Performance Outcomes Adult Specialty Mental …...Performance Outcomes Adult Specialty Mental Health...

Performance Outcomes Adult Specialty Mental Health Services Report Report Date August, 2017

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) 12/13, 13/14, 14/15, and 15/16.

Definitions *Population - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were:• Age 21 or older during the approved date of service on the claim.

Data Sources - ▪Short-Doyle/Medi-Cal II (SD/MC II) claims with dates of service in FY 12/13 through FY 15/16.▪Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 12/13 through15/16.

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

Performance Outcomes Adult Specialty Mental Health Services Report Report Date August, 2017

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 for thatFY. 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 FY15/16. 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 YearStanislaus County as of August, 2017

SFYUnique Count

Receiving SMHS*

Year-Over-Year

Percentage Change

Unique Count of

Medi-Cal Eligibles

Year-Over-Year

Percentage Change

FY 12-13 2,929 68,411

FY 13-14 3,603 23.0% 98,587 44.1%

FY 14-15 4,291 19.1% 121,912 23.7%

FY 15-16 3,995 -6.9% 134,926 10.7%

Compound

Annual Growth

Rate SFY**

10.9% 25.4%

*SMHS = Specialty Mental Health Services. See Measures Catalog for more detailed information.

**SFY = State Fiscal Year which is July 1 through June 30.

2,929

3,603

4,2913,995

0

1,000

2,000

3,000

4,000

5,000

FY 12-13 FY 13-14 FY 14-15 FY 15-16

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 12-13 24 0.8% 113 3.9% 174 5.9% 546 18.6% 1,619 55.3% 42 1.4% 411 14.0%

FY 13-14 33 0.9% 132 3.7% 234 6.5% 753 20.9% 1,925 53.4% 53 1.5% 473 13.1%

FY 14-15 29 0.7% 148 3.4% 275 6.4% 953 22.2% 2,293 53.4% 66 1.5% 527 12.3%

FY 15-16 23 0.6% 143 3.6% 254 6.4% 911 22.8% 2,064 51.7% 61 1.5% 539 13.5%

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

Please note: This report uses the 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.

1% 4%

6%

19%

55%

1% 14%

Fiscal Year 12-13 Race Distribution

Alaskan Native or AmericanIndianAsian or Pacific Islander

Black

Hispanic

White

Other

Unknown

1% 4%

7%

21%

53%

2% 13%



Black

Hispanic

White

Other

Unknown

1% 3%

6%

22%

53%

2% 12%



Black

Hispanic

White

Other

Unknown

1% 4%

6%

23%

52%

2% 14%



Black

Hispanic

White

Other

Unknown

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Fiscal

Year

Adults 21-44

Count Adults 21-44 %

Adults 45-64

Count Adults 45-64 %

Adults 65+

Count Adults 65+ %

FY 12-13 1,560 53.3% 1,190 40.6% 179 6.1%

FY 13-14 1,984 55.1% 1,420 39.4% 199 5.5%

FY 14-15 2,392 55.7% 1,696 39.5% 203 4.7%

FY 15-16 2,272 56.9% 1,508 37.7% 215 5.4%

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

53.3%40.6%

6.1%

Fiscal Year 12-13 Age Group Distribution

Adults 21-44

Adults 45-64

Adults 65+

55.1%39.4%

5.5%


Adults 21-44

Adults 45-64

Adults 65+

55.7%

39.5%

4.7%


Adults 21-44

Adults 45-64

Adults 65+

56.9%

37.7%

5.4%


Adults 21-44

Adults 45-64

Adults 65+

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Fiscal

Year

Female

Count Female %

Male

Count Male %

FY 12-13 1,723 58.8% 1,206 41.2%

FY 13-14 2,050 56.9% 1,553 43.1%

FY 14-15 2,226 51.9% 2,065 48.1%

FY 15-16 1,997 50.0% 1,998 50.0%

58.8%

41.2%

Fiscal Year 12-13 Gender Distribution

Female Male

56.9%

43.1%


Female Male

51.9%

48.1%


Female Male 50.0%50.0%


Female Male

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Penetration Rates* Report: Adults With At Least One SMHS Visit** Stanislaus County as of August, 2017

