Performance Outcomes Adult Specialty Mental Health ...

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.

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

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 inmethodology makes comparison between the POS penetration rates and the EQRO penetration rates not appropriate nor useful. The POS methodology for calculatingpenetration 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 iscalculated 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 forthat 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 similarlyimpacted.

*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 (e.g., arriving and exiting). As of now, this report only classifies adults and their service usage for FY 12/13through 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 receivingservices 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 UseSystem 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 measured in the time to step-down services report relies solely on claims data from Short Doyle/Medi-Cal II. Currently, thenumber 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 downservice. 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 fromwhich the patient is discharged and receives step-down services.

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

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http://www.dhcs.ca.gov/services/MH/Documents/MedCCC/Library/POSMeasuresCatalog_Sept15Reporting_Final_1.11.15.pdf

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

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

Demographics Report: Unique Count of Adults Receiving SMHS by Fiscal YearOrange County

SFYUnique Count

Receiving SMHS*

Year-Over-Year

Percentage Change

Unique Count of

Medi-Cal Eligibles

Year-Over-Year

Percentage Change

FY 11-12 9,882 192,332

FY 12-13 9,723 -1.6% 199,668 3.8%

FY 13-14 11,561 18.9% 357,080 78.8%

FY 14-15 12,775 10.5% 454,210 27.2%

Compound

Annual Growth

Rate SFY**

8.9% 33.2%

*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

9,882 9,723

11,56112,775

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

FY 11-12 FY 12-13 FY 13-14 FY 14-15

Unique Count of Adults Receiving SMHS

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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 47 0.5% 2,337 23.6% 396 4.0% 1,848 18.7% 4,183 42.3% 313 3.2% 758 7.7%

FY 12-13 51 0.5% 2,154 22.2% 394 4.1% 1,845 19.0% 4,047 41.6% 325 3.3% 907 9.3%

FY 13-14 69 0.6% 2,246 19.4% 432 3.7% 2,185 18.9% 4,930 42.6% 584 5.1% 1,115 9.6%

FY 14-15 69 0.5% 2,425 19.0% 499 3.9% 2,323 18.2% 5,357 41.9% 821 6.4% 1,281 10.0%

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

1%

24%

4%

19%

42%

3%8%

Fiscal Year 11-12 Race Distribution

Alaskan Native or AmericanIndianAsian or Pacific Islander

Black

Hispanic

White

Other

Unknown

1%

22%

4%

19%42%

3%9%



Black

Hispanic

White

Other

Unknown

1%

19%

4%

19%43%

5%

10%



Black

Hispanic

White

Other

Unknown

1%

19%

4%

18%

42%

6%

10%



Black

Hispanic

White

Other

Unknown

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Fiscal

Year

Adults 21-44

Count Adults 21-44 %

Adults 45-64

CountAdults 45-64 %

Adults 65+

Count Adults 65+ %

FY 11-12 4,449 45.0% 5,057 51.2% 376 3.8%

FY 12-13 4,386 45.1% 4,944 50.8% 393 4.0%

FY 13-14 5,438 47.0% 5,740 49.6% 383 3.3%

FY 14-15 6,356 49.8% 6,059 47.4% 360 2.8%

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

45.0%

51.2%

3.8%

Fiscal Year 11-12 Age Group Distribution

Adults 21-44

Adults 45-64

Adults 65+

45.1%

50.8%

4.0%


Adults 21-44

Adults 45-64

Adults 65+

47.0%

49.6%

3.3%


Adults 21-44

Adults 45-64

Adults 65+

49.8%

47.4%

2.8%


Adults 21-44

Adults 45-64

Adults 65+

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Fiscal

Year

Female

Count Female %

Male

Count Male %

FY 11-12 6,038 61.1% 3,844 38.9%

FY 12-13 5,846 60.1% 3,877 39.9%

FY 13-14 6,554 56.7% 5,007 43.3%

FY 14-15 6,743 52.8% 6,032 47.2%

61.1%

38.9%

Fiscal Year 11-12 Gender Distribution

Female Male

60.1%

39.9%


Female Male

56.7%

43.3%


Female Male52.8%

47.2%


Female Male

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Penetration Rates* Report: Adults With At Least One SMHS Visit** Orange 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 9,882 192,332 5.1% 9,723 199,668 4.9% 11,561 357,080 3.2% 12,775 454,210 2.8%

Adults 21-44 4,449 68,932 6.5% 4,386 72,139 6.1% 5,438 152,202 3.6% 6,356 210,782 3.0%

Adults 45-64 5,057 50,030 10.1% 4,944 51,771 9.5% 5,740 125,724 4.6% 6,059 158,104 3.8%

