performance outcomes system initial reports...2 00,235 2.5% fy 12-13 1 0,182 1.5% 2 26,052 12.9% fy...

Performance Outcomes System Initial ReportsReport run on July 29, 2015

Background

This is the first round of county-specific reporting produced for the Performance Outcomes System which reflects a refresh of the data on the indicators that were reported in

February 2015 at the statewide aggregate level. These reports help meet the intent of the Legislature, as stated in Welfare and Institutions Code Section 14707.5, to develop a

performance outcomes system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services that will improve outcomes at the individual, program, and

system levels and inform fiscal decision-making related to the purchase of services. This reporting effort is part of the implementation of a performance outcomes system for Medi-

Cal Specialty Mental Health Services (SMHS) for children and youth.

Since 2012 DHCS has worked with several groups of stakeholders to create a structure for reporting, develop the Performance Measurement Paradigm, and develop indicators and

measures. The Performance Outcomes System will be used to evaluate the domains of access, engagement, service appropriateness to need, service effectiveness, linkages, cost

effectiveness and satisfaction.

Purpose and Overview

Moving forward, three reports will be created during each new reporting period. The reports that will be produced are the following: statewide aggregate data; population-based

county groups; and county-specific data. These are the first county-specific reports providing updated information on the initial indicators that were developed for the Performance

Outcomes System and reported on at the statewide aggregate level in February 2015; they help establish a foundation for on-going reporting. DHCS plans to move to annual

reporting of this data for the Performance Outcomes System.

Where possible, the reports provide trend information by displaying information for Fiscal Years (FY) 10/11, 11/12, 12/13, and 13/14.

The first reports focus on the demographic characteristics of the children and youth under 21 who are receiving Specialty Mental Health Services (SMHS), based on approved claims

for Medi-Cal eligible beneficiaries. The reports include data on the demographics of this population by age, gender, race/ethnicity. Two types of penetration information is provided

for children/youth served and not served. Both penetration rate tables are also broken out by demographic characteristics.

Utilization of services reports are shown in terms of dollars, as well as by service in time increments. The snapshot report provides a point-in-time view of children arriving, exiting

and continuing services over a two year period. The final report provides a view over the past four years of the time to step-down services (i.e., time to next contact after an

inpatient discharge). Note: The time to step-down report has a change in methodology from the first report produced in February 2015. In the initial report only outpatient services

provided at least one day after the inpatient discharge were included in the calculations. Starting with this report, any outpatient service that occurs on or after the inpatient

discharge is included in the analysis.

DefinitionsPopulation - Beneficiaries with approved services adjudicated through the Short Doyle/Medi-Cal II claiming system that were:

• Age 20 or younger during the approved date of service on the claim; or

• Age 21 during the approved date of the service on the claim and a birth date on or after January 1st of the Fiscal Year.

Data Sources -

• Short-Doyle/Medi-Cal II (SD/MC II) claims with dates of service in FY 10/11 through FY 13/14.

• Medi-Cal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY 10/11 through FY 13/14.

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Performance Outcomes System Initial ReportsReport run on July 29, 2015

Additional Information

The Measures Catalog is the companion document for these reports and provides the methodology and definitions for the measures. Each measure is defined and the numerator

and denominator used to develop the metrics are provided with relevant notes and additional references. The Measures Catalog may be found at:

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

Background 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:

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

Report Interpretation

*County-specific findings may be interpreted alongside the POS statewide and population-based report findings.

*The penetration rates reported here were calculated using a different methodology than that used by the External Quality Review Organization (EQRO). The differences in

methodology make comparison between the POS penetration rates and the EQRO penetration rates not appropriate or useful. The POS methodology for calculating penetration

rates was selected because it is easier to compute, more straightforward to interpret, and is in use by other states and counties. For the POS, the penetration rate is calculated by

taking the total number of youth who received X number of Specialty Mental Health Services (1 or 5 for POS) in a FY and dividing that by the total number of Medi-Cal eligible youth

for that FY. This methodology results in lower penetration rates as compared to the EQRO rates, but it does so across the board so that all counties and the state will be similarly

impacted.

