Mhbg
Mental Health Services Block Grant (MHBG) and the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG)
FY2026-2027_MHBG_Report
OMB: 0930-0168
OMB Number: 0930-0168
Expiration Date: X
Block Grant Reporting Section
CFDA 93.958
Community Mental Health Services Block Grant
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Table of Contents
MHBG Table 1 - Priority Area and Annual Performance Indicators – Progress Report 2
C. State Agency Expenditure Reports 4
MHBG Table 2A (URS Table 7A) State Agency Expenditure Report 6
MHBG Table 2C (URS Table 7C) MHBG State Agency Crisis Services Expenditures Report 9
MHBG Table 3 Set-Aside for Children’s Mental Health Services 10
MHBG Table 4B (URS Table 8B) State Agency MHBG Expenditures 12
MHBG Table 6 Maintenance of Effort for State Expenditures on Mental Health Services 14
D. Populations and Services Report 16
MHBG Table 7 (URS Table 1) Profile of State Population by Diagnosis 18
MHBG Table 8A (URS Table 2A) Profile of Persons Served, All Programs, by Age, Gender, and Race 19
MHBG Table 11 (URS Table 6) Profile of Client Turnover 32
MHBG Table 12 (URS Table 12) State Mental Health Agency Profile 34
MHBG Table 13A (URS Table 14A) Profile of Persons with SMI/SED Served by Age, Gender, and Race 37
E. Performance Indicators and Accomplishments 44
MHBG Table 15A (URS Table 4) Profile of Adult Clients by Employment Status 46
MHBG Table 15B (URS Table 4A) Profile of Adult Clients by Employment Status and Primary Diagnosis 48
MHBG Table 16 (URS Table 9) Social Connectedness and Improved Functioning 49
MHBG Table 17A (URS Table 11) Summary Profile of Client Evaluation of Care 51
MHBG Table 18 (URS Table 15) Living Situation Profile 55
MHBG Table 20 (URS Table 17) Profile of Persons Receiving Crisis Response Services 65
MHBG Table 21 (URS Table 19A) Profile of Criminal Justice or Juvenile Justice Involvement 67
MHBG Table 22 (URS Table 19B) Profile of Change in School Attendance 70
F. State General Data Notes 77
Appendix A: MHBG Data Definitions 78
The reporting document is comprised of the following sections:
Section A: Introduction – this section provides a brief introduction to the MHBG Annual Report as well as due dates for submission.
Section B: Implementation Report (Table 1) – In this section, states and jurisdictions are required to provide a brief review of the extent to which their respective plans were implemented and met priorities and goals identified in the Block Grant Plan covering the last completed fiscal year. The report should also include a brief review of areas the state or jurisdiction identified in the Block Grant Plan as needing improvement and changes the state or jurisdiction would propose to achieve the goals established for the priorities.
Section C: State Agency Expenditure Reports (Tables 2 through 8) – In this section, states and jurisdictions are required provide information regarding expenditures for authorized activities and services for mental health, including crisis services.
Section D: Populations and Services Report (Tables 9 through 14) – In this section, states and jurisdictions are required to provide specific information regarding the number of individuals served that are the focus of the state’s Mental Health Block Grant plan. States should report all mental health clients whose care is funded by MHBG, State funds, and any other funds that the SMHA considers part of their behavioral health system. Additionally, states and jurisdictions should provide specific information regarding the services these individuals received.
Section E: Performance Indicators and Accomplishments (Tables 15 through 24) – In this section, states and jurisdictions are required to complete the Performance Indicator tables. Performance indicators should be reported using the table format provided in this document. The purpose of the performance indicator tables is to show progress made over time, using SAMHSA’s National Outcome Measures (NOMS) for mental health services as well as any state- or jurisdiction-selected performance indicators.
Section F: State General Data Notes – In this section, states and jurisdictions may provide data notes deemed necessary to provide context for the data reported.
A. Introduction
Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C. 300x-52(a)), requires the Secretary of the Department of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to determine the extent to which states and jurisdictions have implemented the state plan for the prior fiscal year. The purpose of the Mental Health Block Grant Annual Report is to provide information to assist the Secretary in making this determination.
States and jurisdictions are required to prepare and submit their reports for the last completed state fiscal year (SFY), in the format provided in this guidance. The report will address the purposes for which the MHBG were expended, the recipients of grant funds, the authorized activities conducted, and services purchased with such funds. Particular attention should be given to the progress made toward accomplishing the goals and performance indicators identified in the states’ and jurisdictions’ plans.
All states and jurisdictions are required to prepare and submit their respective reports utilizing the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Web Block Grant Application System (WebBGAS). This report must be received by SAMHSA no later than December 1, for a state or jurisdiction to receive its next grant. If the due date falls on a weekend or federal holiday, the report will be due on the next business day. In addition, states and jurisdictions are required to submit their client level data (using MH-CLD or MH-TEDS data formats) through the Behavioral Health Services Information System (BHSIS) by the same deadline. The following schedule includes specific due dates for annual reports:
Due Dates for MH and Combined BG Components |
|||
FY the state is applying for funds |
Application Due |
Reporting Period |
MHBG Report Due |
2026 |
9/2/2025 |
Report year is Last Completed SFY |
12/1/2025 |
2027 |
9/1/2026 |
Report year is Last Completed SFY |
12/1/2026 |
B. Implementation Report
Information entered by states and jurisdictions into the performance indicator table (Plan Table 1) within the planning section of the 2024/2025 Behavioral Health Assessment and Plan will automatically populate cells 1 – 6 in the progress report table below. States and jurisdictions are required to indicate whether each year performance target/outcome measurement identified in the 2024/2025 Plan was “Achieved” or “Not Achieved” in Cell 8, Report of Progress toward Goal Attainment. If a target was not achieved, provide a detailed explanation with remedial steps proposed to meet the target.
MHBG Table 1 - Priority Area and Annual Performance Indicators – Progress Report
Priority Areas and Annual Performance Indicators |
|
1. Priority Area: |
|
3. Population(s) (SMI, SED, ESMI, BHCS, PWWDC, PP, PWID, EIS/HIV, TB, PRSUD, OTHER): |
|
|
|
5. Objective: |
|
6. Strategies to attain the objective: |
|
7. Annual Performance Indicators/objectives to measure goal success: |
|
Indicator #1: |
|
|
|
|
|
|
|
|
|
|
|
|
|
8. Report of Progress toward Goal Attainment: First-year Target: ____ Achieved _____ Not Achieved (If not achieved, explain why.) |
|
Reason why target was not achieved, and changes proposed to meet target: |
|
SMI – adults with serious mental illness; SED – children with serious emotional disturbance; ESMI – individuals with early serious mental illness including psychosis; BHCS – individuals receiving behavioral health crisis services; PWWDC – pregnant women and/or women with dependent children who are receiving SUD treatment services; PP – individuals in need of substance use primary prevention; PWID – individuals who inject drugs (formerly known as intravenous drug users (IVDU); EIS – early intervention services/HIV – individuals with or at risk for HIV/AIDS who are receiving SUD treatment services; TB – individuals with or at risk of tuberculosis who are receiving SUD treatment services; PRSUD – persons in or seeking recovery from SUD; other – specify .
C. State Agency Expenditure Reports
States and jurisdictions are required to provide information regarding MHBG, Medicaid, other federal funding sources, state, local and other funds expended for authorized activities to treat mental illness during the last completed SFY. Please complete the tables described below.
Please Note: Data for all tables contained in the Uniform Reporting System (URS) will continue to be submitted into the URS database maintained by the BHSIS Contractor.
MHBG Table 2A (URS Table 7A) State Agency Expenditure Report: MHBG Table 2A collects information on mental health expenditures by sources of funding. This includes funding from the MHBG, Medicaid, other federal funding sources, state, local, other funds, and MHBG supplemental funds including the Coronavirus Response and Relief Supplement Appropriations Act, 2021 [P.L. 116-260] (COVID-19), the American Rescue Plan Act, 2021 [P.L. 117-2] (ARP), and the Bipartisan Safer Communities Act [P.L. 117-159] (BSCA).
MHBG Table 2B (URS Table 7B) State Agency Early Serious Mental Illness (ESMI) including First Episode Psychosis Expenditures Report: MHBG Table 2B collects information on mental health expenditures by sources of funding specifically for Coordinated Specialty Care (CSC) Programs as well as other evidence-based Early Serious Mental Illness (ESMI) programs through the MHBG 10% set-aside. This includes funding from the MHBG, Medicaid, other federal funding sources, state, local, other, and MHBG supplemental funds including COVID-19, ARP, and BSCA.
MHBG Table 2C (URS Table 7C) MHBG State Agency Crisis Services Expenditures Report: MHBG Table 2C collects information on mental health expenditures by sources of funding specifically for behavioral health crisis response services (BHCS). This includes funding from the MHBG, Medicaid, other federal funding sources, state, local, other, and MHBG supplemental funds including COVID-19, ARP, and BSCA.
MHBG Table 3 Set-aside for Children’s Mental Health Service: MHBG table 3 collects information on statewide expenditures for children’s mental health services during the last completed SFY. States are required to provide systems of integrated services for children with SED. Each year the State shall expend not less than the amount expended in FY 1994. If there is a shortfall in funding available for children’s mental health services, the state may request a waiver. A waiver may be granted if the Secretary determines that the State is providing an adequate level of comprehensive community mental health services for children with SED, as indicated by comparing the number of children in need of such services with the services actually available within the State. The Secretary shall approve or deny the request for a waiver no later than 120 days after the request has been made. A waiver granted by the Secretary shall be applicable only for the fiscal year in question.
MHBG Table 4A (URS Table 8A) Profile of Mental Health Block Grant Expenditures for Other Capacity Building/Systems Development Activities: MHBG Table 4A collects information on expenditures of MHBG funds including COVID-19, ARP, and BSCA supplemental funds for other capacity building/systems development activities (non-direct service activities) that are funded or conducted by the State Mental Health Authority during the last completed SFY. Expenditures reported in this table should not include administration activities which are capped at 5 percent.
MHBG Table 4B (URS Table 8B) State Agency MHBG Expenditures: MHBG Table 4B collects information on MHBG expenditures for direct and other capacity building/systems development activities (non-direct services), as well as administrative costs during the last completed state fiscal year that are funded or conducted by the SMHA during the last completed SFY.
MHBG Table 5 (URS Table 10) Profiles of Agencies Receiving Block Grant Funds Directly from the State Mental Health Authority: This table collects information on payments to recipients of MHBG funds including intermediaries (e.g., administrative service organizations, and other organizations) which provided mental health services during the last completed SFY, including services for those experiencing early serious mental illness (ESMI), including psychotic disorders, and crisis services.
MHBG Table 6 Maintenance of Effort for Statewide Expenditures for Mental Health Service: This table collects information on expenditures of all statewide, non-Federal expenditures for authorized activities to treat mental illness during the last completed SFY.
MHBG Table 2A (URS Table 7A) State Agency Expenditure Report
This table collects information on mental health expenditures by sources of funding. This includes funding from the MHBG, Medicaid, other federal funding sources, state, local, other funds, and MHBG supplemental funds including COVID-19, ARP, and BSCA.
MHBG Table 2a |
|
||||||||||||
Reporting Period |
From: |
|
To: |
|
|||||||||
State Identifier: |
|
||||||||||||
Activity |
Sources of Funds |
|
|||||||||||
A. Mental Health Block Grant |
B. Medicaid (Federal, State, and Local) |
C. Other Federal Funds (e.g., ACF (TANF), CDC, CMS (Medicare) SAMHSA, etc.) |
D. State Funds |
E. Local Funds (excluding local Medicaid) |
F. Other |
G. COVID-19 Relief Funds (MHBG)1 |
H. ARP Funds2 |
I. Bipartisan Safer Communities Funds3 |
J. Total |
||||
|
|
|
|
|
|
|
|
|
|
|
|||
1. Evidence-Based Practices for Early Serious Mental Illness including Psychotic Disorders (10 percent of total award MHBG)4 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
2. State Hospital |
|
$ |
$ |
$ |
$ |
$ |
|
|
|
$ |
|||
3. Other Psychiatric Inpatient Care |
|
$ |
$ |
$ |
$ |
$ |
|
|
|
$ |
|||
4. Other 24-Hour Care (Residential Care) |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
5. Ambulatory/ Community Non-24-Hour Care |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
6. Crisis Services (5 percent set-aside)5 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
MHBG Table 2a (Cont.) |
|
||||||||||||
Reporting Period |
From: |
|
To: |
|
|||||||||
State Identifier: |
|
||||||||||||
Activity |
Sources of Funds |
|
|||||||||||
A. Mental Health Block Grant |
B. Medicaid (Federal, State, and Local) |
C. Other Federal Funds (e.g., ACF (TANF), CDC, CMS (Medicare) SAMHSA, etc.) |
D. State Funds |
E. Local Funds (excluding local Medicaid) |
F. Other |
G. COVID-19 Relief Funds (MHBG)1 |
H. ARP Funds2 |
I. Bipartisan Safer Communities Funds3 |
J. Total |
||||
7. Administration (Excluding Program and Provider Level)6 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
Total |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
Comments on Data |
|
||||||||||||
1 The 24-month expenditure period for the COVID-19 Relief supplemental funding is March 15, 2021 – March 14, 2023. Column G should reflect the COVID-19 Relief supplemental funding allotment portion used during the state reporting period. Note: If your state has an approved second no cost extension, you have until March 14, 2025 to expend the COVID-19 Relief supplemental funds.
2 The expenditure period for The American Rescue Plan Act of 2021 (ARP) supplemental funding is September 1, 2021 – September 30, 2025. Column H should reflect the ARP supplemental funding allotment portion used during the state reporting period.
3 The expenditure period for the 3rd and 4th allocations of the Bipartisan Safer Communities Act (BSCA) supplemental funding is September 30, 2024 – September 29, 2026 (3rd increment), and September 30, 2025 – September 29, 2027 (4th increment). Column I should reflect the BSCA allotment portion used during the state reporting period.
4 Column A row 2 should include Early Serious Mental Illness including First Episode Psychosis programs funded through different funding sources, including the MHBG, ARP, and BSCA set aside. States may expend more than 10 percent of their MHBG, ARP, and BSCA allocations.
5 Row 7 should include Crisis Services programs funded through different funding sources, including the MHBG and BSCA set aside. States may expend more than 5 percent of their MHBG and BSCA allocations.
6 Per statute, administrative expenditures for MHBG, COVID-19, ARP, and BSCA funds cannot exceed 5 percent of the fiscal year award.
MHBG Table 2B (URS Table 7B) MHBG State Agency Early Serious Mental Illness including Psychotic Disorders Expenditure Report
This table collects information on mental health expenditures by sources of funding specifically for Coordinated Specialty Care (CSC) Programs as well as other Early Serious Mental Illness (ESMI) programs through the MHBG 10% set-aside and other funding sources.
MHBG Table 2b |
|
||||||||||||
Reporting Period: |
From: |
|
To: |
|
|||||||||
State Identifier: |
|
||||||||||||
Activity
|
Sources of Funds |
||||||||||||
A. Mental Health Block Grant |
B. Medicaid (Federal, State, and local) |
C. Other Federal Funds (e.g., ACF (TANF), CDC, CMS (Medicare), SAMHSA, etc.) |
D. State Funds |
E. Local funds (excluding local Medicaid) |
F. Other |
G. COVID-19 Funds (MHBG)1 |
H. ARP Funds (MHBG)2 |
I. BSCA Funds (MHBG)3 |
J. Total |
||||
1. Coordinated Specialty Care (CSC) Programs4 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
5. Training for ESMI |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
6. Planning for ESMI |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
7. Other5 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
Total |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
|||
Comments on Data: |
|
||||||||||||
1 The 24-month expenditure period for the COVID-19 Relief supplemental funding is March 15, 2021 – March 14, 2023. Column G should reflect the COVID-19 Relief supplemental funding allotment portion used during the state reporting period. Note: If your state has an approved second no cost extension, you have until March 14, 2025 to expend the COVID-19 Relief supplemental funds.
2 The expenditure period for The American Rescue Plan Act of 2021 (ARP) supplemental funding is September 1, 2021 – September 30, 2025. Column H should reflect the ARP supplemental funding allotment portion used during the state reporting period.
3 The expenditure period for the 3rd and 4th allocation of the Bipartisan Safer Communities Act (BSCA) supplemental funding is September 30, 2024 – September 29, 2026 (3rd increment) and September 30, 2025 – September 29, 2027 (4th increment). Column I should reflect the BSCA allotment portion used during the state reporting period.
