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Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth

Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth. MHDDAD G-5 with DFCS Regional Directors August 7, 2008. What questions are we asking?.

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Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth

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  1. Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth MHDDAD G-5 with DFCS Regional Directors August 7, 2008

  2. What questions are we asking? • Purpose is to provide DFCS Regional Directors with snapshot of DFCS custody youth in their region involved with DMHDDAD’s community behavioral health services. • How many kids? • How many authorized for MH/AD services? • How many receiving (billed) MH/AD services? • What is the intensity (amount) of service provided? • Who are the providers of behavioral health services? • What sort of behavioral health problems are being treated?

  3. Data from DFCS DFCS Custody Youth in Foster Care as of 3/31/08 • 11,175 youth

  4. MHDDAD Data • MICP Service Authorizations active in FY08 for consumers <=23 • MRO claims for service date 7/1/07-6/30/08 matching these authorizations • State encounters for service date 7/1/07-6/30/08 matching these authorizations • PRTF spreadsheets maintained by regional offices (analyzed separately) NOTE: All data current through June 2008 processing period. State Hospital data not yet included as part of the analysis

  5. MH service language • MICP –the form for authorizing MH services • MICP authorizations—reflects the number and types of services authorized • MRO claims—services billed through the Medicaid Rehab. Option • State claims—MH services billed non-Medicaid

  6. Note on MRO Claims and State Encounters • Providers have 180 days from date of service to submit claim/encounter • DMHDDAD community service data for FY08 will not be considered final until 2009.

  7. Matching Procedures for DFCSRBWO and MHDDADMICP files • 3 matching variables • SSN (800+ DFCS youth had no SSN) • First 3 letters of first name + first three letters of last name + DOB (the “twins” problem) • First 3 letters of last name + last 4 digits of SSN • Match (deterministic) = match on one or more of the matching variables

  8. DFCS Custody Youths in Foster CareMICP – MRO Claims – State Encounters Analysis

  9. 4,696 (or 42%) of DFCS custody foster care youths had MICP authorizations Analysis in March indicated that 3,936 RBWO youths had MICP authorizations Estimated prevalence for mental disorders among Medicaid-eligible foster care youth = 57% S. dosReis, et al. (July 2001) “Mental Health Services for Youths in Foster Care and Disabled Youths,” American Journal of Public Health

  10. “MICP Penetration” by DFCS Region • “Region” based upon county listed in DFCS file • Highest penetration rate • DFCS Region 8 (53%) (Columbus/Americus) • Lowest penetration rate • DFCS Region 7 (28%) (Augusta) • DFCS Region 12 (34%) (Savannah)

  11. Current “Unknowns” about DFCS Custody Foster Care Youth without MICP authorizations Of the 6,479 youth in foster care without a MICP authorization: • How many receive mental health services through the Medicaid psychology program? • How many did not require behavioral health services?

  12. 4,108 youths in foster care (87% of those authorized) with MRO claims or state encounters in FY08 • Of the 4,108 consumers with community claims/encounters: • 91% of consumers had only MRO claims (no state encounters) • 3,871 (94%) had claims/encounters for core services • 657 (16%) had claims/encounters for intensive family intervention (IFI)

  13. Service Penetration by DFCS Region • Consumers receiving core services varies from 85% – 99% • Of those receiving core services, most likely to receive dx assessment, physician services, and individual counseling • IFI - Highest in metro Atlanta, where most IFI services exist • DFCS Region 14 (DeKalb) – 39% of consumers receive IFI • Little to no utilization of other specialty services

  14. Core Service Providers • DFCS regional breakout provided on separate sheets

  15. Diagnostic Categories (Axis I Primary) of Foster Care Youth with MICP Authorizations

  16. Top Diagnoses (Axis I Primary) of Foster Care Youth with MICP Authorizations

  17. CAFAS Types

  18. DFCS Custody Youths PRTF Analysis

  19. Notes on PRTF data • Utilization pulled from regional spreadsheets • DFCS custody and region based upon designation in spreadsheet, not matching • Missing admission dates – supplemented with APS initial auth date when available • Length of time treatment – based upon original admission date

  20. PRTF: Average Daily Census

  21. PRTF: Length of Time in Treatment, June 30, 2008

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