*The snapshot report provides a point-in-time look at children and youth's movement through the SMHS system. The report uses five general categories to classify if a youth is

entering, exiting, continuing services, or a combination of these categories (e.g., arriving and exiting). As of now, this report only classifies youth and their service usage for FY 12/13

and FY13/14. Eventually the snapshot data will be used along with measures of service effectiveness to identify whether youth are improving as a result of receiving services from

the time they first arrived in the system to when they exit the system. This methodology was adapted from the California Mental Health and Substance Use System Needs

Assessment (2012). More information on the original methodology can be found here: http://www.dhcs.ca.gov/provgovpart/Documents/1115 Waiver Behavioral Health-Services-Needs-Assessment-3.1.pos/Pages/Performance-Outcomes-System-Reports-and-Measures-Catalog.aspx

*The psychiatric emergency services/hospital data reported on in the time to step-down services report relies solely on claims data from Short Doyle/Medi-Cal II. In the future this

report will incorporate other outpatient and inpatient Medi-Cal SMHS' billed through the Managed Care healthcare delivery systems.

*DHCS is in process of updating the data source for the two following types of Service Usage: Hospital Inpatient and Hospital Inpatient Admin.. This is being done to ensure the

findings are complete. June 2016 is slated for an update of the POS reports and will include fee-for service data where it is appropriate.

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

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Demographics Report: Unique Count of Children and Youth Receiving SMHS by Fiscal YearSacramento County as of July 29, 2015

SFYUnique Count

Receiving SMHS*

Year-Over-Year

Percentage Change

Unique Count of

Medi-Cal Eligibles

Year-Over-Year

Percentage Change

FY 10-11 9,581 195,283

FY 11-12 10,030 4.7% 200,235 2.5%

FY 12-13 10,182 1.5% 226,052 12.9%

FY 13-14** 10,727 5.4% 245,808 8.7%

Compound

Annual Growth

Rate SFY**

3.8% 8.0%

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

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

9,581 10,030 10,182 10,727

-

2,000

4,000

6,000

8,000

10,000

12,000

FY 10-11 FY 11-12 FY 12-13 FY 13-14**

Unique Count of Children and Youth 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 10-11 107 1.1% 428 4.5% 2,808 29.3% 2,124 22.2% 3,216 33.6% 363 3.8% 535 5.6%

FY 11-12 106 1.1% 441 4.4% 2,916 29.1% 2,311 23.0% 3,217 32.1% 449 4.5% 590 5.9%

FY 12-13 105 1.0% 469 4.6% 2,840 27.9% 2,381 23.4% 3,211 31.5% 526 5.2% 650 6.4%

FY 13-14 95 0.9% 493 4.6% 2,823 26.3% 2,484 23.2% 3,375 31.5% 704 6.6% 753 7.0%

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

.

1%

4%

29%

22%

34%

4%

6%

Fiscal Year 10-11 Race Distribution

Alaskan Native or AmericanIndianAsian or Pacific Islander

Black

Hispanic

White

Other

Unknown

1%

4%

29%

23%

32%

4% 6%



Black

Hispanic

White

Other

Unknown

1%

5%

28%

23%

32%

5% 6%



Black

Hispanic

White

Other

Unknown

1%

5%

26%

23%

31%

7% 7%



Black

Hispanic

White

Other

Unknown

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Fiscal

Year

Children 0-5

Count Children 0-5 %

Children 6-11


Children 12-17


Youth 18-20

Count Youth 18-20 %

FY 10-11 1,307 13.6% 3,351 35.0% 3,937 41.1% 986 10.3%

FY 11-12 1,252 12.5% 3,599 35.9% 4,047 40.3% 1,132 11.3%

FY 12-13 1,184 11.6% 3,697 36.3% 4,053 39.8% 1,248 12.3%

FY 13-14 1,213 11.3% 4,033 37.6% 4,231 39.4% 1,250 11.7%

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

.

