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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
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


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 MRO claims or state encounters in FY08DFCS 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 MRO claims or state encounters in FY08

  • DFCS regional breakout provided on separate sheets




Cafas types
CAFAS with Types


Dfcs custody youths prtf analysis
DFCS with Custody Youths PRTF Analysis


Notes on prtf data
Notes on with 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 with : Average Daily Census


Prtf length of time in treatment june 30 2008
PRTF with : Length of Time in Treatment, June 30, 2008


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