Health and Human Services

20 North San Pedro Road, Ste 2028

San Rafael, CA 94903

415 473 3696 T / 415 473 3344 F

marinhhs.org

Photo Credit: Jeff Wong

MARIN BEHAVIORAL HEALTH AND RECOVERY SERVICES

SUZANNE TAVANO, PHN ,PHDDIRECTOR

Marin CountyCounty Characteristics

• 2016 Population estimate: 260,651 -- 26th

largest California county.

• Population resides in cities along the 101 Freeway corridor. Majority of county is

open space.

• Ranked among the healthiest counties, as well as one of the most expensive.

• Medi-Cal insures 17% of overall population, 34% of children aged 0 – 5.

Race and Hispanic Origin (%)

White alone 85.7%

Black or African American 2.8%

American Indian and Alaska Native 1.0%

Asian 6.3%

Native Hawaiian and Other Pacific Islander 0.2%

Two or More Races 3.9%

Hispanic or Latino 16.0%

White alone, not Hispanic or Latino 71.9%

Behavioral Health & Recovery Services Network Adequacy and Array of Services

Behavioral Health & Recovery Services Service Flow

Access and Assessment

Third Party Payer

Marin Behavioral Health& Recovery Services

(serious to severe)

Adult Outpatient

Youth and Family Outpatient

External Provider Network

Full Service Partnerships

Outreach & Engagement

TransitionMobile Crisis

Psychiatric Emergency Services

Hospital

Crisis Services

Planned Services

New Clients

Beacon(mild to moderate)

Medi-Cal BeneficiariesMC Eligible vs MC Clients Served by Race/ Ethnicity: Under 18

64%

20%

4%

6%6%

67%

19%

4%

5%5%

68%

18%

4%

5%

5%

Hispanic Caucasian or White

Black or African American Other

Unknown / Not Reported

FY14/15

FY15/16

FY16/17

Medi-Cal

Beneficiaries

Children

N~12,000

Children and Youth

59%21%

11%

7% 2%

58%24%

10%

5%3%

60%22%

9%

5%4%

Hispanic Caucasian or White

Black or African American Other

Unknown / Not Reported

FY14/15

FY15/16

FY16/17

Medi-Cal

Beneficiaries

Served

Children

N~460

Medi-Cal BeneficiariesMC Eligible vs MC Clients Served by Race/ Ethnicity: 18 and Older

36%

44%

6%

8%

6%

38%

43%

5%

8%

6%

39%

42%

5%

8%

6%

Hispanic Caucasian or White

Black or African American Other

Unknown / Not Reported

FY14/15

FY15/16

FY16/17

Medi-Cal

Beneficiaries

Adult

N~30,000

Adult

15%

65%

9%

9%2%

17%

63%

8%

8%

4%15%

65%

8%

9%

3%

Hispanic Caucasian or White

Black or African American Other

Unknown / Not Reported

FY14/15

FY15/16

FY16/17

Medi-Cal

Beneficiaries

Served

Adult

N~1,870

Medi-Cal BeneficiariesFull Scope MediCal vs Restricted MC by Race/ Ethnicity

14840 14952

2084 2966 2453

5855 (28%)

274 (1.8%)

23 (1.1%)107 (3.4%)

71 (2.8%)

0

5000

10000

15000

20000

25000

Hispanic Caucasian or

White

Black or African

American

Other Unknown / Not

Reported

# o

f M

C b

en

efic

iarie

sMedi-Cal Beneficiaries - April 2017

Race & Ethnicity

Full Scope MC Restricted MC

Medi-Cal BeneficiariesMedi-Cal Beneficiaries Trend Line: FY 12/13 to FY 16/17

85.4%87.1%

88.7%85.8%

81.5%

65.2%

75.9%

82.1%84.0%

84.0%

50%

60%

70%

80%

90%

100%

FY1213 FY1314 FY1415 FY1516 FY1617

Marin’s Medi-Cal Beneficiaries: Impact of ACA on

Insurance Status

Child (<18) Adult Overall

ACA Jan-14

Medi-Cal Beneficiaries Served FY 2012-2017

FY1213 FY1314 FY1415 FY1516 FY1617

Child (<18) 85.4% 87.1% 88.7% 85.8% 81.5%

Adult 65.2% 75.9% 82.1% 84.0% 84.0%

Overall 70.1% 78.6% 83.4% 84.3% 83.5%

2017 Triennial Review Results SummarySystem Review

Total Number of Requirements Reviewed: 216 (with 5 Attestation Items)

Total Number of SURVEY ONLY Requirements: 16Total Number of Requirements Partial or OOC: 10 out of 200 (16 survey only items not included in calculation)

Overall Percentage of Compliance: 95%

REVIEW SECTION

# COMPLIANT

ITEMS/TOTAL ITEMS

REVIEWED

Attestation 5/5

Network Adequacy

and Array of

Services

14/14

Access 42/48

Authorization 24/26

Beneficiary

Protection 24/25

Interface with

Physical Health

Care

6/6

Provider Relations 6/6

Program Integrity 19/19

Quality

Improvement30/30

Mental Health

Services Act20/21

IN COMPLIANCE %

2017 Triennial Review Results SummaryChart Review

Total Number of Claims Reviewed: 487Total Number of Claims Allowed: 451Total Number of Claims Disallowed: 36

