mhsoac statewide client and service information (csi) data quality report draft

MHSOAC Statewide Client and Service Information (CSI)

Data Quality Report DRAFT

Deliverable #4 of MHSOAC Contract 12MHSOAC025

Report Developed by Mental Health Data Alliance, LLC

1/30/2014

Table of ContentsExecutive Summary………………………………………………………………………………………………………………………………………..Introduction……………………………………………………………………………………………………………………………………………………California Mental Health Regions…………………………………………………………………………………………….............................1. Clients Served………………………………….………………………………………………………………………………………………………..

1.1 Unique CSI Clients Served by County for FY11……………………………………………………….. ……………………1.2 Unique CSI Clients Served by County for FY12…………………………………………………………………………….1.3 # Unique Annual Clients Served by Mode of Service, Region, FY……………………………………………..1.4 # Unique Annual Clients Served Statewide by Mode of Service, FY……………………………………………1.5 # Unique Annual Clients Served by Age Group, Region, FY………………………………………………………1.6 # Unique Annual Clients Served Statewide by Age Group, FY………………………………………………….1.7 % Unique Annual Clients Served by Gender, Region, FY…………………………………………………………..1.8 % Unique Annual Clients Served Statewide by Gender, FY……………………………………………………….1.9 % Unique Annual Clients Served Statewide by Race/Ethnicity, FY…………………………………………….1.10 % Unique Annual Clients Served by Race/Ethnicity, Region, FY……………………………………….……….1.11 % Unique Annual Clients Served Statewide by Primary Language, FY……………………………..........1.12 % Unique Annual Clients Served by Primary Language, Region, FY………………………………………….1.13 % Unique Annual Clients Served with Substance Abuse Indicator by Region, FY…………………….1.14 % Unique Annual Clients Served by Diagnosis Group, Region, FY……………………………………………1.15 # Unique Annual Clients Served Statewide by Special Population, FY…………………………..................1.16 # Unique Annual Clients Served by Special Population, Region, FY…………………………..................

2. Services Provided………….……………….……………………………………………………………………………...............................2.1 # Unique Annual Clients Served Statewide for 24 Hour Services by Service Function, FY………..2.2 Average Annual Service Units per Client for 24 Hour Services Statewide by Service Function, FY ……………………………………………………………………………………………………….……2.3 # Unique Annual Clients Served Statewide for Day Services by Service Function, FY……………….2.4 Average Annual Service Units per Client for Day Services Statewide by Service Function, FY……………………………………………………………………………………………………………2.5 # Unique Annual Clients Served Statewide for Outpatient Services by Service Function, FY………..2.6 Average Annual Service Units per Client for Outpatient Services Statewide by Service Function, FY……………………………………………………………………………………………………………..

3. Periodic Assessments……………...…………………………………………………………………………………………………………….3.1 % Unique Clients Served Annually with Periodic Assessment(s) by Region, FY…………………………3.2 # Total Periodic Assessments Submitted Annually by Region, FY………………………………………….…3.3 Mean Periodic Assessment(s) Annually per Client with Assessments by Region, FY3.4 Periodic Records by Residential Setting for FY11 by Region……………………………………………………3.5 Periodic Records by Residential Setting for FY12 by Region ………………………………………………….3.6 Periodic Records by Work Setting for FY11 by Region…………………………………………………………………3.7 Periodic Records by Work Setting for FY12 by Region………………………………………………………………..3.8 Periodic Records by Conservatorship Setting for 2011 by Region…………………………………………..3.9 Periodic Records by Conservatorship Setting for 2012 by Region…………………………………………..3.10 Periodic Records by Education for 2011 by Region………………………………………………………………...3.11 Periodic Records by Education for 2012 by Region………………………………………………………………….

Appendix A: Diagnosis Groups…………………………………………………………………………………………………………..………….

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Executive SummaryPurpose

The Mental Health Services Oversight and Accountability Commission (MHSOAC) is responsible for providing oversight of the Mental Health Services Act (MHSA) and its components. The ability to successfully use evaluation methods is dependent upon access to valid data that is reliably reported. This report describes and assesses the current levels of data quality for the MHSA Client and Service Information (CSI) data in the CSI repository maintained by the State of California Department of Health Care Services (DHCS). The report provides summaries of CSI data elements across counties, regions and the state for fiscal year 2010/2011 (FY11) and fiscal year 2011/2012 (FY12). This report draft is open for public comment through Friday, June 27th. Public comments can be emailed to [email protected].

