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Performance Outcomes Adult Specialty Mental Health Services Report Report Date September, 2016 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) 11/12, 12/13, 13/14, and 14/15. Definitions *Population - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were: • Age 22 or older during the approved date of service on the claim; or • Age 21 during the approved date of the service on the claim and a birth date on or after July 1st of the Fiscal Year. Data Sources - ▪Short-Doyle/Medi-Cal II (SD/MC II) claims with dates of service in FY 11/12 through FY 14/15. ▪Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 11/12 through 14/15. 1 of 14 ---PAGE BREAK--- Performance Outcomes Adult Specialty Mental Health Services Report Report Date September, 2016 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 arriving and exiting). As of now, this report only classifies adults and their service usage for FY 12/13 through FY14/15. 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 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 the hospital from which the patient is discharged and receives step-down services. Please contact [EMAIL REDACTED] for any questions regarding this report. 2 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year Alpine County SFY Unique Count Receiving SMHS* Year-Over-Year Percentage Change Unique Count of Medi-Cal Eligibles Year-Over-Year Percentage Change FY 11-12 ^ 142 FY 12-13 14 40.0% 130 -8.5% FY 13-14 18 28.6% 244 87.7% FY 14-15 26 44.4% 285 16.8% Compound Annual Growth Rate SFY** 37.5% 26.1% *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. The Measures Catalog may be found at: http://www.dhcs.ca.gov/services/MH/Documents/MedCCC/Library/POSMeasuresCatalog_Sept15Reporting_Final_1.11.15.pdf CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. 3 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year Alpine County 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 ^ ^ 0 0.0% 0 0.0% 0 0.0% ^ ^ 0 0.0% ^ ^ FY 12-13 ^ ^ 0 0.0% ^ ^ ^ ^ ^ ^ 0 0.0% 0 0.0% FY 13-14 ^ ^ 0 0.0% 0 0.0% 0 0.0% 11 61.1% 0 0.0% ^ ^ FY 14-15 ^ ^ 0 0.0% 0 0.0% 0 0.0% 18 69.2% 0 0.0% ^ ^ *FY 13-14 claims are estimated to be 95% complete as of January 1, 2015. ^ Data has been suppressed to protect patient privacy. ^ 0%0% 0% ^ 0% ^ Fiscal Year 11-12 Race Distribution Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Other Unknown ^ 0% ^ ^ ^ 0% 0% Fiscal Year 12-13 Race Distribution Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Other Unknown ^ 0% 0% 0% 61% 0% ^ Fiscal Year 13-14 Race Distribution Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Other Unknown ^ 0% 0% 0% 69% 0% ^ Fiscal Year 14-15 Race Distribution Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Other Unknown CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. 4 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year Alpine County Fiscal Year Adults 21-44 Count Adults 21-44 % Adults 45-64 Count Adults 45-64 % Adults 65+ Count Adults 65+ % FY 11-12 ^ ^ ^ ^ 0 0.0% FY 12-13 ^ ^ ^ ^ 0 0.0% FY 13-14 ^ ^ ^ ^ 0 0.0% FY 14-15 14 53.8% ^ ^ ^ ^ *FY 13-14 claims are estimated to be 95% complete as of January 1, 2015. ^ Data has been suppressed to protect patient privacy. ^ ^ 0.0% Fiscal Year 11-12 Age Group Distribution Adults 21-44 Adults 45-64 Adults 65+ ^ ^ 0.0% Fiscal Year 12-13 Age Group Distribution Adults 21-44 Adults 45-64 Adults 65+ ^ ^ 0.0% Fiscal Year 13-14 Age Group Distribution Adults 21-44 Adults 45-64 Adults 65+ 53.8% ^ ^ Fiscal Year 14-15 Age Group Distribution Adults 21-44 Adults 45-64 Adults 65+ CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. 