Sacramento County Mental Health Services Act

Full Service Partnership (FSP) Annual Report Fiscal Year 2013-14

MHSA Steering Committee November 19, 2015

Today’s Presentation

Demographics of partner’s served in FSPs FY 13-14 outcome data

Where Does Data Come From?

Performance Advisory Committee Development of standard forms

All Counties required to submit FSP data to DMH Partnership Assessment Form (PAF), Quarterly

Assessment (3M), Key Event Tracking (KET) Self report data Inpatient data reported in AVATAR

FSP Assessment Forms Partnership Assessment Form- PAF: establishes

partnership start date, completed once, establishes baseline data and current status

Quarterly Assessment – 3M: every 3 months following the partnership start date, updates status on elements collected on PAF

Key Event Tracking – KET: report changes on key events such as residence changes, arrests, ER visits

Limitations-Considerations to Data Analysis

Self-report

Staff collection and submission

Annualization

Annualization of Data Estimate for full 12 months of data

For example: Partner has been receiving services for 3 months and during that time has gone to the hospital 2 times. If we annualize the data we estimate that if the partner continues this same pattern by the end of the year (12 months) they will have had 8 hospitalizations.

Allows for comparison of equal timeframes (across years) For example: 12 months prior to start of services compared

to most recent 12 months of services Data may be under or over represented due to

annualization Interpret extremes with caution

Turning Point-Integrated Services Agency (ISA) Telecare - Sacramento Outreach Adult Recovery (SOAR) TLCS New Direction Turning Point – Pathways River Oak - Juvenile Justice Diversion and Treatment

Program (JJDTP) Asian Pacific Community Counseling (APCC) -

Transcultural Wellness Center (TWC) El Hogar - Sierra Elder Wellness

7 FSP’s in Sacramento County

Demographics The Full Service Partnerships (FSP’s) served a total of

1,687 partners in FY 13/14

Note: Total N is greater than the number of unduplicated partners, as some partners were served in multiple programs throughout the year

Unduplicated FSP Clients Served by Episode

Undup # Served

(N) Percent

Undup # of Ptnrs Admitted in Year

Undup # of Ptnrs Discharged in Year

Avg LOS

ISA 169 10.0% 25 23 2.2 YearsNew Direction 307 18.1% 62 46 2.5 yearsPathways 396 23.4% 42 41 3.0 YearsJJDTP 163 9.6% 80 83 11.8 MonthsSOAR 173 10.2% 26 21 2.8 YearsTWC 315 18.6% 86 71 2.1 YearsSierra 169 10.0% 48 39 2.9 YearsTotal 1692 100.0% 369 324 2.1 Years

Demographics - Age

9%

14%

60%

17%

Served by Age Group N=1687

0-15

16-25

26-59

60+

Demographics - Gender

51% 49%

0%

Served by Gender N=1687

Male

Female

Unk/Not Reported

Demographics - Race

40%

24% 1%

21%

1% 9% 4%

Served by Race N=1687

Caucasian

African American

Native American/ Alaskan Native

Asian Pacific Islander

Multi Race

Other

Unk/Not Reported

Demographics - Ethnicity

Demographics - Diagnosis

22%

14%

40%

9%

8%

3% 1%

3%

Diagnosis N=1687

Depressive

Bipolar

Psychotic

Anxiety/PTSD

Disruptive Disorders

Adjustment

Personality Disorder

Other

Outcomes

Homelessness Incarceration Inpatient Hospitalization ER Visits (mental & physical health related)

Behind the Numbers The data set includes baseline and 12 months of

comparison data for each partner served in an FSP in 13/14

“At Baseline” - 12 months prior to admission to a FSP “In FY13/14” –comparison data that represents the last

12 months of data for each partner served in FY13/14 For partners not receiving services for the entire FY13/14

data from FY12/13 was used to obtain a full 12 months of data

For partners that had not been receiving FSP services for a full 12 months data was annualized

The data analysis looks at overall improvement regardless of length of time in program

Homelessness Partners living on the streets or living in their car Does not include those in emergency shelters or

temporary housing Captured on the KET Validity and integrity rests upon accuracy of data

being reported and captured Over/under representation of data

Homelessness Comparison of Baseline to FY 13/14

851

215

0

100

200

300

400

500

600

700

800

900

Homeless Occurrences N = 1674

At Baseline

In FY 13-14

71,017

9,735

0

15,000

30,000

45,000

60,000

75,000

Homeless Days N = 1674

At Baseline

In FY 13-14

74.7% Decrease 86.3% Decrease

Arrests Arrests that may or may not lead to incarceration Includes site and release Captured on KET Validity and integrity rests upon accuracy of data

being reported and captured Over/under representation of data

Arrests Comparison of Baseline to FY 13/14

539

200

0

100

200

300

400

500

600

Number of Arrests N = 1674

At Baseline

In FY 13-14

66.3% Decrease 62.9% Decrease

20.5%

7.9%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

Partners With Arrests N=1674

At Baseline

In FY 13-14

Incarceration At least one night spent in jail or a juvenile

detention facility Captured on KET Validity and integrity rests upon accuracy of

data being reported and captured Over/under representation of data

413

263

0

50

100

150

200

250

300

350

400

450

Jail Occurrences N = 1674

At Baseline

In FY 13-14

15,909

11,199

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

Jail Days N = 1674

At Baseline

In FY 13-14

Incarcerations Comparison of Baseline to FY 13/14

36.3% Decrease 29.6% Decrease

Inpatient Admits

• Data extracted from Avatar • Hospitals include:

• Sacramento County Mental Health Treatment Center

• Heritage Oaks • Sierra Vista • Sutter Center for Psychiatry

Inpatient Hospitalizations Comparison of Baseline to FY 13/14

21,798

4,772

0

5,000

10,000

15,000

20,000

25,000

Hospitalized Days N = 1687

At Baseline

In FY 13-14

1,156

375

0

200

400

600

800

1,000

1,200

1,400

Number of Hospitalizations N = 1687

At Baseline

In FY 13-14

67.6% Decrease 78.1% Decrease

Emergency Room Visits

Captured on KET Capture primary reason for ER visit: Mental Health

reasons or Physical Health reasons Validity and integrity rests upon accuracy of data

being reported and captured

Emergency Room Visits Comparison of baseline to FY 13/14

1730

803

0

300

600

900

1200

1500

1800

2100

Mental Health ER Visits N = 1674

At Baseline

In FY 13-14

1184

429

0

200

400

600

800

1000

1200

1400

Physical Health ER Visits N=1674

At Baseline

In FY 13-14

53.6% Decrease 63.8% Decrease

Linked to a Primary Care Physician

Captured on PAF and 3M Data updated as status changes Validity and integrity rests upon accuracy of data

being reported and captured

Partners Linked to a PCP Comparison of baseline to FY 13/14

23.4% Increase

1086

1340

0

200

400

600

800

1000

1200

1400

1600

Partners with Primary Care Physician N = 1674

At Baseline

In FY 13-14

Closing remarks… Key goal of MHSA & FSP programs: decrease the long-

term impact resulting from untreated serious mental illness

FSP programs continue to demonstrate the effectiveness of their programs as indicated by the positive outcomes for the clients they serve.