Client Data  > 2001 > Glossary

Glossary Fiscal Year 2001 - 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.

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. Also included here are Day Treatment services provided on an outpatient basis at the Child Study and Treatment Center at Western State Hospital. Expenditures for RSN Administration are not included.

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. Inpatient 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: (1) According to MHD staff, oxygen claims from community hospitals were incorrectly coded and included as Community Inpatient services for Fiscal Year 01. 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. (2) Also according to MHD staff, the number of clients receiving Community Inpatient services in Fiscal Year 01 is understated due to Pierce RSN authorizing and paying for these services outside the Medicaid Management Information System (MMIS). No automated data for these transactions were made available for collection by CSDB.

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

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.

Pierce County Regional Support Network (RSN) began authorizing and paying for Community Inpatient services outside the Medicaid Management Information System (MMIS). Since CSDB did not have access to automated data for these transactions, the total number of Community Inpatient clients for Fiscal Year 01 will be understated in CSDB.

Source: CSDB  - State Fiscal Year 2001

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