Agency Data Sumary Comparing FY08 and FY09

A fiscal year is defined as July 1st to June 30th.
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Census Data Summary

Community Support Program (CSP)

• Nearly 2 times as many clients were admitted to CSP in FY09 as in FY08.
• On the last day of FY 09, there were 120 more active clients on the CSP census than on the first day.
• Overall, 31% more CSP clients were served in FY09 than FY08.
• These increased admissions and clients served can be attributed to multiple factors. Economic conditions increased the number of eligible clients. In an effort to address this need, NRICS made efforts to improve efficiency and consequeently, its capacity to serve a larger poulation. Initial CNOM (costs not otherwise matchable) protocols indicated that underinsured, as well as uninsured, individuals would be funded via DBH contracts.

General Outpatient (GOP) Adults

• Adult Outpatient Census started FY09 a little higher (12%) than at the beginning of FY08.
• Due to a much higher number of admissions (37%), the active census on the last day of FY09 was 41% higher than at the end of FY08.
• Overall, 28% more Adult Outpatient clients were served in FY09 than FY08. This may be attributed to a higher influx of insured clients encountering behavioral health problems due to the economy.

General Outpatient (GOP) Children's

• Children’s Outpatient services started the first day of FY09 29% higher than at the beginning of FY08.
• Throughout FY09, there was a substantially higher rate of admissions (19%).
• Due to CAITS, the active census on the last day of FY09 was 12% lower than FY08.
• Throughout the FY, 23% more clients were served than in FY08. The primary reason for the lower active census on the last day, despite a greater number of clients being served, is the change from CIS, which allowed a 6 month length of stay, to CAITS, which has a length of stay of only 16 weeks.

The mandated shift from Children’s Intensive Services (CIS) to Child & Adolescent Intensive Treatment (CAITS) resulted in a shorter 16 week program per year. The duration of services available in a year is significant from the previous CIS services that allowed for a 6 month provision of services. This change in service is detrimental to the service of the children. Although we served 23% more clients it is believed that part of that may be because we processed more children through faster due to the 16 weeks restriction of CAITS. It also appears that hospital admissions are rising statewide.

Service Data

Community Support Program (CSP)

Significant increases occurred in the following CSP services:

• Emergency Face-to-Face: + 51%
• Individual Counseling: + 31%
• Case management (CPST): + 25%
• Med Maintenance: + 21%
• Psych/Rehab: +14%
• Drop-in Center: + 7%
• Case Management (MTT II): + 6%
• Case Management (MTT I): + 5%

These increases would be expected by the substantial increase in the CSP clients served (31%).

Significant decreases occurred in the following CSP services:

• Job Find/Development: - 32%
• Supported Workshop/TEP: – 30%
• Group Counseling: - 20% Other Changes/Comments:
• Substance Abuse Counseling increased, but FY08 was so low that the actual increase in hours was minimal (i.e., 89).
• Emergency Telephone contacts with CSP clients are very low at 26 contacts, 37 hours. NRICS interprets this as representing good crisis planning and intervention by the primary CSP Treatment Teams.

The significant decrease in job find/development, supported employment, etc. translate in less ability to bill due to a reduced staffing pattern.

GOP Children's

Decreases were noted in virtually every service type for Child & Family Services.

• Group Counseling: 96% - This is easily explained by the fact that Group Counseling was a reimbursable service for CIS, but not for CAITS.
• Family Treatment: 7% - This is not surprising given the shift in census from intensive home & community based family services to office-based outpatient services, which tends to be more individually focused.
• Case Management: 2 % - Case management services are Bachelor level services provided to families. The shift to CAITS limited the amount of case management services that could be provided to families.

Increases were noted for only two service types for Children’s Outpatient Services.

• Emergency Face-to-Face: + 335% - These services more than tripled. FY08 hours for this service were substantially lower as a consequence of the intensity of services provided in CIS. With the transfer to CAITS, not only was the duration of the program limited from 6 months, to 16 weeks, the intensity of services was drastically limited, negatively impacting the support that could be provided to families. This is reflected also in hospitalization data. In FY08, there were 10 children’s hospitalizations. This FY, there have been 17 hospitalizations, with 12 occurring since May.
• Individual Counseling: + 2%. This is a slight increase. This may be due to the large number of children discharged from CAITS during the year.

GOP Adult

Increases were noted in the following two Adult Outpatient services:

• Group Counseling: + 50%
• Substance Abuse Counseling - It should be noted that the actual hours reported for FY08 were extremely low (i.e., 4) and remain low in FY09 (i.e., 35)

Decreases were noted in all other Adult Outpatient services:

• Emergency Telephone – 88%
• CPST Case Management - 67% Case management is, in theory, provided by the health plans as Medicaid clients become auto-enrolled in HMO coverage.
• Med Maintenance: - 21%
• Emergency Face-to-Face: - 19%
• Individual Counseling: The decrease in Individual Counseling of 263 hours was offset by 246 more hours of group counseling.
• Family Treatment – Only 4 hours fewer family treatment services were provided in FY09, which is essentially negligible.

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