14%

35% 41%

10%

Fiscal Year 10-11 Age Group Distribution

Children 0-5

Children 6-11

Children 12-17

Youth 18-20

12%

36% 40%

11%


Children 0-5

Children 6-11

Children 12-17

Youth 18-20

12%

36% 40%

12%


Children 0-5

Children 6-11

Children 12-17

Youth 18-20

11%

38% 39%

12%


Children 0-5

Children 6-11

Children 12-17

Youth 18-20

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Demographics Report: Unique Count of Children and Youth by Fiscal YearSacramento County as of July 29, 2015

Fiscal

Year

Female

Count Female %

Male

Count Male %

FY 10-11 4,224 44.1% 5,357 55.9%

FY 11-12 4,368 43.5% 5,662 56.5%

FY 12-13 4,479 44.0% 5,703 56.0%

FY 13-14 4,714 43.9% 6,013 56.1%

44.1%

55.9%

Fiscal Year 10-11 Gender Distribution

Female Male

43.5%

56.5%


Female Male

44.0%

56.0%


Female Male

43.9%

56.1%


Female Male

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Penetration Rates* Report: Children and Youth With At Least One SMHS Visit**Sacramento County as of July 29, 2015

Children and

Youth with 1 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1

or more

SMHS Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 1 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

All 9,581 195,283 4.9% 10,030 200,235 5.0% 10,182 226,052 4.5% 10,727 245,808 4.4%

Children 0-5 1,307 71,052 1.8% 1,252 71,280 1.8% 1,184 75,515 1.6% 1,213 78,338 1.5%

Children 6-11 3,351 50,890 6.6% 3,599 53,197 6.8% 3,697 64,549 5.7% 4,033 70,623 5.7%

Children 12-17 3,937 46,438 8.5% 4,047 46,600 8.7% 4,053 55,511 7.3% 4,231 60,379 7.0%

Youth 18-20 986 26,903 3.7% 1,132 29,158 3.9% 1,248 30,477 4.1% 1,250 36,468 3.4%

Alaskan Native or American Indian 107 1,547 6.9% 106 1,539 6.9% 105 1,600 6.6% 95 1,647 5.8%

Asian or Pacific Islander 428 29,831 1.4% 441 29,701 1.5% 469 34,206 1.4% 493 38,800 1.3%

Black 2,808 39,454 7.1% 2,916 40,593 7.2% 2,840 41,769 6.8% 2,823 43,318 6.5%

Hispanic 2,124 51,888 4.1% 2,311 53,450 4.3% 2,381 60,871 3.9% 2,484 64,738 3.8%

White 3,216 44,805 7.2% 3,217 45,907 7.0% 3,211 51,247 6.3% 3,375 55,841 6.0%

Other 363 18,340 2.0% 449 19,254 2.3% 526 24,711 2.1% 704 28,367 2.5%

Unknown 535 9,418 5.7% 590 9,791 6.0% 650 11,648 5.6% 753 13,097 5.7%

Female 4,224 96,905 4.4% 4,368 99,484 4.4% 4,479 111,699 4.0% 4,714 121,269 3.9%

Male 5,357 98,378 5.4% 5,662 100,751 5.6% 5,703 114,353 5.0% 6,013 124,539 4.8%

*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. **Children and Youth 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.

FY 10-11 FY 11-12 FY 12-13 FY 13-14

1.8% 1.8% 1.6% 1.5%

6.6% 6.8% 5.7% 5.7%

8.5% 8.7%

7.3% 7.0%

3.7% 3.9% 4.1% 3.4%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 71,052)

FY 11-12(n= 71,280)

FY 12-13(n= 75,515)

FY 13-14(n= 78,338)

FY 10-11(n= 50,890)

FY 11-12(n= 53,197)

FY 12-13(n= 64,549)

FY 13-14(n= 70,623)

FY 10-11(n= 46,438)

FY 11-12(n= 46,600)

FY 12-13(n= 55,511)

FY 13-14(n= 60,379)

FY 10-11(n= 26,903)

FY 11-12(n= 29,158)

FY 12-13(n= 30,477)

FY 13-14(n= 36,468)

Children 0-5 Children 6-11 Children 12-17 Youth 18-20

Penetration Rates by Age Children and Youth With At Least One SMHS Visit**, By Fiscal Year

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Penetration Rates* Report: Children and Youth With At Least One SMHS Visit**Sacramento County as of July 29, 2015

*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. **Children and Youth 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.

