bringing (keeping) the kids home update – february 2009
DESCRIPTION
Bringing (Keeping) the Kids Home Update – February 2009. A collaboration of Department of Health and Social Services, Alaska Mental Health Trust Authority & partner boards, Denali Commission, Rasmuson Foundation, Alaska Native health providers & other service providers, parents, advocacy groups. - PowerPoint PPT PresentationTRANSCRIPT
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Bringing (Keeping) the Kids Home Update – February 2009
A collaboration of Department of Health and Social Services, Alaska Mental Health Trust Authority & partner boards, Denali Commission, Rasmuson Foundation, Alaska Native health providers & other service providers, parents, advocacy groups
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Exponential Growth In Use of Out-of State Residential Psychiatric Treatment Centers (RPTC)
TotalOut of StateIn State
Medicaid RPTC Recipients
83149
247
429
536
637
749
0
200
400
600
800
1000
1200
SFY98
SFY99
SFY00
SFY01
SFY02
SFY03
SFY04
State Fiscal Year
Und
uplic
ated
Cou
nt Total
Out ofState
In State
OOSLinearRegression
Data are from Behavioral Health, Policy and Planning based on Medicaid claims paid for unduplicated RPTC recipients. Recipients include all children served per fiscal year – including those admitted in a previous year but served during the current year.
Between 1998- 2004, out-of-state RPTC placements for children with severe emotional disturbances (SED) grew by nearly 800%
Results:
•Disconnection
•Transition Problems
•Weaker Outcomes
•Expense
•Erosion of In-State Services
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Who does this effort impact? • In SFY04, 749 Alaskan children received care in
out-of-state RPTC– Add 2 parents and 1 sibling = 2,996 Alaskans.
• The DBH prevalence estimate for children with SED is 7.2% (12,725 Alaskan children) – Add 2 parents and 1 sibling = 50,900 Alaskans.
Primary goals:• Reduce the number of children in out-of-state RPTC
• Keep future use of out-of-state RPTC at a minimum
• Build capacity to serve children with SED in Alaska
• Develop integrated, seamless, culturally competent, least restrictive services, close to home
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Progress: Decrease in RPTC Admissions (Youth who enter RPTC during each fiscal year)
Data are from Behavioral Health, Policy and Planning based on Medicaid claims paid for unduplicated RPTC admissions. Includes only those admitted during the current year.
Drop of 73% in out-of-state admissions between FY04 and FY08
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Progress: Recidivism
Overall Recidivism Rate for RPTC Care within 1 Yr. of Discharge
20.00%
11.00%
14.00%
8.75% 8.40%
0
0.05
0.1
0.15
0.2
0.25
SFY04 SFY 05 SFY 06 SFY 07 SFY 08
State Fiscal Year
Per
cen
t o
f Y
ou
th
Recidivism Rate:
Recidivism: Significant decrease since FY04 from 20% to 8.4%
Data are from Behavioral Health, Policy and Planning
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Progress: Medicaid Expenditures for Residential Psychiatric Treatment Centers (RPTC)
Shift In RPTC Expenditures
$20,896,822
$14,297,112
$40,008,891
$26,848,252
$0
$5,000,000
$10,000,000
$15,000,000
$20,000,000
$25,000,000
$30,000,000
$35,000,000
$40,000,000
$45,000,000
SFY
98
SFY
99
SFY
00
SFY
01
SFY
02
SFY
03
SFY
04
SFY
05
SFY
06
SFY
07
SFY
08
State Fiscal Year
Ex
pe
nd
itu
res
In-state
Out-of-state
Data for FY05-07 are from Behavioral Health based on paid claims for Medicaid data. Expenditure data for FY08 are from Finance Management Services and includes all claims incurred and paid in FY08 and claims incurred in FY08 and paid in the first quarter of FY09.
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BTKH Activities
1) Gatekeeping, Care Coordination & Individualized Funding
2) BTKH Capacity Enhancement Grants
3) Training and TA
4) Leverage Other Funding Sources
5) Rate Increases
88
Ahead in FY 2010: Support for On-going Efforts
*Includes Federal match not listed separately.
ITEM MHTAAR GF/MH
incrm Total
Enhance Home, School & Community-based Services
Outpatient Grants $250.0 $1,100 $1,350
Crisis Bed Stabilization $150 $0 $150
School-Based Tool Kit $100 $0 $100
School-Based Grants $200 $0 $200Tribal/Rural System Development $400 $400 $900*Individualized Services into Base
$0 $500 $500
Enhance Best Practices
Technical Assistance $100 $100 $275*Parent & Foster Parent Training $75 $0 $75
99
Ahead in FY2010: Expanding In-State Capacity
*Includes Federal match not listed separately.
ITEM MHTAARGF/MH incrm Total
Intervene Earlier to Prevent Problems
Early Childhood Grants $75 $100 $175Early Childhood Learning Network $100 $100 $250*
Assist in the Transition to Adulthood
Transitional Aged Youth $200 $200 $400
BTKH Capital Development (matches Denali Commission funding) $2,316 $2,316
Group Homes, Transitional-aged Youth & Crisis Stabilization
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Reports and detailed information on BTKH at: http://www.hss.state.ak.us/commissioner/btkh/
DHSS BTKH Coordinator: Brita Bishop, LCSW [email protected]. Box 110601 Phone: 907-465-4994Juneau, Alaska 99811-0601 Fax: 907-465-3068