4 Use row 1 to report only those programs that are providing all components of a CSC model.
5 Use row 7 if the state uses only certain components of a CSC model.
Note, The Totals for this table should equal the amounts reported on Row 2 (Evidence-Based Practices for Early Serious Mental Illness including Other Psychotic Disorders) on MHBG Table 2A (URS Table 7A).
MHBG Table 2C (URS Table 7C) MHBG State Agency Crisis Services Expenditures Report
This table collects information on mental health expenditures specifically for behavioral health crisis response services (BHCS) provided or funded by the state mental health authority through the MHBG 5% set-aside and other funding sources.
MHBG Table 2c |
|
|||||||||||
Reporting Period |
From: |
|
To: |
|
||||||||
State Identifier: |
|
|||||||||||
Sources of Funds |
||||||||||||
Services
|
A. Mental Health Block Grant |
B. Medicaid (Federal, State, and local) |
C. Other Federal Funds (e.g., ACF (TANF), CDC, CMS (Medicare), SAMHSA, etc.) |
D. State Funds |
E. Local funds (excluding local Medicaid) |
F. Other
|
H. COVID-19 Funds (MHBG)1 |
I. ARP Funds (MHBG)2 |
J. BSCA Funds (MHBG)3 |
K. Total |
||
1. Crisis Contact Centers |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
2. 24/7 Mobile Crisis Teams |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
3. Crisis Stabilization Programs |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
4. Training and Technical Assistance |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
5. Strategic Planning and Coordination |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
Total |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
||
Comments on Data: |
|
|||||||||||
1 The 24-month expenditure period for the COVID-19 Relief supplemental funding is March 15, 2021 – March 14, 2023. Column H should reflect the COVID-19 Relief supplemental funding allotment portion used during the state reporting period. Note: If your state has an approved second no cost extension, you have until March 14, 2025 to expend the COVID-19 Relief supplemental funds.
2 The expenditure period for The American Rescue Plan Act of 2021 (ARP) supplemental funding is September 1, 2021 – September 30, 2025, which is different from the expenditure period for the “standard” MHBG. Column I should reflect the ARP supplemental funding allotment portion used during the state reporting period.
3 The expenditure period for the 3rd and 4th allocation of the Bipartisan Safer Communities Act (BSCA) supplemental funding is September 30, 2024 – September 29, 2026 (3rd increment) and September 30, 2025 – September 29, 2027 (4th increment). Column J should reflect the BSCA allotment portion used during the state reporting period.
Note, The Totals for this table should equal the amounts reported on Row 7 (Crisis Services (5 percent set-aside)) on MHBG Table 2a (URS Table 7a).
For definitions, please refer to the National Guidelines for Behavioral Health Crisis Care – A Best Practice Toolkit.
MHBG Table 3 Set-Aside for Children’s Mental Health Services
This table collects information on the statewide expenditures for children’s mental health services during the last completed SFY. States and jurisdictions are required not to spend less than the amount expended in FY 1994.
Statewide Expenditures for Children’s Mental Health Services |
|||
MHBG Table 3: |
|||
State Identifier: |
|
||
Reporting Period: From: |
|
To: |
|
A Actual SFY 1994 |
B Actual SFY 2024 |
C Estimated/Actual SFY 2025 |
Please specify if expenditure amount reported in Column C is actual or estimated. |
|
|
|
Actual Estimated |
If estimated expenditures are provided, please indicate when actual expenditure data will be submitted to SAMHSA: ___/___/_____
mm/dd/yyyy
MHBG Table 4A (URS Table 8A) Profile of Community Mental Health Block Grant Expenditures for Other Capacity Building/Systems Development Activities
This table collects information on expenditures of MHBG funds including COVID-19, ARP, and BSCA supplemental funds for other capacity building/systems development activities (non-direct service activities) that are funded or conducted by the SMHA during the last completed SFY. Expenditures reported in this table should not include administration activities which is capped at 5 percent. Please enter the total amount of the block grant expended for each activity.
MHBG Table 4A |
||||||||
Reporting Period: |
From: |
|
To: |
|
||||
State Identifier |
|
|
||||||
Non-Direct-Services/System Development |
||||||||
Activity |
A. MHBG |
B. COVID Funds1 |
C. ARP2 |
D. BSCA3 |
E. Total |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
|
$ |
$ |
$ |
$ |
$ |
|||
Total |
$ |
$ |
$ |
$ |
$ |
|||
Comments on Data |
|
|||||||
1 The 24-month expenditure period for the COVID-19 Relief supplemental funding is March 15, 2021 – March 14, 2023. Column B should reflect the COVID-19 Relief supplemental funding allotment portion used during the state reporting period. Note: If your state has an approved second no cost extension, you have until March 14, 2025 to expend the COVID-19 Relief supplemental funds.
2 The expenditure period for The American Rescue Plan Act of 2021 (ARP) supplemental funding is September 1, 2021 – September 1, 2025. Column C should reflect the ARP supplemental funding allotment portion used during the state reporting period.
3 The expenditure period for the 3rd and 4th allocation of the Bipartisan Safer Communities Act (BSCA) supplemental funding is September 30, 2024 – September 29, 2026 (3rd increment) and September 30, 2025 – September 29, 2027 (4th increment). Column D should reflect the BSCA allotment portion used during the state reporting period.
MHBG Table 4B (URS Table 8B) State Agency MHBG Expenditures
This table collects information on MHBG expenditures on direct and other capacity building/systems development (non-direct services), as well as administrative costs during the last completed state fiscal year. Total MHBG expenditures reported for non-direct services must be the same as those reported in MHBG Table 4A (URS Table 8A). Administrative costs should not be more than 5 percent of total MHBG allocation. Please include a brief explanation of expenditures for services with an asterisk in the Comments on Data section of the table below.
MHBG Table B |
||||
Reporting Period |
From: |
|
To: |
|
State Identifier |
|
|||
Services for Adults |
||||
|
$ |
|||
|
$ |
|||
|
$ |
|||
|
$ |
|||
|
$ |
|||
Subtotal of services for adults |
$ |
|||
Services for Children |
||||
|
$ |
|||
|
$ |
|||
|
$ |
|||
|
$ |
|||
|
$ |
|||
Subtotal of services for children |
$ |
|||
Non-Direct Services (other capacity building/systems development) |
$ |
|||
Administrative Costs |
$ |
|||
*Any other Costs |
$ |
|||
Total |
$ |
|||
Comments on Data |
|
|||
MHBG Table 5 (URS Table 10) Profiles of Agencies Receiving Block Grant Funds Directly from the State Mental Health Authority
This table collects information on payments to recipients of MHBG funds including intermediaries, (e.g., administrative service organizations, and other organizations), which provided mental health services during the last completed SFY, including services for those experiencing early serious mental illness (ESMI), including psychotic disorders, and crisis services. This table is to be used to provide an inventory of providers/agencies who directly receive Block Grant allocations. Only report those programs that receive MHBG funds to provide services. Do not report planning council members reimbursements or other administrative reimbursements related to running the MHBG Program.
State Identifier: |
|
|
|
|
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
|||||||||
State Identifier: |
|
||||||||||||
Entity Number |
Area Served (Statewide or Sub-State Planning Area) |
Provider/ Program Name |
Street Address |
City |
State |
Zip |
Total Block Grant Funds |
Adults with serious mental illness |
Children with serious emotional disturbance |
Set-aside for ESMI including psychotic disorders |
Set-aside for crisis services |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
|
|
|
|
|
|
|
$ |
$ |
$ |
$ |
$ |
||
MHBG Table 6 Maintenance of Effort for State Expenditures on Mental Health Services
This table collects information on expenditures of all statewide, non-Federal expenditures for authorized activities to treat mental illness during the last completed SFY.
MHBG Table 6: |
|
||||
State Identifier: |
|||||
Report Period: |
From: |
|
To: |
|
|
Total Expenditures for State: |
|
||||
A Period |
B Expenditures |
C B1 (2023) + B2 (2024) 2 |
Please specify if expenditure amounts reported in Column B are actual or estimated. |
||
SFY 2023 (1) |
|
|
Actual Estimated |
||
SFY 2024 (2) |
|
|
Actual Estimated |
||
SFY 2025 (3) |
|
|
Actual Estimated |
||
If estimated expenditures are provided, please indicate when actual expenditure data will be submitted to SAMHSA: ___/___/_____
mm/dd/yyyy
States are required to submit sufficient information for the Secretary to make a determination of compliance with the statutory maintenance of effort (MOE) requirements.1 MOE information is necessary to document that the State has maintained expenditures for community mental health services at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant. The State shall only include community mental health services expenditures for individuals that meet the federal or state definition of SMI for adults and SED for children. States that received approval to exclude funds from the maintenance of effort calculation should include the appropriate MOE approval documents.
A. MOE Exclusion
The Secretary may exclude from the aggregate amount any State funds appropriated to the principal agency for authorized activities of a non-recurring nature and for a specific purpose.2
A request for MOE exclusion should meet the following requirements:
The State shall request the exclusion separately from the application.
The request shall be signed by the State’s Chief Executive Officer or by an individual authorized to apply for CMHS Block Grant on behalf of the Chief Executive Officer.
The State shall provide documentation that supports its position that the funds were appropriated by the State legislature for authorized activities which are of a non-recurring nature and for a specific purpose; indicates the length of time the project is expected to last in years and months; and affirms that these expenditures would be in addition to funds needed to otherwise meet the State’s maintenance of effort requirement for the year for which it is applying for exclusion.
The State may not exclude funds from the MOE calculation until such time as the SAMHSA Administrator has approved in writing the State’s request for exclusion.
B. MOE Shortfalls
States are expected to meet the MOE requirement. If a state cannot meet the MOE requirement, the legislation permits relief, based on the recognition that extenuating circumstances may explain the shortfall. These conditions are described below.
1. Waiver for Extraordinary Economic Conditions
A state may request a waiver to the MOE requirement if it can be demonstrated that the MOE deficiency was the result of extraordinary economic conditions that occurred during the State Fiscal Year in question. An extraordinary economic condition is defined as a financial crisis in which the total tax revenues declined at least one and one-half percent, and either the unemployment increases by at least one percentage point, or employment declines by at least one and one-half percent.
2. Material Compliance
If the state is unable to meet the requirements for a waiver under extraordinary economic conditions, the authorizing legislation does permit the Secretary, under certain circumstances, to make a finding that even though there was a shortfall on the MOE, the State maintained material compliance with the MOE requirement for the fiscal year in question. Therefore, the State is given an opportunity to submit information that might lead to a finding of material compliance. The relevant factors that SAMHSA considers in making a recommendation to the Secretary include: (1) whether the State maintained service levels; (2) the State’s mental health expenditure history; and (3) the State’s future commitment to funding mental health services.
D. Populations and Services Report
States and jurisdictions are required to provide information regarding individuals that are served by the state mental health authority using MHBG Tables 7 through 14.
MHBG Table 7 (URS Table 1) Profile of the State Population by Diagnosis: MHBG Table 7 provides the estimates of adults with serious mental illness (SMI) and children with serious emotional disturbance (SED) residing within the state in the current reporting period and three years forward. Data for this table is prepared for the States by SAMHSA.
MHBG Tables 8A and 8B (URS Tables 2A and 2B) Profile of Persons Served in All Programs by Age, Gender, Race, and Ethnicity: MHBG Tables 8A and 8B collect information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest SFY for which data are available. This profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for all such programs. States and jurisdictions are to provide this information on all programs by age, gender, race, and ethnicity.
MHBG Tables 8C and 8D (URS Tables 2C and 2D) [optional reporting tables] Profile of Persons Served in All Programs by Sexual Orientation, Race, and Ethnicity: MHBG Tables 8C and 8D request information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest SFY for which data are available. This profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for all such programs. States and jurisdictions are to provide this information on all programs by sexual orientation, race, and ethnicity.
MHBG Table 9 (URS Table 3) Profile of Persons Served in Community Mental Health Settings, State Psychiatric Hospitals, and Other Settings by Age and Gender: MHBG Table 9 collects information on the aggregate profile of the number of persons that received public mental health services in community mental health settings, state psychiatric hospitals, other psychiatric inpatient settings, residential treatment centers, and institutions under the justice system. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age and gender.
MHBG Table 10A and 10B (URS Tables 5A and 5B) Profile of Persons Served by Type of Funding Support in All Programs by Gender, Race, and Ethnicity: MHBG Tables 10A and 10B collect information on the unduplicated aggregate profile of the number of persons served in the reporting period by type of funding support (Medicaid Only, Non-Medicaid Sources Only, Both Medicaid and Non-Medicaid, and Status Not Available). The reporting period should be the latest SFY for which data are available. The client profile takes into account all institutional and community services for all such programs. States and jurisdictions are to provide this information on all programs by gender, race, and ethnicity.
MHBG Table 11 (URS Table 6) Profile of Client Turnover: MHBG Table 11 collects information on the aggregate profile of client turnover in various out-of-home settings (state hospitals, inpatient psychiatric hospitals, residential treatment centers). Information collected in this table includes total number of served at the begging of the year, admissions and discharges during the year, and length of stay. The reporting period should be the latest SFY for which data are available.
MHBG Table 12 (URS Table 12) State Mental Health Agency Profile: MHBG Table 12 collects information that provides context for the data reported in the MHBG tables. This profile includes the populations served by age groups, services for which the state mental health agency is responsible, data reporting capacities, percentage of children and adults that meet the federal definition of SED and SMI, respectively, the percentage of children and adults with co-occurring mental and substance use disorders (M/SUD), as well as other summary administrative information. The reporting period should be the latest SFY for which data are available.
MHBG Tables 13A and 13B (URS Tables 14A and 14B) Profile of Persons with SMI/SED Served in All Programs by Age, Gender, and Ethnicity: MHBG Tables 13A and 13B collect information on the unduplicated aggregate profile of the number of persons with SMI or SED served in the reporting period. The reporting period should be the latest SFY for which data are available. The profile is based on a client receiving services in programs provided or funded by the state mental health agency. States and jurisdictions should report data using the Federal Definitions of SMI and SED if they can; if not, please report using the state’s definitions of SMI and SED and provide information in these tables describing your state’s definitions.
MHBG Table 14 (URS Table 14C) Profile of Persons with SMI/SED Served in Community Mental Health Settings, State Psychiatric Hospitals, and Other Settings by Age and Gender: MHBG Table 15A collects information on the unduplicated aggregate profile of the number of adults with SMI and children with SED that received public mental health services in community mental health settings, state psychiatric hospitals, other psychiatric inpatient settings, residential treatment centers, and institutions under the justice system. The reporting period should be the latest SFY for which data are available. This profile takes into account all institutional and community services for all such programs. State and jurisdictions are to provide this information on all programs by age and gender.
MHBG Table 7 (URS Table 1) Profile of State Population by Diagnosis
This table summarizes the estimates of adults residing within the state with serious mental illness (SMI) and children residing within the state with serious emotional disturbance (SED). The table calls for estimates for two time periods, one for the report year and one for three years into the future. CMHS will provide this data to states based on the standardized methodology developed and published in the Federal Register to estimate the state level of adults with SMI and children with SED.
MHBG Table 7 |
|
|||||
Reporting Period: |
From: |
|
To: |
|
||
State Identifier: |
|
|||||
|
Current Report Year |
Three Years Forward |
||||
Adults with Serious Mental Illness (SMI) |
|
|
||||
Children with Serious Emotional Disturbances (SED) |
|
|
||||
Note: CMHS will complete this table for the states.
MHBG Table 8A (URS Table 2A) Profile of Persons Served, All Programs, by Age, Gender, and Race
This table collection information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest state fiscal year for which data are available. This profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for such programs. States and jurisdictions are to provide this information on all programs by age, gender, and race.
MHBG Table 8A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||
State Identifier: |
|
||||||||||||||||||||||
|
Total |
American Indian or Alaska Native |
Asian |
||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender (Female
to Male) |
Two-Spirit (if client is AI/AN)
|
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if client is AI/AN) |
Other |
Not Available |
||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Pregnant Women |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Are these measures unduplicated? |
☐ Unduplicated ☐ Duplicated between hospitals and community ☐ Duplicated among community programs ☐ Duplicated between children and adults ☐ Other, please describe: ___________________________________________ |
||||||||||||||||||||||
Comments on Data (Age): |
|
||||||||||||||||||||||
Comments on Data (Gender): |
|
||||||||||||||||||||||
Comments on Data (Race): |
|
||||||||||||||||||||||
Comments on Data (Overall): |
|
||||||||||||||||||||||
(Continued on next page)
MHBG Table 8A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||
|
Total |
Black or African American |
Native Hawaiian or Pacific Islander |
|||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Pregnant Women |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Continued below)
MHBG Table 8A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
White |
Some Other Race |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender (Female to Male) |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Pregnant Women |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
(Continued on next page)
MHBG Table 8A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
More than One Race |
Not Available |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Pregnant Women |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
MHBG Table 8B (URS Table 2B) Profile of Persons Served, All Programs by Age, Gender, and Ethnicity
This table collects information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest state fiscal year for which data are available. This profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for such programs. States and jurisdictions are to provide this information on all programs by age, gender, and ethnicity. Total persons served would be the same as the total indicated in MHBG Table 8A.