Adults 65+ 376 73,370 0.5% 393 75,758 0.5% 383 79,154 0.5% 360 85,324 0.4%

Alaskan Native or American Indian 47 512 9.2% 51 537 9.5% 69 961 7.2% 69 1,197 5.8%

Asian or Pacific Islander 2,337 59,423 3.9% 2,154 60,888 3.5% 2,246 113,484 2.0% 2,425 143,284 1.7%

Black 396 4,408 9.0% 394 4,614 8.5% 432 7,607 5.7% 499 9,442 5.3%

Hispanic 1,848 52,782 3.5% 1,845 56,159 3.3% 2,185 89,859 2.4% 2,323 111,927 2.1%

White 4,183 49,204 8.5% 4,047 49,832 8.1% 4,930 92,665 5.3% 5,357 117,904 4.5%

Other 313 10,599 3.0% 325 11,264 2.9% 584 28,582 2.0% 821 41,276 2.0%

Unknown 758 15,404 4.9% 907 16,374 5.5% 1,115 23,922 4.7% 1,281 29,180 4.4%

Female 6,038 119,992 5.0% 5,846 124,822 4.7% 6,554 206,491 3.2% 6,743 255,766 2.6%

Male 3,844 72,340 5.3% 3,877 74,846 5.2% 5,007 150,589 3.3% 6,032 198,444 3.0%

*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.

**Adults 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.

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

6.5% 6.1%

3.6%3.0%

10.1%9.5%

4.6%3.8%

0.5% 0.5% 0.5% 0.4%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 68,932)

FY 12-13(n= 72,139)

FY 13-14(n= 152,202)

FY 14-15(n= 210,782)

FY 11-12(n= 50,030)

FY 12-13(n= 51,771)

FY 13-14(n= 125,724)

FY 14-15(n= 158,104)

FY 11-12(n= 73,370)

FY 12-13(n= 75,758)

FY 13-14(n= 79,154)

FY 14-15(n= 85,324)

Adults 21-44 Adults 45-64 Adults 65+

Penetration Rates by AgeAdults With At Least One SMHS Visit**, By Fiscal Year

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Penetration Rates* Report: Adults With At Least One SMHS Visit** Orange County


**Adults 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.



9.2% 9.5%

7.2%

5.8%

3.9% 3.5%

2.0% 1.7%

9.0%8.5%

5.7% 5.3%

3.5% 3.3%2.4% 2.1%

8.5% 8.1%

5.3%4.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 512)

FY 12-13(n= 537)

FY 13-14(n= 961)

FY 14-15(n= 1,197)

FY 11-12(n= 59,423)

FY 12-13(n= 60,888)

FY 13-14(n= 113,484)

FY 14-15(n= 143,284)

FY 11-12(n= 4,408)

FY 12-13(n= 4,614)

FY 13-14(n= 7,607)

FY 14-15(n= 9,442)

FY 11-12(n= 52,782)

FY 12-13(n= 56,159)

FY 13-14(n= 89,859)

FY 14-15(n= 111,927)

FY 11-12(n= 49,204)

FY 12-13(n= 49,832)

FY 13-14(n= 92,665)

FY 14-15(n= 117,904)

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

Penetration Rates by RaceAdults With At Least One SMHS Visit**, By Fiscal Year

5.0% 4.7%

3.2%2.6%

5.3% 5.2%

3.3% 3.0%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 119,992)

FY 12-13(n= 124,822)

FY 13-14(n= 206,491)

FY 14-15(n= 255,766)

FY 11-12(n= 72,340)

FY 12-13(n= 74,846)

FY 13-14(n= 150,589)

FY 14-15(n= 198,444)

Female Male

Penetration Rates by GenderAdults With At Least One SMHS Visit**, By Fiscal Year

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Penetration Rates* Report: Adults with Five or More SMHS Visits**Orange County

Penetration Rate 3.6% 3.0% 2.1% 1.4% 4.0% 3.6% 2.2% 1.7%

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 7,270 192,332 3.8% 6,421 199,668 3.2% 7,549 357,080 2.1% 7,019 454,210 1.5%

Adults 21-44 3,054 68,932 4.4% 2,643 72,139 3.7% 3,233 152,202 2.1% 3,330 210,782 1.6%

Adults 45-64 3,962 50,030 7.9% 3,514 51,771 6.8% 4,063 125,724 3.2% 3,437 158,104 2.2%

Adults 65+ 254 73,370 0.3% 264 75,758 0.3% 253 79,154 0.3% 252 85,324 0.3%

Alaskan Native or American Indian 30 512 5.9% 30 537 5.6% 42 961 4.4% 33 1,197 2.8%

