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Performance Outcomes System Reports Report run on August 3, 2016 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 SMHS 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 Fiscal Years (FY) 11/12, 12/13, 13/14, and 14/15. 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 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; or • Age 21 during the approved date of the service on the claim and a birth date on or after January 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 FY 14/15. Page 1 of 14 ---PAGE BREAK--- Performance Outcomes System Reports Report run on August 3, 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/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 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 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 arriving and exiting). As of now, this report only classifies youth and their service usage for FY 12/13 and FY13/14. 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 emergency services/hospital data reported on in the time to step-down services report relies solely on claims data from Short Doyle/Medi-Cal II. In the future this 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 REDACTED] for any questions regarding this report. Page 2 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Alpine County 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 ^ 132 FY 12-13 ^ ^ 139 ^ FY 13-14 11 10.0% 149 7.2% FY 14-15 17 54.5% 172 15.4% Compound Annual Growth Rate SFY** 50.4% 9.2% *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. ^ ^ 11 17 - 5 10 15 20 FY 11-12 FY 12-13 FY 13-14 FY 14-15 Unique Count of Children and Youth Receiving SMHS Page 3 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Alpine County 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 ^ ^ 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% FY 13-14 ^ ^ 0 0.0% 0 0.0% 0 0.0% ^ ^ 0 0.0% 0 0.0% FY 14-15 12 70.6% 0 0.0% 0 0.0% ^ ^ ^ ^ 0 0.0% 0 0.0% *FY 13-14 claims are estimated to be 95% complete as of January 1, 2015. Please note: This report uses 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. Please note: This report uses the Medi-Cal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by County Welfare Departments and may differ from data maintained by County Mental Health Plans. For more information, please refer to the Measures Catalog. ^ 0% 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% ^ 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% ^ 0% 0% Fiscal Year 13-14 Race Distribution Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Other Unknown 71% 0% 0% ^ ^ 0% 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. Page 4 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Alpine County 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 0 0.0% ^ ^ ^ ^ 0 0.0% FY 12-13 0 0.0% ^ ^ ^ ^ ^ ^ FY 13-14 0 0.0% ^ ^ ^ ^ ^ ^ FY 14-15 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% Fiscal Year 11-12 Age Group Distribution Children 0-5 Children 6-11 Children 12-17 Youth 18-20 0% ^ ^ ^ Fiscal Year 12-13 Age Group Distribution Children 0-5 Children 6-11 Children 12-17 Youth 18-20 0% ^ ^ ^ Fiscal Year 13-14 Age Group Distribution Children 0-5 Children 6-11 Children 12-17 Youth 18-20 0% ^ ^ ^ Fiscal Year 14-15 Age Group Distribution Children 0-5 Children 6-11 Children 12-17 Youth 18-20 CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. Page 5 of 14 ---PAGE BREAK--- Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal Year Alpine County as of August 3, 2016 Fiscal Year Female Count Female % Male Count Male % FY 11-12 ^ ^ ^ ^ FY 12-13 ^ ^ ^ ^ FY 13-14 ^ ^ ^ ^ FY 14-15 12 70.6% ^ ^ ^ Data has been suppressed to protect patient privacy. ^ Fiscal Year 11-12 Gender Distribution Female Male ^ Fiscal Year 12-13 Gender Distribution Female Male ^ Fiscal Year 13-14 Gender Distribution Female Male 70.6% ^ Fiscal Year 14-15 Gender Distribution Female Male CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES. Page 6 of 14 ---PAGE BREAK--- Penetration Rates* Report: Children and Youth With At Least One SMHS Visit** Alpine County as of August 3, 2016 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 ^ 132 ^ ^ 139 ^ 11 149 7.4% 17 172 9.9% Children 0-5 0 42 0.0% 0 36 0.0% 0 42 0.0% 0 47 0.0% Children 6-11 ^ 33 ^ ^ 39 ^ ^ 46 ^ ^ 54 ^ Children 12-17 ^ 40 ^ ^ 