Adults and

Older Adults

with 1 or

more SMHS

Certified

Eligible

Adults and

Older Adults

Penetration

Rate

Adults and

Older Adults

with 1 or

more SMHS

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

Adults and

Older Adults

with 1 or more

SMHS Visits

Certified

Eligible

Adults and

Older Adults

Penetration

Rate

Adults and

Older Adults

with 1 or more

SMHS Visits

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

All 2,929 68,411 4.3% 3,603 98,587 3.7% 4,291 121,912 3.5% 3,995 134,926 3.0%

Adults 21-44 1,560 35,471 4.4% 1,984 52,165 3.8% 2,392 67,253 3.6% 2,272 75,670 3.0%

Adults 45-64 1,190 18,435 6.5% 1,420 31,463 4.5% 1,696 38,685 4.4% 1,508 42,312 3.6%

Adults 65+ 179 14,505 1.2% 199 14,959 1.3% 203 15,974 1.3% 215 16,944 1.3%

Alaskan Native or American Indian 24 264 9.1% 33 357 9.2% 29 443 6.5% 23 469 4.9%

Asian or Pacific Islander 113 4,665 2.4% 132 6,832 1.9% 148 8,343 1.8% 143 9,456 1.5%

Black 174 3,023 5.8% 234 4,256 5.5% 275 5,196 5.3% 254 5,694 4.5%

Hispanic 546 25,717 2.1% 753 38,032 2.0% 953 48,791 2.0% 911 55,563 1.6%

White 1,619 28,165 5.7% 1,925 40,362 4.8% 2,293 48,837 4.7% 2,064 52,323 3.9%

Other 42 793 5.3% 53 1,316 4.0% 66 1,750 3.8% 61 1,952 3.1%

Unknown 411 5,784 7.1% 473 7,432 6.4% 527 8,552 6.2% 539 9,469 5.7%

Female 1,723 42,685 4.0% 2,050 57,387 3.6% 2,226 68,458 3.3% 1,997 75,027 2.7%

Male 1,206 25,726 4.7% 1,553 41,200 3.8% 2,065 53,454 3.9% 1,998 59,899 3.3%

*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 and Older Adults 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.

^ Data has been suppressed to protect patient privacy. of 14

FY 12-13 FY 13-14 FY 14-15 FY 15-16

4.4%

3.8%3.6%

3.0%

6.5%

4.5% 4.4%

3.6%

1.2% 1.3% 1.3% 1.3%

0%

1%

2%

3%

4%

5%

6%

7%

FY 12-13(n= 35,471)

FY 13-14(n= 52,165)

FY 14-15(n= 67,253)

FY 15-16(n= 75,670)

FY 12-13(n= 18,435)

FY 13-14(n= 31,463)

FY 14-15(n= 38,685)

FY 15-16(n= 42,312)

FY 12-13(n= 14,505)

FY 13-14(n= 14,959)

FY 14-15(n= 15,974)

FY 15-16(n= 16,944)

Adults 21-44 Adults 45-64 Adults 65+

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

Penetration Rates* Report: Adults With At Least One SMHS Visit** Stanislaus County as of August, 2017


**Adults and Older Adults 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.


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9.1% 9.2%

6.5%

4.9%

2.4%1.9% 1.8%

1.5%

5.8%5.5% 5.3%

4.5%

2.1% 2.0% 2.0%1.6%

5.7%

4.8% 4.7%

3.9%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

FY 12-13(n= 264)

FY 13-14(n= 357)

FY 14-15(n= 443)

FY 15-16(n= 469)

FY 12-13(n= 4,665)

FY 13-14(n= 6,832)

FY 14-15(n= 8,343)

FY 15-16(n= 9,456)

FY 12-13(n= 3,023)

FY 13-14(n= 4,256)

FY 14-15(n= 5,196)

FY 15-16(n= 5,694)

FY 12-13(n= 25,717)

FY 13-14(n= 38,032)

FY 14-15(n= 48,791)

FY 15-16(n= 55,563)

FY 12-13(n= 28,165)

FY 13-14(n= 40,362)

FY 14-15(n= 48,837)

FY 15-16(n= 52,323)