MHBG Table 8B. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||
State Identifier: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
Not Hispanic or Latino |
Hispanic or Latino |
Not Available |
||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Pregnant Women |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Comments on Data (Age): |
|
||||||||||||||||||||||
Comments on Data (Gender): |
|
||||||||||||||||||||||
Comments on Data (Ethnicity): |
|
||||||||||||||||||||||
Comments on Data (Overall): |
|
||||||||||||||||||||||
(Continued on next page)
MHBG Table 8B (Cont.) |
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
||||
State Identifier: |
|
|
|
|
|
|
|
|
|
Total |
|||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
|
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Pregnant Women |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
MHBG Table 8C (URS Table 2C) Profile of Persons Served, All Programs by Sexual Orientation and Race (Optional Reporting Table)
This table collects information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest state fiscal year for which data are available. This profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for such programs. States and jurisdictions are to provide this information on all programs by sexual orientation and race. Total persons served would be the same as the total indicated in MHBG Table 8A.
MHBG Table 8C |
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
|||||
State Identifier: |
|
||||||||
|
American Indian or Alaska Native |
Asian |
Black or African American |
Native Hawaiian or Pacific Islander |
White |
Some Other Race |
More than One Race |
Not Available |
Total |
Straight or Heterosexual |
|
|
|
|
|
|
|
|
0 |
Lesbian or Gay |
|
|
|
|
|
|
|
|
0 |
Bisexual |
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if Client if AI/AN) |
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
0 |
Not Available |
|
|
|
|
|
|
|
|
0 |
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Comments on Data (Sexual Orientation): |
|
||||||||
Comments on Data Race): |
|
||||||||
Comments on Data (Overall): |
|
||||||||
MHBG Table 8D (URS Table 2D) Profile of Persons Served, All Programs by Sexual Orientation and Ethnicity (Optional Reporting Table)
This table collects information on the unduplicated aggregate profile of persons served in the reporting period. The reporting period should be the latest state fiscal year for which data are available. The profile is based on a client receiving services in programs provided or funded by the state mental health agency. The client profile takes into account all institutional and community services for such programs. States and jurisdictions are to provide this information on all programs by sexual orientation and ethnicity. Total persons served would be the same as the total indicated in MHBG Table 8B.
MHBG Table 8D |
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
State Identifier: |
|
|||
|
Not Hispanic or Latino |
Hispanic or Latino |
Not Available |
Total |
Straight or Heterosexual |
|
|
|
0 |
Lesbian or Gay |
|
|
|
0 |
Bisexual |
|
|
|
0 |
Two-Spirit (if Client is AI/AN) |
|
|
|
0 |
Other |
|
|
|
0 |
Not Available |
|
|
|
|
Total |
0 |
0 |
0 |
0 |
Comments on Data (Sexual Orientation): |
|
|||
Comments on Data (Ethnicity): |
|
|||
Comments on Data (Overall): |
|
|||
MHBG Table 9 (URS Table 3) Profile of Persons Served in Community Mental Health Settings, State Psychiatric Hospitals and Other Settings by Age and Gender
This table collects information on the aggregate profile of the number of persons that received public mental health services in community mental health settings, state psychiatric hospitals, other psychiatric inpatient settings, residential treatment centers, and institutions under the justice system. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age and gender.
MHBG Table 9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
0-5 Years |
6-12 Years |
13-17 Years |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Comments on Data (Age): |
|
|||||||||||||||||||||||
Comments on Data (Gender): |
|
|||||||||||||||||||||||
Comments on Data (Race): |
|
|||||||||||||||||||||||
Comments on Data (Overall): |
|
|||||||||||||||||||||||
(Continued below)
MHBG Table 9 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
18-20 Years |
21-24 Years |
25-44 Years |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
(Continued on next page)
MHBG Table 9 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
45-64 Years |
65-74 Years |
75 or over |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
(Continued below)
MHBG Table 9 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||
State Identifier: |
|
|||||||||||||||||
|
Not Available |
Total |
||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
||||
Community Mental Health Programs |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Residential Treatment Centers |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Institutions under the Justice System |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Note: clients can be duplicated between rows, e.g., the same client may be served in both state psychiatric hospitals and community mental health centers during the same year and thus would be reported in both rows.
MHBG Table 10A (URS Table 5A) Profile of Persons Served by Type of Funding Support in All Programs by Gender and Race
This table collects information on the unduplicated aggregate profile of persons served in the reporting period by type of funding support (Medicaid Only, Non-Medicaid Sources Only, Both Medicaid and Non-Medicaid, and Status Not Available). The reporting period should be the latest SFY for which data are available. The client profile takes into account all institutional and community services for all such programs. States and jurisdictions are to provide this information on all programs by gender and race. Persons are to be counted in the Medicaid row if they received a service reimbursable through Medicaid. Total persons served would be the same as the total indicated in MHBG Table 8A.
MHBG Table 10A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
|
||||||||||||||||||||
State Identifier: |
|
|
|||||||||||||||||||||||
|
Total |
American Indian or Alaska Native |
Asian |
|
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|
|||
Medicaid Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Non-Medicaid Sources Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
People Served by Both Medicaid and Non-Medicaid |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Medicaid Status Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
||
☐ Data based on Medicaid services ☐ Data based on Medicaid eligibility, not Medicaid paid services ☐ ‘People served by both’ includes people with any Medicaid |
|||||||||||||||||||||||||
Comments on Data (Race): |
|
|
|||||||||||||||||||||||
Comments on Data (Gender): |
|
|
|||||||||||||||||||||||
Comments on Data (Overall): |
|
|
|||||||||||||||||||||||
Each row should have a unique (deduplicated) count of clients: (1) Medicaid Only, (2) Non-Medicaid Only, (3) Both Medicaid and Other Sources funded their treatment, and (4) Medicaid Status Not Available.
If a state is unable to deduplicate counts of people whose care is paid for by Medicaid only or Medicaid and other funds, then all data should be reported into the ‘People Served by Both Medicaid and Non-Medicaid Sources’ and the ‘People Served by Both includes people with any Medicaid’ checkbox should be checked.
(Continued on next page)
MHBG Table 10A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
Black or African American |
Native Hawaiian or Pacific Islander |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
Medicaid Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Non-Medicaid Sources Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
People Served by Both Medicaid and Non-Medicaid |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Medicaid Status Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
(Continued below)
MHBG Table 10A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
White |
Some Other Race |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
Medicaid Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Non-Medicaid Sources Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
People Served by Both Medicaid and Non-Medicaid |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Medicaid Status Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
(Continued on next page)
MHBG Table 10A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||||
|
Total |
More than One Race |
Not Available |
|||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||||
Medicaid Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Non-Medicaid Sources Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
People Served by Both Medicaid and Non-Medicaid |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Medicaid Status Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
MHBG Table 10B (URS 5B) Profile of Persons Served by Type of Funding Support in All Programs by Gender and Ethnicity
This table collects information on the unduplicated aggregate profile of persons served in the reporting period by type of funding support (Medicaid Only, Non-Medicaid Sources Only, Both Medicaid and Non-Medicaid, and Status Not Available). The reporting period should be the latest SFY for which data are available. The client profile takes into account all institutional and community services for all such programs. States and jurisdictions are to provide this information on all programs by gender and ethnicity. Persons are to be counted in the Medicaid row if they received a service reimbursable through Medicaid. Total persons served would be the same as the total indicated in MHBG Table 10A.
MHBG Table 10B |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||
State Identifier: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
Not Hispanic or Latino |
Hispanic or Latino |
Not Available |
||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
Medicaid Only |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Non-Medicaid Sources Only |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
People Served by Both Medicaid and Non-Medicaid |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Medicaid Status Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Comments on Data (Ethnicity): |
|
||||||||||||||||||||||
Comments on Data (Gender): |
|
||||||||||||||||||||||
Comments on Data (Overall): |
|
||||||||||||||||||||||
(Continued below)
MHBG Table 10B (Cont.) |
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
||||
State Identifier: |
|
|
|
|
|
|
|
|
|
Total |
|||||||
Female |
Male |
Transgender (Female to Male) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
|
Medicaid Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Non-Medicaid Sources Only |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
People Served by Both Medicaid and Non-Medicaid |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Medicaid Status Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Each row should have a unique (deduplicated) count of clients: (1) Medicaid Only, (2) Non-Medicaid Only, (3) Both Medicaid and Other Sources funded their treatment, and (4) Medicaid Status Not Available.
If a state is unable to deduplicate counts of people whose care is paid for by Medicaid only or Medicaid and other funds, then all data should be reported into the ‘People Served by Both Medicaid and Non-Medicaid Sources’ and the ‘People Served by Both includes people with any Medicaid’ checkbox should be checked.
MHBG Table 11 (URS Table 6) Profile of Client Turnover
This table collects information on the aggregate profile of client turnover in various out-of-home settings (state hospitals, inpatient psychiatric hospitals, residential treatment centers). Information collected by this table includes total served at the beginning of year, admissions and discharge during the year, and lengths of stay. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age.
MHBG Table 11 |
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
|
|
|||
State Identifier: |
|
|
|
||||||
Profile of Service Utilization |
Total Served at Beginning of Year (unduplicated) |
Admissions During the Year (duplicated) |
Discharges During the Year (duplicated) |
Length of Stay (in Days): Discharged Patients |
For Clients in Facility for 1 Year or Less: Average Length of Stay (in Days): Residents at End of Year |
For Clients in Facility More Than 1 Year: Average Length of Stay (in Days): Residents at End of Year |
|||
Average (Mean) |
Median |
Average (Mean) |
Median |
Average (Mean) |
Median |
||||
State Hospitals |
0 |
0 |
0 |
|
|
|
|
|
|
0-5 years |
|
|
|
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
|
|
|
75 or over |
|
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
Other Psychiatric Inpatient |
0 |
0 |
0 |
|
|
|
|
|
|
0-5 years |
|
|
|
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
|
|
|
75 or over |
|
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
(Continued on next page)
MHBG Table 11 (cont.) |
|
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
|
|
|||
State Identifier: |
|
|
|
||||||
Profile of Service Utilization |
Total Served at Beginning of Year (unduplicated) |
Admissions During the Year (duplicated) |
Discharges During the Year (duplicated) |
Length of Stay (in Days): Discharged Patients |
For Clients in Facility for 1 Year or Less: Average Length of Stay (in Days): Residents at End of Year |
For Clients in Facility More Than 1 Year: Average Length of Stay (in Days): Residents at End of Year |
|||
Average (Mean) |
Median |
Average (Mean) |
Median |
Average (Mean) |
Median |
||||
Residential Treatment Centers |
0 |
0 |
0 |
|
|
|
|
|
|
0-5 years |
|
|
|
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
|
|
|
75 or over |
|
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
Community Programs |
0 |
0 |
|
||||||
0-5 years |
|
|
|||||||
6-12 years |
|
|
|||||||
13-17 years |
|
|
|||||||
18-20 years |
|
|
|||||||
21-24 years |
|
|
|||||||
25-44 years |
|
|
|||||||
45-64 years |
|
|
|||||||
65-74 years |
|
|
|||||||
75 or over |
|
|
|||||||
Not Available |
|
|
|||||||
Comments on Data (State Hospital): |
|
|
|
||||||
Comments on Data (Other Inpatient): |
|
|
|
||||||
Comments on Data (Residential Treatment Centers): |
|
|
|
||||||
Comments on Data (Community Programs): |
|
|
|
||||||
Comments on Data (Overall): |
|
|
|
||||||
MHBG Table 12 (URS Table 12) State Mental Health Agency Profile
This table collects information that provides context for the data reported in the MHBG tables. This profile includes the populations that receive services operated or funded by the state mental health agency, data reporting capacities, percentage of children and adults that meet the federal definition of SED and SMI, respectively, the percentage of children and adults with co-occurring mental and substance use disorders (M/SUD), as well as other summary administrative information.
MHBG Table 12 |
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
State Identifier: |
|
|||
Populations Served
1 |
Which of the following populations receive services operated or funded by the state mental health agency? Please indicate if they are included in the data provided in the tables. (Check all that apply.) |
|
|
|||||||||||
|
|
Populations Covered |
Included in Data |
|
|
|||||||||
|
State Hospitals |
Community Programs |
State Hospitals |
Community Programs |
|
|
||||||||
|
1. 0 to 5 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
2. 6 to 12 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
3. 13 to 17 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
4. 18 to 20 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
5. 21 to 24 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
6. 25 to 44 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
7. 45 to 64 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
8. 65 to 74 years |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
9. 75 or over |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
4. Forensics |
☐ Yes |
☐ Yes |
☐ Yes |
☐ Yes |
|
|
|||||||
|
Comments on Data: |
|
|
|
||||||||||
2 |
Do all of the adults and children served through the state mental health agency meet the federal definitions of serious mental illness and serious emotional disturbances? |
|
|
|||||||||||
|
|
☐ Serious Mental Illness
|
|
|
||||||||||
2.a. |
If no, please indicate the percentage of persons served for the reporting period who met the federal definitions of serious mental illness and serious emotional disturbance. |
|||||||||||||
2.a.1 |
Percentage of adults meeting federal definition of SMI: |
|
|
|
|
|||||||||
2.a.2 |
Percentage of children/adolescents meeting federal definition of SED |
|
|
|
||||||||||
3 |
Co-Occurring Mental and Substance Use Disorders |
|
|
|
|
|||||||||
3.a. |
What percentage of persons served by the SMHA for the reporting period have a dual diagnosis of mental and substance use disorders? |
|
|
|
|
|||||||||
(Continued on next page)
MHBG Table 12 (cont.) |
|
|
|
|
|
|||||||||||||||
Reporting Period: |
From: |
|
To: |
|
|
|||||||||||||||
State Identifier: |
|
|
||||||||||||||||||
3.a.1 |
Percentage of adults served by the SMHA who also have a substance use disorder: |
|
|
|||||||||||||||||
3.a.2. |
Percentage of children/adolescents served by the SMHA who also have a substance use disorder: |
|
|
|||||||||||||||||
3.b. |
What percentage of persons served in the reporting period who met the federal definitions of adults with SMI and children/adolescents with SED have a dual diagnosis of mental and substance use disorders? |
|
||||||||||||||||||
3.b.1 |
Percentage of adults meeting federal definition of SMI who also have a substance use disorder: |
|
|
|||||||||||||||||
3.b.2. |
Percentage of children/adolescents meeting the federal definition of SED who also have a substance use disorder: |
|
|
|||||||||||||||||
3b.3 |
Please describe how you calculate and count the number of persons with co-occurring mental and substance disorders: |
|
|
|||||||||||||||||
4 |
State Mental Health Agency Responsibilities |
|
||||||||||||||||||
4a. Medicaid: Does the State Mental Health Agency have any of the following responsibilities for mental health services provided through Medicaid? (Check all that apply.) |
|
|||||||||||||||||||
1. State Medicaid Operating Agency |
☐ |
|
|
|
|
|||||||||||||||
2. Setting Standards |
☐ |
|
|
|
|
|||||||||||||||
3. Quality Improvement/Program Compliance |
☐ |
|
|
|
|
|||||||||||||||
4. Resolving Consumer Complaints |
☐ |
|
|
|
|
|||||||||||||||
5. Licensing |
☐ |
|
|
|
|
|||||||||||||||
6. Sanctions |
☐ |
|
|
|
|
|||||||||||||||
7. Other |
|
|
|
|||||||||||||||||
|
|
|
|
|
Are data for these programs reported on URS Tables? |
|||||||||||||||
4b. Managed Care (Mental Health Managed Care) |
|
|
||||||||||||||||||
4.b.1 |
Does the state have a Medicaid Managed Care initiative? |
☐ Yes |
☐ Yes |
|||||||||||||||||
4.b.2 |
Does the State Mental Health Agency have any responsibilities for mental health services provided through Medicaid Managed Care? |
☐ Yes |
|
|||||||||||||||||
(Continued on next page)
MHBG Table 12 (cont.) |
|
|
|
|
|
|
|
||||||||||||
Reporting Period: |
From: |
|
To: |
|
|
|
|
||||||||||||
State Identifier: |
|
|
|
|
|||||||||||||||
|
If yes, please check the responsibilities the SMHA has: |
|
|
||||||||||||||||
4.b.3 |
Direct contractual responsibility and oversight of the Managed Care Organizations (MCOs) or specialty Behavioral Health Organizations (BHOs) |
☐ |
|
||||||||||||||||
4.b.4 |
Setting standards for mental health services |
|
☐ |
|
|||||||||||||||
4.b.5 |
Coordination with state health and Medicaid agencies |
|
☐ |
|
|||||||||||||||
4.b.6 |
Resolving mental health consumer complaints |
|
☐ |
|
|||||||||||||||
4.b.7 |
Input in contract development |
|
|
☐ |
|
||||||||||||||
4.b.8 |
Performance monitoring |
|
|
☐ |
|
||||||||||||||
4.b.9 |
Other |
|
|
|
|||||||||||||||
5 |
Data Reporting: Please describe the extent to which your information systems allow the generation of unduplicated client counts between different parts of your mental health system. Please respond in particular for MHBG Table 8, which requires unduplicated counts of clients served across your entire mental health system. |
|
|
|
|
||||||||||||||
|
The data reported in the tables are: |
|
|
|
|
|
|||||||||||||
5.a. |
Unduplicated: counted once even if they were served in both state hospitals and community programs and if they were served in community mental health agencies responsible for different geographic or programmatic areas. |
|
|
||||||||||||||||
5.b. |
Duplicated: across state hospital and community programs |
|
☐ |
|
|||||||||||||||
5.c. |
Duplicated: within community programs |
|
|
☐ |
|
||||||||||||||
5.d. |
Duplicated: between child and adult agencies |
|
|
☐ |
|
||||||||||||||
5.e. |
Plans for reporting unduplicated data: If you are not currently able to provide unduplicated client counts across all parts of your mental health system, please describe your plans to report unduplicated client counts. |
|
|||||||||||||||||
|
|
|
|||||||||||||||||
6 |
Summary Administrative Data |
|
|
|
|
|
|
||||||||||||
6.a. |
Report Year: |
|
|
|
|
|
|
||||||||||||
6.b. |
State Identifier: |
|
|
|
|
|
|||||||||||||
|
Summary Information on Data Submitted by SMHA: |
|
|
|
|
|
|||||||||||||
6.c. |
Year being reported: From: |
|
To: |
|
|
|
|
||||||||||||
6.d. |
Person Responsible for Submission: |
|
|
|
|||||||||||||||
6.e. |
Contact Phone Number: |
|
|
|
|||||||||||||||
6.f. |
Contact Address: |
|
|
|
|||||||||||||||
|
|
|
|
||||||||||||||||
6.g. |
E-mail: |
|
|
|
|||||||||||||||
MHBG Table 13A (URS Table 14A) Profile of Persons with SMI/SED Served in All Programs by Age, Gender, and Race
This table collects information on the unduplicated aggregate profile of persons with SMI or SED served in the reporting period. The profile is based on a client receiving services in programs provided or funded by the state mental health agency. States and jurisdictions should report data using the Federal Definitions of SMI and SED if they can, if not, please report using the state’s definition of SMI and SED and provide information below describing your state’s definition. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age, gender, and race.