IntroductionThis report describes and assesses the current levels of data quality for the MHSA Client and Service Information (CSI) data in the CSI repository maintained by the State of California Department of Health Care Services (DHCS). The report provides summaries of CSI data elements across counties, regions and the state for fiscal year 2010/2011 (FY11) and fiscal year 2011/2012 (FY12). This report draft is open for public comment through Friday, June 27th. Public comments can be emailed to [email protected]. Background InformationThe Mental Health Services Oversight and Accountability Commission (MHSOAC) is responsible for providing oversight for the Mental Health Services Act (MHSA) and its components. Within this role, the MHSOAC ensures accountability. As one of its oversight approaches, the MHSOAC has adopted a commitment to pursuing meaningful evaluation of the MHSA and greater community mental health system.

The ability to successfully use evaluation methods to provide oversight and accountability within the MHSA is dependent upon access to valid data that is reliably reported and made available to the MHSOAC on a regular basis. The MHSOAC has identified areas within the current county-level and statewide data collection and reporting systems that are problematic and in need of improvement. The MHSOAC has begun to directly address some of these issues, although it is not clear that the MHSOAC was intended to provide this function. Nonetheless, the MHSOAC is committed to advocating for improvement of the current data collection and reporting systems since the MHSOAC is dependent on the information that is made available via these systems in order to fulfill the statutory role in evaluation of the public mental health system. Improvements in data collection and reporting systems will increase confidence in the information obtained and conclusions drawn regarding the state of the MHSA and California community mental health system.

As part of its oversight and accountability role, the MHSOAC conducts statewide evaluations of services funded under the Community Services and Supports (CSS) component of the MHSA. Counties, providers, and stakeholders need accurate and timely data that promote quality improvement efforts within the services that are being offered throughout the state. The MHSOAC also requires data on CSS component services and Clients in order to fulfill part of its oversight and accountability role and to support quality improvement efforts of the mental health system and services within that system. Unfortunately, the data collection and reporting systems used for CSS services have not been properly maintained, which limits the quality of data collected and reported via these systems.

MHSA data regarding client CSS services are primarily collected via the Client and Service Information (CSI) system, which is currently owned and maintained by the Department of Health Care Services (DHCS). In an effort to strengthen the data collected and reported via the CSI system, MHSOAC sponsored this effort to provide reporting on data that has been submitted to the CSI system.

mailto:[email protected]

IntroductionOverview of the CSS ProgramCSS is the largest component of the MHSA. The CSS component is focused on community collaboration, cultural competence, client and family driven services and systems, wellness focus, which includes concepts of recovery and resilience, integrated service experiences for Clients and families, as well as serving un-served and underserved populations. Housing is also a large part of the CSS component.

According to Cal. Admin. Code title 9, § 3200.080, “Community Services and Supports means the component of the Three-Year Program and Expenditure Plans that refers to service delivery systems for mental health services and supports for children and youth, transition age youth, adults, and older adults. These services and supports are similar to those found in Welfare and Institutions Code Sections 5800 et. seq. (Adult and Older Adult Systems of Care) and 5850 et. seq. (Children's System of Care).”

Mental Health Plans (MHPs) receive supplemental state-based funding for mental health services as a result of California Proposition 63 (now known as the Mental Health Services Act or MHSA), passed in November of 2004. MHSA provides increased funding to support California’s county mental health programs. The MHSA imposes a one percent income tax on personal income in excess of $1 million to address a broad continuum of prevention, early intervention and service needs and the necessary infrastructure, technology and training elements that will effectively support this system, with the purpose of promoting recovery for individuals with serious mental illness. MHPs develop customized plans for mental health client service in accordance with numerous requirements, including that it must provide for significant local stakeholder input and involvement. Some community mental health services in the CSI database are CSS which are funded by MHSA, but MHPs are not currently required to identify MHSA funded services in the CSI database.

IntroductionHistory of the CSI SystemWIC §5610 required MHPs to report data to the State for non-duplicative client-based information including all information necessary to meet federal Medicaid reporting requirements, as well as any other state requirements established by law. There are 59 MHPs (56 counties + Yuba/Sutter combined counties + Berkeley City region + Tri-City), which will be referred to as “counties” hereafter.

Counties currently report client-based information to the CSI system, which began July 1, 1998 and replaced the Client Discharge System (CDS). The CSI System collects data pertaining to mental health Clients and the services they receive at the county level. A basic principle of the CSI system is that it reflects both Medi-Cal and non-Medi-Cal Clients and services provided in the County/City/Mental Health Plan program. In county-staffed providers, all Clients and services must be reported. In contract providers, those Clients and services provided under the contract with the county must be reported. This data is processed and stored on a database at DHCS. Counties send a CSI Submission File to DHCS monthly and are required to submit data no later than 60 days after the end of the month in which the services were provided.

On July 1st, 2006, The California Department of Mental Health (DMH) introduced a modified data format which included changes to the CSI system documentation, changes to the client record format (such as Race/Ethnicity, Data Infrastructure Grant Indicator (DIG)), services record format (such as Diagnosis, Evidence-Based Practices and Service Strategies (EBP)), and the periodic record (such as Caregiver).

