Performance Outcomes System Reports Report run on August 3, 2016

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1 Performance Outcomes System Reports Report run on August 3, 26 Background Three reports will be created during each new reporting period. The reports that will be produced are as follows: statewide aggregate data; populationbased county groups; and countyspecific data. These reports help meet the intent of the Legislature, as stated in Welfare and Institutions Code Section 477.5, to develop a performance outcomes system for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services that will improve outcomes at the individual, program, and system levels and inform fiscal decisionmaking related to the purchase of services. This reporting effort is part of the implementation of a performance outcomes system for Medi Cal Specialty Mental Health Services (SMHS) for children and youth. Since 22 DHCS has worked with several groups of stakeholders to create a structure for reporting, to develop the Performance Measurement Paradigm, and to develop indicators and measures. The Performance Outcomes System will be used to evaluate the domains of access, engagement, service appropriateness to need, service effectiveness, linkages, cost effectiveness and satisfaction. Further information on the Performance Measures System implementation is available on the DHCS website. Documents posted include the relevant legislation, plans submitted to the Legislature, and handouts for meetings with the Stakeholder Advisory Committee back to the first meeting in 22. To obtain this information go to: Purpose and Overview These countyspecific reports provide updated information on the initial indicators that were developed for the Performance Outcomes System and reported on at the statewide aggregate level in February 25; they help establish a foundation for ongoing reporting. DHCS plans to move to annual reporting of this data for the Performance Outcomes System. The first series of charts and tables focus on the demographics of children and youth under 2 who are receiving SMHS based on approved claims for MediCal eligible beneficiaries. Specifically, this includes demographics tables of this population by age, gender, and race/ethnicity. Two types of penetration information are provided. Both penetration rates tables are also broken out by demographic characteristics. Utilization of services data are shown in terms of dollars, as well as by service, in time increments. The snapshot table provides a pointintime view of children/youth arriving, exiting, and continuing services over a twoyear period. The time to step down table provides a view over the past four years of the time to stepdown services following inpatient discharge. Where possible, the reports provide trend information by displaying information for Fiscal Years (FY) /2, 2/3, 3/4, and 4/5. Utilization of services reports are shown in terms of dollars, as well as by service in time increments. The snapshot report provides a pointintime view of children arriving, exiting and continuing services over a twoyear period. The final report provides a view over the past four years of the time to stepdown services (i.e., time to next contact after an inpatient discharge). Note: The time to stepdown report has a change in methodology from the first report produced in February 25. In the initial report only outpatient services provided at least one day after the inpatient discharge were included in the calculations. On subsequent reports, any outpatient service that occurs on or after the inpatient discharge is included in the analysis. Definitions Population Beneficiaries with approved services adjudicated through the Short Doyle/MediCal II claiming system that were: Age 2 or younger during the approved date of service on the claim; or Age 2 during the approved date of the service on the claim and a birth date on or after January st of the Fiscal Year. Data Sources ShortDoyle/MediCal II (SD/MC II) claims with dates of service in FY /2 through FY 4/5. MediCal Eligibility Data System (MEDS) data from the Management Information System/Decision Support System (MIS/DSS) FY /2 through FY 4/5. Page of 4