5 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal Year Alpine County Fiscal Year Female Count Female % Male Count Male % FY 11-12 ^ ^ ^ ^ FY 12-13 11 78.6% ^ ^ FY 13-14 13 72.2% ^ ^ FY 14-15 19 73.1% ^ ^ ^ Data has been suppressed to protect patient privacy. ^ Fiscal Year 11-12 Gender Distribution Female Male 78.6% ^ Fiscal Year 12-13 Gender Distribution Female Male 72.2% ^ Fiscal Year 13-14 Gender Distribution Female Male 73.1% ^ Fiscal Year 14-15 Gender Distribution Female Male CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. 6 of 14 ---PAGE BREAK--- Penetration Rates* Report: Adults With At Least One SMHS Visit** Alpine County 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 ^ 142 ^ 14 130 10.8% 18 244 7.4% 26 285 9.1% Adults 21-44 ^ 59 ^ ^ 53 ^ ^ 118 ^ 14 144 9.7% Adults 45-64 ^ 60 ^ ^ 53 ^ ^ 99 ^ ^ 107 ^ Adults 65+ 0 23 0.0% 0 24 0.0% 0 27 0.0% ^ 34 ^ Alaskan Native or American Indian ^ 69 ^ ^ 61 ^ ^ 105 ^ ^ 103 ^ Asian or Pacific Islander 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Black 0 ^ 0.0% ^ ^ ^ 0 ^ 0.0% 0 ^ 0.0% Hispanic 0 ^ 0.0% ^ ^ ^ 0 ^ 0.0% 0 18 0.0% White ^ 50 ^ ^ 51 ^ 11 108 10.2% 18 139 12.9% Other 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Unknown ^ ^ ^ 0 ^ 0.0% ^ 12 ^ ^ 16 ^ Female ^ 83 ^ ^ 74 ^ ^ 120 ^ ^ 143 ^ Male ^ 59 ^ ^ 56 ^ ^ 124 ^ ^ 142 ^ *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 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. 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. ^ Data has been suppressed to protect patient privacy. FY 11-12 FY 12-13 FY 13-14 FY 14-15 ^ ^ ^ 9.7% ^ ^ ^ ^ 0.0% 0.0% 0.0% ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 59) FY 12-13 53) FY 13-14 118) FY 14-15 144) FY 11-12 60) FY 12-13 53) FY 13-14 99) FY 14-15 107) FY 11-12 23) FY 12-13 24) FY 13-14 27) FY 14-15 34) Adults 21-44 Adults 45-64 Adults 65+ Penetration Rates by Age Adults With At Least One SMHS Visit**, By Fiscal Year 7 of 14 ---PAGE BREAK--- Penetration Rates* Report: Adults With At Least One SMHS Visit** Alpine County *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 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. 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. ^ Data has been suppressed to protect patient privacy. ^ ^ ^ ^ 0.0% 0.0% 0.0% 0.0% 0.0% ^ 0.0% 0.0% 0.0% ^ 0.0% 0.0% ^ ^ 10.2% 12.9% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 69) FY 12-13 61) FY 13-14 105) FY 14-15 103) FY 11-12 FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 18) FY 11-12 50) FY 12-13 51) FY 13-14 108) FY 14-15 139) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Penetration Rates by Race Adults With At Least One SMHS Visit**, By Fiscal Year ^ ^ ^ ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 83) FY 12-13 74) FY 13-14 120) FY 14-15 143) FY 11-12 59) FY 12-13 56) FY 13-14 124) FY 14-15 142) Female Male Penetration Rates by Gender Adults With At Least One SMHS Visit**, By Fiscal Year 8 of 14 ---PAGE BREAK--- Penetration Rates* Report: Adults with Five or More SMHS Visits** Alpine County FY 13-14 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 ^ 142 ^ ^ 130 ^ 15 244 6.1% 19 285 6.7% Adults 21-44 ^ 59 ^ ^ 53 ^ ^ 118 ^ ^ 144 ^ Adults 45-64 ^ 60 ^ ^ 53 ^ ^ 99 ^ ^ 107 ^ Adults 65+ 0 23 0.0% 0 24 0.0% 0 27 0.0% ^ 34 ^ Alaskan Native or American Indian 0 69 0.0% ^ 61 ^ ^ 105 ^ ^ 103 ^ Asian or Pacific Islander 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Black 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Hispanic 0 ^ 0.0% ^ ^ ^ 0 ^ 0.0% 0 18 0.0% White ^ 50 ^ ^ 51 ^ ^ 108 ^ 13 139 9.4% Other 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Unknown ^ ^ ^ 0 ^ 0.0% ^ 12 ^ ^ 16 ^ Female ^ 83 ^ ^ 74 ^ ^ 120 ^ ^ 143 ^ Male ^ 59 ^ ^ 56 ^ ^ 124 ^ ^ 142 ^ *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 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. 