The DMH Statistics and Data Analysis (SDA) provided administrative statistical information and reports about county mental health programs using the CSI system monthly by county mental health programs and state-level summarization from 1998 to 2012.

In 2012, as a result of the dissolution of DMH, ownership of these systems was transferred to DHCS. DHCS now hosts and provides support for the CSI system and publishes statistical information and reports. These reports provide statewide utilization by various demographic variables and are available on the DHCS website.

IntroductionOverview of the Statewide CSI Data Quality Report The purpose of the Statewide Data Quality Report is to describe county, regional, and statewide CSI data and to identify inconsistent or aberrant data points. The report provides basic information regarding CSI data, including annual counts of total clients, special population clients, services, service types, lengths of service, diagnoses, and completed periodic assessments. The reports compare two recent years of CSI data statewide. The reports use the same two years of data for all counties.

The results from the Data Quality Report are not meant for comparison between groups of clients or between counties and regions for purposes other than data quality. The results are meant to inform data collectors and data users about areas of strength and areas of weakness which may exist in the dataset. Therefore, informed decisions can be made about the collection and/or use of the data for more sophisticated and informed analyses in the future.

Reviewing data quality requires looking for patterns in the data in places where patterns should not reasonably exist, and vice versa. For example, if there are large differences between regions for results of the same age group, this might (but not always) suggest a systematic difference in data collection or data reporting between counties and regions. The purpose of this data quality report is to help identify systematic differences in the data.

Data DescriptionThe data for this report was obtained via a one-time export from the CSI system by DHCS. This data was made available on August 2nd, 2013 and contains Client, Service and Periodic data up to May 31, 2013 with 10 years of history.

CSI data files were made available for download in Comma Separated Value (CSV) format via the ITWS website file transfer functionality. These files were separated into Client, Services and Periodic data file types and were formatted according to the CSI Data Dictionary (July 2007 revision).

The data was analyzed for these reports using SAS® Enterprise Guide 5.1. Client, Services and Periodic data were linked via the 9-digit County Client Number (CCN) which provides a unique identifier for each client served by each County.

Reporting TimeframeAll reports compare the following two recent years of CSI data for each county. The reports use the same two years of data for all counties. The reporting timeframes coincide with California State Fiscal Years 2011 and 2012 as shown in the following table.

Fiscal Year Start Date End DateFY11 July 1, 2010 June 30, 2011FY12 July 1, 2011 June 30, 2012

California Mental Health Regions

1 Alameda 13 Imperial 25 Modoc 37 San Diego 49 Sonoma2 Alpine 14 Inyo 26 Mono 38 San Francisco 50 Stanislaus3 Amador 15 Kern 27 Monterey 39 San Joaquin 52 Tehama4 Butte 16 Kings 28 Napa 40 San Luis Obispo 53 Trinity5 Calaveras 17 Lake 29 Nevada 41 San Mateo 54 Tulare6 Colusa 18 Lassen 30 Orange 42 Santa Barbara 55 Tuolumne7 Contra Costa 19 Los Angeles 31 Placer 43 Santa Clara 56 Ventura8 Del Norte 20 Madera 32 Plumas 44 Santa Cruz 57 Yolo9 El Dorado 21 Marin 33 Riverside 45 Shasta 58 Yuba

10 Fresno 22 Mariposa 34 Sacramento 46 Sierra 63 Sutter & Yuba11 Glenn 23 Mendocino 35 San Benito 47 Siskiyou 66 Tri City12 Humboldt 24 Merced 36 San Bernadino 48 Solano

1. Clients ServedID Partners1= 35,250

2= 36

3= 683

4= 7,046

5= 701

6= 559

7= 18,687

8= 1,036

9= 2,366

10= 13,621

11= 799

12= 3,678

13= 4,808

14= 0

15= 17,722

16= 2,991

17= 1,065

18= 878

19= 190,056

20= 2,567

21= 2,929

22= 568

23= 2,062

24= 4,339

25= 428

26= 304

27= 5,738

28= 1,353

29= 1,820

30= 45,570

ID Partners31 = 2,454

32 = 612

33 = 41,721

34 = 20,125

35 = 1,439

36 = 36,820

37 = 54,001

38 = 9,125

39 = 13,492

40 = 4,518

41 = 11,103

42 = 7,179

43 = 6,372

44 = 4,067

45 = 4,795

46 = 164

47 = 1,485

48 = 4,293

49 = 4,634

50 = 9,148

52 = 4,649

53 = 2,006

54 = 1,488

55 = 353

56 = 8,928

57 = 980

63 = 11,847

66 = 2,937

1.1: Unique CSI Clients Served by County for FY11

1.1 and 1.2 provide a total annual count of unique clients served under any mode of service at any time during the Fiscal Year by each county. This report allows Counties to identify trends of increasing or decreasing number of unique Clients served by Fiscal Year.