2 Performance Outcomes System Reports Report run on August 3, 26 Additional Information The Measures Catalog is the companion document for these reports and provides the methodology and definitions for the measures. Each measure is defined and the numerator and denominator used to develop the metrics are provided with relevant notes and additional references. The Measures Catalog may be found at: Note on Privacy: The Health Insurance Portability and Accountability Act (HIPAA) and Code of Federal Regulations (CFR) 42 rules protect most individually identifiable health information in any form or medium, medium, whether electronic, on paper, or oral. DHCS has strict rules in place to protect the identification of individuals in public reports. A Public Aggregate Reporting DHCS Business Reports process has been established to maintain confidentiality of client Personal Information. The Performance Outcomes System complies with Federal and State privacy laws. Thus, the POS must appropriately and accurately deidentify data for public reporting. Due to privacy concerns, some cells in this report may have been suppressed to comply with state and federal rules. When necessary, this data is represented as follows: ) Data that is missing is indicated as "" 2) Data that has been suppressed due to privacy concerns is indicated as "". Report Interpretation *yspecific findings may be interpreted alongside the POS statewide and populationbased report findings. *The penetration rates reported here were calculated using a different methodology than that used by the External Quality Review Organization (EQRO). The differences in methodology make comparison between the POS penetration rates and the EQRO penetration rates not appropriate or useful. The POS methodology for calculating penetration rates was selected because it is easier to compute, more straightforward to interpret, and is in use by other states and counties. For the POS, the penetration rate is calculated by taking the total number of youth who received X number of SMHS ( or 5 for POS) in a FY and dividing that by the total number of MediCal eligible youth for that FY. This methodology results in lower penetration rates as compared to the EQRO rates, but it does so across the board so that all counties and the state will be similarly impacted. *The snapshot report provides a pointintime look at children and youth's movement through the SMHS system. The report uses five general categories to classify if a youth is entering, exiting, continuing services, or a combination of these categories (e.g., arriving and exiting). As of now, this report only classifies youth and their service usage for FY 2/3 and FY3/4. Eventually the snapshot data will be used along with measures of service effectiveness to identify whether youth are improving as a result of receiving services from the time they first arrived in the system to when they exit the system. This methodology was adapted from the California Mental Health and Substance Use System Needs Assessment (22). More information on the original methodology can be found here: *The psychiatric emergency services/hospital data reported on in the time to stepdown services report relies solely on claims data from Short Doyle/MediCal II. In the future this report will incorporate other outpatient and inpatient MediCal SMHS' billed through the Managed Care healthcare delivery systems. Currently, the number of days is capped at 365 days (to mitigate the impact of extreme statistical anomalies) when calculating the mean and max for time between discharge and step down service. This methodology will be updated in the next reporting cycle. Additionally, county specific and populationbased reports are based off of the county of the hospital the patient is discharged from and whom has been attributed the time to next service in days used in the calculations for this indicator. Please contact cmhpos@dhcs.ca.gov for any questions regarding this report. Page 2 of 4

3 Demographics Report: Unique of Youth Receiving SMHS by Fiscal Year Fresno y as of August 3, 26 SFY Unique Receiving SMHS* YearOverYear Percentage Change Unique of MediCal Eligibles YearOverYear Percentage Change 5,3 24,964 5,948 2.% 22, % 6,96 6.3% 236,99 6.8% 7, , Compound Annual Growth Rate SFY** 2.% 6. Unique of Youth Receiving SMHS 8, 6, 5,3 5,948 6,96 7,48 4, 2, *SMHS = Specialty Mental Health Services. See Measures Catalog for more detailed information. **SFY = State Fiscal Year which is July through June 3. Data has been suppressed to protect patient privacy. Page 3 of 4

4 Demographics Report: Unique of Youth Receiving SMHS by Fiscal Year Fresno y as of August 3, 26 Fiscal Year Alaskan Native or American Indian Alaskan Native or American Indian % Asian or Pacific Islander Asian or Pacific Islander % Black Black % Hispanic Hispanic % White White % Other Other % Unknown Unknown % % 68. 2, %,76 2.3% % 76.3% % 3, %, % % 6.9% % 737.7% 3,9 56.5%, % 43 2.% % % 84.7% 4,22 56., % Fiscal Year 2 Race Distribution Fiscal Year 23 Race Distribution 5% % Alaskan Native or American Indian Asian or Pacific Islander Black 9% 5% % 3% Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic Hispanic White White 5 Other Unknown 57% Other Unknown Fiscal Year 34 Race Distribution 7% % % Black Hispanic * claims are estimated to be 95% complete as of January, 25. Alaskan Native or American Indian Asian or Pacific Islander White 9% 3% Fiscal Year 45 Race Distribution % % Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White 57% Other Unknown 5 Other Unknown Please note: This report uses the MediCal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by y Welfare Departments and may differ from data maintained by y Mental Health Plans. For more information, please refer to the Measures Catalog. Data has been suppressed to protect patient privacy. Page 4 of 4

5 Demographics Report: Unique of Youth Receiving SMHS by Fiscal Year Fresno y as of August 3, 26 Fiscal Year Children 5 Children 5 % Children 6 Children 6 % Children 27 Children 27 % Youth 82 Youth 82 % 73 3., , % 574.8% 689., , % 2, , % 2, % 3,68 4.%,72 4.3% Fiscal Year 2 Age Group Distribution Fiscal Year 23 Age Group Distribution % 3% Children 5 Children 5 Children 6 Children 6 4 3% Children % Children 27 Youth 82 Youth 82 Fiscal Year 34 Age Group Distribution Fiscal Year 45 Age Group Distribution 3% % Children 5 3% Children 5 Children 6 Children 6 * claims are estimated to be 95% complete as of January, % 4 Children 27 3 Children 27 Youth 82 Youth 82 Data has been suppressed to protect patient privacy. Page 5 of 4

