MARIN BEHAVIORAL HEALTH AND RECOVERY SERVICES

Transcription

1 MARIN BEHAVIORAL HEALTH AND RECOVERY SERVICES SUZANNE TAVANO, PHN,PHD D I R E CTOR Photo Credit: Jeff Wong Health and Human Services 20 North San Pedro Road, Ste 2028 San Rafael, CA T / F marinhhs.org

2 Marin County County Characteristics 2016 Population estimate: 260, th 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%

3 Behavioral Health & Recovery Services Network Adequacy and Array of Services

4 Behavioral Health & Recovery Services Service Flow New Clients Access and Assessment Marin Behavioral Health & Recovery Services (serious to severe) Beacon (mild to moderate) Third Party Payer Adult Outpatient Youth and Family Outpatient External Provider Network Planned Services Full Service Partnerships Crisis Services Outreach & Engagement Transition Mobile Crisis Psychiatric Emergency Services Hospital

5 Medi-Cal Beneficiaries MC Eligible vs MC Clients Served by Race/ Ethnicity: Under 18 Children and Youth 4% 4% 5% 5% 6% 5% 5% 6% 9% 10% 5% 4% 5% 3% 7% 2% 18% 19% 20% 4% Medi-Cal Beneficiaries Children N~12,000 FY14/15 64% 67% 68% 22% 21% 24% 11% Medi-Cal Beneficiaries Served Children N~460 FY14/15 59% 58% 60% FY15/16 FY15/16 FY16/17 FY16/17 Hispanic Black or African American Unknown / Not Reported Caucasian or White Other Hispanic Black or African American Unknown / Not Reported Caucasian or White Other

6 Medi-Cal Beneficiaries MC Eligible vs MC Clients Served by Race/ Ethnicity: 18 and Older Adult 5% 5% 8% 6% 8% 8% 6% 6% 6% Medi-Cal Beneficiaries Adult N~30,000 38% 39% 36% 8% 8% 9% 9% 8% 3% 4% 9% 2% 15% 17% Medi-Cal Beneficiaries Served Adult N~1,870 15% 65% 43% 42% 44% FY14/15 FY15/16 FY16/17 FY14/15 FY15/16 FY16/17 63% 65% Hispanic Black or African American Unknown / Not Reported Caucasian or White Other Hispanic Black or African American Unknown / Not Reported Caucasian or White Other

7 # of MC beneficiaries Medi-Cal Beneficiaries Full Scope MediCal vs Restricted MC by Race/ Ethnicity Medi-Cal Beneficiaries - April 2017 Race & Ethnicity (28%) (1.8%) (1.1%) 107 (3.4%) 71 (2.8%) 0 Hispanic Caucasian or White Black or African American Other Unknown / Not Reported Full Scope MC Restricted MC

8 Medi-Cal Beneficiaries Medi-Cal Beneficiaries Trend Line: FY 12/13 to FY 16/17 Marin s Medi-Cal Beneficiaries: Impact of ACA on Insurance Status 100% ACA Jan-14 90% 85.4% 87.1% 88.7% 85.8% 80% 82.1% 84.0% 84.0% 81.5% 70% 75.9% 60% 65.2% 50% FY1213 FY1314 FY1415 FY1516 FY1617 Child (<18) Adult Overall Medi-Cal Beneficiaries Served FY 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%

9 2017 Triennial Review Results Summary System Review Total Number of Requirements Reviewed: 216 (with 5 Attestation Items) Total Number of SURVEY ONLY Requirements: 16 Total 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 IN COMPLIANCE % # COMPLIANT ITEMS/TOTAL ITEMS REVIEWED Attestation 5/5 Network Adequacy and Array of 14/14 Services Access 42/48 Authorization 24/26 Beneficiary 24/25 Protection Interface with Physical Health 6/6 Care Provider Relations 6/6 Program Integrity 19/19 Quality Improvement 30/30 Mental Health Services Act 20/21

10 2017 Triennial Review Results Summary Chart Review Total Number of Claims Reviewed: 487 Total Number of Claims Allowed: 451 Total Number of Claims Disallowed: 36 Overall Percentage of Compliance: 92.6% REVIEW SECTION Medical Necessity # COMPLIANT ITEMS/TOTAL ITEMS REVIEWED 18/20 Assessment 250/250 Medication Consent 132/192 Client Plan 246/260 Progress Notes Cultural Competency/ Alternative Format IN COMPLIANCE % 3269/3409 4/5

11 Increased Data Quality

12 POQI (Adults) N=221 May 2017

13 # Responses POQI Survey Response Trend POQI Response Trend May-14 Nov-14 May-15 Nov-15 May-16 Nov-16 May-17 Nov-17 Total Responses Spanish Responses 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.

14 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 # of participants Customer Satisfaction Survey Crisis Continuum & Access Team Crisis Continuum - Mobile Crisis Response & Transition teams Access Team Q10: If these services were not available at the time you used them, would you: Went to Psychiatric Emergency Went to a hospital ER Call Law Enforcement 0% 10% 20% 30% 8% 19% 23% Client Satisfaction Survey Total Responses (N=268) Not access any services at all 29% Other 21% Overall, how satisfied are you with your assessment/services today? Overall Satisfaction 9% 83% 8% N=73 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 0% 0% 3% Very Dissatisfied Somewhat Dissatisfied Neither Satisfied nor Dissatisfied 8% Somewhat Satisfied 89% Very Satisfied Satisfied Neutral Dissatisfied

15 Impact of the Three New Teams Community Crisis Response Teams - (12/31/2017) T MCR O&E 1,851 Individuals treated by the three teams 8,807 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) Services provided by the three teams

16 Mar-15 Jun-15 Sep-15 Dec-15 Mar-16 Jun-16 Sep-16 Dec-16 Mar-17 Jun-17 Sep-17 Dec-17 Sep-15 Dec-15 Mar-16 Jun-16 Sep-16 Dec-16 Mar-17 Jun-17 Sep-17 Dec-17 Mar-15 Jun-15 Sep-15 Dec-15 Mar-16 Jun-16 Sep-16 Dec-16 Mar-17 Jun-17 Sep-17 Dec-17 Three New Mobile Teams Service Counts - (12/31/2017) Transition Team: Count of Contact (Mar 2015 to Dec 2017) ,807 Total Contacts 5014 Transition MCRT O&E # of Contact # of Unique Client Mobile Crisis Response Team: Count of Contact (July 2015 to Dec 2017) Outreach & Engagement: Count of Contact (Feb 2015 to Dec 2017) # of Contact # of Unique Client # of Contact # of Unique Client

17 Reducing Crises Transition Team (n = 422) Mar 2015 Dec 2017 T

18 Monthly Data Report Access Line Analysis October 2017

19 Monthly Data Report Crisis Stabilization Unit September 2017

20 Behavioral Health & Recovery Services Website Redesign

21 Staff Survey BHRS Town Hall Follow Up April 2017 Q1: Did you attend the Monday 4/10 Town Hall? 50% Q2: If you did not attend, what caused you to miss it? 45% 40% 33% No 54% N=70 Yes 46% 30% 20% 10% 21% 5% 10% 0% Too busy Scheduling conflict Not Interested Didn't know about it N/A--I was there Q3: If you attended, what did you think of the Town Hall? 0% 10% 20% 30% 40% 50% 60% I learned something 53% It helped improve communication 44% It wasn't useful 11% It would have been better if 39%

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