Asian or Pacific Islander 1,986 59,423 3.3% 1,713 60,888 2.8% 1,690 113,484 1.5% 1,302 143,284 0.9%

Black 259 4,408 5.9% 221 4,614 4.8% 270 7,607 3.5% 285 9,442 3.0%

Hispanic 1,218 52,782 2.3% 1,073 56,159 1.9% 1,333 89,859 1.5% 1,240 111,927 1.1%

White 2,945 49,204 6.0% 2,496 49,832 5.0% 3,033 92,665 3.3% 2,973 117,904 2.5%

Other 219 10,599 2.1% 213 11,264 1.9% 347 28,582 1.2% 399 41,276 1.0%

Unknown 613 15,404 4.0% 675 16,374 4.1% 834 23,922 3.5% 787 29,180 2.7%

Female 4,363 119,992 3.6% 3,759 124,822 3.0% 4,246 206,491 2.1% 3,666 255,766 1.4%

Male 2,907 72,340 4.0% 2,662 74,846 3.6% 3,303 150,589 2.2% 3,353 198,444 1.7%


**Adults 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.



FY 14-15FY 11-12 FY 12-13

4.4%3.7%

2.1%1.6%

7.9%6.8%

3.2%2.2%

0.3% 0.3% 0.3% 0.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 68,932)

FY 12-13(n= 72,139)

FY 13-14(n= 152,202)

FY 14-15(n= 210,782)

FY 11-12(n= 50,030)

FY 12-13(n= 51,771)

FY 13-14(n= 125,724)

FY 14-15(n= 158,104)

FY 11-12(n= 73,370)

FY 12-13(n= 75,758)

FY 13-14(n= 79,154)

FY 14-15(n= 85,324)

Adults 21-44 Adults 45-64 Adults 65+

Penetration Rates by AgeAdults With Five or More SMHS Visits**, By Fiscal Year

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Penetration Rates* Report: Adults with Five or More SMHS Visits**Orange County


**Adults 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.



5.9% 5.6%

4.4%

2.8%3.3%

2.8%

1.5%0.9%

5.9%

4.8%

3.5%3.0%

2.3%1.9%

1.5%1.1%

6.0%

5.0%

3.3%2.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 512)

FY 12-13(n= 537)

FY 13-14(n= 961)

FY 14-15(n= 1,197)

FY 11-12(n= 59,423)

FY 12-13(n= 60,888)

FY 13-14(n= 113,484)

FY 14-15(n= 143,284)

FY 11-12(n= 4,408)

FY 12-13(n= 4,614)

FY 13-14(n= 7,607)

FY 14-15(n= 9,442)

FY 11-12(n= 52,782)

FY 12-13(n= 56,159)

FY 13-14(n= 89,859)

FY 14-15(n= 111,927)

FY 11-12(n= 49,204)

FY 12-13(n= 49,832)

FY 13-14(n= 92,665)

FY 14-15(n= 117,904)

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

Penetration Rates by RaceAdults With Five or More SMHS Visits**, By Fiscal Year

3.6%3.0%

2.1%1.4%

4.0% 3.6%

2.2%1.7%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 11-12(n= 119,992)

FY 12-13(n= 124,822)

FY 13-14(n= 206,491)

FY 14-15(n= 255,766)

FY 11-12(n= 72,340)

FY 12-13(n= 74,846)

FY 13-14(n= 150,589)

FY 14-15(n= 198,444)

Female Male

Penetration Rates by GenderAdults With Five or More SMHS Visits**, By Fiscal Year

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Utilization Report*: Approved Specialty Mental Health Services for Adults

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year*Orange 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)

Psychiatric Health

Facility (Days)

FY 11-12 3,400 382 499 194 167 15 0 0 0 0 21 11 0 0

FY 12-13 3,791 333 403 231 177 16 0 0 0 0 23 13 0 0

FY 13-14 3,837 234 407 313 188 17 0 0 0 0 18 13 0 0

FY 14-15 3,956 172 368 297 155 18 0 0 0 0 19 13 0 0

MEAN 3,745.99$ 280 419 259 172 17 0 0 0 0 20 13 0 0

SFY

2012

2013

2014

2015

*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 adults that received the SMHS represented in their respective graph by Fiscal Year.