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

4.0% 3.6% 3.3%2.7%

4.7%3.8% 3.9%

3.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 42,685)

FY 13-14(n= 57,387)

FY 14-15(n= 68,458)

FY 15-16(n= 75,027)

FY 12-13(n= 25,726)

FY 13-14(n= 41,200)

FY 14-15(n= 53,454)

FY 15-16(n= 59,899)

Female Male

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

Penetration Rates* Report: Adults with Five or More SMHS Visits**Stanislaus County as of August, 2017

Adults and

Older Adults

with 5 or more

SMHS Visits

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

Adults and

Older Adults

with 5 or more

SMHS Visits

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

Adults and

Older Adults

with 5 or more

SMHS Visits

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

Adults and

Older Adults

with 5 or more

SMHS Visits

Certified

Eligible Adults

and Older

Adults

Penetration

Rate

All 1,942 68,411 2.8% 2,073 98,587 2.1% 2,230 121,912 1.8% 2,230 134,926 1.7%

Adults 21-44 917 35,471 2.6% 1,008 52,165 1.9% 1,134 67,253 1.7% 1,137 75,670 1.5%

Adults 45-64 872 18,435 4.7% 902 31,463 2.9% 941 38,685 2.4% 929 42,312 2.2%

Adults 65+ 153 14,505 1.1% 163 14,959 1.1% 155 15,974 1.0% 164 16,944 1.0%

Alaskan Native or American Indian 20 264 7.6% 19 357 5.3% 16 443 3.6% 13 469 2.8%

Asian or Pacific Islander 84 4,665 1.8% 89 6,832 1.3% 90 8,343 1.1% 90 9,456 1.0%

Black 111 3,023 3.7% 138 4,256 3.2% 148 5,196 2.8% 138 5,694 2.4%

Hispanic 329 25,717 1.3% 368 38,032 1.0% 431 48,791 0.9% 464 55,563 0.8%

White 1,079 28,165 3.8% 1,111 40,362 2.8% 1,159 48,837 2.4% 1,140 52,323 2.2%

Other 27 793 3.4% 30 1,316 2.3% 40 1,750 2.3% 34 1,952 1.7%

Unknown 292 5,784 5.0% 318 7,432 4.3% 346 8,552 4.0% 351 9,469 3.7%

Female 1,086 42,685 2.5% 1,132 57,387 2.0% 1,107 68,458 1.6% 1,093 75,027 1.5%

Male 856 25,726 3.3% 941 41,200 2.3% 1,123 53,454 2.1% 1,137 59,899 1.9%


**Adults and Older Adultsthat 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.

^ Data has been suppressed to protect patient privacy. of 14

FY 12-13 FY 13-14 FY 14-15 FY 15-16

2.6%

1.9%1.7%

1.5%

4.7%

2.9%

2.4%2.2%

1.1% 1.1% 1.0% 1.0%

0%

1%

1%

2%

2%

3%

3%

4%

4%

5%

5%

FY 12-13(n= 35,471)

FY 13-14(n= 52,165)

FY 14-15(n= 67,253)

FY 15-16(n= 75,670)

FY 12-13(n= 18,435)

FY 13-14(n= 31,463)

FY 14-15(n= 38,685)

FY 15-16(n= 42,312)

FY 12-13(n= 14,505)

FY 13-14(n= 14,959)

FY 14-15(n= 15,974)

FY 15-16(n= 16,944)

Adults 21-44 Adults 45-64 Adults 65+

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

Penetration Rates* Report: Adults with Five or More SMHS Visits**Stanislaus County as of August, 2017


**Adults and Older Adultsthat 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.


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7.6%

5.3%

3.6%2.8%

1.8%1.3% 1.1% 1.0%

3.7%3.2% 2.8% 2.4%

1.3% 1.0% 0.9% 0.8%

3.8%2.8% 2.4% 2.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 264)

FY 13-14(n= 357)

FY 14-15(n= 443)

FY 15-16(n= 469)

FY 12-13(n= 4,665)

FY 13-14(n= 6,832)

FY 14-15(n= 8,343)

FY 15-16(n= 9,456)

FY 12-13(n= 3,023)