6 Demographics Report: Unique of Youth Receiving SMHS by Fiscal Year Fresno y as of August 3, 26 Fiscal Year Female Female % Male Male % 2,8 4.% 3,3 58.9% 2,54 42.% 3, % 2, % 3, , , Fiscal Year 2 Gender Distribution Fiscal Year 23 Gender Distribution 58.9% 4.% Female Male 57.9% 42.% Female Male Fiscal Year 34 Gender Distribution Fiscal Year 45 Gender Distribution % Female Male Female Male Data has been suppressed to protect patient privacy. Page 6 of 4

7 Penetration Rates* Report: Youth With At Least One SMHS Visit** Fresno y as of August 3, 26 Youth with Eligible Penetration Youth with Eligible Penetration Youth with or Eligible Penetration Youth with or Eligible or more SMHS Rate or more Rate more SMHS Rate more SMHS Visits Youth SMHS Visits Youth Visits Youth Visits Youth Penetration Rate All 5,3 24, ,948 22, % 6,96 236,99 2.9% 7,48 246,859 3.% Children ,93.9% ,574.9% 78 77,37.% ,52. Children 6,66 55, %,858 63, % 2,298 69,8 3.3% 2,382 7, % Children 27 2,47 47,644 5.% 2,594 53,88 4.9% 2,92 57,398 5.% 3,68 59,7 5.% Youth , , % 96 33,33 2.8%,72 37,93 2.8% Alaskan Native or American Indian 74, ,26 6.3% 6,26 4.8% 48, % Asian or Pacific Islander 28 25,27.9% 9 27,37.7% ,7.8% 34 3,249.% Black 68 4, , ,79 4.7% 84 6,235 5.% Hispanic 2,975 27, % 3,399 39, ,9 47, % 4,22 53, % White,76 22,49 4.9%,52 24,3 4.8%,378 26,22 5.3%,448 27,26 5.3% Other 85 5, , ,49.8% 98 9,38 2. Unknown 264 7,99 3.3% 36 8,26 3.8% 449 8,889 5.% 458 8,945 5.% Female 2,8,589 2.% 2,54, % 2,957 7, % 3,258 2,97 2.7% Male 3,3 3,375 3.% 3,444,587 3.% 3,959 9, % 4,222 24, % % 8% Penetration Rates by Age Youth With At Least One SMHS Visit**, By Fiscal Year 5.% 4.9% 5.% 5.%.9%.9%.%. 2.9% 2.9% 3.3% 3.3% % 2.8% 2.8% % (n= 74,93) (n= 76,574) (n= 77,37) (n= 77,52) (n= 55,846) (n= 63,449) (n= 69,8) (n= 7,727) Children 5 Children 6 Children 27 Youth 82 *Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the ShortDoyle/MediCal claiming system. This does not include nonspecialty mental health services provided in the MediCal Managed Care system. ** Youth that have received at least one SMHS in the Fiscal Year. Please note: This report uses the MediCal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by y Welfare Departments and may differ from data maintained by y Mental Health Plans. For more information, please refer to the Measures Catalog. (n= 47,644) (n= 53,88) (n= 57,398) (n= 59,7) (n= 26,56) (n= 28,672) (n= 33,33) (n= 37,93) Page 7 of 4

8 Penetration Rates* Report: Youth With At Least One SMHS Visit** Fresno y as of August 3, 26 8% Penetration Rates by Race Youth With At Least One SMHS Visit**, By Fiscal Year % 8% % 4.8% 3.7%.9%.7%.8%.% % 5.% 2.3% % 2.7% 4.9% 4.8% 5.3% 5.3% % 8% (n=,54) (n=,26) (n=,26) (n=,287) (n= 25,27) (n= 27,37) (n= 29,7) (n= 3,249) (n= 4,793) (n= 5,23) (n= 5,79) (n= 6,235) (n= 27,938) (n= 39,24) (n= 47,457) (n= 53,889) (n= 22,49) (n= 24,3) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White Penetration Rates by Gender Youth With At Least One SMHS Visit**, By Fiscal Year (n= 26,22) (n= 27,26) % 8% 2.% 2.3% 2.5% 2.7% 3.% 3.% 3.3% 3. % (n=,589) (n=,296) (n= 7,352) (n= 2,97) (n= 3,375) (n=,587) (n= 9,567) (n= 24,942) Female Male *Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the ShortDoyle/MediCal claiming system. This does not include nonspecialty mental health services provided in the MediCal Managed Care system. ** Youth that have received at least one SMHS in the Fiscal Year. Please note: This report uses the MediCal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by y Welfare Departments and may differ from data maintained by y Mental Health Plans. For more information, please refer to the Measures Catalog. Page 8 of 4