MHBG Table 13A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
American Indian or Alaska Native |
Asian |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Comments on Data (Age): |
|
|||||||||||||||||||||||
Comments on Data (Gender): |
|
|||||||||||||||||||||||
Comments on Data (Race): |
|
|||||||||||||||||||||||
Comments on Data (Overall): |
|
|||||||||||||||||||||||
Do the State definitions of SMI/SED match the Federal definition?
Adults
with SMI, If no, describe or attach state definition:
__________________________________________________________________________________________________________________________
Diagnoses
included in state SMI definition:
__________________________________________________________________________________________________________________________
Children with SED, if no, describe or attach state definition: __________________________________________________________________________________________________________________________
Diagnoses included in state SED definition: __________________________________________________________________________________________________________________________
(Continued on next page)
MHBG Table 13A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
Total |
Black or African American |
Native Hawaiian or Pacific Islander |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
(Continued below)
MHBG Table 13A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||||
State Identifier: |
|
||||||||||||||||||||||||
|
Total |
White |
Some Other Race |
||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
(Continued on next page)
MHBG Table 13A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||||
State Identifier: |
|
||||||||||||||||||||||||
|
Total |
More than One Race |
Not Available |
||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female)
|
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|
|||
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
||
MHBG Table 13B (URS Table 14B) Profile of Persons with SMI/SED Served in All Programs by Age, Gender, and Ethnicity
This table collects the unduplicated aggregate profile of persons with SMI or SED served in the reporting period. The profile is based on a client receiving services in programs provided or funded by the state mental health agency. States and jurisdictions should report data using the Federal Definitions of SMI and SED if they can, if not, please report using the state’s definition of SMI and SED and provide information below describing your state’s definition. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age, gender, and ethnicity. The total persons served who meet the Federal definition of SMI or SED would be the same as the total in MHBG Table 13A.
MHBG Table 13B. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||||||
State Identifier: |
|
||||||||||||||||||||||
|
Not Hispanic or Latino |
Hispanic or Latino |
Not Available |
||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
|||
0-5 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
6-12 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13-17 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
18-20 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
21-24 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
25-44 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
45-64 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
65-74 years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
75 or over |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Comments on Data (Age): |
|
||||||||||||||||||||||
Comments on Data (Gender): |
|
||||||||||||||||||||||
Comments on Data (Ethnicity): |
|
||||||||||||||||||||||
Comments on Data (Overall): |
|
||||||||||||||||||||||
(Continued on next page)
MHBG Table 13B (Cont.) |
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
||||
State Identifier: |
|
|
|
|
|
|
|
|
|
Total |
|||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
|
0-5 years |
0 |
0 |
|
|
|
|
0 |
0 |
6-12 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
13-17 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
18-20 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
21-24 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
25-44 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
45-64 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
65-74 years |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
75 or over |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Not Available |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
MHBG Table 14 (URS Table 14C) Profile of Persons with SMI/SED Served in Community Mental Health Settings, State Psychiatric Hospitals, and Other Settings by Age and Gender
This table collects information on the aggregate profile of the number of adults with serious mental illness (SMI) and children with serious emotional disturbance (SED) that received publicly funded mental health services in community mental health settings, state psychiatric hospitals, other psychiatric inpatient programs, residential treatment centers, and institutions under the justice system. The reporting period should be the latest SFY for which data are available. States and jurisdictions are to provide this information on all programs by age and gender.
MHBG Table 14 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||||
|
0-5 Years |
6-12 Years |
13-17 Years |
|||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Comments on Data (Age): |
|
|||||||||||||||||||||||||
Comments on Data (Gender): |
|
|||||||||||||||||||||||||
Comments on Data (Race): |
|
|||||||||||||||||||||||||
Comments on Data (Overall): |
|
|||||||||||||||||||||||||
(Continued below)
MHBG Table 14 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||||
|
18-20 Years |
21-24 Years |
25-44 Years |
|||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
(Continued on next page)
MHBG Table 14 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||||
|
45-64 Years |
65-74 Years |
75 or Over |
|||||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||||
Community Mental Health Programs |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Residential Treatment Centers |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Institutions under the Justice System |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
(Continued below)
MHBG Table 14 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Reporting Period: |
From: |
|
To: |
|
|||||||||||||||
State Identifier: |
|
||||||||||||||||||
|
Not Available |
Total |
|||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
|||||
Community Mental Health Programs |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
State Psychiatric Hospitals |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
Other Psychiatric Inpatient |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
Residential Treatment Centers |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
Institutions under the Justice System |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||||
Note: clients can be duplicated between rows, e.g., the same client may be served in both state psychiatric hospitals and community mental health centers during the same year and thus would be reported in counts for both rows.
E. Performance Indicators and Accomplishments
MHBG Table 15A (URS Table 4) Profile of Adult Clients by Employment Status: MHBG Table 15A collects information on the employment status of adult clients served in the reporting period. The focus is on employment for adults recognizing, however, that there are clients who are disabled, retired or who are homemakers, caregivers, etc., and not a part of the labor force. These persons should be reported under the “Not in Labor Force” category. Unemployed refers to persons who are looking for work but have not found employment. Data should be reported for clients in non-institutional settings at time of discharge or last evaluation. The reporting period should be the latest SFY for which data are available.
MHBG Table 15B (URS Table 4A) Profile of Adult Clients by Employment Status and Primary Diagnosis: MHBG Table 15B collects information on the employment status of adult clients served in the reporting period by primary diagnosis. Data should be reported for clients in non-institutional settings at time of discharge or last evaluation. The reporting year should be the latest SFY for which data are available.
MHBG Table 16 (URS Table 9) Social Connectedness and Improved Functioning: MHBG Table 16 collects information on the number of children/adolescents and adults reporting positively on the improved social connectedness and functioning domains.
MHBG Table 17A (URS Table 11) Summary Profile of Client Evaluation of Care: MHBG Table 17A collects information that evaluates the “experience” of care for individuals that participate in the public mental health system. Specifically, the evaluation focuses on several areas including access, quality and the appropriateness of services, outcomes, participation in treatment planning, cultural sensitivity of staff, and general satisfaction with services.
MHBG Table 17B (URS Table 11A) [optional reporting table]: Consumer Evaluation of Care by Race and Ethnicity: MHBG Table 17B requests information that evaluates the “experience” of care for individuals that participate in the public mental health system, broken down by race, ethnicity, and age category (adult and child/adolescent).
MHBG Table 18 (URS Table 15) Living Situation Profile: MHBG Table 18 collects information on the on the living situation of persons served in the reporting period. Living situation categories include, but are not limited to, private residence, foster care, residential care, jail/correctional facility, homeless shelter, etc. Data should be based on the most recent assessment in the reporting period. Specifically, information is collected on the individual’s living situation at time of discharge or last evaluation. The reporting period should be the latest SFY for which data are available.
MHBG Table 19A (URS Table 16A) Profile of Adults with Serious Mental Illness and Children with Serious Emotional Disturbance Receiving Specific Services: MHBG Table 19A collects information on the profile of adults with SMI and children with SED receiving specific evidence-based practices in the reporting period. In addition, the table collects information on if and how states and jurisdictions monitor fidelity for the evidence-based services. The reporting period should be the latest SFY for which data are available.
MHBG Table 19B (URS Table 16B) Profile of Adults with Serious Mental Illness Receiving Specific Services: MHBG Table 19B provides a profile of adults with SMI receiving family psychoeducation, integrated treatment for co-occurring disorders, illness self-management and recovery, and medication management. In addition, this table collects information on if, and how, states and jurisdictions monitor the fidelity for the evidence-based services. The reporting period should be the latest SFY for which data are available.
MHBG Table 19C (URS Table 16C) Profile of Adults with Serious Mental Illness and Children with Serious Emotional Disturbance receiving Coordinated Specialty Care Services: MHBG Table 19C collects information on the number of adults with SMI and children with SED that were admitted into and received Coordinated Specialty Care (CSC) services, the number of clients successfully discharged from CSC services, the number of clients who discontinued CSC services, and the number of clients that received CSC services. In addition, the table collects information on if, and how, states and jurisdictions monitor fidelity for the CSC program. The reporting period should be the latest SFY for which data are available.
MHBG Table 19D (URS Table 16D) Profile of Adults with Serious Mental Illness and Children with Serious Emotional Disturbance Receiving Coordinated Specialty Care Services who Experienced No Psychiatric Hospitalization or Arrest: MHBG Table 19D collects information on the percentage of adults with SMI and children with SED enrolled in Coordinated Specialty Care (CSC) services who experienced no psychiatric hospitalization in the current fiscal year and the percentage of adults with SMI and children with SED enrolled in CSC services who experienced no arrests in the current fiscal year. The reporting period should be the latest SFY for which data are available.
MHBG Table 20 (URS Table 17) Profile of Persons Receiving Crisis Response Services: MHBG Table 20 collects information on the number of persons that received crisis response services. In addition, this table also collects information on the estimated percentage of the state population with access to crisis response services. The reporting period should be the latest SFY for which data are available.
MHBG Table 21 (URS Table 19A) Profile of Criminal Justice or Juvenile Justice Involvement: MHBG Table 21 collects information on the number of children/youth and adults with an arrest in T1 (prior 12 months) and T2 (most recent 12 months) to measure the change in arrests over time. Information required includes information on arrests and impact of services.
MHBG Table 22 (URS Table 19B), Profile of Change in School Attendance: MHBG Table 22 collects information on the number of children with suspension and expulsion from school in T1 (prior 12 months) and T2 (most recent 12 months) to measure the change in school attendance over time. Information required includes information on suspensions/expulsions, and impact of services.
MHBG Table 23A (URS Table 20A) Profile of Non-Forensic (Voluntary and Civil-Involuntary) Patients Readmission to Any State Psychiatric Inpatient Hospital Within 30/180 Days of Discharge: MHBG Table 23A collects information on the total number of civil discharges within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting period should be the latest SFY for which data are available.
MHBG Table 23B (URS Table 20B) Profile of Forensic Patients Readmission to Any State Psychiatric Inpatient Hospital within 30/180 Days of Discharge: MHBG Table 23B collects information on the total number of forensic discharges within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting period should be the latest SFY for which data are available.
MHBG Table 24 (URS Table 21) [Optional Reporting Table]: Profile of Non-Forensic (Voluntary and Civil-Involuntary) Patients Readmission to Any Psychiatric Inpatient Care Unit (State Operated or Other Psychiatric Inpatient Unit) within 30/180 Days of Discharge: MHBG Table 24 collects information the total number of civil discharges from inpatient care units within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting period should be the latest SFY for which data are available.
MHBG Table 15A (URS Table 4) Profile of Adult Clients by Employment Status
This table collects information on the employment status of adult clients served in the reporting period. The focus is on employment for adults recognizing, however, that there are clients who are disabled, retired or who are homemakers, caregivers, etc., and not a part of the labor force. These persons should be reported under the “Not in Labor Force” category. Unemployed refers to persons who are looking for work but have not found employment. Data should be reported for clients in non-institutional settings at time of discharge or last evaluation. The reporting year is the latest SFY for which data are available.
MHBG Table 15A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
18-20 Years |
21-24 Years |
25-44 Years |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN)g |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
Competitively Employed Full- or Part-Time (including Supported Employment) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Unemployed |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Not in Labor Force (retired, sheltered employment, sheltered workshops, homemaker, student, volunteer, disabled, etc.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
H
ow
often does your state measure employment status? ☐
At
Admission ☐
At
Discharge ☐
Monthly
☐
Quarterly
☐
Other,
please describe:
________________________________________________________________________
What populations are included in reported data? All clients Only selected groups. Please describe: __________________________________________________________
Comments on Data (Age): |
|
Comments on Data (Gender): |
|
Comments on Data (Overall): |
|
(Continued on next page)
MHBG Table 15A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||
|
45-64 Years |
65-74 Years |
75 or Over |
|||||||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
||||
Competitively Employed Full- or Part-Time (including Supported Employment) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Unemployed |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Not in Labor Force (retired, sheltered employment, sheltered workshops, homemaker, student, volunteer, disabled, etc.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
(Continued below)
MHBG Table 15A (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||
State Identifier: |
|
|||||||||||||||||
|
Not Available |
Total |
||||||||||||||||
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Female |
Male |
Transgender (Male to Female) |
Transgender |
Two-Spirit (if Client is AI/AN) |
Other |
Not Available |
Total |
||||
Competitively Employed Full- or Part-Time (including Supported Employment) |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Unemployed |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Not in Labor Force (retired, sheltered employment, sheltered workshops, homemaker, student, volunteer, disabled, etc.) |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Not Available |
|
|
|
|
|
|
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|||
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|||
MHBG Table 15B (URS Table 4A) Profile of Adult Clients by Employment Status and Primary Diagnosis
This table collects information on the employment status of adult clients served in the reporting period by primary diagnosis. Data should be reported for clients in non-institutional settings at time of discharge or last evaluation. The reporting period is the latest SFY for which data are available. Total persons reported on this table would be the same as the total indicated in MHBG Table 15A.