As seen in 1.1, In FY11, 640,395 clients were served statewide for the counties reporting to the CSI system. Los Angeles County served roughly one third of the clients (n=190,056), and San Diego County served the next largest number of clients (n=54,001).


32 = 578

33 = 16,893

34 = 21,150

35 = 1,560

36 = 38,990

37 = 55,779

38 = 12,608

39 = 13,768

40 = 4,182

41 = 11,166

42 = 6,817

43 = 5,472

44 = 4,056

45 = 4,515

46 = 135

47 = 1,071

48 = 3,462

49 = 4,449

50 = 6,870

52 = 4,694

53 = 2,135

54 = 1,435

55 = 331

56 = 9,322

57 = 998

63 = 13,055

66 = 2,653

1. Clients Served1.2: Unique CSI Clients Served by County for FY12

As seen in 1.2, 663,803 clients were served statewide for the counties reporting to the CSI system in FY12. This represents a 3.7% increase in clients served in comparison to FY11. Los Angeles County admitted over one third of the clients (n=231,830), and San Diego County served the next largest number of clients (n=55,779).


2 = 39

3 = 740

4 = 7,161

5 = 1,065

6 = 610

7 = 19,368

8 = 974

9 = 2,470

10 = 15,407

11 = 688

12 = 3,770

13 = 5,073

14 = 0

15 = 18,696

16 = 2,902

17 = 1,187

18 = 843

19 = 231,830

20 = 2,584

21 = 0

22 = 616

23 = 1,790

24 = 4,406

25 = 465

26 = 248

27 = 5,538

28 = 1,473

29 = 1,900

30 = 46,727

An annual count of total Clients served any time during the reporting timeframe (FY11 and FY12), by region and Mode of Service is shown in 1.3. All regions provided Outpatient services to the greatest number of unique clients in comparison to other modes of service. Most regions provided more Day Services than 24 Hour Services (except for the Central Counties region.)

An annual count of total Clients statewide served any time during the reporting timeframe (FY11 and FY12) by Mode of Service is shown in 1.4.

One client may receive services under multiple Modes of Service. As a result, the number of Clients who received services for all Modes of Service may be greater than the total population served by region if added together.

1.3: # Unique Annual Clients Served by Mode of Service, Region, FY

1. Clients Served

1.4: # Unique Annual Clients Served Statewide by Mode of Service, FY

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0

50,000

100,000

150,000

200,000

250,000

FY11 FY120

100,000

200,000

300,000

400,000

500,000

600,000

700,000

An annual count of total Clients served any time during the reporting timeframe (FY11 and FY12) by Region and Age Group is shown in 1.5.

An annual count of total Clients statewide served any time during the reporting timeframe (FY11 and FY12) by Age Group is shown in 1.6.

The age categories include Child (0-15 Years), Transition Age Youth (TAY, 16-25 Years), Adult (26-59 Years), and Older Adult (60+ Years).

All counties served more Adults than any other Age Group, serving 304,975 Adults annually statewide in FY12. The second highest age group served for all counties was Child, serving 205,796 Children statewide in FY12.

1.5: # Unique Annual Clients Served by Age Group, Region, FY

1. Clients Served

1.6: # Unique Annual Clients Served Statewide by Age Group, FY

FY11 FY120

50,000

100,000

150,000

200,000

250,000

300,000

350,000

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0

20,000

40,000

60,000

80,000

100,000

120,000

As seen in 1.7, regions of California served differing proportions of clients by gender. The largest proportions of clients served in Los Angeles, Southern and Bay Area regions were male, while the largest proportions for Central and Superior regions were female. A similar distribution of clients served by gender existed for FY11 as compared to FY12.

As seen in 1.8, the largest proportion of clients served statewide in FY11 and FY12 were male.

1.7: % Unique Annual Clients Served by Gender, Region, FY

1. Clients Served

1.8: % Unique Annual Clients Served Statewide by Gender, FY

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

FY11 FY120.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

1. Clients Served

1.9.2: % Unique Annual Clients Served Statewide by Race/Ethnicity, FY (“Other”, “Unknown / Not Reported”)

FY11 FY120.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

FY11 FY120.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

1.9.1: % Unique Annual Clients Served Statewide by Race/Ethnicity, FY (Top 4)

1. Clients Served1.10.1: % Unique Annual Clients Served by Race/Ethnicity, Region, FY (Top 4)

1.10.2: % Unique Annual Clients Served by Race/Ethnicity, Region, FY (Remaining)