FY 13-14(n= 4,256)

FY 14-15(n= 5,196)

FY 15-16(n= 5,694)

FY 12-13(n= 25,717)

FY 13-14(n= 38,032)

FY 14-15(n= 48,791)

FY 15-16(n= 55,563)

FY 12-13(n= 28,165)

FY 13-14(n= 40,362)

FY 14-15(n= 48,837)

FY 15-16(n= 52,323)

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

2.5%2.0% 1.6% 1.5%

3.3%2.3% 2.1% 1.9%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 12-13(n= 42,685)

FY 13-14(n= 57,387)

FY 14-15(n= 68,458)

FY 15-16(n= 75,027)

FY 12-13(n= 25,726)

FY 13-14(n= 41,200)

FY 14-15(n= 53,454)

FY 15-16(n= 59,899)

Female Male

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

Utilization Report*: Approved Specialty Mental Health Services for Adults

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Stanislaus County as of August, 2017

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 12-13 6,220.77$ 512 958 323 215 30 0 111 11 19 7 24 90 13

FY 13-14 5,421.19$ 498 899 295 239 25 0 160 9 16 7 13 87 7

FY 14-15 5,196.86$ 494 833 294 273 26 0 241 4 9 7 11 33 5

FY 15-16 6,401.70$ 506 969 316 297 29 0 36 11 18 7 14 38 5

MEAN 5,810.13$ 503 915 307 256 27 0 137 9 16 7 15 62 7

*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 children/youth that received the SMHS represented in their respective graph by Fiscal Year.


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$6,220.77

$5,421.19 $5,196.86

$6,401.70

$-

$1,000.00

$2,000.00

$3,000.00

$4,000.00

$5,000.00

$6,000.00

$7,000.00

FY 12-13(n = 2,929)

FY 13-14(n = 3,603)

FY 14-15(n = 4,291)

FY 15-16(n = 3,995)

Total Approved Per Unique Beneficiary By Service Fiscal Year

512

498

494

506

480

485

490

495

500

505

510

515

FY 12-13(n = 1,237)

FY 13-14(n = 1,354)

FY 14-15(n = 1,524)

FY 15-16(n = 1,600)

Case Management/Brokerage Minutes Per Unique Beneficiary By Service Fiscal Year

958899

833

969

-

200

400

600

800

1,000

1,200

FY 12-13(n = 2,221)

FY 13-14(n = 2,596)

FY 14-15(n = 2,900)

FY 15-16(n = 2,562)

Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year

323295 294

316

-

50

100

150

200

250

300

350

FY 12-13(n = 2,150)

FY 13-14(n = 2,262)

FY 14-15(n = 2,237)

FY 15-16(n = 2,130)

Medication Support Services Minutes Per Unique Beneficiary By Service Fiscal Year

215239

273297

-

50

100

150

200

250

300

350

FY 12-13(n = 1,008)

FY 13-14(n = 1,402)

FY 14-15(n = 1,836)

FY 15-16(n = 1,913)

Crisis Intervention Minutes Per Unique Beneficiary By Service Fiscal Year

30.2

24.8 25.7

29.3

-

5

10

15

20

25

30

35

FY 12-13(n = 58)

FY 13-14(n = 73)

FY 14-15(n = 146)

FY 15-16(n = 162)

Crisis Stabilization Hours Per Unique BeneficiaryBy Service Fiscal Year

0 0 0 0 -

0

0

0

0

1

1

1

1

1

1

FY 12-13(n = )

FY 13-14(n = )

FY 14-15(n = )

FY 15-16(n = )

Full Day Treatment Intensive Hours Per Unique BeneficiaryBy Service Fiscal Year

111

160

241

36

-

50

100

150

200

250

300

FY 12-13(n = ^)

FY 13-14(n = ^)

FY 14-15(n = ^)

FY 15-16(n = ^)

Full Day Rehabilitation Hours Per Unique Beneficiary By Service Fiscal Year

11

9

4

11

-

2

4

6

8

10

12

FY 12-13(n = 16)

FY 13-14(n = 16)

FY 14-15(n = 21)

FY 15-16(n = 19)

Hospital Inpatient Days Per Unique BeneficiaryBy Service Fiscal Year

Utilization Report*: Approved Specialty Mental Health Services for Adults

Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Stanislaus County as of August, 2017

*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 children/youth that received the SMHS represented in their respective graph by Fiscal Year.