MHBG Table 15B |
|
|
|
|
|
|
||||
Reporting Period |
From: |
|
To: |
|
||||||
State Identifier: |
||||||||||
Clients Primary Diagnosis |
Competitively Employed Full- or Part-Time (including Supported Employment) |
Unemployed |
Not in Labor Force (retired, sheltered employment, sheltered workshops, homemaker, student, volunteer, disabled, etc.) |
Employment Status Not Available |
Total |
|
||||
|
||||||||||
Schizophrenia & Related Disorders (F20, F25) |
|
|
|
|
0 |
|
||||
Bipolar and Mood Disorders (F30, F31, F32, F32.9, F33, F34.0, F34.1) |
|
|
|
|
0 |
|
||||
Other Psychoses (F22, F23, F24, F28, F29) |
|
|
|
|
0 |
|
||||
All Other Diagnoses |
|
|
|
|
0 |
|
||||
No Diagnosis and Deferred Diagnosis (R69, R99, Z03.89) |
|
|
|
|
0 |
|
||||
Total |
0 |
0 |
0 |
0 |
0 |
|
||||
Comments on Data: |
|
|||||||||
MHBG Table 16 (URS Table 9) Social Connectedness and Improved Functioning
This table collects information on children/adolescents and adults reporting positively on the improved social connectedness and functioning domains.
MHBG Table 16 |
|
|
|
|
|
|
|
||||||||
Reporting Period (Year Survey was Conducted): From: |
|
To: |
|
|
|
|
|
||||||||
State Identifier: |
|
|
|
|
|
||||||||||
Adult Consumer Survey Results: |
Number of Positive Responses |
Responses |
Percent Positive (calculated) |
|
|
|
|
||||||||
1. Social Connectedness |
|
|
|
|
|
|
|
||||||||
2. Functioning |
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|||||||
Child/Adolescent Consumer Survey Results: |
Number of Positive Responses |
Responses |
Percent Positive (calculated) |
|
|
|
|
||||||||
3. Social Connectedness |
|
|
|
|
|
|
|
||||||||
4. Functioning |
|
|
|
|
|
|
|
||||||||
Comments on Data: |
|
|
|
|
|
||||||||||
Adult Social Connectedness and Functioning Measures |
|
|
|||||||||||||
1 |
|
|
Measure used |
||||||||||||
2 |
|
|
Measure used |
||||||||||||
3. Did you collect these as part of your MHSIP Adult Consumer Survey? |
|
|
|
|
|
|
|||||||||
|
If no, what source did you use? |
|
|
|
|
||||||||||
Child/Family Social Connectedness and Functioning Measures |
|
|
|||||||||||||
4 |
|
|
Measure used |
||||||||||||
5 |
|
|
Measure used |
||||||||||||
6. Did you collect these as part of your YSS-F Survey? |
|
|
|
|
|
|
|||||||||
|
If no, what source did you use? |
|
|
|
|
||||||||||
.
Did you use the recommended Social Connectedness Domain Questions?
Recommended Scoring Rules
Please use the same rules for reporting Social Connectedness and Functioning Domain scores as for calculating other Consumer Survey Domain sores for Table 11: i.e.:
Recode ratings of “not applicable” as missing values.
Exclude respondents with more than 1/3rd of the items in that domain missing.
Calculate the mean of the items for each respondent.
FOR ADULTS: calculate the percent of scores less than 2.5 (percent agree and strongly agree).
FOR YSS-F: calculate the percent of scores greater than 3.5 (percent agree and strongly agree).
Items to Score in the Functioning Domain:
Adult MHSIP Functioning Domain Items
I do thinks that are more meaningful to me.
I am better able to take care of my needs.
I am better able to handle things when they go wrong.
I am better able to do things that I want to do.
My symptoms are not bothering me as much (this question already is a part of the MHSIP adult survey).
YSS-F Functioning Domain Items:
My child is better able to do things he or she wants to do.
My child is better at handling daily life (existing YSS-F Survey item).
My child gets along better with family members (existing YSS-F Survey item).
My child gets along better with friends and other people (existing YSS-F Survey item).
My child is doing better in school and/or work (existing YSS-F Survey item).
My child is better able to cope when things go wrong (existing YSS-F Survey item).
Items to Score in the Social Connectedness Domain:
Adult MHSIP Social Connectedness Domain:
I am happy with the friendships I have.
I have people with whom I can do enjoyable things.
I feel I belong in my community.
In a crisis, I would have the support I need from family or friends.
YSS-F Social Connectedness Domain Items:
I know people who will listen and understand me when I need to talk.
I have people that I am comfortable taking with about my child’s problems.
In a crisis, I would have the support I need from family or friends.
I have people with whom I can do enjoyable things.
MHBG Table 17A (URS Table 11) Summary Profile of Client Evaluation of Care
This table collects information that evaluates the “experience” of care for individuals that participate in the public mental health system. Specifically, the evaluation focuses on several areas including access, quality and appropriateness of services, outcomes, participation in treatment planning, cultural sensitivity of staff, and general satisfaction with services. Please enter the number of persons responding positively to the questions and the number of total responses within each group. Percent positive will be calculated from these data.
MHBG Table 17A |
|
|
|
||
Reporting Period (Year Survey was Conducted): From: |
|
To: |
|
||
State Identifier: |
|
||||
Adult Consumer Survey Results: |
Number of Positive Responses |
Responses |
Confidence Interval* |
||
1. Reporting Positively About Access |
|
|
|
||
2. Reporting Positively About Quality and Appropriateness |
|
|
|
||
3. Reporting Positively About Outcomes |
|
|
|
||
4. Adults Reporting on Participation in Treatment Planning |
|
|
|
||
5. Adults Positively about General Satisfaction with Services |
|
|
|
||
|
|
|
|
|
|
Child/Adolescent Consumer Survey Results: |
Number of Positive Responses |
Responses |
Confidence Interval* |
||
1. Reporting Positively About Access |
|
|
|
||
2. Reporting Positively about General Satisfaction |
|
|
|
||
3. Reporting Positively about Outcomes for Children |
|
|
|
||
4. Family Members Reporting on Participation in Treatment Planning |
|
|
|
||
5. Family Members Reporting High Cultural Sensitivity of Staff |
|
|
|
||
Comments on Data: |
|
||||
* Please report Confidence Intervals at the 95% level. See directions below regarding the calculation of confidence intervals. |
|||||
Adult Consumer Surveys |
|||||
1.a. If no, which version:
1.
Original 40 Item Version
2.
21-Item Version
3.
State Variation of MHSIP
4.
Other Consumer Survey
1.b.If other, please attach instrument used. 1c. Did you use any translation of MHSIP into another language? 1. Spanish 2. Other Language: __________________________________ |
|||||
Adult Survey Approach |
|||||
|
|
||||
2.a. If a sample was used, what sample methdology was used? |
|
||||
4. Other sample: ___________________________________________
|
|||||
as
the Official 28 Item MHSIP Adult Outpatient Consumer
Survey used?
(Continued on next page)
MHBG Table 17A (Cont.) |
|||
2.b. Do you survey only people currently in services, or do you also survey persons no longer in service? 1. Persons currently receiving services 2. Persons no longer receiving services 2.c. If yes, please describe how you survey persons no longer receiving services: _____________________________________________________________________________________________________________________ |
|||
1. All adult consumers in state 2. Adults with serious mental illness 3. Adults who were Medicaid eligible or in Medicaid Managed Care 4. Other, describe (for example, if you survey anyone served in the last 3 months, describe that here): __________________________________________________________________________________________ |
|||
|
|||
|
Self-Administered |
Interview |
|
Phone |
Yes |
Yes |
|
Yes |
|
||
Face-to-face |
Yes |
Yes |
|
Web-based |
Yes |
Yes |
|
4.a. Who administered the survey (check all that apply)? 1. MH consumers 2. Family members 3. Professional interviewers 4. MH clinicians 5. Non-direct treatment staff 6. Other: describe: __________________________________________________________________ |
|||
1. Responses are anonymous 2. Responses are confidential 3. Responses are matched to client databases |
|||
|
|||
6a. How many surveys were attempted (sent out or calls initiatied)? |
|
||
6b. How many survey contacts were made (surveys to valid phone numbers or addresses)? |
|
||
6c. How many surveys were completed (survey forms returned or calls completed)? |
|
||
6d. What was your response rate (number of completed surveys dividied by number of contacts)? |
|
||
6e. If you received “blank” surveys back from consumers (surveys with no responses on them), did you count these surveys as “completed” for the calculation of response rates? |
|
||
|
|||
7a. SMHA conducted or contracted for the survey (survey done at state level) |
|
||
7b. Local mental health providers/county mental health providers conducted or contracted for the survey (survey was done at the local or regional level) |
|
||
7c. Other: describe: ____________________________________________________________________________________________________ |
|||
Note: The confidence interval is the plus-or-minus figure usually reported in newspaper or television opinion poll results. For example, if you use a confidence interval of 4 and 47 percent of your sample picks an answer you can be "sure" that if you had asked the question of the entire relevant population between 43 percent (47-4) and 51 percent (47+4) would have picked that answer. The confidence level tells you how sure you can be. It is expressed as a percentage and represents how often the true percentage of the population who would pick an answer lies within the confidence interval. The 95 percent confidence level means you can be 95 percent certain; the 99 percent confidence level means you can be 99 percent certain. Most researchers use the 95 percent confidence level. When you put the confidence level and the confidence interval together, you can say that you are 95 percent sure that the true percentage of the population is between 43 percent and 51 percent. (from www.surveysystem.com) |
|||
(Continued on next page)
MHBG Table 17A (Cont.) |
||||
Child/Family Consumer Surveys |
||||
If no, what survey was used? ________________________________________________ If no, please attached instrument used. |
||||
1.a Did you use any translations of the YSS-F into another language? 1. Spanish 2. Other Language: __________________________________ |
||||
Child/Family Survey Approach: |
||||
|
|
|||
2a. If a sample was used, what approach was used? |
|
|||
4. Other sample: ___________________________________________ |
||||
2.b. Do you survey only people currently in services, or do you also survey persons no longer in service? 1. Persons currently receiving services 2. Persons no longer receiving services 2.c. If yes, please describe how you survey persons no longer receiving services: _____________________________________________________________________________________________________________________ |
||||
1. All child consumers in state 2. Children with serious emotional disturbances 3. Children who were Medicaid eligible or in Medicaid Managed Care 4. Other, describe (for example, if you survey anyone served in the last 3 months, describe that here): ____________________________________________________________________________________________________________________ |
||||
|
||||
|
Self-Administered |
Interview |
||
Phone |
Yes |
Yes |
||
Yes |
|
|||
Face-to-face |
Yes |
Yes |
||
Web-based |
Yes |
Yes |
||
4.a. Who administered the survey (check all that apply)? 1. MH consumers 2. Family members 3. Professional interviewers 4. MH clinicians 5. Non direct treatment staff 6. Other: describe: __________________________________________________________________ |
||||
1. Responses are anonymous 2. Responses are confidential 3. Responses are matched to client databases |
||||
|
||||
6a. How many surveys were attempted (sent out or calls initiatied)? |
|
|||
6b. How many survey contacts were made (surveys to valid phone numbers or addresses)? |
|
|||
6c. How many surveys were completed (survey forms returned or calls completed)? |
|
|||
6d. What was your response rate (number of completed surveys dividied by number of contacts)? |
|
|||
6e. If you received “blank” surveys back from consumers (surveys with no responses on them), did you count these surveys as “completed” for the calculation of response rates? |
|
|||
|
||||
7a. SMHA conducted or contracted for the survey (survey done at state level) |
|
|||
7b. Local mental health providers/county mental health providers conducted or contracted for the survey (survey was done at the local or regional level) |
|
|||
7c. Other: describe: ____________________________________________________________________________________________________ |
||||
MHBG Table 17B (URS Table 11A) Consumer Evaluation of Care by Race and Ethnicity (Optional Reporting Table)
This table requests information that evaluates the “experience” of care for individuals that participate in the public mental health system, broken down by race, ethnicity, and age category (adult and child/adolescent). Please enter the number of persons responding positively to the questions and the number of total responses within each group. Percent positive will be calculated from these data.
Table 17B |
|
|
||||||||||||||||||||||||
Reporting Year: |
From: |
|
To: |
|
||||||||||||||||||||||
State Identifier: |
|
|||||||||||||||||||||||||
|
|
|||||||||||||||||||||||||
Adult Consumer Survey Results: |
||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||
Indicators |
Total |
American Indian or Alaska Native |
Asian |
Black or African American |
Native Hawaiian or Pacific Islander |
White |
Some Other Race |
More than One Race |
Not Available |
Hispanic Origin |
||||||||||||||||
Adult Consumer Survey Results: |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
||||||
1. Reporting Positively About Access |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
2. Reporting Positively About Quality and Appropriateness |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
3. Reporting positively About Outcomes |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
4. Reporting Positively About Participation in Treatment Planning |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
5. Reporting Positively About General Satisfaction |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
6. Social Connectedness |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
7. Functioning |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Child/Adolescent Family Survey Results: |
||||||||||||||||||||||||||
|
||||||||||||||||||||||||||
Indicators |
Total |
American Indian or Alaska Native |
Asian |
Black or African American |
Native Hawaiian or Other Pacific Islander |
White |
Some Other Race |
More than One Race |
Not Available |
Hispanic Origin |
||||||||||||||||
Child/Adolescent Family Survey Results: |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
# Positive |
Responses |
||||||
1. Reporting Positively About Access |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
2. Reporting Positively About General Satisfaction |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
3. Reporting Positively About Outcomes |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
4. Reporting Positively About Participation in Treatment Planning |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
5. Reporting Positively About Cultural Sensitivity of Staff |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
6. Social Connectedness |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
7. Functioning |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Comments on Data: |
|
|||||||||||||||||||||||||
MHBG Table 18 (URS Table 15) Living Situation Profile
This table collects information on the living situation of persons served in the reporting period. Living situation categories include, but are not limited to, private residence, foster care, residential care, jail/correctional facility, homeless shelter, etc. Data should be based on the most recent assessment in the reporting period. Specifically, information is collected on the individual’s living situation at time of discharge or last evaluation. The reporting period should be the latest SFY for which data are available.
MHBG Table 18 |
|
|
|||||||||||
Reporting Year: |
From: |
|
To: |
|
|||||||||
State Identifier: |
|
||||||||||||
|
Private Residence |
Foster Home |
Residential Care |
Crisis Residence |
Residential Treatment |
Institutional Setting |
Jail/ Correctional Facility |
Homeless/ Shelter |
Other |
Not Available |
Total |
||
0-5 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
6-12 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
13-17 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
18-20 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
21-24 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
25-44 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
45-64 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
65-74 years |
|
|
|
|
|
|
|
|
|
|
0 |
||
75 or over |
|
|
|
|
|
|
|
|
|
|
0 |
||
Not Available |
|
|
|
|
|
|
|
|
|
|
0 |
||
TOTAL |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
Female |
|
|
|
|
|
|
|
|
|
|
0 |
||
Male |
|
|
|
|
|
|
|
|
|
|
0 |
||
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
0 |
||
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
0 |
||
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
0 |
||
Other |
|
|
|
|
|
|
|
|
|
|
0 |
||
Not Available |
|
|
|
|
|
|
|
|
|
|
0 |
||
TOTAL |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
American Indian or Alaska Native |
|
|
|
|
|
|
|
|
|
|
0 |
||
Asian |
|
|
|
|
|
|
|
|
|
|
0 |
||
Black or African American |
|
|
|
|
|
|
|
|
|
|
0 |
||
Native Hawaiian or Pacific Islander |
|
|
|
|
|
|
|
|
|
|
0 |
||
White |
|
|
|
|
|
|
|
|
|
|
0 |
||
Some Other Race |
|
|
|
|
|
|
|
|
|
|
0 |
||
More than One Race |
|
|
|
|
|
|
|
|
|
|
0 |
||
Not Available |
|
|
|
|
|
|
|
|
|
|
0 |
||
TOTAL |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
||
(Continued on next page)
MHBG Table 18 (cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
||
Reporting Year: |
From: |
|
To: |
|
||||||||||
State Identifier: |
|
|||||||||||||
|
Private Residence |
Foster Home |
Residential Care |
Crisis Residence |
Residential Treatment |
Institutional Setting |
Jail/ Correctional Facility |
Homeless/ Shelter |
Other |
Not Available |
Total |
|
||
Hispanic or Latino |
|
|
|
|
|
|
|
|
|
|
0 |
|
||
Not Hispanic or Latino |
|
|
|
|
|
|
|
|
|
|
0 |
|
||
Not Available |
|
|
|
|
|
|
|
|
|
|
0 |
|
||
TOTAL |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
||
Comments on Data: |
|
|||||||||||||
How often does your state measure living situation? ☐ At Admission ☐ At Discharge ☐ Monthly ☐ Quarterly ☐ Other, please describe: _____________________________________________________
MHBG Table 19A (URS Table 16A) Profile of Adults with Serious Mental Illnesses and Children with Serious Emotional Disturbances Receiving Specific Services
This table collects information on the aggregate profile of adults with SMI and children with SED receiving specific evidence-based practices in the reporting year. In addition, the table captures information on if and how states and jurisdictions monitor fidelity for the evidence-based services. The reporting period should be the latest SFY for which data are available. The total unduplicated number of adults with SMI and children with SED should be the same as those reported in MHBG Tables 13A and 13B.
