DSHS-McKeon, Stacii DSHS-McKeon, Stacii

created Sep 18, 2013

updated May 05, 2016

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Goal 4: Healthy and Safe Communities
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1.2.a.b, outpatient mental health, dshs, healthy people, healthy adults, behavioral health, outpatient, mental health, healthy youth
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Data Source
Mental Health Consumer Information System (CIS), via the System for Communicating Outcomes, Performance & Evaluation (SCOPE-WA), provided by Looking Glass Analytics
Data Definition
Number of Medicaid and Non-Medicaid adults (ages 18 and older) receiving (1) outpatient services and (2) inpatient (i.e., Community Hospital Psychiatric Unit services or Evaluation and Treatment [E&T] Center) services from RSNs; and (3) forensic and non-forensic inpatient services from the state psychiatric hospitals (including ESH and WSH). All Community Outpatient utilization rates (i.e. count of hours of service) exclude services reported as a day of service (i.e. stabilization, residential, clubhouse, and some high intensity services) AND clients who only received services reported using a daily value. Community hospital data is based on Medicaid paid claims. Counts for Inpatient Services are of Inpatient Days (for those served in community hospitals, E&Ts, or state psychiatric hospitals). For outpatient services, the RSN count shows the number of unduplicated clients within each RSN (i.e. a person is counted once in each RSN where they received services). Inpatient counts are unduplicated across Community Hospitals and E&Ts. If a client receives services in both settings within the Fiscal Year/Calendar Year, they are only counted once. Counts in the 'Clients Served' columns are of people, not admissions, episodes, or units of service. The statewide count shows the number of unduplicated clients within the state (i.e. a person is counted only once in the state even if they received services at multiple RSNs). Medicaid status for E&T services was obtained by matching the client to Medicaid eligibility data using name, date of birth, and social security numbers. Limitations of this matching could result in Medicaid eligibility counts that are low. The Community Hospital data is processed to include the MHD RSN Dispute Resolution table. This table tracks changes to the RSN which is assigned the Community Hospital episode. The most recent RSN assigned to the hospital episode is used. The category MHD/Unassigned includes Medicare crossover claims and Medical/detox/psychiatric pilot project clients who are not assigned to RSNs. Outpatient service data since SFY 2002 excludes Stabilization services. Reporting of these excluded services varies across the State. The counts of individuals receiving outpatient and inpatient mental health services are not mutually exclusive. A person could be counted in each service population.
Data Frequency
Quarterly - data is an average of the monthly data for the three months in that quarter.
Target Rationale
This target is based on the legislative budget and forecast assumptions for 2013-15 related to Medicaid expansion and RSN funding. This is an 11% increase to the total caseload [Medicaid + state-only clients], and is a best guess for the newly eligible and welcome mat populations.
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