6.9% 6.9% 6.6% 5.8%

1.4% 1.5% 1.4% 1.3%

7.1% 7.2% 6.8% 6.5%

4.1% 4.3% 3.9% 3.8%

7.2% 7.0% 6.3% 6.0%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 1,547)

FY 11-12(n= 1,539)

FY 12-13(n= 1,600)

FY 13-14(n= 1,647)

FY 10-11(n= 29,831)

FY 11-12(n= 29,701)

FY 12-13(n= 34,206)

FY 13-14(n= 38,800)

FY 10-11(n= 39,454)

FY 11-12(n= 40,593)

FY 12-13(n= 41,769)

FY 13-14(n= 43,318)

FY 10-11(n= 51,888)

FY 11-12(n= 53,450)

FY 12-13(n= 60,871)

FY 13-14(n= 64,738)

FY 10-11(n= 44,805)

FY 11-12(n= 45,907)

FY 12-13(n= 51,247)

FY 13-14(n= 55,841)

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

Penetration Rates by Race Children and Youth With At Least One SMHS Visit**, By Fiscal Year

4.4% 4.4% 4.0% 3.9%

5.4% 5.6% 5.0% 4.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 96,905)

FY 11-12(n= 99,484)

FY 12-13(n= 111,699)

FY 13-14(n= 121,269)

FY 10-11(n= 98,378)

FY 11-12(n= 100,751)

FY 12-13(n= 114,353)

FY 13-14(n= 124,539)

Female Male

Penetration Rates by Gender Children and Youth With At Least One SMHS Visit**, By Fiscal Year

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Penetration Rates* Report: Children and Youth With Five or More SMHS Visits**Sacramento County as of July 29, 2015

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

Children and

Youth with 5 or

more SMHS

Visits

Certified

Eligible

Children and

Youth

Penetration

Rate

All 8,079 195,283 4.1% 8,444 200,235 4.2% 8,519 226,052 3.8% 9,046 245,808 3.7%

Children 0-5 1,034 71,052 1.5% 971 71,280 1.4% 917 75,515 1.2% 950 78,338 1.2%

Children 6-11 2,891 50,890 5.7% 3,085 53,197 5.8% 3,137 64,549 4.9% 3,432 70,623 4.9%

Children 12-17 3,354 46,438 7.2% 3,463 46,600 7.4% 3,446 55,511 6.2% 3,617 60,379 6.0%

Youth 18-20 800 26,903 3.0% 925 29,158 3.2% 1,019 30,477 3.3% 1,047 36,468 2.9%

Alaskan Native or American Indian 89 1,547 5.8% 96 1,539 6.2% 88 1,600 5.5% 80 1,647 4.9%

Asian or Pacific Islander 346 29,831 1.2% 369 29,701 1.2% 385 34,206 1.1% 407 38,800 1.0%

Black 2,346 39,454 5.9% 2,406 40,593 5.9% 2,366 41,769 5.7% 2,371 43,318 5.5%

Hispanic 1,775 51,888 3.4% 1,905 53,450 3.6% 1,987 60,871 3.3% 2,044 64,738 3.2%

White 2,747 44,805 6.1% 2,773 45,907 6.0% 2,684 51,247 5.2% 2,885 55,841 5.2%

Other 305 18,340 1.7% 375 19,254 1.9% 452 24,711 1.8% 589 28,367 2.1%

Unknown 471 9,418 5.0% 520 9,791 5.3% 557 11,648 4.8% 670 13,097 5.1%

Female 3,529 96,905 3.6% 3,691 99,484 3.7% 3,716 111,699 3.3% 3,952 121,269 3.3%

Male 4,550 98,378 4.6% 4,753 100,751 4.7% 4,803 114,353 4.2% 5,094 124,539 4.1%

*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. **Children and Youth 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 10-11 FY 11-12 FY 12-13 FY 13-14

1.5% 1.4% 1.2% 1.2%

5.7% 5.8% 4.9% 4.9%

7.2% 7.4%

6.2% 6.0%

3.0% 3.2% 3.3% 2.9%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 71,052)

FY 11-12(n= 71,280)

FY 12-13(n= 75,515)

FY 13-14(n= 78,338)

FY 10-11(n= 50,890)

FY 11-12(n= 53,197)

FY 12-13(n= 64,549)