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. ^ Data has been suppressed to protect patient privacy. FY 14-15 FY 11-12 FY 12-13 ^ ^ ^ ^ ^ ^ ^ ^ 0.0% 0.0% 0.0% ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 59) FY 12-13 53) FY 13-14 118) FY 14-15 144) FY 11-12 60) FY 12-13 53) FY 13-14 99) FY 14-15 107) FY 11-12 23) FY 12-13 24) FY 13-14 27) FY 14-15 34) Adults 21-44 Adults 45-64 Adults 65+ Penetration Rates by Age Adults With Five or More SMHS Visits**, By Fiscal Year 9 of 14 ---PAGE BREAK--- Penetration Rates* Report: Adults with Five or More SMHS Visits** Alpine County *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 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. 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. ^ Data has been suppressed to protect patient privacy. 0.0% ^ ^ ^ 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% ^ 0.0% 0.0% ^ ^ ^ 9.4% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 69) FY 12-13 61) FY 13-14 105) FY 14-15 103) FY 11-12 FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 18) FY 11-12 50) FY 12-13 51) FY 13-14 108) FY 14-15 139) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Penetration Rates by Race Adults With Five or More SMHS Visits**, By Fiscal Year ^ ^ ^ ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 83) FY 12-13 74) FY 13-14 120) FY 14-15 143) FY 11-12 59) FY 12-13 56) FY 13-14 124) FY 14-15 142) Female Male Penetration Rates by Gender Adults With Five or More SMHS Visits**, By Fiscal Year 10 of 14 ---PAGE BREAK--- Utilization Report*: Approved Specialty Mental Health Services for Adults Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Alpine County 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 3,746 986 488 610 0 0 0 0 0 0 0 0 0 0 FY 12-13 4,600 781 854 349 270 0 0 0 0 0 0 0 0 0 FY 13-14 8,563 442 1,523 408 30 0 0 0 0 0 0 0 0 0 FY 14-15 5,905 163 1,160 251 236 0 0 0 0 0 0 0 0 0 MEAN 5,703.49 $ 593 1,006 404 179 0 0 0 0 0 0 0 0 0 *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 that received the SMHS represented in their respective graph by Fiscal Year. ^ Data has been suppressed to protect patient privacy. $3,746 $4,600 $8,563 $5,905 $1,000.00 $2,000.00 $3,000.00 $4,000.00 $5,000.00 $6,000.00 $7,000.00 $8,000.00 $9,000.00 FY 11-12 (n = 10) FY 12-13 (n = 18) FY 13-14 (n = 22) FY 14-15 (n = 29) Total Approved Per Unique Beneficiary By Service Fiscal Year 488 854 1,523 1,160 - 200 400 600 800 1,000 1,200 1,400 1,600 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = 18) FY 14-15 (n = 24) Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year 610 349 408 251 - 100 200 300 400 500 600 700 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = 11) FY 14-15 (n = Medication Support Services Minutes Per Unique Beneficiary By Service Fiscal Year 0 270 30 236 - 50 100 150 200 250 300 FY 11-12 (n = ) FY 12-13 (n = FY 13-14 (n = FY 14-15 (n = Crisis Intervention Minutes 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 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Crisis Stabilization Hours Per Unique Beneficiary By Service Fiscal Year 986 781 442 163 - 200 400 600 800 1,000 1,200 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = 17) FY 14-15 (n = 19) Case Management/Brokerage Minutes Per Unique Beneficiary By Service Fiscal Year 11 of 14 ---PAGE BREAK--- Utilization Report*: Approved Specialty Mental Health Services for Adults Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Alpine County *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 that received the SMHS represented in their respective graph by Fiscal Year. 0 0 0 0 - 0 0 0 0 1 1 1 1 1 1 FY 