Outcomes Tool Selection Committee

May 27, 2015

Introduction of CommitteeChildren’s Behavioral Health Care Commission Terry LawlerHot Springs School District Department of Human ServicesBob DarlingDirector’s Office Dixie WallaceDivision of Medical Services Community Mental Health CentersRoland Irwin, PhDMid-South Health Systems Patricia Gann, LPCSouth Arkansas Regional Health Center

Private ProvidersDr. Keith NoblePreferred Family Health Jason Turner, LCSWFamilies, Inc. Youth and Family Noelle StimachYouthMOVE Angela LassiterArkansas Behavioral Health Planning and Advisory Council CASSP Executive Committee Derek SpiegelMid-South Health Systems PsychiatristDr. Peter JensenUniversity of Arkansas for Medical Sciences

Y-OQ® Outcomes Report

Prepared by:Elizabeth Childers, Ph.D., MPH

3

4

There are 3 age-specific Y-OQ®s: Age 4-17 uses the (Y-OQ® 2.0*) which consists of 64 items (Parent) and is completed by the parent or caregiver. Age 12-18 uses (Y-OQ® 2.0-SR*) which consists of 64 items (Youth - Self) and is completed by the youth. Age 18-21 uses (OQ®-45.2.2) which consists of 45 items (Adult -Self) and is completed by the young adult.

What is Y-OQ®?

60,547 clients had at least one valid Parent, Youth or Adult Y-OQ® instrument administered

35,827* clients had two or more valid Parent, Youth or Adult Y-OQ®; of which

24,799 were Parent 10,546 were Youth 424 were Adult

12,195 (34% of 35,827) clients were in Treatment (Active)

23,632 (66% of 35,827) clients were Inactive (“Discharged”)

*Contains duplicated clients with more than one treatment period (clients who had a 120 day break in services were counted more than once).

5

Population

Recovered

Improved

Stable

Deteriorated

6

Four Outcome Categories

7

Y-OQ® Parent, Youth & Adult Combined

N= 35,827

Active Inactive50

54

58

62

6666.65

63.92

58.92

55.63

Y-OQ® First and Last Score by Active and Inactive Clients

(Combined)

First Current ScoreLast Current Score

The mean Last Current Score compared to the mean First Current Score is significantly lower for both Active and Inactive clients; lower scores indicate fewer problems

8

N= 35,827

9

Y-OQ® Parent

N= 24,799

Y-OQ® 2.01 Youth Outcome Measure (Ages 4-17)

64 Items

Active Inactive52

56

60

64

6868.8

65.99

61.61

58.07

Y-OQ® First and Last Score by Active and Inactive Clients

(Parent )

First Current ScoreLast Current Score

10

N= 24,799

11

Y-OQ® Youth

N= 10,546

Y-OQ® 2.0 SR Youth Outcome Measure (Ages 12 -18)

64 Items

Active Inactive0

1020304050607080

66.7759.81

51.48 50.41

Y-OQ® First and Last Score by Active and Inactive Clients

(Youth )

First Current ScoreLast Current Score

12

N= 10,546

13

Y-OQ® Adults

N= 482

OQ®-45.2.2 Adult Outcome Measure (Ages 18- 21)

45 Items

Overall First Current Score Overall Last Current Score53

54

55

56

57

58

59

57.77

54.78

Overall First and Last Current Score (Adult )

Similar to Parent and Youth YOQ, Adult YOQ also showed overall score improvement between first and last scores

14

N= 482

Outcomes were analyzed for clients with valid Parent, Youth, and Adult (and combined) Y-OQ®s Separate analyses were performed on the Parent, Youth, Adult Y-OQ®s, and the Combined group

In all groups the rate of stable outcome was significantly higher than any of the other outcome categories

Recovered rate was the highest among Youth Y-OQ®

Adult Y-OQ® had the highest rate of stable client outcome

Inactive Client outcomes were better in general compared to the Active clients

15

Summary

RSPMI InformationCY 2014

Medicaid Claims Data

16

8 35

1

7

13

2

8 11 2 2

2 4 6 7

74 8

54

2 6 84 2 6

4

3 98 22 5

11

130(2)2

8 4 15

8

1

1

2

3

65

3

4 42

1

1

34

23

2 44

1

3

43

1

(1)

1(1)

RSPMI Provider Sites Per County

There were 4,384,163 paid Medicaid claims billed by RSPMI providers.

106,146 unique individuals were served.

18

In CY2014…

50,020 people used between 1 and 10 services.

31,978 people used between 11 and 50 services.

24,148 people used more than 50 services.

19

Service Counts

0-5 = 12,420 (338,678 claims)

6-10 = 24,425 (1,240,669 claims)

11-13 = 13,541 (624,504 claims)

14-17 = 17,647 (635,370 claims)

18+ = 38,113 (1,544,942 claims)

20

Age Distribution

YOQ Challenges

21

RSPMI covers wide population◦ Age range◦ Specialty population◦ Service location◦ Intensity of service

OQ Measures separate database◦ Inability to determine beginning of treatment◦ Inability to determine discharge◦ Complexities involved in sorting by population

22

State Level Data Challenges

Family involvement Literacy Internet connectivity Instrument length and time Clinician endorsement

23

Provider Agency Challenges

Presentation and use by agency staff Repetitive questions Instrument time

24

Family Challenges

Plan Moving Forward

25

Frequency: Every 2 weeks (more frequently, if needed)

Location: Will be confirmed at least a week in advance of meeting

Teleconference / Video Conference: DBHS is looking into the availability of utilizing this to reduce travel time for committee members and the public

26

Upcoming Meetings

Scheduled June 10th from 1:00 to 3:00

Proposed Agenda Items:◦ What is goal of tracking behavioral health

outcomes? Clinicians Clinical Directors Quality Assurance Staff/Directors State Family/Consumers

27

NEXT MEETING