FY 13-14(n= 70,623)

FY 10-11(n= 46,438)

FY 11-12(n= 46,600)

FY 12-13(n= 55,511)

FY 13-14(n= 60,379)

FY 10-11(n= 26,903)

FY 11-12(n= 29,158)

FY 12-13(n= 30,477)

FY 13-14(n= 36,468)

Children 0-5 Children 6-11 Children 12-17 Youth 18-20

Penetration Rates by Age Children and Youth With Five or More SMHS Visits**, By Fiscal Year

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Penetration Rates* Report: Children and Youth With Five or More SMHS Visits**Sacramento County as of July 29, 2015

*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. **Children and Youth 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.

5.8% 6.2%

5.5% 4.9%

1.2% 1.2% 1.1% 1.0%

5.9% 5.9% 5.7% 5.5%

3.4% 3.6% 3.3% 3.2%

6.1% 6.0% 5.2% 5.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 1,547)

FY 11-12(n= 1,539)

FY 12-13(n= 1,600)

FY 13-14(n= 1,647)

FY 10-11(n= 29,831)

FY 11-12(n= 29,701)

FY 12-13(n= 34,206)

FY 13-14(n= 38,800)

FY 10-11(n= 39,454)

FY 11-12(n= 40,593)

FY 12-13(n= 41,769)

FY 13-14(n= 43,318)

FY 10-11(n= 51,888)

FY 11-12(n= 53,450)

FY 12-13(n= 60,871)

FY 13-14(n= 64,738)

FY 10-11(n= 44,805)

FY 11-12(n= 45,907)

FY 12-13(n= 51,247)

FY 13-14(n= 55,841)

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

Penetration Rates by Race Children and Youth With Five or More SMHS Visits**, By Fiscal Year

3.6% 3.7% 3.3% 3.3%

4.6% 4.7% 4.2% 4.1%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY 10-11(n= 96,905)

FY 11-12(n= 99,484)

FY 12-13(n= 111,699)

FY 13-14(n= 121,269)

FY 10-11(n= 98,378)

FY 11-12(n= 100,751)

FY 12-13(n= 114,353)

FY 13-14(n= 124,539)

Female Male

Penetration Rates by Gender Children and Youth With Five or More SMHS Visits**, By Fiscal Year

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Utilization Report*: Approved Specialty Mental Health Services for Children and YouthMean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year**

Sacramento County as of July 29, 2015

Fiscal Year SDMC Total Approved IHBS

(Minutes) ICC

(Minutes)

Case Management/Brokerage (Minutes)

Mental Health Services (Minutes)

Therapeutic Behavioral Services

(Minutes)

Medication Support Services

(Minutes)

Crisis Intervention (Minutes)

Crisis Stabilization (Hours)

Full Day Treatment Intensive (Hours)

Full Day Rehabilitation

(Hours)

Hospital Inpatient (Days)***

Hospital Inpatient Admin (Days)***

Crisis Residential Treatment Services

(Days)

Adult Residential Treatment Services

(Days)

Psychiatric Health Facility

(Days)

FY 10-11 5,699.75$ 0 0 597 1915 2725 323 111 8 732 834 N/A N/A 14 0 11FY 11-12 5,168.80$ 0 0 524 1738 2724 308 102 16 630 777 N/A N/A 13 0 5FY 12-13 5,186.29$ 0 0 481 1748 3049 324 110 13 630 609 N/A N/A 19 0 12FY 13-14 5,025.96$ 1160 569 480 1691 2575 325 97 12 615 602 N/A N/A 18 0 12MEAN 5,270.20$ 1160 569 520 1773 2768 320 105 12 652 705 N/A N/A 16 0 10

*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. ***This data will be available in June, 2016^ Data has been suppressed to protect patient privacy. of 14

$5,699.75 $5,168.80 $5,186.29 $5,025.96

$-

$1,000.00

$2,000.00

$3,000.00

$4,000.00

$5,000.00

$6,000.00

FY 10-11(n = 9,663)

FY 11-12(n = 10,133)

FY 12-13(n = 10,291)

FY 13-14(n = 10,810)