9 Youth with 5 or more SMHS Visits Penetration Rates* Report: Youth with Five or More SMHS Visits** Fresno y as of August 3, 26 Eligible Youth Penetration Rate Youth with 5 or more SMHS Visits Eligible Youth Penetration Rate Youth with 5 or more SMHS Visits Eligible Youth Penetration Rate Youth with 5 or more SMHS Visits Eligible Youth All 3,594 24,964.8% 4,6 22,883.8% 4, ,99.9% 5,57 246,859 2.% Children , , ,37.5% ,52. Children 6,93 55,846 2.%,3 63,449 2.%,579 69,8 2.3%,753 7, Children 27,77 47,644 3.,878 53,88 3.5% 2,52 57, ,259 59,7 3.8% Youth ,56.3% ,672.8% 62 33,33.8% ,93.7% Alaskan Native or American Indian 55,54 4.8% 62,26 5.% 48,26 3.8% 3, Asian or Pacific Islander 3 25,27.5% 32 27,37.5% 52 29,7.5% 27 3,249.7% Black 45 4, % 467 5,23 3.% 466 5,79 3.% 549 6, Hispanic,99 27,938. 2,26 39,24. 2,565 47,457.7% 2,843 53,889.8% White ,49 3.3% , ,22 3.5%,3 27,26 3.8% Other 67 5,94.% 75 7,2.% 3 8,49.3% 35 9,38.5% Unknown 99 7,99 2.5% 242 8,26 2.9% 339 8, % 352 8, % Female,455,589.,656,296.5%,969 7,352.7% 2,222 2,97.8% Male 2,39 3,375 2.% 2,35,587 2.% 2,625 9, ,935 24, % Penetration Rate 8% Penetration Rates by Age Youth With Five or More SMHS Visits**, By Fiscal Year % 8% %...5%. (n= 74,93) (n= 76,574) (n= 77,37) (n= 77,52) 2.% 2.% 2.3% 2. (n= 55,846) (n= 63,449) (n= 69,8) (n= 7,727) % % (n= 47,644) (n= 53,88) (n= 57,398) (n= 59,7).3% (n= 26,56).8%.8%.7% (n= 28,672) Children 5 Children 6 Children 27 Youth 82 (n= 33,33) (n= 37,93) *Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the ShortDoyle/MediCal claiming system. This does not include nonspecialty mental health services provided in the MediCal Managed Care system. ** Youth that have received at least five SMHS in the Fiscal Year. Please note: This report uses the MediCal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by y Welfare Departments and may differ from data maintained by y Mental Health Plans. For more information, please refer to the Measures Catalog. Page 9 of 4

10 Penetration Rates* Report: Youth with Five or More SMHS Visits** Fresno y as of August 3, 26 8% Penetration Rates by Race Youth With Five or More SMHS Visits**, By Fiscal Year % 8% % 4.8% 5.% (n=,54) (n=,26) 3.8% (n=,26) 2. (n=,287).5%.5%.5%.7% (n= 25,27) (n= 27,37) (n= 29,7) (n= 3,249) 2.8% 3.% 3.% (n= 4,793) (n= 5,23) (n= 5,79) 3. (n= 6,235)...7%.8% (n= 27,938) (n= 39,24) (n= 47,457) (n= 53,889) 3.3% % 3.8% (n= 22,49) (n= 24,3) Alaskan Native or American Indian Asian or Pacific Islander Black Hispanic White (n= 26,22) (n= 27,26) 8% Penetration Rates by Gender Youth With Five or More SMHS Visits**, By Fiscal Year % 8%..5%.7%.8% 2.% 2.% % % (n=,589) (n=,296) (n= 7,352) (n= 2,97) (n= 3,375) (n=,587) (n= 9,567) (n= 24,942) Female Male *Penetration Rate is defined as the percentage of SMHS eligible beneficiaries that have received a SMHS that was claimed via the ShortDoyle/MediCal claiming system. This does not include nonspecialty mental health services provided in the MediCal Managed Care system. ** Youth that have received at least five SMHS in the Fiscal Year. Please note: This report uses the MediCal Eligibility Data System (MEDS) to obtain race/ethnicity data. The MEDS data is entered by y Welfare Departments and may differ from data maintained by y Mental Health Plans. For more information, please refer to the Measures Catalog. Page of 4