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12Filipino 2.0% 1.0% 0.2% 0.8% 0.3% 2.0% 0.9% 0.1% 0.9% 0.3%Hmong 0.1% 1.5% 0.0% 0.2% 1.2% 0.1% 1.5% 0.0% 0.0% 1.2%Other Asian 1.4% 0.7% 0.1% 0.4% 0.4% 1.4% 0.7% 0.1% 0.4% 0.3%Chinese 1.8% 0.3% 0.2% 0.2% 0.1% 2.1% 0.3% 0.1% 0.2% 0.1%Cambodian 0.6% 0.9% 0.1% 0.2% 0.1% 0.6% 0.9% 0.0% 0.2% 0.0%Laotian 0.3% 0.7% 0.0% 0.2% 0.6% 0.3% 0.8% 0.0% 0.2% 0.5%Viatnamese 0.3% 0.7% 0.0% 0.2% 0.6% 0.3% 0.8% 0.0% 0.2% 0.5%Korean 0.2% 0.1% 0.2% 0.3% 0.1% 0.2% 0.1% 0.1% 0.3% 0.1%Asian Indian 0.4% 0.3% 0.0% 0.1% 0.1% 0.4% 0.4% 0.0% 0.2% 0.2%Japanese 0.3% 0.2% 0.0% 0.2% 0.1% 0.3% 0.2% 0.0% 0.2% 0.1%Other Pacific Islander 0.3% 0.2% 0.0% 0.1% 0.1% 0.4% 0.2% 0.0% 0.1% 0.1%Samoan 0.2% 0.1% 0.0% 0.1% 0.1% 0.2% 0.1% 0.0% 0.1% 0.1%Guamanian 0.3% 0.0% 0.0% 0.2% 0.0% 0.3% 0.0% 0.0% 0.1% 0.0%Native Hawaiian 0.1% 0.1% 0.0% 0.1% 0.1% 0.1% 0.1% 0.0% 0.1% 0.2%Mien 0.1% 0.2% 0.0% 0.0% 0.1% 0.2% 0.2% 0.0% 0.0% 0.1%

1. Clients Served1.10.3: % Unique Annual Clients Served by Race/Ethnicity, Region, FY (“Other”, “Unknown / Not Reported”)

Up to 6 Race/Ethnicity codes can be reported for each client. These include five Race Code fields which allow clients to be identified as belonging to up to five separate Race categories and an Ethnicity code which indicates if the client is of Hispanic or Latino ethnicity. These fields have been aggregated to report the total percent of Clients that were identified as belonging to each Race/Ethnicity group in any of the Race or Ethnicity fields. Since Clients are able to report multiple races, the number of clients served for all Races/Ethnicity categories may be greater than the total clients served if added together.

In the CSI system, “Unknown / Not Reported” can be reported in combination with other Race/Ethnicity codes. For example, a client could be reported as “Mien” and “Unknown / Not Reported” simultaneously. For the purposes of this report, any clients without a Race or Ethnicity other than “Unknown / Not Reported” are identified as “Unknown / Not Reported”.

For ease of review, the data has been split into three sections. 1.10.1 displays the next top 4 most common races by percentage. 1.10.2 displays the data for the remaining Race/Ethnicity types of lower frequency. 1.10.3 displays only the percent of clients identified as “Other” or “Unknown / Not Reported”.

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

FY11 FY120.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

1. Clients Served1.11.1: % Unique Annual Clients Served Statewide by Primary Language, FY (Top 3)

1.11.2: % Unique Annual Clients Served Statewide by Primary Language, FY (Remaining)

FY11 FY12Other Non-English 0.5% 0.5%Vietnamese 0.5% 0.5%Cambodian 0.4% 0.3%Armenian 0.2% 0.2%Cantonese 0.2% 0.2%Farsi 0.2% 0.1%Hmong 0.2% 0.2%Tagalog 0.2% 0.1%American Sign Language (ASL) 0.1% 0.0%Arabic 0.1% 0.0%Korean 0.1% 0.1%Lao 0.1% 0.1%Mandarin 0.1% 0.0%Mien 0.1% 0.1%Other Chinese Dialects 0.1% 0.1%Russian 0.1% 0.1%French 0.0% 0.0%Hebrew 0.0% 0.0%Ilocano 0.0% 0.0%Italian 0.0% 0.0%Japanese 0.0% 0.0%Other Sign Language 0.0% 0.0%Polish 0.0% 0.0%Portugese 0.0% 0.0%Samoan 0.0% 0.0%Thai 0.0% 0.0%Turkish 0.0% 0.0%

1. Clients Served1.12.1: % Unique Annual Clients Served by Primary Language, Region, FY (Top 3)

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

1.12.2: % Unique Annual Clients Served by Primary Language, Region, FY (Remainder)