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Full Day Treatment Intensive Hours Per Unique Beneficiary By Service Fiscal Year 0 0 0 0 - 0 0 0 0 1 1 1 1 1 1 FY 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) 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 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Adult Residential Treatment Services Days 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 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Health Facility Days Per Unique Beneficiary By Service Fiscal Year 0 0 0 0 - 0 0 0 0 1 1 1 1 1 1 FY 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Hospital Inpatient Days Per Unique Beneficiary By Service Fiscal Year 0 0 0 0 - 0 0 0 0 1 1 1 1 1 1 FY 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Hospital Inpatient Admin Days Per Unique Beneficiary By Service Fiscal Year 0 0 0 0 - 0 0 0 0 1 1 1 1 1 1 FY 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Fee for Service Inpatient Days 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 11-12 (n = ) FY 12-13 (n = ) FY 13-14 (n = ) FY 14-15 (n = ) Crisis Residential Treatment Services Days Per Unique Beneficiary By Service Fiscal Year 12 of 14 ---PAGE BREAK--- Snapshot Report: Unique Count of Adults Receiving SMHS Arriving, Exiting, and with Service Continuance by Fiscal Year Alpine County 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 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 14 0% FY 13-14 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 18 0% FY 14 - 15 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 26 0% 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.) 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. Fiscal Year 12-13 Arrivals, Service Continuance, & Exits Distribution Arrivals Service Continuance 2 YR) Service Continuance 2 YR) Exiting Arriving & Exiting Service Continuance 2 YR) & Exiting Fiscal Year 13-14 Arrivals, Service Continuance, & Exits Distribution Arrivals Service Continuance 2 YR) Service Continuance 2 YR) Exiting Arriving & Exiting Service Continuance 2 YR) & Exiting Fiscal Year 14-15 Arrivals, Service Continuance, & Exits Distribution Arrivals Service Continuance 2 YR) Service Continuance 2 YR) Exiting Arriving & Exiting Service Continuance 2 YR) & Exiting CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. 13 of 14 ---PAGE BREAK--- Time to Step Down Report: Children and Youth Stepping Down in SMHS Services Post Inpatient Discharge County 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 within 30 Days of Discharge Percentage of Inpatient Discharges with Step Down within 30 Days of Discharge 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 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0 0.0 0 FY 12-13 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0 0.0 0 FY 13-14 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0 0.0 0 FY 14-15 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0 0.0 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. 0 0 0 0 0 1 2 3 4 5 6 7 8 9 10 FY 10-11 FY 11-12 FY 12-13 FY 13-14 Median Time Between Inpatient Discharge and Step Down Service in Days 0.0 0.0 0.0 0.0 0 0 0 1 1 1 FY 10-11 FY 11-12 FY 12-13 FY 13-14 Mean Time Between Inpatient Discharge and Step Down Service in Days 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0% 20% 40% 60% 80% 100% FY 10-11 ( Unique Beneficiaries with Total Inpatient Discharges ) FY 11-12 ( Unique Beneficiaries with Total Inpatient Discharges ) FY 12-13 ( Unique Beneficiaries with Total Inpatient Discharges ) FY 13-14 ( Unique Beneficiaries with 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 TABLES AND CHARTS NOT PRODUCED FOR THIS INDICATOR DUE TO SMALL CELL SIZES. 14 of 14