Total Approved Per Unique Beneficiary By Service Fiscal Year

0 0 0

1,160

0

200

400

600

800

1,000

1,200

1,400

FY 10-11(n = )

FY 11-12(n = )

FY 12-13(n = )

FY 13-14(n = 149)

IHBS Minutes Per Unique Beneficiary By Service Fiscal Year

0 0 0

569

0

100

200

300

400

500

600

FY 10-11(n = )

FY 11-12(n = )

FY 12-13(n = )

FY 13-14(n = 213)

ICC Minutes Per Unique Beneficiary By Service Fiscal Year

597 524

481 480

0

100

200

300

400

500

600

700

FY 10-11(n = 7,771)

FY 11-12(n = 7,824)

FY 12-13(n = 7,451)

FY 13-14(n = 8,199)

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

1,915 1,738 1,748 1,691

0

500

1,000

1,500

2,000

2,500

FY 10-11(n = 9,310)

FY 11-12(n = 9,792)

FY 12-13(n = 10,006)

FY 13-14(n = 10,476)

Mental Health Services Minutes Per Unique Beneficiary By Service Fiscal Year

2,725 2,724 3,049

2,575

0

500

1,000

1,500

2,000

2,500

3,000

3,500

FY 10-11(n = 309)

FY 11-12(n = 297)

FY 12-13(n = 300)

FY 13-14(n = 332)

Therapeutic Behavioral Services Minutes Per Unique Beneficiary By Service Fiscal Year

323 308

324 325

0

50

100

150

200

250

300

350

FY 10-11(n = 3,399)

FY 11-12(n = 3,574)

FY 12-13(n = 3,646)

FY 13-14(n = 3,917)

Medication Support Services Minutes Per Unique Beneficiary By Service Fiscal Year

111 102

110 97

0

20

40

60

80

100

120

FY 10-11(n = 251)

FY 11-12(n = 269)

FY 12-13(n = 249)

FY 13-14(n = 185)

Crisis Intervention Minutes Per Unique Beneficiary By Service Fiscal Year

8.2

16.1

13.3 12.1

0

2

4

6

8

10

12

14

16

18

FY 10-11(n = 248)

FY 11-12(n = 153)

FY 12-13(n = 312)

FY 13-14(n = 288)

Crisis Stabilization Hours Per Unique Beneficiary By Service Fiscal Year

Utilization Report*: Approved Specialty Mental Health Services for Children and YouthMean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year**

Sacramento County as of July 29, 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 children/youth that received the SMHS represented in their respective graph by Fiscal Year. ***This data will be available in June, 2016^ Data has been suppressed to protect patient privacy. of 14

732

630 630 615

0

100

200

300

400

500

600

700

800

FY 10-11(n = 33)

FY 11-12(n = 32)

FY 12-13(n = 43)

FY 13-14(n = 47)

Full Day Treatment Intensive Hours Per Unique Beneficiary By Service Fiscal Year

834 777

609 602

0

100

200

300

400

500

600

700

800

900

FY 10-11(n = ^)

FY 11-12(n = ^)

FY 12-13(n = ^)

FY 13-14(n = ^)

Full Day Rehabilitation Hours Per Unique Beneficiary By Service Fiscal Year

Hospital Inpatient Days Per Unique Beneficiary By Service Fiscal Year

Hospital Inpatient Admin Days Per Unique Beneficiary By Service Fiscal Year

14.0 13.4

19.2 18.0

0

5

10

15

20

25

FY 10-11(n = ^)

FY 11-12(n = ^)

FY 12-13(n = 13)

FY 13-14(n = 14)

Crisis Residential Treatment Services Days Per Unique Beneficiary

By Service Fiscal Year

0 0 0 0 00000111111

FY 10-11(n = )

FY 11-12(n = )

FY 12-13(n = )

FY 13-14(n = )

Adult Residential Treatment Services Days Per Unique Beneficiary

By Service Fiscal Year

10.8

5.2

11.9 12.1

0

2

4

6

8

10

12

14

FY 10-11(n = 26)

FY 11-12(n = 43)

FY 12-13(n = 107)

FY 13-14(n = 90)

Psychiatric Health Facility Days Per Unique Beneficiary By Service Fiscal Year

Snapshot Report: Unique Count of Children and Youth Receiving SMHS

Arriving, Exiting, and with Service Continuance by Fiscal YearSacramento County as of August 3, 2015

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 3,007 29.5% 880 8.6% 973 9.6% 2,113 20.8% 2,680 26.3% 529 5.2% 10,182 100%

FY 13-14 2,988 27.9% 949 8.8% 1,103 10.3% 2,294 21.4% 2,775 25.9% 618 5.8% 10,727 100%

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.)