MHBG Table 19A |
|
|
|
|
|
|
|
|
Reporting Period: |
From: |
|
To: |
|
||||
State Identifier: |
|
|||||||
|
Adults with Serious Mental Illness (SMI) |
Children with Serious Emotional Disturbance (SED) |
||||||
N Receiving Supported Housing |
N Receiving Supported Employment |
N Receiving Assertive Community Treatment |
Total unduplicated N - Adults with SMI served |
N Receiving Therapeutic Foster Care |
N Receiving Multisystemic Therapy |
N Receiving Family Functional Therapy |
Total unduplicated N - Children with SED |
|
Age |
|
|||||||
0-5 years |
|
|
|
|
|
|||
6-12 years |
|
|
|
|
|
|||
13-17 years |
|
|
|
|
||||
18-20 years |
|
|
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|||
25-44 years |
|
|
|
|
||||
45-64 years |
|
|
|
|
||||
65-74 years |
|
|
|
|
||||
75 or over |
|
|
|
|
||||
Not Available |
|
|
|
|
|
|
|
|
TOTAL |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
Gender |
|
|||||||
Female |
|
|
|
|
|
|
|
|
Male |
|
|
|
|
|
|
|
|
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
Other |
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
||||||||
Race |
|
|||||||
American Indian or Alaska Native |
|
|
|
|
|
|
|
|
Asian |
|
|
|
|
|
|
|
|
Black or African American |
|
|
|
|
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
|
|
|
|
White |
|
|
|
|
|
|
|
|
Some Other Race |
|
|
|
|
|
|
|
|
More than one race |
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
||||||||
Ethnicity |
|
|||||||
Hispanic or Latino |
|
|
|
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
(Continued on next page)
MHBG Table 19A (cont.) |
|
||||||||||||||
Reporting Period: |
From: |
|
To: |
|
|||||||||||
State Identifier: |
|
||||||||||||||
|
Adults with Serious Mental Illness (SMI) |
Children with Serious Emotional Disturbance (SED) |
|||||||||||||
N Receiving Supported Housing |
N Receiving Supported Employment |
N Receiving Assertive Community Treatment |
Total unduplicated N - Adults with SMI served |
N Receiving Therapeutic Foster Care |
N Receiving Multi-Systemic Therapy |
N Receiving Family Functional Therapy |
Total unduplicated N - Children with SED |
||||||||
|
|
|
|
|
|
|
|
|
|||||||
Do you monitor fidelity |
Yes / No |
Y |
Y |
|
Yes / No |
Y |
Y |
|
|||||||
for this service? |
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|||||||||
IF YES, |
|
|
|
|
|
|
|||||||||
What fidelity measure do you use? |
|
|
|
|
|
|
|||||||||
Who measures fidelity? |
|
|
|
|
|
|
|||||||||
How often is fidelity measured? |
|
|
|
|
|
|
|||||||||
|
Yes / No |
Yes / No |
Y |
Y |
Y |
Y |
|||||||||
Is the SAMHSA EBP Toolkit used to guide EBP Implementation? |
|
|
|
|
|
|
|||||||||
Have staff been specifically trained to implement the EBP? |
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|||||||
Comments on Data (Overall): |
|
||||||||||||||
Comments on Data (Supported Housing): |
|
||||||||||||||
Comments on Data (Supported Employment): |
|
||||||||||||||
Comments on Data (Assertive Community Treatment): |
|
||||||||||||||
Comments on Data (Therapeutic Foster Care): |
|
||||||||||||||
Comments on Data (Multisystemic Therapy): |
|
||||||||||||||
Comments on Data (Family Functional Therapy): |
|
||||||||||||||
es
/ No
es
/ No
es
/ No
es
/ No
es
/ No
es
/ No
es
/ No
MHBG Table 19B (URS Table 16B) Profile of Adults with Serious Mental Illness Receiving Specific Services During the Year
This table collects information on the aggregate profile of adults with SMI receiving family psychoeducation, integrated treatment for co-occurring disorders, illness self-management and recovery, and medication management. In addition, this table provides information on if, and how, states and jurisdictions monitor the fidelity for the evidence-based services. The reporting period should be the latest SFY for which data are available.
MHBG Table 19B |
|
||||
Reporting Year |
From: |
|
To: |
|
|
State Identifier: |
|
||||
|
ADULTS WITH SERIOUS MENTAL ILLNESS: |
||||
Receiving Family Psychoeducation |
Receiving Integrated Treatment for Co-occurring Disorders (M/SUD) |
Receiving Illness Self-Management and Recovery |
Receiving Medication Management |
||
Age |
|
||||
18-20 years |
|
|
|
|
|
21-24 years |
|
|
|
|
|
25-44 years |
|
|
|
|
|
45-64 years |
|
|
|
|
|
65-74 years |
|
|
|
|
|
75 or over |
|
|
|
|
|
Not Available |
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
|||||
Gender |
|
||||
Female |
|
|
|
|
|
Male |
|
|
|
|
|
Transgender (Male to Female) |
|
|
|
|
|
Transgender (Female to Male) |
|
|
|
|
|
Two-Spirit (if client is AI/AN |
|
|
|
|
|
Other |
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|||||
Race |
|
||||
American Indian or Alaska Native |
|
|
|
|
|
Asian |
|
|
|
|
|
Black or African American |
|
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
|
White |
|
|
|
|
|
Some Other Race |
|
|
|
|
|
More than One Race |
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|||||
Ethnicity |
|
||||
Hispanic or Latino |
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
|
|
Not Available |
|
|
|
|
|
(Continued on next page)
MHBG Table 19B (cont.) |
|
||||
Reporting Year |
From: |
|
To: |
|
|
State Identifier: |
|
||||
|
ADULTS WITH SERIOUS MENTAL ILLNESS |
||||
Receiving Family Psychoeducation |
Receiving Integrated Treatment for Co-occurring Disorders (M/SUD) |
Receiving Illness Self-Management |
Receiving Medication Management |
||
Do You monitor fidelity for this service? |
Y
|
Y
|
Y
|
Y
|
|
IF YES, |
|
|
|
|
|
What fidelity measure do you use? |
|
|
|
|
|
Who measures fidelity? |
|
|
|
|
|
How often is fidelity measured? |
|
|
|
|
|
|
Yes No |
Yes No |
Yes No |
Yes No |
|
Is the SAMHSA EBP Toolkit used to guide EBP implementation? |
|
|
|
|
|
Have staff been specifically trained to implement the EBP? |
|
|
|
|
|
|
|||||
Comments on Data (Overall): |
|
||||
Comments on Data (Family Psychoeducation): |
|
||||
Comments on Data (Integrated Treatment for Co-occurring Disorders): |
|
||||
Comments on Data (Illness Self-Management): |
|
||||
Comments on Data (Medication Management): |
|
||||
MHBG Table 19C (URS Table 16C) Profile of Adults with Serious Mental Illnesses and Children with Serious Emotional Disturbances Receiving Coordinated Specialty Care Services
This table collects information on the number of adults with SMI and children with SED that were admitted into and received Coordinated Specialty Care (CSC) services, the number of clients successfully discharged from CSC services, the number of clients who discontinued CSC services, and the number of clients that received CSC services. In addition, the table collects information on if, and how, states and jurisdictions monitor fidelity for the CSC program. The reporting period should be the latest SFY for which data are available.
MHBG Table 19C |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
State Identifier: |
|
|||||||||||||||||||||
Reporting Period: |
From: |
|
|
To: |
|
|||||||||||||||||
Program Name |
Number of Admissions into CSC Services During FY |
Number of Clients Successfully Discharged from CSC Services During the FY |
||||||||||||||||||||
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
(Continued on next page)
MHBG Table 19C (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
State Identifier: |
|
|||||||||||||||||||
Reporting Period: |
From: |
|
To: |
|
||||||||||||||||
Program Name |
Number of Clients who Discontinued CSC Services Prior to Discharge During the FY |
Number of Clients Receiving CSC Services During the FY |
||||||||||||||||||
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Continued on next page)
MHBG Table 19C (cont.) |
|
|||||||
State Identifier: |
|
|||||||
Reporting Period: |
From: |
|
To: |
|
||||
Program Name |
Do you monitor fidelity for this service? |
What fidelity measure do you use? |
Who measures fidelity? |
How often is fidelity measured? |
Has staff been specifically trained to implement the CSC EBP? |
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|||
MHBG Table 19D (URS Table 16D) Adults with Serious Mental Illnesses and Children with Serious Emotional Disturbances Receiving Coordinated Specialty Care Services who Experienced No Psychiatric Hospitalization or Arrest
This table collects information on the percentage of adults with SMI and children with SED enrolled in Coordinated Specialty Care (CSC) who experienced no psychiatric hospitalization in the current fiscal year and the percentage of adults with SMI and children with SED enrolled in CSC services who experienced no arrest in the current fiscal year by age groups. The reporting period should be the latest state fiscal year for which data are available.
MHBG Table 19D |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
State Identifier: |
|
||||||||||||||||||||
Reporting Period: |
From: |
|
|
To: |
|
|
|||||||||||||||
Program Name |
Percentage of Clients Enrolled in CSC Services who Experienced No Psychiatric Hospitalization in the FY1 |
Percentage of Clients Enrolled in CSC Services who Experienced No Arrest in the FY2 |
|||||||||||||||||||
0-5 Years |
6-12 Years |
18-20 Years |
13-17 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 and Over |
Age Not Available |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 Report the percentage of individuals who experienced no psychiatric hospitalization while enrolled in the CSC program during the fiscal year.
2 Report the percentage of individuals who experienced no arrest while enrolled in the CSC program during the fiscal year.
MHBG Table 20 (URS Table 17) Profile of Persons Receiving Crisis Response Services
This table collects information on the number of persons that received crisis response services by age groups. In addition, this table also collects information on the estimated percentage of the state population with access to crisis response services. The reporting period should be the latest SFY for which data are available.
MHBG Table 20 |
|
|||||||||
State Identifier: |
|
|||||||||
Reporting Period: |
From: |
|
To: |
|
||||||
Service |
Actual Number of Persons Served |
|||||||||
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 or Over |
Not Available |
|
Crisis Contact Centers |
|
|
|
|
|
|
|
|
|
|
24/7 Mobile Crisis Team |
|
|
|
|
|
|
|
|
|
|
Crisis Stabilization Programs |
|
|
|
|
|
|
|
|
|
|
Comments on Data: |
|
|||||||||
(Continued on next page)
Table 20 (cont.) |
|
|||||||||
State Identifier: |
|
|||||||||
Reporting Period: |
From: |
|
To: |
|
||||||
Service |
Estimated Percentage of State Population with Access to Service |
|||||||||
0-5 Years |
6-12 Years |
13-17 Years |
18-20 Years |
21-24 Years |
25-44 Years |
45-64 Years |
65-74 Years |
75 and Over |
Not Available |
|
Crisis Contact Centers |
|
|
|
|
|
|
|
|
|
|
24/7 Mobile Crisis Team |
|
|
|
|
|
|
|
|
|
|
Crisis Stabilization Programs |
|
|
|
|
|
|
|
|
|
|
MHBG Table 21 (URS Table 19A) Profile of Criminal Justice or Juvenile Justice Involvement
This table collects information on the number of children/youth and adults with an arrest in T1 (prior 12 months) and T2 (most recent 12 months) to measure the change in arrests over time. Information required includes information on arrests and impact of services.
The SAMHSA National Outcome Measure for Criminal Justice or Juvenile Justice measures change in arrests over time.
If your SMHA has data on arrest records from alternative sources, you may also report that here. If you only have data for arrests for consumers in this year, please report that in the T2 column. If you can calculate the change in arrests from T1 to T2, please use the “T1 to T2 change” columns.
Please complete the checkboxes at the bottom of the table to help explain the data sources that you have used to complete the table.
Please tell us anything else that would help us to understand your indicator (e.g., list surveys or MIS questions; describe linking methodology and data sources; specify time period for criminal or juvenile justice involvement; explain whether treatment data are collected).
State: |
|
|
|
Reporting Period: |
From: |
|
to: |
|
|
|
|
|||||||
For Consumers in Service for at least 12 months |
||||||||||||||||||
|
T1 |
T2 |
T1 to T2 Change |
Assessment of the Impact of Services |
||||||||||||||
|
"T1"
Prior 12 months |
"T2"
Most Recent 12 months |
If Arrested at T1 (Prior 12 Months) |
If Not Arrested at T1 (Prior 12 Months) |
Over the last 12 months, my encounters with the police have… |
|||||||||||||
Arrested |
Not Arrested |
No Response |
Arrested |
Not Arrested |
No Response |
# with an Arrest in T2 |
# with No Arrest at T2 |
No Response |
# with an Arrest in T2 |
# with No Arrest at T2 |
No Response |
# Reduced (fewer encounters) |
# Stayed the Same |
# Increased |
# Not Applicable |
No Response |
Total Responses |
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total Children/Youth (under age 18) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Total Adults (age 18 and over) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
(Continued on next page)
MHBG Table 21 (cont.) |
||||||||||||||||||
For Consumers Who Began Mental Health Services during the past 12 months |
||||||||||||||||||
|
T1 |
T2 |
T1 to T2 Change |
Assessment of the Impact of Services |
||||||||||||||
"T1" 12 months prior to beginning services |
"T2"
Since Beginning Services |
If Arrested at T1 (Prior 12 Months) |
If Not Arrested at T1 (Prior 12 Months) |
Since starting to receive MH Services, my encounters with the police have… |
||||||||||||||
Arrested |
Not Arrested |
No Response |
Arrested |
Not Arrested |
No Response |
# with an Arrest in T2 |
# with No Arrest at T2 |
No Response |
# with an Arrest in T2 |
# with No Arrest at T2 |
No Response |
# Reduced (fewer encounters) |
# Stayed the Same |
# Increased |
# Not Applicable |
No Response |
Total Responses |
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Total Children/Youth (under age 18) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Total Adults (age 18 and over) |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
(Continued on next page)
MHBG Table 21 (cont.) |
|
Please Describe the Sources of your Criminal Justice Data Source of adult criminal justice information ☐1) Consumer survey (recommended questions) ☐2) Other Consumer Survey: Please send copy of questions ☐3) Mental health MIS ☐4) State criminal justice agency ☐5) Local criminal justice agency ☐6) Other (specify): ______________________________ Sources of children/youth criminal justice Information: ☐1) Consumer survey (recommended questions) ☐2) Other Consumer Survey: Please send copy of questions ☐3) Mental health MIS ☐4) State criminal/juvenile justice agency ☐5) Local criminal/juvenile justice agency ☐6) Other (specify): _______________________________ |
|
Measure of adult criminal Involvement: ☐1) Arrests ☐2) Other (specify): ___________________________________ |
|
Measure of children/youth criminal justice Involvement: ☐1) Arrests ☐2) Other (specify): |
|
Mental health programs included: ☐1) Adults with SMI only ☐2) Other adults (specify): ____________________________________ ☐3) Both (all adults) ☐1) Children with SED only ☐2) Other Children (specify): __________________________________ ☐3) Both (all Children) |
|
Region for which adult data are reported: ☐1) The whole state ☐2) Less than the whole state (please describe): |
|
Region for which children/youth data are reported: ☐1) The whole state ☐2) Less than the whole state (please describe): ____________________________________ |
|
What is the total number of persons surveyed, or for whom criminal justice/juvenile justice data are reported? Child/Adolescents Adults 1 2. What was your sample size (how many individuals were selected for the sample)? 3. How many survey contacts were made (surveys to valid phone numbers or addresses)? 4. How many surveys were completed (survey forms returned or calls completed), if data source was not a Survey. How many persons were CJ data available for? 5. What was your response rate (number of completed surveys divided by number of contacts)? |
|
Comments on Data: |
|
Instructions: If you have responses to a survey by person not in the expected age group, you should include those responses with other responses from the survey (e.g., if a 16- or 17-year-old responds to the Adult MHSIP survey, please include their responses in the adult categories since that was the survey they used). |
|
MHBG Table 22 (URS Table 19B) Profile of Change in School Attendance
This table collects information on the number of children with suspension and expulsion from school in T1 (prior 12 months) and T2 (most recent 12 months) to measures the change in school attendance over time. Information required includes information on suspensions/expulsions, and impact of services.
