Mental Health Division (MHD) administers treatment services for adults and children who are severely and/or chronically mentally ill. MHD administers services through three channels. (1) MHD directly operates state mental hospitals, which deliver services to clients with severe mental disorders. (2) Single counties or groups of counties administer Regional Support Networks (RSNs), which contract with licensed community mental health providers to supply mental health services. RSNs coordinate crisis response, community support, residential, and resource management services. MHD funds services to Medical Assistance-eligible consumers within an RSN through capitated Prepaid Health Plans (PHPs). (3) Community Evaluation and Treatment facilities include general hospitals and psychiatric hospitals that deliver inpatient psychiatric treatment, both voluntary and involuntary, to consumers authorized by the RSNs. For involuntary admissions, either general or psychiatric hospitals in the community serve as hospital-based Evaluation and Treatment (E&T) facilities that provide services during emergency situations for the initial 72-hour detention and for an additional 14 days of commitment if necessary. E&Ts may also be free-standing residential treatment facilities.
MHD ServicesIncluded in this presentation:
Excluded in this presentation:
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Community Services: Community
mental health providers deliver Individual Therapy, Group Therapy, Day
Treatment, and Medication
Management on an outpatient basis in both emergent and non-emergent situations.
State Hospitals: MHD operates two
state hospitals, Eastern State Hospital and Western State Hospital.
State Hospitals provide inpatient services to both voluntary and involuntary
clients. Services offered at Western State Hospital also include the
Program for Adaptive Living Skills (PALS).
Child Study and Treatment
Center (CSTC): MHD operates a state hospital for children
who are psychiatrically disturbed. Services are provided on the grounds
of Western State Hospital.
Community Evaluation and Treatment:
Community general hospitals, psychiatric hospitals, and free-standing
residential treatment facilities provide services to clients who are
voluntarily admitted for inpatient care. In addition, the Involuntary
Treatment Act (ITA) authorizes involuntary admissions to these community
facilities.
Note: According to MHD staff, the number of clients receiving Community Inpatient services in Fiscal Year 00 is inflated due to incorrect coding of oxygen claims from community hospitals. These claims were erroneously charged to involuntary mental health inpatient services. This problem was identified early in Fiscal Year 00 and it is expected that data for these claims will be correctly reported starting in April 2001.
Changes from the Needs Assessment Data Base (NADB) produced for Fiscal Year 94:
- Several outpatient service categories (Individual Therapy, Group Therapy, Day Treatment, Medication Management) that were reported as individual modalities in NADB for Fiscal Year 94 are now included in a single Community Support Service report group by CSDB for Fiscal Year 99 since they are no longer paid for on a fee-for-service basis. As part of its move to a managed care financial model, MHD funds these collectively as Community Support Services based on a capitated rate.
- Case Management as well as Intake and Assessment services were included as two separate report groups in NADB for Fiscal Year 94. Since these activities are no longer captured in the MHD database as distinct modalities, CSDB for Fiscal Year 99 does not report either Case Management or Intake/Assessment as separate service categories. Instead, these activities are considered essential elements of all Community Support Services
- Crisis and Stabilization services were included as a separate report group in NADB for Fiscal Year 94. These activities are no longer captured in the MHD database as a distinct modality. Instead, each of the various Community Support Services are coded in the MHD database as either "emergent" or "non-emergent". CSDB for Fiscal Year 99 includes both emergent and non-emergent outpatient encounters in a single Community Service report group.
- Mentally Ill Chemical Abuser (MICA) Treatment services are provided at the Pioneer Center North Facility under a contract paid jointly by MHD and the Division of Alcohol and Substance Abuse (DASA). NADB for Fiscal Year 94 reported clients receiving MICA services under both MHD and DASA. NADB for Fiscal Year 94 allocated expenditures for the jointly contracted services between MHD and DASA according to each program's share of the total contract. CSDB for Fiscal Year 99 reports clients receiving MICA services under DASA only. CSDB Fiscal Year 99 allocates expenditures between MHD and DASA according to each program's share of the total contract. Applicable costs are then reported for each of the two programs.
- NADB for Fiscal Year 94 reported Voluntary Admissions and Involuntary Commitments to Community Hospitals as separate services. CSDB for Fiscal Year 99 reports these services in a single Community Inpatient/Evaluation and Treatment category.
- NADB for Fiscal Year 94 reported all Evaluation and Treatment (E&T) services in the program total for MHD but not as a separate service category. CSDB for Fiscal Year 99 reports both free-standing and hospital-based E&Ts in the Community Inpatient/Evaluation and Treatment category.
Changes from CSDB for Fiscal Year 99
- CSDB for Fiscal Year 99 reported client counts for Mentally Ill Chemical Abuser (MICA) Treatment at the Pioneer Center North Facility under the DASA results while expenditures were reported under both DASA and MHD. CSDB for Fiscal Year 00 does not report data for this service due to the elimination of MICA Treatment at Pioneer North.