11 Fiscal Year SDMC Total Approved IHBS (Minutes) ICC (Minutes) Case Management/ Brokerage (Minutes) Mental Health Services (Minutes) Therapeutic Behavioral Services (Minutes) Utilization Report*: Approved Specialty Mental Health Services for Youth Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Fresno y as of August 3, 26 Medication Support Services (Minutes) Crisis Intervention (Minutes) Crisis Stabilization (Hours) Full Day Treatment Intensive (Hours) Full Day Rehabilitation (Hours) Hospital Inpatient (Days) Hospital Inpatient Admin (Days) Fee for Service Inpatient (Days) Crisis Residential Treatment Services (Days) Adult Residential Treatment Services (Days) $ 4, ,6 5, $ 4, ,24 5, $ 3, ,49, , $ 4, ,7, , MEAN $ 4, ,28,542 47,4 5, Psychiatric Health Facility (Days) Total Approved Per Unique Beneficiary IHBS Minutes Per Unique Beneficiary ICC Minutes Per Unique Beneficiary $6,. $5,. $4,. $3,. $2,. $,. $ $4, (n = 5,799) $4, (n = 6,558) $3,865.8 (n = 7,45) $4,93.88 (n = 7,537) 5, 4,5 4, 3,5 3, 2,5 2,,5, 5 4,49 (n = 62) 4,7 (n = 28),8,6,4,2, ,67 (n = 68),467 (n = 26) Case Management/Brokerage Minutes Per Unique Beneficiary,4 Mental Health Services Minutes Per Unique Beneficiary Therapeutic Behavioral Services Minutes Per Unique Beneficiary ,2, ,6, , 5, 4, 3, 2,, 5,39 5,493 4,839 5,24 (n = 2,938) (n = 3,472) (n = 3,736) (n = 3,56) (n = 4,97) (n = 5,65) (n = 6,464) (n = 6,285) (n = 352) (n = 456) (n = 248) (n = 276) Medication Support Services Minutes Per Unique Beneficiary 323 (n = 2,2) 336 (n = 2,422) 267 (n = 2,93) *The graphs are color coded so that those reported in the same unit of analysis (e.g., minutes) are colored similarly. Please note that (n) values listed at the bottom of each bar graph represent the actual number of children/youth that received the SMHS represented in their respective graph by Fiscal Year. 244 (n = 3,78) Crisis Intervention Minutes Per Unique Beneficiary 47 (n = 55) 74 (n = 898) 25 (n =,48) 3 (n = 799) (n = 26) Crisis Stabilization Hours Per Unique Beneficiary 2.3 (n = 95) 2.4 (n = 25) 2.9 (n = 476) Page of 4

12 Utilization Report*: Approved Specialty Mental Health Services for Youth Mean Expenditures and Mean Service Quantity per Unique Beneficiary by Fiscal Year* Fresno y as of August 3, Full Day Treatment Intensive Hours Per Unique Beneficiary 227 (n = 23) 36 (n = 23) 428 (n = 24) 343 (n = 9) Full Day Rehabilitation Hours Per Unique Beneficiary 45 (n = ) 2 (n = ) Hospital Inpatient Days Per Unique Beneficiary Hospital Inpatient Admin Days Per Unique Beneficiary Fee for Service Inpatient Days Per Unique Beneficiary 6 (n = 94) 7 (n = 7) 6 (n = 29) 6 (n = 62) Crisis Residential Treatment Services Days Per Unique Beneficiary.... Adult Residential Treatment Services Days Per Unique Beneficiary.... *The graphs are color coded so that those reported in the same unit of analysis (e.g., minutes) are colored similarly. Please note that (n) values listed at the bottom of each bar graph represent the actual number of children/youth that received the SMHS represented in their respective graph by Fiscal Year. Data has been suppressed to protect patient privacy. Page 2 of Psychiatric Health Facility Days Per Unique Beneficiary 5. (n = 2) 2. (n = 23) 34. (n = 2).9 (n = 72)

