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Katie A. Financial Issues

Katie A. Financial Issues. Los Angeles County DMH Children’s Provider Meeting May 26, 2010. Los Angeles County EPSDT. Total EPSDT Allocations of $480 Million Total of $96 Million Katie A. Related 20 % of Total County EPSDT Contracts. Katie A. Related EPSDT. Wraparound $52 Million

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Katie A. Financial Issues

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  1. Katie A. Financial Issues Los Angeles County DMH Children’s Provider Meeting May 26, 2010

  2. Los Angeles County EPSDT • Total EPSDT Allocations of $480 Million • Total of $96 Million Katie A. Related • 20 % of Total County EPSDT Contracts

  3. Katie A. Related EPSDT Wraparound $52 Million MAT $21 Million Intensive In Home $12 Million Basic MHS $7 Million

  4. Katie A. Providers • Total of 61 Legal Entities • 50 MAT Providers • 34 Wraparound Providers • 13 Intensive In Home Providers • 20 Family Preservation Providers

  5. IS Plans • Wraparound • Tier I DCFS • Tier II DCFS • Tier II FSP – Child • Tier II FSP – TAY • MAT • MAT DMH • MAT DCFS

  6. IS Plans • Intensive In Home Mental Health Services • Multidimensional Treatment Foster Care (MTFC) • Intensive Treatment Foster Care (ITFC) • Comprehensive Children’s Service Program (CCSP) • Multisystemic Therapy (MST) • Basic-Enhanced Specialized Foster Care • Family Preservation

  7. Utilization of Katie A. Allocations • Based upon paid claims in IS • Tracked by Plans • Year to Date Target (83%) • 21 Providers Over-utilizing (> 90% YTD) • 59 Providers (LE Level) Underutilizing (< 70% YTD)

  8. EPSDT Allocations vs. Utilization • Wraparound • $ 52 Million Allocated • $10 Million Spent YTD • MAT • $21 Million Allocated • $5 Million Spent YTD • Intensive In Home MHS • $12 Million Allocated • $3 Million Spent YTD

  9. Katie A. Allocations vs. Utilization • Total allocations of $ 96 Million • Spent YTD $21 Million (22%) • Projected unspent allocation for FY 2009/2010 of…… $61 Million

  10. Katie A. Claims Cube Data • Based upon matching of DMH and DCFS client files • Includes ALL paid claims; including but not limited to Katie A. allocations • Updated on monthly basis • Organized by Service Area, Legal Entity, Client, etc.

  11. Katie A. Claims CubeJuly 2009 through February 2010 • 29,101 DCFS children served by DMH • Total EPSDT claims of $154 Million • Projected annual claims $231 Million • 48% of Total EPSDT Budget • Range of YTD EPSDT claims from $5 to $141,697. • Average EPSDT claim per DCFS child YTD of $5,278.

  12. Improving Utilization of Katie A. Allocations • Dr. Southard Letter to Providers (Jan. 2010) regarding flexibility of use of Katie A. allocations • Addition of Basic MHS Plan for all Katie A. Providers • Addition of TBS to all Katie A. Providers

  13. Going Forward • Need to use IS Plans to claim Katie A. services • DMH to provide lists of DCFS clients being served by each provider • Use Basic MHS Plan for services to DCFS children • Close monitoring of utilization • Plans of Correction/Redirection of allocations as necessary

  14. Let’s Talk

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