$3,400

$3,791 $3,837 $3,956

$-

$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

FY 11-12(n = 10,669)

FY 12-13(n = 10,497)

FY 13-14(n = 12,454)

FY 14-15(n = 13,272)

Total Approved Per Unique Beneficiary By Service Fiscal Year

499

403 407368

-

100

200

300

400

500

600

FY 11-12(n = 6,973)

FY 12-13(n = 8,577)

FY 13-14(n = 10,126)

FY 14-15(n = 10,819)

Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year

194

231

313297

-

50

100

150

200

250

300

350

FY 11-12(n = 8,292)

FY 12-13(n = 6,856)

FY 13-14(n = 5,493)

FY 14-15(n = 6,076)

Medication Support Services Minutes Per Unique Beneficiary

By Service Fiscal Year167

177188

155

-

20

40

60

80

100

120

140

160

180

200

FY 11-12(n = 600)

FY 12-13(n = 700)

FY 13-14(n = 1,243)

FY 14-15(n = 1,490)

Crisis Intervention Minutes Per Unique Beneficiary By Service Fiscal Year

15.116.3

17.318.5

-

2

4

6

8

10

12

14

16

18

20

FY 11-12(n = 585)

FY 12-13(n = 529)

FY 13-14(n = 1,018)

FY 14-15(n = 1,792)

Crisis Stabilization Hours Per Unique BeneficiaryBy Service Fiscal Year

382

333

234

172

-

50

100

150

200

250

300

350

400

450

FY 11-12(n = 2,695)

FY 12-13(n = 2,692)

FY 13-14(n = 3,329)

FY 14-15(n = 2,925)

Case Management/Brokerage Minutes Per Unique Beneficiary

By Service Fiscal Year

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Utilization Report*: Approved Specialty Mental Health Services for Adults

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year*Orange County

*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 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


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


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 = )

Psychiatric Health Facility Days Per Unique BeneficiaryBy 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 BeneficiaryBy 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 BeneficiaryBy Service Fiscal Year

21

23

1819

-

5

10

15

20

25

FY 11-12(n = 1,648)

FY 12-13(n = 1,638)

FY 13-14(n = 2,191)

FY 14-15(n = 2,228)

Fee for Service Inpatient Days Per Unique BeneficiaryBy Service Fiscal Year

11.0

13.412.5

13.2

-

2

4

6

8

10

12

14

16

FY 11-12(n = 43)

FY 12-13(n = 91)

FY 13-14(n = 206)

FY 14-15(n = 262)

Crisis Residential Treatment Services Days Per Unique Beneficiary


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Snapshot Report: Unique Count of Adults Receiving SMHS

Arriving, Exiting, and with Service Continuance by Fiscal YearOrange County

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 1,646 16.9% 1,963 20.1% 1,499 15.4% 1,417 14.5% 2,943 30.2% 281 2.9% 9,749 100%

FY 13-14 2,539 22.0% 2,006 17.4% 1,294 11.2% 1,474 12.8% 3,920 33.9% 326 2.8% 11,559 100%

FY 14 - 15 2,015 15.8% 1,292 10.1% 1,617 12.7% 2,414 18.9% 4,900 38.4% 531 4.2% 12,769 100%

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.)

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.

17%

20%

15%15%

30%

3%

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

22%

17%

11%13%

34%

3%


Arrivals



Exiting

Arriving & Exiting


16%

10%

13%

19%

38%

4%


Arrivals



Exiting

Arriving & Exiting


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Time to Step Down Report: Adults Stepping Down in SMHS Services Post Inpatient DischargeOrange County

Service FY

Count of Inpatient

Discharges with Step

Down within 7 Days

of Discharge a

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 b

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 1,474 68.5% 202 9.4% 326 15.1% 151 7.0% 0 365 30.8 0

FY 12-13 1,005 46.2% 379 17.4% 550 25.3% 241 11.1% 0 365 52.3 6

FY 13-14 995 37.1% 492 18.3% 798 29.7% 399 14.9% 0 365 64.6 12

FY 14-15 751 26.0% 551 19.0% 929 32.1% 663 22.9% 0 365 63.1 20

Total_Discharges

13,775

2,296

357

460

a Adults aged 22-64 receiving inpatient services from Institution for Mental Disease (IMD) facilities not included in count of inpatient discharges.b 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

6

12

20

0

5

10

15

20

25

FY 11-12 FY 12-13 FY 13-14 FY 14-15

Median Time Between Inpatient Discharge and Step Down Service in Days

30.8

52.3

64.6 63.1

0

10

20

30

40

50

60

70

FY 11-12 FY 12-13 FY 13-14 FY 14-15

Mean Time Between Inpatient Discharge and Step Down Service in Days

68.5%46.2% 37.1%

26.0%

9.4%

17.4%18.3%

19.0%

15.1%25.3%

29.7%32.1%

7.0% 11.1% 14.9% 22.9%

0%

20%

40%

60%

80%

100%

FY 11-12( 1,550 Unique Beneficiaries with 2,153 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

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Performance Outcomes Adult Specialty Mental Health ...

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