13 Category Arrivals Exiting Arriving & Exiting & Exiting Snapshot Report: Unique of Youth Receiving SMHS Arriving, Exiting, and with by Fiscal Year Fresno y as of August 3, 26 Description (Please refer to the Measures Catalog for more detailed descriptions on all Performance Outcomes System measures.) Children/Youth that did not receive any SMHS within 3 months of their first date of service in the Fiscal Year. Children/Youth receiving continuous services with no breaks in service greater than 9 days for a period of at least 2 years (>= 2 YR) or a period of to 2 years (< 2 YR). Children/Youth that did not receive any SMHS within 3 months after their last date of service in the Fiscal Year. A distinct category in which children/youth met both the criteria for Arrivals and Exiting above for the fiscal year. A distinct category in which Children/Youth had at least 2 years of going into the Fiscal Year and then Exited within the same Fiscal Year. Service Fiscal Year Arrivals Arrivals % Service Continuance (>= 2 YR) Service Continuance (>= 2 YR) % Service Continuance (<2 YR) Service Continuance (< 2 YR) % Exiting Exiting % Arriving & Exiting Arriving & Exiting % Service Continuance (>= 2 YR) & Exiting Service Continuance (>= 2 YR) and Exiting % Total Total %, % %, , % 5,946 %, % % %, % 2, ,9 %, % 64 8., % 2, % % 7,477 % Fiscal Year 23 Arrivals, Service Continuance, & Exits Distribution Fiscal Year 34 Arrivals, Service Continuance, & Exits Distribution Fiscal Year 45 Arrivals, Service Continuance, & Exits Distribution 3% Arrivals Arrivals 3% Arrivals 2 (>= 2 YR) 23% (>= 2 YR) 2 (>= 2 YR) 7% 7% (< 2 YR) Exiting Arriving & Exiting 43% 8% (< 2 YR) Exiting Arriving & Exiting 9% (< 2 YR) Exiting Arriving & Exiting 7% (>= 2 YR) & Exiting 8% (>= 2 YR) & Exiting 7% (>= 2 YR) & Exiting Page 3 of 4

14 Service FY of Inpatient Discharges with Step Down within 7 Days of Discharge Percentage of Inpatient Discharges with Step Down within 7 Days of Discharge Time to Step Down Report: Youth Stepping Down in SMHS Services Post Inpatient Discharge* Fresno y as of August 3, 26 of Inpatient Discharges with Step Down Between 8 and 3 Days Percentage of Inpatient Discharges with Step Down Between 8 and 3 Days of Inpatient Discharges with a Step Down > 3 Days from Discharge Percentage of Inpatient Discharges with a Step Down > 3 Days from Discharge of Inpatient Discharges with No Step Down* Percentage of Inpatient Discharges with No Step Down* Minimum Number of Days between Discharge and Step Down Maximum Number of Days between Discharge and Step Down Mean Time to Next Contact Post Inpatient Discharge (Days) Median Time to Next Contact Post Inpatient Discharge (Days) 9 9.5% % 7.7% % % Median Time Between Inpatient Discharge and Step Down Service in Days Mean Time Between Inpatient Discharge and Step Down Service in Days CHARTS NOT PRODUCED DUE TO SMALL CELL SIZES Percentage of Discharges by Time Between Inpatient Discharge and Step Down Service Within 7 Days Within 8 3 Days 3 Days + No Step Down % 95% 9% 85% 8% 9.5% 7.7% 85.9% 89.3% % 75% ( 88 Unique Beneficiaries with 3 Total Inpatient Discharges ) ( 99 Unique Beneficiaries with 42 Total Inpatient Discharges ) ( 27 Unique Beneficiaries with 77 Total Inpatient Discharges ) ( 56 Unique Beneficiaries with 232 Total Inpatient Discharges ) * No Step Down is defined as no MediCal eligible service was claimed through ShortDoyle/MediCal after a claimed inpatient service was billed with a discharge date. This category may include data currently unavailable to DHCS, such as beneficiaries that were moved to a communitybased program or beneficiaries that were incarcerated. Data has been suppressed to protect patient privacy. Page 4 of 4