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12Other Non-English 0.9% 0.8% 0.2% 0.6% 0.3% 0.8% 0.7% 0.1% 0.6% 0.3%Vietnamese 1.0% 0.4% 0.4% 0.6% 0.0% 0.9% 0.3% 0.3% 0.6% 0.0%Cambodian 0.4% 0.5% 0.6% 0.1% 0.0% 0.4% 0.5% 0.4% 0.1% 0.0%Armenian 0.0% 0.0% 0.7% 0.0% 0.0% 0.0% 0.1% 0.5% 0.0% 0.0%Cantonese 0.8% 0.0% 0.1% 0.0% 0.0% 0.8% 0.0% 0.1% 0.0% 0.0%Farsi 0.3% 0.1% 0.2% 0.1% 0.0% 0.3% 0.0% 0.2% 0.1% 0.0%Hmong 0.0% 1.0% 0.0% 0.0% 0.9% 0.0% 0.9% 0.0% 0.0% 0.8%Tagalog 0.4% 0.1% 0.2% 0.1% 0.0% 0.4% 0.1% 0.1% 0.1% 0.0%American Sign Language (ASL) 0.1% 0.0% 0.1% 0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0%Arabic 0.0% 0.0% 0.1% 0.1% 0.0% 0.0% 0.0% 0.1% 0.1% 0.0%Korean 0.1% 0.0% 0.2% 0.0% 0.0% 0.1% 0.0% 0.1% 0.0% 0.0%Lao 0.1% 0.3% 0.0% 0.0% 0.2% 0.1% 0.3% 0.0% 0.0% 0.2%Mandarin 0.1% 0.0% 0.1% 0.0% 0.0% 0.1% 0.0% 0.1% 0.0% 0.0%Mien 0.1% 0.2% 0.0% 0.0% 0.3% 0.1% 0.2% 0.0% 0.0% 0.3%Other Chinese Dialects 0.3% 0.0% 0.1% 0.0% 0.0% 0.3% 0.0% 0.0% 0.0% 0.0%Russian 0.2% 0.2% 0.1% 0.0% 0.0% 0.2% 0.2% 0.1% 0.0% 0.0%French 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Hebrew 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Ilocano 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Italian 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Japanese 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

Other Sign Language 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Polish 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Portugese 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Samoan 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Thai 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%Turkish 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

1.13.1: % Unique Annual Clients Served with Substance Abuse Indicator by Region, FY

1. Clients Served

1.13.2: # Unique Annual Clients Served with Substance Abuse Indicator by Region, FY

All Service records for each Client were analyzed to determine if any Service records during the reporting period indicated a substance abuse or dependence issue. Clients who had at least one Service record containing an answer of ‘Yes’ in the Substance Abuse Indicator field were identified as having a substance abuse or dependence issue reported during the Fiscal Year. For reporting purposes, any Clients missing Substance Abuse Indicators are identified as not having reported a substance abuse or dependence issue.

FY11 FY120

10,000

20,000

30,000

40,000

50,000

60,000

70,000

FY11 FY20120.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

Statewide0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

1. Clients Served1.14.1: % Unique Annual Clients Served by Diagnosis Group, Region, FY (Top Group)

As seen in 1.14.1 through 1.14.3, the annual percent of total unique clients served by each Region by Diagnosis Group and Fiscal Year is presented. Each Service record contains 4 fields representing diagnosis (Axis I Diagnosis, Axis I Additional Diagnosis, Axis II Diagnosis, Axis II Additional Diagnosis). All Service records for each Client were analyzed to determine if any Service records during the reporting period indicated a diagnosis code included in one of the identified Diagnosis Groups. The algorithm used to classify Diagnosis is included in Appendix A. The most common diagnosis group reported was Depressive Diagnosis with all regions reporting 25%-35% of clients served being diagnosed with a diagnosis in this group.

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

FY11 FY12

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

1. Clients Served1.14.2: % Unique Annual Clients Served by Diagnosis Group, Region, FY (Middle Group)

1.14.3: % Unique Annual Clients Served by Diagnosis Group, Region, FY (Lower Group)

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

FY11 FY12

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

Stat

ewid

e

Bay

Area

Cou

nties

Cent

ral C

ounti

es

Los

Ange

les

Regi

on

Sout

hern

Cou

nties

Supe

rior C

ounti

es

FY11 FY12

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

1. Clients Served

1.16: # Unique Annual Clients Served by Special Population, Region, FY

Each Service record identifies whether the services provided to the client were provided as the result of the client belonging to a Special Population receiving Assisted Outpatient Treatment (AOT) services , Individualized Education Plan required (IEP) services, Governor’s Homeless Initiative (GHI) services, or Welfare-to-work (WTW) plan specified services.

