Expenditures & Utilization Tracking Update Joint LOC on MH/DD/SAS November 9, 2010
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1 & Utilization Tracking Update Joint LOC on MH/DD/SAS November 9, 2010 Division of Medical Assistance Kelly Crosbie, LCSW Behavioral Health Manager 1
2 SFY 2010 DMA Utilization & Tracking Per LOC request: update on utilization/expenditures that exceed 5% (increase or decrease) Comparison of SFY10 Q4 to SFY11 YTD Request that report be given quarterly Uneven monthly reports based on paid claims 2
3 Children s Services Community Support Intensive In-Home Multisystemic Therapy (MST) 3
4 Community Support-Child Community Support - Individual Child $30,000,000 $25,000,000 $20,000,000 $15,000,000 $10,000,000 $5,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 4
5 Community Support-Child Community Support - Individual Child 25,000 20,000 15,000 10,000 5,000 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 5
6 Community Support-Child are down 43% = $1.4 million/month (less) ~2500 fewer children per month ~ 6400 children still receive this service Service ends December 31,
7 Intensive In-Home Intensive In-Home $25,000,000 $20,000,000 $15,000,000 $10,000,000 $5,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 7
8 Intensive In-Home Intensive In-Home 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 8
9 Intensive In-Home are up 12.7% = $2 million/month (more) Increase of ~700 children per month Clinically appropriate transfers from CS and Level III, IV 9
10 Day Treatment Child and Adolescent Day Treatment $8,000,000 $7,000,000 $6,000,000 $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 10
11 Day Treatment Child and Adolescent Day Treatment 3,000 2,500 2,000 1,500 1, Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 11
12 Day Treatment are down 17.3% = $1 million/month (less) Less ~450 children/month Stricter policy criteria updated eligibility guidelines increased clinical staffing requirements 12
13 Multisystemic Therapy (MST) Multisystemic Therapy $1,000,000 $800,000 $600,000 $400,000 $200,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 13
14 Multisystemic Therapy (MST) Multisystemic Therapy Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 14
15 Multisystemic Therapy (MST) are up 13.7% = $98,000/month (more) 30 more children/month Growth is + Evidence-based practice with outcome metrics 15
16 Adult Services Community Support Community Support Team Assertive Community Treatment Team (ACTT) Psychosocial Rehabilitation (PSR) 16
17 Community Support Adult Community Support - Individual Adult $14,000,000 $12,000,000 $10,000,000 $8,000,000 $6,000,000 $4,000,000 $2,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 17
18 Community Support-Adults Community Support - Individual Adult 30,000 25,000 20,000 15,000 10,000 5,000 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 18
19 Community Support-Adults are down 35% = $407,000/month (less) ~800 fewer adults per month ~ 2600 adults still receive this service Trend continues downward Service ends December 31,
20 Community Support Team (CST) Community Support Team $25,000,000 $20,000,000 $15,000,000 $10,000,000 $5,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 20
21 Community Support Team (CST) Community Support Team 12,000 10,000 8,000 6,000 4,000 2,000 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 21
22 Community Support Team (CST) are down 28% = $5.5 million/month (less) ~ 390 fewer adults per month Trend continues downward New policy changes included: more clinical staffing, decrease in unit limits/month, rate decrease 22
23 Assertive Community Treatment Team (ACTT) Assertive Community Treatment Team H0040 $4,500,000 $4,000,000 $3,500,000 $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 09 SFY 10 SFY 11 23
24 Assertive Community Treatment Team (ACTT) Assertive Community Treatment Team H0040 3,000 2,000 1,000 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 09 SFY 10 SFY 11 24
25 Assertive Community Treatment Team (ACTT) have increased 7.4% = $211,000/month (more) ~ 60 more adults per month + Growth Evidence-based service 25
26 Psychosocial Rehabilitation (PSR) Psychosocial Rehab H2017 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 09 SFY 10 SFY 11 26
27 Psychosocial Rehabilitation (PSR) Psychosocial Rehab H2017 2,500 2,000 1,500 1, Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 09 SFY 10 SFY 11 27
28 Psychosocial Rehabilitation (PSR) have increased 11.3% =$187,000/month (more) ~200 more adults per month May be referrals from CS-Adult or CST Clinically appropriate 28
29 Children & Adult Services Substance Abuse Intensive Outpatient (SAIOP) Mobile Crisis I/DD Targeted Case Management (CAP waiver & non-waiver) 29
30 Substance Abuse Intensive Outpatient (SAIOP) Substance Abuse Intensive Outpt Program $700,000 $600,000 $500,000 $400,000 $300,000 $200,000 $100,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 30
31 Substance Abuse Intensive Outpatient (SAIOP) Substance Abuse Intensive Outpt Program Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 31
32 Substance Abuse Intensive Outpatient (SAIOP) are up 25% =$100,000/month (more) ~90 more recipients per month + Growth New policy guidelines allowed for a 30-day pass-through before prior authorization is required 32
33 Mobile Crisis Management Mobile Crisis Management $400,000 $350,000 $300,000 $250,000 $200,000 $150,000 $100,000 $50,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 33
34 Mobile Crisis Management Mobile Crisis Management 1, Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 34
35 Mobile Crisis Management have increased 26% =$68,000/month (more) ~120 more recipients per month Should divert from emergency departments and inpatient 35
36 I/DD Targeted Case Management (CAP & non-waiver) Targeted Case Management-DD (All) $7,000,000 $6,000,000 $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 $0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 36
37 I/DD Targeted Case Management (CAP and non-waiver) Targeted Case Management-DD (All) 17,500 15,000 12,500 10,000 7,500 5,000 2,500 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun SFY 10 SFY 11 37
38 I/DD Targeted Case Management (CAP & non-waiver) are down 19.3% =$334,000/month (less) CAP recipients (in case management) have increased 3% ~150 more CAP recipients per month Non-waiver recipients (in case management) have decreased 7% ~170 less recipients per month # of I/DD case management recipients is fairly static Decreased expenditures likely to 3 unit/month limit Limit phases-out with weekly case rate 38
39 Questions 39
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