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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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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

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?


Data from dfcs

Data from DFCS

DFCS Custody Youth in Foster Care as of 3/31/08

  • 11,175 youth


Mhddad data

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


Mh service language

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


Note on mro claims and state encounters

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.


Matching procedures for dfcs rbwo and mhddad micp files

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


Dfcs custody youths in foster care micp mro claims state encounters analysis

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


Behavioral health services to dfcs custody foster care youth

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


Micp penetration by dfcs region

“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)


Current unknowns about dfcs custody foster care youth without micp authorizations

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?


Behavioral health services to dfcs custody foster care youth

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)


Service penetration by dfcs region

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


Core service providers

Core Service Providers

  • DFCS regional breakout provided on separate sheets


Diagnostic categories axis i primary of foster care youth with micp authorizations

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


Top diagnoses axis i primary of foster care youth with micp authorizations

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


Cafas types

CAFAS Types


Dfcs custody youths prtf analysis

DFCS Custody Youths PRTF Analysis


Notes on prtf data

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


Prtf average daily census

PRTF: Average Daily Census


Prtf length of time in treatment june 30 2008

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


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