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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
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
  • 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

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?

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
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