Overall Percentage of Compliance: 92.6%

REVIEW SECTION

# COMPLIANT

ITEMS/TOTAL

ITEMS REVIEWED

Medical

Necessity18/20

Assessment 250/250

Medication

Consent132/192

Client Plan 246/260

Progress

Notes3269/3409

Cultural

Competency/

Alternative

Format

4/5

IN COMPLIANCE %

Increased Data Quality

POQI (Adults)N=221 May 2017

POQI SurveyResponse Trend

Note: During the POQI week of May 2017, the number of responses was lower than usual because many staff was participating on mandatory trainings during the same week as POQI.

302 293318

357 350

323

258

440

28 15 24 17 17

0

50

100

150

200

250

300

350

400

450

500

May-14 Nov-14 May-15 Nov-15 May-16 Nov-16 May-17 Nov-17

# R

esp

on

ses

POQI Response Trend

Total Responses Spanish Responses

Customer Satisfaction SurveyCrisis Continuum & Access Team

Crisis Continuum - Mobile Crisis Response & Transition teams

83%

9%

8%

Overall Satisfaction

Satisfied Neutral Dissatisfied

N=73

19%

8%

23%

29%

21%

0% 10% 20% 30%

Went to Psychiatric Emergency

Went to a hospital ER

Call Law Enforcement

Not access any services at all

Other

Q10: If these services were not available at the

time you used them, would you:

Access Team

14

28 2830

36

28 29

11

20

14

27

3

05

10152025303540

Jan

-17

Feb

-17

Mar

-17

Ap

r-1

7

May

-17

Jun

-17

Jul-

17

Au

g-1

7

Sep

-17

Oct

-17

No

v-1

7

De

c-1

7

# o

f p

arti

cip

ants

Client Satisfaction Survey Total Responses

(N=268)

0% 0% 3%8%

89%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Very

Dissatisfied

Somewhat

Dissatisfied

Neither

Satisfied nor

Dissatisfied

Somewhat

Satisfied

Very Satisfied

Overall, how satisfied are you with your

assessment/services today?

Impact of the Three New TeamsCommunity Crisis Response Teams - (12/31/2017)

1,851Individuals treated by the three teams

8,807Services provided by the three teams

MCR O&ET

• Majority of contacts initiated by

Family/ Friends and Law

Enforcement

• Reduced use of acute and crisis

services (hospital, CSU,

detoxification) and increased

use of planned services

(medication support, case

management and FSP)

Three New Mobile TeamsService Counts - (12/31/2017)

85 238503

7541153

1684

2171

2795

3400

3991

4527

5014

110143223 260 312 355 409 467 512 545

Ma

r-1

5

Jun

-15

Se

p-1

5

De

c-1

5

Ma

r-1

6

Jun

-16

Se

p-1

6

De

c-1

6

Ma

r-1

7

Jun

-17

Se

p-1

7

De

c-1

7

Transition Team: Count of Contact

(Mar 2015 to Dec 2017)

# of Contact # of Unique Client

19 49 98169

336

493599

758

905998

12001333

106

129 148 158 169 178 183 207 229

Ma

r-1

5

Jun

-15

Se

p-1

5

De

c-1

5

Ma

r-1

6

Jun

-16

Se

p-1

6

De

c-1

6

Ma

r-1

7

Jun

-17

Se

p-1

7

De

c-1

7

Outreach & Engagement: Count of Contact

(Feb 2015 to Dec 2017)

# of Contact # of Unique Client

64

276

518

864

1186

14801655

1903

2208

2460

283426

543668 738

857963

1077

Se

p-1

5

De

c-1

5

Ma

r-1

6

Jun

-16

Se

p-1

6

De

c-1

6

Ma

r-1

7

Jun

-17

Se

p-1

7

De

c-1

7

Mobile Crisis Response Team: Count of Contact

(July 2015 to Dec 2017)

# of Contact # of Unique Client

50142460

1333

Transition

MCRT

O&E

8,807Total Contacts

Reducing CrisesTransition Team (n = 422) Mar 2015 – Dec 2017

T

Monthly Data Report Access Line Analysis – October 2017

Monthly Data Report Crisis Stabilization Unit – September 2017

Behavioral Health & Recovery Services Website Redesign

Staff SurveyBHRS Town Hall Follow Up – April 2017

Yes

46%No

54%

Q1: Did you attend the

Monday 4/10 Town Hall?

21%

45%

5%10%

33%

Too busy Scheduling

conflict

Not Interested Didn't know

about it

N/A--I was there

0%

10%

20%

30%

40%

50%

Q2: If you did not attend, what caused you to miss

it?

53%

44%

11%

39%

I learned something

It helped improve communication

It wasn't useful

It would have been better if …

0% 10% 20% 30% 40% 50% 60%

Q3: If you attended, what did you think of the Town Hall?

N=70

Increasing the Availability of Relevant Information BHRS INTRAWEB - Soft launch in Jan 2018