7 8 * 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. 21