Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth
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Transcript of Behavioral Health Services to DFCS CUSTODY FOSTER CARE Youth
MHDDAD G-5 with DFCS Regional DirectorsAugust 7, 2008
BEHAVIORAL HEALTH SERVICES TO DFCS CUSTODY FOSTER CARE YOUTH
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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?
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Data from DFCS
DFCS Custody Youth in Foster Care as of 3/31/08
• 11,175 youth
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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 4
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
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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.
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Matching Procedures for DFCS RBWO and MHDDAD MICP files 3 matching variables
1. SSN (800+ DFCS youth had no SSN)2. First 3 letters of first name + first three letters
of last name + DOB (the “twins” problem)3. First 3 letters of last name + last 4 digits of
SSN
Match (deterministic) = match on one or more of the matching variables
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DFCS Custody Youths in Foster Care
MICP – MRO Claims – State Encounters Analysis
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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
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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
“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)
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Current “Unknowns” about DFCS Custody Foster Care Youth without MICP authorizationsOf 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?
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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)
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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
services13
Core Service Providers
DFCS regional breakout provided on separate sheets
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Diagnostic Categories (Axis I Primary) of Foster Care Youth with MICP AuthorizationsConduct DisordersConduct Disorders 32.4%32.4%
Affective DisordersAffective Disorders 28.5%28.5%
Anxiety DisordersAnxiety Disorders 9.6%9.6%
Childhood DisordersChildhood Disorders 5.9%5.9%
All OthersAll Others 23.6%23.6%
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Top Diagnoses (Axis I Primary) of Foster Care Youth with MICP AuthorizationsADHD, combined type (314.01)ADHD, combined type (314.01) 25.5%25.5%
Oppositional Defiant (313.81)Oppositional Defiant (313.81) 13.8%13.8%
PTSD (309.81)PTSD (309.81) 7.2%7.2%
Adj. Disorder w/Emotions & Conduct Adj. Disorder w/Emotions & Conduct (309.4)(309.4)
4.5%4.5%
Depressive Disorder NOS (311)Depressive Disorder NOS (311) 4.5%4.5%
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CAFAS Types
Thought Problems 14%
Maladaptive Substance Use 7%
Self Harmful Potential 13%
Delinquent Behavior 21%
Behav Prob – Mild Mood 30%
Behav Prob 12%
Mod Mood/Mild Behav 3%
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DFCS Custody Youths
PRTF Analysis
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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
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PRTF: Average Daily Census
DFCS Custody Total
October 159 239
November 163 250
December 160 252
January 153 251
February 144 247
March 138 248
April 142 252
May 140 251
June 137 255
Total 149 24920
PRTF: Length of Time in Treatment, June 30, 2008
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DFCS Custody
Total
N 141 261
Median 269 250
Mean 344 316
Min 4 1
Max 1,987 1,987