41 ^ ^ 31 ^ ^ 41 ^ Youth 18-20 0 17 0.0% ^ 23 ^ ^ 30 ^ ^ 30 ^ Alaskan Native or American Indian ^ 75 ^ ^ 82 ^ ^ 85 ^ 12 81 14.8% Asian or Pacific Islander 0 0 0.0% 0 0 0.0% 0 ^ 0.0% 0 ^ 0.0% Black 0 0 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Hispanic 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% ^ 13 ^ White ^ 47 ^ ^ 46 ^ ^ 40 ^ ^ 46 ^ Other 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Unknown 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 28 0.0% Female ^ 65 ^ ^ 66 ^ ^ 77 ^ ^ 85 ^ Male ^ 67 ^ ^ 73 ^ ^ 72 ^ ^ 87 ^ *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 the Medi-Cal Managed Care system. **Children and Youth that have received at least one SMHS in the Fiscal Year. ^ Data has been suppressed to protect patient privacy. Please note: This report uses the Medi-Cal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by County Welfare Departments and may differ from data maintained by County Mental Health Plans. For more information, please refer to the Measures Catalog. Page 7 of 14 FY 11-12 FY 12-13 FY 13-14 FY 14-15 0.0% 0.0% 0.0% 0.0% ^ ^ ^ ^ ^ ^ ^ ^ 0.0% ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 42) FY 12-13 36) FY 13-14 42) FY 14-15 47) FY 11-12 33) FY 12-13 39) FY 13-14 46) FY 14-15 54) FY 11-12 40) FY 12-13 41) FY 13-14 31) FY 14-15 41) FY 11-12 17) FY 12-13 23) FY 13-14 30) FY 14-15 30) Children 0-5 Children 6-11 Children 12-17 Youth 18-20 Penetration Rates by Age Children and Youth With At Least One SMHS Visit**, By Fiscal Year ---PAGE BREAK--- Penetration Rates* Report: Children and Youth With At Least One SMHS Visit** Alpine County as of August 3, 2016 *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 the Medi-Cal Managed Care system. **Children and Youth that have received at least one SMHS in the Fiscal Year. ^ Data has been suppressed to protect patient privacy. ^ ^ ^ 14.8% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 75) FY 12-13 82) FY 13-14 85) FY 14-15 81) FY 11-12 00) FY 12-13 00) FY 13-14 FY 14-15 FY 11-12 00) FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 13) FY 11-12 47) FY 12-13 46) FY 13-14 40) FY 14-15 46) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Penetration Rates by Race Children and Youth With At Least One SMHS Visit**, By Fiscal Year ^ ^ ^ ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 65) FY 12-13 66) FY 13-14 77) FY 14-15 85) FY 11-12 67) FY 12-13 73) FY 13-14 72) FY 14-15 87) Female Male Penetration Rates by Gender Children and Youth With At Least One SMHS Visit**, By Fiscal Year Please note: This report uses the Medi-Cal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by County Welfare Departments and may differ from data maintained by County Mental Health Plans. For more information, please refer to the Measures Catalog. Page 8 of 14 ---PAGE BREAK--- Penetration Rates* Report: Children and Youth with Five or More SMHS Visits** Alpine County as of August 3, 2016 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 ^ 132 ^ ^ 139 ^ ^ 149 ^ 12 172 7.0% Children 0-5 0 42 0.0% 0 36 0.0% 0 42 0.0% 0 47 0.0% Children 6-11 0 33 0.0% ^ 39 ^ ^ 46 ^ ^ 54 ^ Children 12-17 ^ 40 ^ ^ 41 ^ ^ 31 ^ ^ 41 ^ Youth 18-20 ^ 17 ^ ^ 23 ^ ^ 30 ^ ^ 30 ^ Alaskan Native or American Indian ^ 75 ^ ^ 82 ^ ^ 85 ^ ^ 81 ^ Asian or Pacific Islander 0 0 0.0% 0 0 0.0% 0 ^ 0.0% 0 ^ 0.0% Black 0 0 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Hispanic 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% ^ 13 ^ White ^ 47 ^ ^ 46 ^ ^ 40 ^ ^ 46 ^ Other 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% Unknown 0 ^ 0.0% 0 ^ 0.0% 0 ^ 0.0% 0 28 0.0% Female ^ 65 ^ ^ 66 ^ ^ 77 ^ ^ 85 ^ Male ^ 67 ^ ^ 73 ^ ^ 72 ^ ^ 87 ^ *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 the Medi-Cal Managed Care system. **Children and Youth that have received at least five SMHS in the Fiscal Year. ^ Data has been suppressed to protect patient privacy. Please note: This report uses the Medi-Cal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by County Welfare Departments and may differ from data maintained by County Mental Health Plans. For more information, please refer to the Measures Catalog. Page 9 of 14 FY 11-12 FY 12-13 FY 13-14 FY 14-15 0.0% 0.0% 0.0% 0.0% 0.0% ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 42) FY 12-13 36) FY 13-14 42) FY 14-15 47) FY 11-12 33) FY 12-13 39) FY 13-14 46) FY 14-15 54) FY 11-12 