The SAMHSA National Outcome Measure for School Attendance measures the change in school attendance over time.
If your SMHA has data on school attendance from alternative sources, you may also report that here. If you only have data for school attendance for consumers in this year, please report that in the T2 column, if you can calculate the change in attendance from T1 to T2, please use the T1 to T2 Change columns.
Please complete the checkboxes at the bottom of the table to help explain the data sources that you used to complete this table.
Please tell us anything else that would help us to understand your indicator (e.g., list surveys or MIS questions; describe linking methodology and data sources; specify time period for school attendance; explain whether treatment data are collected).
State: |
|
|
|
Reporting Period: |
From: |
|
to: |
|
|
|
|
|||||||
For Consumers in Service for at least 12 months |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
T1 |
T2 |
T1 to T2 Change |
|
Impact of Services |
|||||||||||||
"T1"
Prior 12 months |
"T2"
Most Recent 12 months |
If Suspended at T1 (Prior 12 Months) |
If Not Suspended at T1 (Prior 12 Months) |
Over the last 12 months, the number of days my child was in school have |
||||||||||||||
# Suspended or Expelled |
# Not Suspended or Expelled |
No Response |
# Suspended or Expelled |
# Not Suspended or Expelled |
No Response |
# with an Expulsion or Suspension in T2 |
# with no Expulsion or Suspension in T2 |
No Response |
# with an Expulsion or Suspension in T2 |
# with no Expulsion or Suspension in T2 |
No Response |
# Greater (Improved) |
# Stayed the Same |
# Fewer days (gotten worse) |
# Not Applicable |
No response |
Total Responses |
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Gender |
|
|||||||||||||||||
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Age |
|
|||||||||||||||||
Under 18 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
(Continued on next page)
MHBG Table 22 (Cont.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
For Consumers Who Began Mental Health Services during the past 12 months |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
T1 |
T2 |
T1 to T2 Change |
Impact of Services |
||||||||||||||
"T1" 12 months prior to beginning services |
"T2"
Since Beginning Services |
If Suspended at T1 (Prior 12 Months) |
If
Not Suspended at T1 |
Since starting to receive MH Services, the number of days my child was in school have |
||||||||||||||
# Suspended or Expelled |
# Not Suspended or Expelled |
No Response |
# Suspended or Expelled |
# Not Suspended or Expelled |
No Response |
# with an Expelled or Suspended in T2 |
# with No Suspension or Expulsion at T2 |
No Response |
# with an Expelled or Suspended in T2 |
# with No Suspension or Expulsion at T2 |
No Response |
# Greater (Improved) |
# Stayed the Same |
# Fewer days (gotten worse) |
# Not Applicable |
No Response |
Total Responses |
|
Total |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Gender |
|
|||||||||||||||||
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Male |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Male to Female) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Transgender (Female to Male) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Other |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Gender Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
Age |
|
|||||||||||||||||
Under 18 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
(Continued on next page)
MHBG Table 22 (cont.) |
|
Sources of School Attendance Information ☐ 1) Consumer survey (recommended questions) ☐2) Other Survey: Please send copy of questions ☐ 3) Mental health MIS ☐ 4) State Education Department ☐ 5) Local Schools/Education Agencies ☐ 6) Other (specify): _______________________________ |
|
Measure of School Attendance ☐ 1) School Attendance ☐ 2) Other (specify): ___________________________________ |
|
Mental health programs include: ☐ 1) Children with SED only ☐ 2) Other Children (specify): __________________________________ ☐ 3) Both (all Children) |
|
Region for which data are reported: ☐ 1) The whole state ☐ 2) Less than the whole state (please describe): ____________________________________ |
|
What is the total number of persons surveyed, or for whom criminal justice/juvenile justice data are reported? Child/Adolescents 1 2. What was your sample size (how many individuals were selected for the sample)? 3. How many survey contacts were made (surveys to valid phone numbers or addresses)? 4. How many surveys were completed (survey forms returned or calls completed). If data source was not a survey, how many persons were data available for? 5. What was your response rate (number of completed surveys divided by number of contacts)? |
|
Comments on Data: |
|
MHBG Table 23A (URS Table 20A) Profile of Non-Forensic (Voluntary and Civil Involuntary) Patients Readmission to Any State Psychiatric Inpatient Hospital within 30/180 Days of Discharge
This table collects information on the total number of civil discharges within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting period should be the latest SFY for which data are available.
MHBG Table 23A. |
|
|||||
Reporting Year: |
From: |
|
To: |
|
||
State Identifier: |
|
|||||
|
Total number of Discharges in Year |
Number of Readmissions to ANY STATE Hospital within |
Percent Readmitted |
|||
30 days |
180 days |
30 days |
180 days |
|||
TOTAL |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
Age |
||||||
0-5 years |
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
75 and over |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Gender |
||||||
Female |
|
|
|
|
|
|
Male |
|
|
|
|
|
|
Transgender (Male to Female) |
|
|
|
|
|
|
Transgender (Female to Male) |
|
|
|
|
|
|
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
Other |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Race |
||||||
American Indian or Alaska Native |
|
|
|
|
|
|
Asian |
|
|
|
|
|
|
Black or African American |
|
|
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
|
|
White |
|
|
|
|
|
|
Some Other Race |
|
|
|
|
|
|
More than One Race |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Ethnicity |
||||||
Hispanic or Latino |
|
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
||||||
A |
||||||
Comments on Data: |
|
|||||
MHBG Table 23B (URS Table 20B) Profile of Forensic Patients Readmission to Any State Psychiatric Inpatient Hospital within 30/180 Days of Discharge
This table collects information on the total number of forensic discharges within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting year should be the latest SFY for which data are available.
MHBG Table 23B. |
|
|||||
Reporting Year: |
From: |
|
To: |
|
||
State Identifier: |
|
|||||
|
Total number of Discharges in Year |
Number of Readmissions to ANY STATE Hospital within |
Percent Readmitted |
|||
30 days |
180 days |
30 days |
180 days |
|||
TOTAL |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
Age |
||||||
0-5 years |
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
75 and over |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Gender |
||||||
Female |
|
|
|
|
|
|
Male |
|
|
|
|
|
|
Transgender (Male to Female) |
|
|
|
|
|
|
Transgender (Female to Male) |
|
|
|
|
|
|
Two-Spirit (if client is AI/AN) |
|
|
|
|
|
|
Other |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Race |
||||||
American Indian or Alaska Native |
|
|
|
|
|
|
Asian |
|
|
|
|
|
|
Black or African American |
|
|
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
|
|
White |
|
|
|
|
|
|
Some Other Race |
|
|
|
|
|
|
More than One Race |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Ethnicity |
||||||
Hispanic or Latino |
|
|
|
|
|
|
Not- Hispanic or Latino |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
||||||
Comments on Data: |
|
|||||
MHBG Table 24 (URS Table 21) Profile of Non-Forensic (Voluntary and Civil-Involuntary Patients) Readmission to Any Psychiatric Inpatient Care Unit (State Operated or Other Psychiatric Inpatient Unit) Within 30/180 Days of Discharge (Optional Reporting Table)
This table collects information the total number of discharges from inpatient care units within the year, the number of readmissions within 30-days and 180-days, and the percent readmitted by age, gender, race, and ethnicity. The reporting year should be the latest SFY for which data are available.
MHBG Table 23B. |
|
|||||
Reporting Year: |
From: |
|
To: |
|
||
State Identifier: |
|
|||||
|
Total number of Discharges in Year |
Number of Readmissions to Any State Hospital within |
Percent Readmitted |
|||
30 days |
180 days |
30 days |
180 days |
|||
TOTAL |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
Age |
||||||
0-5 years |
|
|
|
|
|
|
6-12 years |
|
|
|
|
|
|
13-17 years |
|
|
|
|
|
|
18-20 years |
|
|
|
|
|
|
21-24 years |
|
|
|
|
|
|
25-44 years |
|
|
|
|
|
|
45-64 years |
|
|
|
|
|
|
65-74 years |
|
|
|
|
|
|
75 and over |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Gender |
||||||
Female |
|
|
|
|
|
|
Male |
|
|
|
|
|
|
Transgender (Male to Female) |
|
|
|
|
|
|
Transgender (Female to Male) |
|
|
|
|
|
|
Two-Spirt (if client is AI/AN) |
|
|
|
|
|
|
Other |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Race |
||||||
American Indian or Alaska Native |
|
|
|
|
|
|
Asian |
|
|
|
|
|
|
Black or African American |
|
|
|
|
|
|
Native Hawaiian or Pacific Islander |
|
|
|
|
|
|
White |
|
|
|
|
|
|
Some Other Race |
|
|
|
|
|
|
More than One Race |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
|
|
|
|
|
|
Ethnicity |
||||||
Hispanic or Latino |
|
|
|
|
|
|
Not Hispanic or Latino |
|
|
|
|
|
|
Not Available |
|
|
|
|
|
|
|
||||||
|
||||||
|
||||||
Comments on Data: |
|
|||||
F. State General Data Notes
States may utilize this table to provide additional data notes deemed necessary to provide context for the data reported.
MHBG Table Number |
General Data Note |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Appendix A: MHBG Data Definitions
Term |
Definition |
Access |
Access refers to the quickness, ease, and convenience with which clients received services. |
Administration |
This line item includes expenditures for the administration of the State Mental Health Agency (SMHA), including central and regional offices, defined as SMHA activities that provide centralized policy direction and administrative management for all operational segments of the SMHA program. Include the following components as applicable: SMHA Functions, Supplemental and Support Activities, Research, Training. As SMHAs may operate from one central office or through a regional structure, please report expenditures of the total central and/or regional structure in this row. The infrastructure of the SMHA may include separate administrative components for the planning, coordination, and development of community administered programs, state psychiatric hospitals, and/or other programs. Expenditures for these SMHA divisions and/or components should be included in the total administration category. The following functions and activities are to be included: SMHA Functions
Supplemental and Support Activities performed by the SMHA may include:
Research (Funded or funded and conducted by the SMHA; Include all funds from federal HRD grants as well as state funds devoted toward training activities.) Research activities may:
Training (Include all funds from federal HRD grants as well as state funds devoted toward training activities) Training refers to identifiable staff training and human resource development (HRD) activities or facilities funded or funded and operated by the SMHA. Training activities may:
|
Admission |
The point at which a person begins an episode of care. |
Ambulatory/Community Non-24-Hour Care
|
Ambulatory/Community Non-24-Hour Care services are provided in less-than 24-hour care setting and not overnight. This category includes outpatient, partial care, and case management services. Outpatient: This treatment modality describes mental health services that are:
Outpatient services may be diagnostic, therapeutic, or adjunctive. Include expenditures for wraparound services in the ambulatory/community non-24-hour care category. Services such as screening, outreach, and psychiatric treatment can be included. Partial care/day treatment: structured programs of treatment, activity, or other mental health services provided in clusters of three or more hours per day. These programs are often called day treatment, partial hospitalization, psychosocial rehabilitation, or activity centers. Case management: functions as an outreach intervention for clients with primary purpose of:
|
American Indian or Alaska Native |
Individuals with origins in any of the original peoples of North, Central, and South America, including, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, and Maya (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
Appropriateness |
Appropriate services are those that are individualized to meet a client’s needs. They address a client’s strengths and challenges, cultural context, service preferences, and recovery goals. |
Asian |
Individuals with origins in any of the original peoples of Central or East Asia, Southeast Asia, or South Asia, including, for example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
Assertive Community Treatment (ACT) |
ACT is a team-based approach to the provision of treatment, rehabilitation, and support services. ACT models of treatment are built around a self-contained multi-disciplinary team that serves as the fixed point of responsibility for all patient care for a fixed group of clients. In this approach, normally used with clients with severe and persistent mental illness, the treatment team typically provides all client services using a highly integrated approach to care. |
Average Length of Stay |
This represents the average amount of time a client receives services in a specified service setting (e.g., state psychiatric hospital, residential treatment centers, etc.) during a specified time period. Average Length of Stay = (Number of days individual received service (numerator) / Total number of individuals receiving service (denominator) Use the same time period for both numerator and denominator. Admission day = 1 day Do not include furlough/leave days or days with no service provision |
Black or African American |
Individuals with origins in any of the Black racial groups of Africa, including, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, and Somali (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
Case Management Services |
Case management services include activities for the purpose of locating services, linking the client with these services, and monitoring the client’s/patient’s receipt of these services on behalf of the client. Case management can be provided by an individual or a team; it may include both face-to-face and telephone contact with the client as well as contact with other service providers. |
Community Services |
Community services refer to all services that are provided in a community setting (i.e., services not provided in an inpatient setting). |
Convenience Sample |
Convenience sample refers to a type of non-probability sample where the survey respondents are selected, in part or in whole, at the convenience of the researcher. The researcher makes no attempt, or only a limited attempt, to ensure that the sample is an accurate representation of some larger group or population. An example would be giving the consumer survey to all persons who attend services in a given week or month. |
Co-occurring M/SUD Disorders |
The coexistence of both a mental and substance use disorder is referred to as co-occurring disorders. |
Coordinated Specialty Care (CSC) |
Coordinated specialty care is a recovery-oriented, team approach to treating early psychosis that promotes easy access to care and shared decision-making among specialists, the person experiencing psychosis, and family members. Specifically, coordinated specialty care involves multiple components: individual or group psychotherapy is tailored to a person’s recovery goals. Cognitive and behavioral therapy focuses on developing the knowledge and skills necessary to build resilience and cope with aspects of psychosis while maintaining and achieving person goals; family support and education programs team family members about psychosis as well as coping communication, and problem-solving skills; medication management involves health care providers tailoring medication to a person’s specific needs by selecting the appropriate type and dose to help reduce psychosis symptoms; supported employment and education services aim to help individuals return to work or school, using the support of coach to help people achieve their goals; case management allows people with psychosis to work with a case manager to address practical problems and improve access to needed support services.”(National Institute of Mental Health: https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/recovery-after-an-initial-schizophrenia-episode-raise). |
Criminal Justice |
“A criminal justice system is a set of legal and social institutions for enforcing the criminal law in accordance with a defined set of procedural rules and limitations. In the United States, there are separate federal, state, and military criminal justice systems, and each state has separate systems for adults and juveniles.” Frase, R.S. & Weidner, R.R. (2002). Criminal Justice System. In J. Dressler (Ed.), Encyclopedia of Crime and Justice (2nd ed., Vol. 1, pp. 371-393). Macmillan Reference USA. |
Crisis Residence |
A residential (24 hours/day) stabilization program that delivers services for acute symptom reduction and restores clients to a pre-crisis level of functioning. These programs are time limited for persons until they achieve stabilization. Crisis residences serve persons experiencing rapid or sudden deterioration of social and personal conditions such that they are clinically at risk of hospitalization but may be treated in this alternative setting. |
Crisis Services |
Crisis services include centrally deployed 24/7 mobile crisis units, short-term residential crisis stabilization beds, evidence-based protocols for delivering services to individuals with suicide risk, and regional or statewide crisis contact centers coordinating in real time that connect people as soon as possible to care (please see page 39 of the National Guidelines for Behavioral Health Crisis Care – A Best Practice Toolkit). Crisis services are for anyone who is in a behavioral health crisis regardless of their SMI or SED status. Crisis services should not be viewed as stand-alone resources operating independent of the local community mental health and hospital systems but rather as an integrated part of a coordinated continuum of care. |
Discharge |
A discharge is the formal termination of service generally when treatment has been completed or through administrative discharge. |
Dual Diagnoses |
The coexistence of both a mental and substance use disorder is referred to as co-occurring disorders or dual diagnoses. |
Duplicated Count |
Counting a client/consumer and their service more than once. Duplication can exist at different levels: within the same service setting, across service setting, between children and adults, especially for transition age youth, and at the sate-level. |
Early Serious Mental Illness (ESMI) |
An early serious mental illness or ESMI is a condition that affects an individual regardless of their age and that is a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-5 (APA, 2013) or ICD-10. For a significant portion of the time since the onset of the disturbance, the individual has not achieved or is at risk for not achieving the expected level of interpersonal, academic, or occupational functioning. This definition is not intended to include conditions that are attributable to the physiologic effects of a substance, a substance use disorder, an intellectual developmental disorder, or to another medical condition. The term ESMI is intended for the initial period of onset. |
Employed |
This is a broad category of full- or part-time employment within the competitive labor market. States may use their own definition for full- and part-time employment but the states’ definitions are expected to be consistent with the basic concept used by the Department of Labor (for more information please refer to https://www.bls.gov/cps/cps_htgm.htm). |
Episode of Care |
An episode of care begins when a client enters treatment or services, as defined by the program, and ends when the client is discharged and no longer receiving treatment or services. A new episode of care begins when the client returns for treatment after a lapse of service of 90 calendar days or more or after being discharged. |
Family Psychoeducation |