Service records for all Clients were analyzed and any clients who received any Special Population services in any service mode were identified by Special Population Group.

As shown in 1.15, the total number of clients reported as receiving Special Population services at any time during the fiscal year was fairly low. IEP and WTW services were the most common.

FY11 FY120

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

1.15: # Unique Annual Clients Served Statewide by Special Population, FY

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

Bay Area Counties

Central Counties

Los Angeles Region

Southern Counties

Superior Counties

FY11 FY12

0

1,000

2,000

3,000

4,000

5,000

6,000

2. Services Provided2.1.1: # Unique Annual Clients Served Statewide for 24 Hour Services by Service Function, FY (Top 5)

As shown in 2.1.1 and 2.1.2, the total count of unique clients served annually statewide for FY11 and FY12 who received 24 Hour Services are displayed by Service Function. Since a single client may receive multiple Modes of Service, the total number of clients for all Modes of Service may be greater than the number of unique clients served if added together.

The most common Mode of Service for 24 Hour Services received by clients was Hospital Inpatient (n=18,472 in FY11 and n=16,615 in FY12). The second most common Mode of Service was Psychiatric Health Facility (n=6,904 in FY11 and n=6,218 in FY12). The least common Mode of Service was Independent Living (n=75 in FY11 and n=0 in FY12).

2.1.2: # Unique Annual Clients Served Statewide for 24 Hour Services by Service Function, FY (Remaining)

Hospital In

patien

t

Psychiat

ric Heal

th Facili

ty (PHF)

Adult Cris

is Resi

dential

Hospital A

dministrati

ve Days

SNF/I

MD Servi

ces0

4,000

8,000

12,000

16,000

20,000

Adult Resi

dential

Mental

Health Reh

ab Cen

ter

Residen

tial, Other

Semi-S

upervise

d Living

Jail In

patien

t

Indepen

dent Li

ving

0

500

1,000

1,500

2,000

2,500

As shown in 2.2.1 and 2.2.2, the average length of annual service per client by Service Function is displayed for the reporting timeframe. This represents the ratio of total service units to the total number of unique Clients who received 24 Hour Services for each Service Function and is measured in days of service per client per year.

2.2.1: Average Annual Days of 24 Hour Services per Client with Service Function Statewide by FY (Top 6)

2. Services Provided

2.2.2: Average Annual Days of 24 Hour Services per Client with Service Function Statewide by FY (Remaining)

Residen

tial, Other

SNF/I

MD Servi

ces

Semi-S

upervise

d Living

Mental

Health Reh

ab Cen

ter

Adult Resi

dential

Indepen

dent Li

ving

0.020.040.060.080.0

100.0120.0140.0160.0180.0200.0

Jail Inpatient Adult Crisis Residential Hospital Administrative Days

Psychiatric Health Facility (PHF)

Hospital Inpatient0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

2.3.1 # Unique Annual Clients Served Statewide for Day Services by Service Function, FY (Top 4)

As shown in 2.2, the total count of unique clients served annually statewide for FY11 and FY12 who received Day Hour Services are displayed by Service Function. Since a single client may receive multiple Modes of Service, the total number of clients for all Modes of Service may be greater than the number of unique clients served if added together.

The most common Mode of Service for Day Services received by clients was Crisis Stabilization – Emergency Room (n=34,310 in FY11 and n=29,224 in FY12). The second most common Mode of Service was Crisis Stabilization – Urgent Care (n=26,986 in FY11 and n=28,565 in FY12). The least common Mode of Service was Skilled Nursing Facility (SNF) Augmentation (n=83 in FY11 and n=23 in FY12).


2.3.2: # Unique Annual Clients Served Statewide for Day Services by Service Function, FY (Remaining)

Crisis Stabilization - Emergency Room

Crisis Stabilization - Urgent Care Day Rehabilitation - Full Day Day Treatment - Full Day0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Socialization Vocational Services Day Rehabilitation - Half Day

Day Treatment - Half Day SNF Augmentation0

200

400

600

800

1,000

1,200

1,400

1,600

2.4.1: Average Annual Service Units of Day Services per Client with Service Function Statewide by FY (Top 4)

As shown in 2.4.1 and 2.4.2, the average length of annual service per client by Service Function is displayed for the reporting timeframe. This represents the ratio of total service units to the total number of unique Clients who received Day Services for that service function. Service units reported vary by Service Function (shown in parenthesis for each Service Function type.)