40) FY 12-13 41) FY 13-14 31) FY 14-15 41) FY 11-12 17) FY 12-13 23) FY 13-14 30) FY 14-15 30) Children 0-5 Children 6-11 Children 12-17 Youth 18-20 Penetration Rates by Age Children and Youth With Five or More SMHS Visits**, By Fiscal Year ---PAGE BREAK--- Penetration Rates* Report: Children and Youth with Five or More SMHS Visits** Alpine County as of August 3, 2016 *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 the Medi-Cal Managed Care system. **Children and Youth that have received at least five SMHS in the Fiscal Year. ^ 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% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 75) FY 12-13 82) FY 13-14 85) FY 14-15 81) FY 11-12 00) FY 12-13 00) FY 13-14 FY 14-15 FY 11-12 00) FY 12-13 FY 13-14 FY 14-15 FY 11-12 FY 12-13 FY 13-14 FY 14-15 13) FY 11-12 47) FY 12-13 46) FY 13-14 40) FY 14-15 46) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Penetration Rates by Race Children and Youth With Five or More SMHS Visits**, By Fiscal Year ^ ^ ^ ^ ^ ^ ^ ^ 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% FY 11-12 65) FY 12-13 66) FY 13-14 77) FY 14-15 85) FY 11-12 67) FY 12-13 73) FY 13-14 72) FY 14-15 87) Female Male Penetration Rates by Gender Children and Youth With Five or More SMHS Visits**, By Fiscal Year Please note: This report uses the Medi-Cal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by County Welfare Departments and may differ from data maintained by County Mental Health Plans. For more information, please refer to the Measures Catalog. Page 10 of 14 ---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* Alpine County 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 3,554.80 $ 0 0 423 1,242 0 0 0 0 0 0 0 0 0 0 0 0 FY 12-13 4,540.02 $ 0 0 300 1,211 0 470 120 0 0 0 0 0 0 0 0 0 FY 13-14 6,497.94 $ 0 0 311 1,057 0 424 45 0 0 0 0 0 0 0 0 0 FY 14-15 4,403.62 $ 0 0 47 798 0 323 65 0 0 0 0 0 0 0 0 0 MEAN 4,749.10 $ 0 0 270 1,077 0 406 77 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 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 $3,554.80 $4,540.02 $6,497.94 $4,403.62 $1,000.00 $2,000.00 $3,000.00 $4,000.00 $5,000.00 $6,000.00 $7,000.00 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = 13) FY 14-15 (n = 17) Total Approved 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 = ) IHBS Minutes 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 = ) ICC Minutes Per Unique Beneficiary By Service Fiscal Year 423 300 311 47 - 50 100 150 200 250 300 350 400 450 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = FY 14-15 (n = Case Management/Brokerage Minutes Per Unique Beneficiary By Service Fiscal Year 1,242 1,211 1,057 798 - 200 400 600 800 1,000 1,200 1,400 FY 11-12 (n = FY 12-13 (n = FY 13-14 (n = 13) FY 14-15 (n = 17) Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year - - - - - 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 = ) Therapeutic Behavioral Services Minutes Per Unique Beneficiary By Service Fiscal Year 0 470 424 323 - 50 100 150 200 250 300 350 400 450 500 FY 11-12 (n = ) FY 12-13 (n = FY 13-14 (n = FY 14-15 (n = Medication Support Services Minutes Per Unique Beneficiary By Service Fiscal Year 0 120 45 65 - 20 40 60 80 100 120 140 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 ---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* Alpine County as of August 3, 2016 *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. Page 12 of 14 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 ---PAGE BREAK--- Snapshot Report: Unique Count of Children and Youth Receiving SMHS Arriving, Exiting, and with Service Continuance by Fiscal Year Alpine County as of August 3, 2016 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 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 0% FY 13-14 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 11 0% FY 14-15 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 17 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.) 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. 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. Page 13 of 14 ---PAGE BREAK--- Time to Step Down Report: Children and Youth Stepping Down in SMHS Services Post Inpatient Discharge County 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 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. 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