Children/Youth that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year.

Children/Youth receiving continuous services with no breaks in service greater than 90 days for a period of at least 2 years (>= 2 YR) or a period of 1 to 2 years (< 2 YR).

Children/Youth that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year.

A distinct category in which children/youth met both the criteria for Arrivals and Exiting above for the fiscal year.

A distinct category in which Children/Youth had at least 2 years of Service Continuance going into the Fiscal Year and then Exited within the same Fiscal Year.

30%

9%

10% 21%

26%

5%

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

28%

9%

10% 21%

26%

6%

Fiscal Year 13-14 Arrivals, Service Continuance, & Exits Distribution

Arrivals

Service Continuance(>= 2 YR)

Service Continuance(< 2 YR)

Exiting

Arriving & Exiting

Service Continuance (>= 2 YR) & Exiting

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Time to Step Down Report: Children and Youth Stepping Down in SMHS Services Post Inpatient DischargeSacramento County as of July 28, 2015

Service FY

Count of Inpatient

Discharges with Step

Down within 7 Days

of Discharge

Percentage of

Inpatient

Discharges with

Step Down within

7 Days of

Discharge

Count of Inpatient

Discharges with

Step Down within

30 Days of

Discharge

Percentage of

Inpatient

Discharges with

Step Down within

30 Days of

Discharge

Count of Inpatient

Discharges with a

Step Down > 30

Days from

Discharge

Percentage of

Inpatient

Discharges with a

Step Down > 30

Days from

Discharge

Count of Inpatient

Discharges with

No Step Down*

Percentage of

Inpatient

Discharges with

No Step Down*

Minimum Number

of Days between

Discharge and

Step Down

Maximum

Number of Days

between

Discharge and

Step Down

Mean Time to

Next Contact Post

Inpatient

Discharge

(Days)

Median Time to

Next Contact Post

Inpatient

Discharge

(Days)

FY 10-11 613 58.0% 787 74.5% 177 16.8% 92 8.7% 0 1402 52.9 3

FY 11-12 693 56.8% 884 72.4% 239 19.6% 98 8.0% 0 1303 42.0 3

FY 12-13 935 67.0% 1,136 81.4% 150 10.7% 110 7.9% 0 910 23.5 1

FY 13-14 992 61.2% 1,266 78.1% 192 11.8% 164 10.1% 0 486 18.5 2

3 3

1 2

0123456789

101112

FY 10-11 FY 11-12 FY 12-13 FY 13-14

Median Time Between Inpatient Discharge and Step Down Service in Days

52.9

42.0

23.5 18.5

0

10

20

30

40

50

60

FY 10-11 FY 11-12 FY 12-13 FY 13-14

Mean Time Between Inpatient Discharge and Step Down Service in Days

58.0% 56.8% 67.0% 61.2%

16.5% 15.6% 14.4% 16.9%

16.8% 19.6% 10.7% 11.8% 8.7% 8.0% 7.9% 10.1%

0%

20%

40%

60%

80%

100%

FY 10-11( 818 Unique Beneficiaries with

1,056 Total Inpatient Discharges )

FY 11-12( 947 Unique Beneficiaries with

1,221 Total Inpatient Discharges )

FY 12-13( 1,080 Unique Beneficiaries with 1,396 Total Inpatient Discharges )

FY 13-14( 1,272 Unique Beneficiaries with 1,622 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

* 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.

**Sacramento reports data discrepancies in the data reported on page 14, Post Inpatient Discharge-Time to Step Down Report between the State's data and Sacramento County's data. The State's reported percent of distribution of inpatient discharges is consistent with Sacramento's data however there are discrepancies in the discharge N's. Additional analysis of these discrepancies is needed to ensure that all data reflected in the chart is consistent between the State and the County.

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