Family psychoeducation is an evidence- based practice (EBP) that is offered as part of an overall clinical treatment plan for individuals with mental illness to achieve the best possible outcome through the active involvement of family members in treatment and management and to alleviate the suffering of family members by supporting them in their efforts to aid the recovery of their loved ones. Family psychoeducation programs may be either multi-family or single-family focused. Core characteristics of family psychoeducation programs include the provision of emotional support, education, and resources during periods of crisis, and problem-solving skills. |
First Episode Psychosis (FEP) |
First episode psychosis refers to the beginning of psychotic symptoms due to the onset of serious mental illness, sch as schizophrenia, bipolar disorder, or post-traumatic stress disorder. Psychosis is when a person loses contact with reality and can include symptoms such as hallucinations, delusions, or confused thinking. The onset of symptoms typically occurs between the ages of 16 and 25. |
Foster Care |
Foster care refers to the provision of a living arrangement in a household other than that of the client’s biological family. |
Foster Home |
A home licensed by a county or state department to provide care to children, adolescents, and/or adults. This includes Therapeutic Foster Care Facilities. See Therapeutic Foster Care definition. |
Forensic Clients |
Forensic clients are consumers who enter the mental health system due to their contact with the criminal justice system. Specific forensic activities may include, but are not limited to:
Forensic clients include:
|
Functional Family Therapy (FFT) |
FFT is an evidence-based practice (EBP) designed primarily for at-risk youth who have been referred by the juvenile justice, mental health, school, or child welfare systems. Services are short-term and conducted in both clinic and home settings, and can also be provided in schools, child welfare facilities, probation and parole systems, and mental health facilities.” (https://www.fftllc.com/) |
Gender Non-Conforming |
A gender identity that describes an individual whose gender identity, role, or expression are not typical for individuals in a given assigned sex category (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522917/). |
General Hospital |
A general hospital is a hospital that does not specialize in illness or patients; however, it may have a separate psychiatric unit and specially allocated staff for the treatment of persons with mental illness. |
General Support |
General support, which may also be called “wrap around services” includes transportation, childcare, homemaker services, day care, and other general services for individuals receiving behavioral health services. |
Hispanic or Latino |
A category that includes individuals of Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, and other Central or South American or Spanish culture or origin (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
Homeless/Shelter |
An individual is considered to be experiencing homelessness if she/she lacks a fixed, regular, and adequate nighttime residence, meaning:
|
Housing Services |
Assistance to individuals in finding and/or maintaining appropriate housing arrangements. |
Illness Self-Management and Recovery |
Illness Self-Management and Recovery is an evidence-based practice (EBP). It is a broad set of rehabilitation methods aimed at teaching individuals strategies for collaborating actively in their treatment with professionals; for reducing their risk of relapses and re-hospitalizations; for reducing severity and distress related to symptoms; and for improving their social support. Specific evidence-based practices that are incorporated under the broad rubric of illness self-management are psychoeducation about the nature of mental illness and its treatment; “behavioral tailoring” to help individuals incorporate the taking of medication into their daily routines; relapse prevention planning, teaching coping strategies for managing distressing persistent symptoms; cognitive behavioral therapy for psychosis, and social skills training. The goal of illness self-management is to help individuals develop effective strategies for managing their illness in collaboration with professionals and significant others, thereby freeing up their time to pursue their personal recovery goals. |
Information Systems |
A discrete set of information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of information. This includes collecting and analyzing data in order to monitor performance and outcomes. Costs for electronic health records (EHRs), telehealth platforms, digital therapeutics, and other health information technology also fall under this category. |
Infrastructure Support |
Infrastructure support includes activities that provide the infrastructure to support services but for which there are no individual services delivered. Examples include the development and maintenance of crisis-response capacity, including hotlines, mobile crisis teams, web-based check-in groups (for medication, treatment, and re-entry follow-up), drop-in centers, and respite services. |
Institutional Setting |
An institutional care facility in which care is provided on a 24-hour, 7 day a week basis. This level of care may include a Skilled Nursing/Intermediate Care Facility, Nursing Homes, Institutes of Mental Disease (IMD), Inpatient Psychiatric Hospital, Psychiatric Health Facility (PHF), Veterans Affairs Hospital, or State Hospital. |
Inpatient Care |
A structured service setting or program that provides overnight care delivered within a psychiatric hospital or in a designated and staffed separate psychiatric service or unit of a general hospital/medical center, specifically for the treatment of mental health clients. |
Institutions Under the Justice System |
Institutions under the justice system refers specifically to jails and prisons managed or paid for by a government entity (i.e., federal, state, county, and city). |
Integrated Treatment for Co-occurring Disorders |
Integrated treatment for co-occurring disorders is an evidence-based practice (EBP) that combines or integrates mental health and substance use interventions at the level of the clinical encounter. Hence, integrated treatment means that the same clinicians or teams of clinicians, working in one setting, provide appropriate mental health and substance use interventions in a coordinated fashion. In other words, the caregivers take responsibility for combining the interventions into one coherent package. For the individual with a dual diagnosis, the services appear seamless, with a consistent approach, philosophy, and set of recommendations. The need to negotiate with separate clinical teams, programs, or systems disappears. The goal of co-occurring diagnosis interventions is recovery from M/SUD. |
Jail/Correctional Facility |
A facility where people are kept when they enter the criminal justice system. This setting may include a jail, correctional facility, detention centers, prison, youth authority facility, juvenile hall, boot camp, or boys’ ranch. |
Juvenile Justice |
“Youth under the age of 18 who are accused of committing a delinquent or criminal act are typically processed through a juvenile justice system. While similar to that of the adult criminal justice system in many ways—processes include arrest, detainment, petitions, hearings, adjudications, dispositions, placement, probation, and reentry—the juvenile justice process operates according to the premise that youth are fundamentally different from adults, both in terms of level of responsibility and potential for rehabilitation. The primary goals of the juvenile justice system, in addition to maintaining public safety, are skill development, habilitation, rehabilitation, addressing treatment needs, and successful reintegration of youth into the community” (Youth.gov). |
Medicaid Client |
Mental health clients for whom some services are/were reimbursable through Medicaid. |
Medication Management |
Medication management is an evidence-based practice (EBP) that includes the following elements:
|
Multisystemic Therapy (MST) |
MST is an evidence-based practice (EBP) that views the individual as nestled within a complex network of interconnected systems (family, school, peers). The goal is to facilitate change in this natural environment to promote individual change. The caregiver is viewed as the key to long-term outcomes. |
Native Hawaiian or Pacific Islander |
An individual with origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including, for example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, and Marshallese (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
Non-Institutional Settings |
A setting that provides mental health services, but not on an inpatient facility or nursing home level of care (e.g., care is provided in a community-based setting). |
Non-Medicaid Services |
Services not covered or paid for by Medicaid. |
Not In Labor Force |
Persons who are neither unemployed nor unemployed and not actively looking for employment are not in the labor force. This category includes persons that are retired, students, homemakers, disabled, in sheltered/non-competitive employment, and others who are neither working nor seeking work. Information is collected on their desire for and availability for work, job search activity in the prior year, and reasons for not currently searching. |
Nursing Home |
A facility, also called skilled nursing facility, that provides a wide range of health and personal care services. Their services focus more on medical care than most assisted living facilities or board and care homes. Services offered in a nursing home typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities (https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes#nursing). |
Other 24-Hour Care |
A setting, other than hospital inpatient setting, which provides congregate overnight living. A variety of services along a continuum of living arrangements may be offered, ranging from basic room and board with minimal supervision through 24-hour medical, nursing, and/or intensive therapeutic programs. Activities include diagnosis, treatment, and care to mentally ill individuals, either on a residential treatment or residential support services basis. Residential treatment is overnight care in conjunction with an intensive treatment program. Residential support is overnight care in conjunction with supervised living and other support services. Depending upon the nomenclature used in the state, residential settings may include, but may not be limited to, any of the following:
|
Other Psychiatric Inpatient Care |
Other psychiatric inpatient care refers to inpatient psychiatric services provided in a private psychiatric hospital; a psychiatric bed in a general hospital; or any other psychiatric inpatient bed that is not part of a state psychiatric hospital. Examples of Other Psychiatric Inpatient Care settings include:
|
Partnerships, Community Outreach, and Needs Assessment |
This includes state, regional, and local personnel salaries prorated from time and materials to support planning meetings, information collection, analysis, and travel. It also includes the support for partnerships across state and local agencies, and tribal governments. Community/network development activities such as marketing, communication, and public education, including the planning and coordination of services, fall into this category, as do needs-assessment projects to identify the scope and magnitude of the problem, resources available, gaps in services, and strategies to close those gaps. |
Planning Council Activities |
This includes those activities that support the performance of a Mental Health Planning Council or Behavioral Health Planning Council. |
Private Residence |
Living situation in which an individual lives in a house, apartment, trailer, hotel, dorm, barrack, and/or Single Room Occupancy (SRO). |
Quality Assurance and Improvements |
This includes activities to improve the overall quality of services, including those activities to assure conformity to acceptable professional standards, adaptation, and review of implementation of evidence-based practices, identification of areas of technical assistance related to quality outcomes, including feedback. Administrative agency contracts to monitor service-provider quality fall into this category, as do independent peer-review activities. |
Random Sample |
A subset of the population derived using a sampling technique that gives each member of the population an equal chance of being selected. Using random number generators or selectors reduces sampling bias. |
Research and Evaluation |
This includes performance measurement, evaluation, and research such as services research and demonstration projects to test feasibility and effectiveness of a new approach as well as the dissemination of such information. |
Residential Care |
This level of care may include a Group Home, Therapeutic Group Home, Board and Care, Residential Treatment, or Rehabilitation Center, or Agency-operated residential care facilities. |
Residential Treatment Center for Children (RTC) |
A facility not licensed as a psychiatric hospital that primarily provides individually planned programs of mental health treatment in a residential care setting for children and youth younger than 18 (some RTCs for children may accept persons through age 21). This type of facility must have a clinical program that is directed by a psychiatrist, psychologist, social worker, or psychiatric nurse who has a masters’ or a doctoral degree. |
Retired |
Individuals who have permanently withdrawn from their occupation or active working life. |
School Attendance |
Physical presence of a child in a school setting during scheduled class hours. |
Serious Emotional Disturbance (SED) |
Children with serious emotional disturbance (SED) includes persons up to age 18 who have a diagnosable behavioral, mental, or emotional issue—as defined by the Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders. This condition results in a functional impairment that substantially interferes with, or limits, a child’s role or functioning in family, school, or community activities (https://www.samhsa.gov/sites/default/files/federal-register-notice-58-96-definitions.pdf). |
Serious Mental Illness (SMI) |
Adults with serious mental illness (SMI) includes persons age18 and older who have a diagnosable behavioral, mental, or emotional condition (as defined by the DSM). This condition substantially interferes with, or limits, one or more major life activities, such as: basic daily living (for example, eating or dressing); instrumental living (for example, taking prescribed medications or getting around the community); and participating in a family, school, or workplace (https://www.samhsa.gov/sites/default/files/federal-register-notice-58-96-definitions.pdf). |
Sexual Orientation |
Sexual orientation is an often-enduring pattern of emotional, romantic, and/or sexual attractions to persons of the opposite sex or gender, the same sex or gender, or both sexes or more than one gender. It also refers to an individual’s sense of personal and social identity based on those attractions, related to behaviors, and membership in a community of others who share those attractions and behaviors. |
Some Other Race |
Race other than White, Black or African American, Native Hawaiian or Pacific Islander, American Indian or Alaska Native, and More than One race. |
State Psychiatric Hospital |
A state owned psychiatric inpatient facility licensed as a hospital that provides primarily inpatient care to individuals with mental illness from a specific geographic area and/or statewide. Include state hospitals where the management and operation are contracted out to a non-state organization or company. |
Stratified Random Sample |
Type of random sampling where sub-populations are represented equally or proportionately to the whole population. |
Substance Use |
Substance use refers to the use of selected substances, including alcohol, tobacco products, drugs, inhalants, and other substance that can be consumed, inhaled, injected, or otherwise absorbed into the body with possible dependence and other detrimental effects. |
Supported Employment (SE) |
Supported Employment (SE) is an evidence-based practice (EBP) to promote rehabilitation and return to productive employment or enter into productive employment, for persons with serious mental illnesses. SE programs use a team approach for treatment, with employment specialists responsible for carrying out all vocational services from intake through follow-along. Job placements are community-based (i.e., not sheltered workshops, not onsite at SE or other treatment agency offices), competitive (i.e., jobs are not exclusively reserved for SE clients, but open to public), in normalized settings, and utilize multiple employers. The SE team has a small client to staff ratio. SE contacts occur in the home, at the job site, or in the community. The SE team is assertive in engaging and retaining clients in treatment, especially utilizing face-to-face community visits, rather than phone or mail contacts. The SE team consults/works with family and significant others when appropriate. SE services are frequently coordinated with Vocational Rehabilitation benefits (https://www.samhsa.gov/resource/ebp/supported-employment-evidence-based-practices-ebp-kit). |
Supported Housing |
Supported Housing is an evidence-based practice (EBP) in which a consumer lives in a house, apartment, or similar setting, alone or with others, and has considerable responsibility for residential maintenance but receives periodic visits from mental health staff or family for the purpose of monitoring and/or assisting with residential responsibilities. Criteria identified for supported housing programs include housing choice, functional separation of housing from service provision, affordability, integration (with persons who do not have mental illness), right to tenure, service choice, service individualization and service availability. (https://www.samhsa.gov/resource/ebp/permanent-supportive-housing-evidence-based-practices-ebp-kit). |
Therapeutic Foster Care |
Children are placed with foster parents who are trained to work with children with special needs. Usually, each foster home takes one child at a time, and caseloads of supervisors in agencies overseeing the program remain small. In addition, therapeutic foster parents are given a higher stipend than traditional foster parents, and they receive extensive pre-service training and in-service supervision and support. Frequent contact between case managers or care coordinators and the treatment family is expected, and additional resources and traditional mental health services may be provided as needed. |
Training and Evaluation |
This includes skill development and continuing education for personnel employed in local programs as well as partnering agencies, as long as the training relates to services to adults with SMI or children with SED. Typical costs include course fees, tuition, and reimbursements to employees, trainer(s) and support staff salaries, and certification expenditures. |
Two or More Races |
“A combination of two or more of the following race categories: 1. White 2. Black or African American 3. American Indian or Alaska Native 4. Asian 5. Native Hawaiian or Other Pacific Islander 6. Some Other Race” (U.S. Census Bureau, 2000 Census Population, Public Law 97-171 Redistricting Data File). |
Transgender (Trans Woman and Trans Man) |
Transgender is an umbrella term for persons whose gender identify, gender expression, or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Trans Woman is a person that was assigned male at birth but identifies and lives as a woman. Trans Man is a person that was assigned female at birth but identifies and lives as a man. |
Unduplicated Counts |
Counting a client/consumer and their services uniquely. Unduplicated counts can exist at different levels: a program, a local system of care, or at the state level. |
Unemployed |
According to the U.S. Department of Labor, persons are classified as unemployed if they do not have a job, have actively looked for work in the prior 4 weeks, and are currently available for work. Actively looking for work may consist of any of the following activities:
|
Vocational Rehabilitation |
Services that include job finding/development, assessment and enhancement of work-related skills, attitudes, and behaviors as well as provision of job experience to clients/patients. Includes transitional employment. |
White |
Individuals with origins in any of the original peoples of Europe, including, for example, English, German, Irish, Italian, Polish, and Scottish (https://www.govinfo.gov/content/pkg/FR-2024-03-29/pdf/2024-06469.pdf). |
1Section 1915(b)(1) of the PHS Act (42 USC 300x-4).
2Section 1915(b)(2) of the PHS Act (42 USC 300x-4).
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 2025-02-11 |
© 2025 OMB.report | Privacy Policy