2.4.2: Average Annual Service Units of Day Services per Client with Service Function Statewide by FY (Remainder)

Day Treatment (Half Days) Day Treatment Intensive (Full Days)

Day Rehabilitation (Full Days) Socialization (4-Hours)0

20

40

60

80

100

120

Day Rehabilitation - Half Day (Half Days)

Crisis Stabilization - Emergency Room (Hours)

Vocational Services (4-Hours) Crisis Stabilization - Urgent Care (Hours)

0

5

10

15

20

25

30

35

40

45

50


Mental Health Services (MHS)

Medication Support Linkerage/Brokerage Collateral Crisis Intervention (CI)0

100,000

200,000

300,000

400,000

500,000

600,000

2.5.1 # Unique Annual Clients Served Statewide for Outpatient Services by Service Function, FY (Top 4)

2.5.2: # Unique Annual Clients Served Statewide for Outpatient Services by Service Function, FY (Remainder)

Therapeutic Behavioral Services (TBS)

Professional Inpatient Visit - MS

Professional Inpatient Visit - MHS

Professional Inpatient Visit - CI

Professional Inpatient Visit - Collateral

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


Therapeutic Behavioral Services (TBS) Mental Health Services (MHS)0.0

1,000.0

2,000.0

3,000.0

4,000.0

5,000.0

6,000.0

7,000.0

Collateral

Linkerage/B

rokerage

Professional In

patient Visi

t - M

S

Medication Support

Crisis

Intervention (C

I)

Professional In

patient Visi

t - M

HS

Professional In

patient Visi

t - Colla

teral

Professional In

patient Visi

t - CI

0.050.0

100.0150.0200.0250.0300.0350.0400.0450.0500.0

2.6.1: Average Annual Minutes of Outpatient Services per Client with Service Function Statewide by FY (Top 2)

2.6.2: Average Annual Minutes of Outpatient Services per Client with Service Function Statewide by FY (Remainder)

As shown in 2.6.1 and 2.6.2, the average length of annual service per client by Service Function is displayed for the reporting timeframe. This represents the ratio of total service units to the total number of unique Clients who received Outpatient Services. Service units are measured in minutes.

3.1: % Unique Clients Served Annually with Periodic Assessment(s) by Region, FY

3.1 provides annual counts of Clients who received Periodic Assessments during the Fiscal Year by Mode of Service. 3.2 provides annual counts of assessments submitted by region. In some cases, Periodic Assessments were submitted for Clients who did not receive services during the reporting timeframe; these Periodic Assessments are excluded from these reports.

3.2: # Total Periodic Assessments Submitted Annually by Region, FY

3. Periodic Assessments

Bay Area Counties Central Counties Los Angeles Region

Southern Counties0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

Statewide Bay Area Counties Central Counties Los Angeles Region Southern Counties Superior Counties0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Statewide0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

3.3: Mean Periodic Assessment(s) Annually per Client with Assessments by Region, FY


The Mean Periodic Assessment(s) is the ratio of the total number of assessments submitted during the Fiscal Year for clients with services during the Fiscal Year to the total number of unique clients served during the fiscal year with at least one Periodic Assessment.

Statewide Bay Area Counties Central Counties Los Angeles Region Southern Counties Superior Counties0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

3.4.1: Periodic Records by Residential Setting for FY11 by Region (Top 3)


3.4.1 and 3.4.2 provides the percentage of all Periodic Assessments submitted annually by Residential Setting for FY11.


10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

3.4.2: Periodic Records by Residential Setting for FY11 (Remainder)



5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

3.5.1: Periodic Records by Residential Setting for FY12 by Region (Top 3)

3.5.1 and 3.5.2 provides the percentage of all Periodic Assessments submitted annually by Residential Setting for FY12.



10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

3.5.2: Periodic Records by Residential Setting for FY12 (Remainder)



5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

3.6: Periodic Records by Work Setting for FY11 by Region


3.6 provides the percentage of all Periodic Assessments submitted annually by Work Setting for FY11.

Statewide Bay Area Counties Central Counties Los Angeles Region Southern Counties Superior Counties0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.7: Periodic Records by Work Setting for FY12 by Region


3.7 provides the percentage of all Periodic Assessments submitted annually by Work Setting for FY12.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.8: Periodic Records by Conservatorship Setting for 2011 by Region


3.8 provides the percentage of all Periodic Assessments submitted annually by Conservatorship Status for FY11.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.9: Periodic Records by Conservatorship Setting for 2012 by Region


3.9 provides the percentage of all Periodic Assessments submitted annually by Conservatorship Status for FY12.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.10: Periodic Records by Education for 2011 by Region


3.10 provides the percentage of all Periodic Assessments submitted annually by education for FY11.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

3.11: Periodic Records by Education for 2012 by Region


3.11 provides the percentage of all Periodic Assessments submitted annually by Education for FY12.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

mhsoac statewide client and service information (csi) data quality report draft

Documents

unique clients

unique annual clients

unique csi clients

periodic records

average annual service

service function

mode of service

total periodic assessments