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90.3 87.0

33.038.1

-

10

20

30

40

50

60

70

80

90

100

FY 12-13(n = ^)

FY 13-14(n = ^)

FY 14-15(n = ^)

FY 15-16(n = ^)

Adult Residential Treatment Services Days Per Unique Beneficiary

By Service Fiscal Year 13.1

6.7

4.9 4.7

-

2

4

6

8

10

12

14

FY 12-13(n = 28)

FY 13-14(n = 232)

FY 14-15(n = 657)

FY 15-16(n = 733)

Psychiatric Health Facility Days Per Unique BeneficiaryBy Service Fiscal Year

19

16

9

18

-

2

4

6

8

10

12

14

16

18

20

FY 12-13(n = ^)

FY 13-14(n = ^)

FY 14-15(n = ^)

FY 15-16(n = ^)

Hospital Inpatient Admin Days Per Unique BeneficiaryBy Service Fiscal Year

7 77 7

-

1

2

3

4

5

6

7

8

FY 12-13(n = 637)

FY 13-14(n = 630)

FY 14-15(n = 515)

FY 15-16(n = 624)

Fee for Service Inpatient Days Per Unique BeneficiaryBy Service Fiscal Year

23.6

12.810.8

14.1

-

5

10

15

20

25

FY 12-13(n = 21)

FY 13-14(n = 16)

FY 14-15(n = 20)

FY 15-16(n = 31)

Crisis Residential Treatment Services Days Per Unique Beneficiary

By Service Fiscal Year

Snapshot Report: Unique Count of Adults Receiving SMHS

Arriving, Exiting, and with Service Continuance by Fiscal Year Stanislaus County as of August, 2017

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 12-13 392 13.4% 753 25.7% 290 9.9% 279 9.5% 1,113 38.0% 102 3.5% 2,929 100%

FY 13-14 572 15.9% 712 19.8% 290 8.0% 349 9.7% 1,568 43.5% 112 3.1% 3,603 100%

FY 14-15 514 12.0% 653 15.2% 388 9.0% 467 10.9% 2,161 50.4% 108 2.5% 4,291 100%

FY 15-16 505 12.6% 681 17.0% 348 8.7% 409 10.2% 1,906 47.7% 146 3.7% 3,995 100%

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.

13%

26%

10%10%

38%

4%

Fiscal Year 12-13 Arrivals, Service Continuance, &

Exits Distribution

16%

20%

8%

10%

44%

3%


Exits Distribution

12%

15%

9%

11%

50%

3%


Exits Distribution

13%

17%

9%

10%

48%

4%


Exits Distribution

Arrivals

Service Continuance(>= 2 YR)

Service Continuance(< 2 YR)

Exiting

Arriving & Exiting

Service Continuance (>= 2 YR) & Exiting

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Time to Step Down Report: Adults Stepping Down in SMHS Services Post Inpatient Discharge* Stanislaus County as of August, 2017

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 12-13 689 79.7% 59 6.8% 76 8.8% 40 4.6% 0 352 10.9 0

FY 13-14 469 68.2% 62 9.0% 101 14.7% 56 8.1% 0 326 19.0 0

FY 14-15 387 56.4% 84 12.2% 130 19.0% 85 12.4% 0 360 33.0 2

FY 14-15 401 59.0% 63 9.3% 118 17.4% 98 14.4% 0 354 32.3 2

* 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

2 2

0

1

1

2

2

3

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

Median Time Between Inpatient Discharge and Step Down Service in Days

10.9

19.0

33.0 32.3

0

5

10

15

20

25

30

35

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

Mean Time Between Inpatient Discharge and Step Down Service in Days

79.7%68.2%

56.4% 59.0%

6.8%9.0%

12.2% 9.3%

8.8%14.7%

19.0% 17.4%

4.6% 8.1% 12.4% 14.4%

0%

20%

40%

60%

80%

100%

FY 12-13( 518 Unique Beneficiaries with 864 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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