1. NorthSTAR Data Collection System
What data elements does DSHS collect, and what do NTBHA and DSHS look at?

2. Data-The Big Picture
The NorthSTAR data system is populated by multiple data sources and systems. These sources provide different data elements including:
Enrollment and enrollee demographics (Medicaid and online enrollment system),
Client Level Service Claims data (ValueOptions),
Client Level Medication Claims data (ValueOptions),
Medicaid Pharmacy Data (Vendor Drug),
State hospital admission, stay and discharge information (CARE),
RDM Clinical assessment information-TRAG, uniform assessment (WebCARE),
Substance abuse services intake and outcome (follow up) information (BHIPS)
Complaints, Appeals and Adverse Determinations data
Satisfaction data (annual now, but looking to do rolling surveys)

3. Data-The Big Picture
From this data we can look at aggregate data for system trends, county level trends, provider level trends, and down to individual cases.
This aggregate data can be trended at a very high level, down to a relatively localized level.
The aggregated data can be helpful for counties to see what is being provided for their residents.
HIPAA and 42 CFR, part 2 regulate the sharing of client identifying data.

4. Encounter Data-Very High Level Illustration using FY08 Data
Below is a high level table of unique enrollees served in NorthSTAR in FY08, based on paid claims.
State Fiscal Year
Unduplicated Count of Claimants
2008
53007

5. Same Data-Drilling Down
Now the high level table of unique enrollees served in NorthSTAR in FY08 includes treatment reason, based on paid claims.
State Fiscal Year
SFY Treatment Reason
Unduplicated Count of Claimants
2008
Unspecified
1038
Mental Health
34439
Dual Diagnosis
13027
Chemical Dependency
4503

6. Same Data-Drilling Down Some More
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by treatment reason, based on paid claims.
State Fiscal Year
Month ID
SFY Treatment Reason
Unduplicated Count of
Claimants
2008
200803
Unspecified 92
Mental Health
13285
Dual Diagnosis
4745
Chemical Dependency
1044

7. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason, based on paid claims.
State
Fiscal
Year
County
Name
Month ID
SFY
Treatment
Reason
Unduplicated
Count of
Claimants
2008
COLLIN
200803
Unspecified 7
Mental Health
1010
Dual Diagnosis
282
Chemical
Dependency 37

8. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason (Mental Health), by procedure type description received, based on paid claims.
State Fiscal Year
County
Name
Month ID
SFY
Treatment
Reason
Unduplicated
Count of
Claimants
Procedure Type Description
2008
COLLIN
200803
Mental Health 59
Laboratory 3
Outpatient
341
Case Management 7
Observation Room 76
Other Assessment
177
Outpatient - Kids 9
Inpatient Services 22
Community Inpatient
536
Medication Services 2
Emergency Room Services
Crises Intervention Services
179
Rehab - Skills Training & Development 71
Rehab - Medication Training and Support 67
Rehab - Psychosocial Rehabilitation Services and/or ACT

9. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason Mental Health, by Psychosocial rehab procedure type received, by diagnostic grouping, based on paid claims.
State
Fiscal
Year
County
Name
Month ID
SFY
Treatment
Reason
Unduplicated
Count of
Claimants
Proc Type Description
BH Diagnostic Group
2008
COLLIN
200803
Mental
Health 37
Rehab - Psychosocial Rehabilitation Services
AFFECTIVE DISORDERS - BIPOLAR 8
AFFECTIVE DISORDERS - MAJOR DEPRESSION 4
AFFECTIVE DISORDERS AND OTHER 18
SCHIZOPHRENIA & RELATED DIS

10. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason Mental Health, by psychosocial rehab procedure type received, by diagnostic grouping, by treating provider, based on paid claims.
State
Fiscal
Year
County
Name
Month ID
SFY
Treatment
Reason
Unduplicated
Count of
Claimants
Proc Type Description
BH Diagnostic Group
Provider Name
2008
COLLIN
200803
Mental Health 17
Rehab - Psychosocial Rehabilitation Services
AFFECTIVE DISORDERS - BIPOLAR
LIFE PATH SYSTEMS 2
AFFECTIVE DISORDERS - MAJOR DEPRESSION, and OTHER 8
SCHIZOPHRENIA & RELATED DIS

11. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason Mental Health, by psychosocial rehab procedure type received, by diagnostic grouping, by treating provider, by City and Zip Code of Residence, based on paid claims.
State
Fiscal
Year
County
Name
Month ID
City
Zip
Code
SFY
Treatment
Reason
Unduplicated
Count of
Claimants
Proc Type
Description
Provider
2008
COLLIN
200803
ALLEN
75002,
75013
Mental
Health 3
Rehab –
Psychosocial
Rehabilitation
Services
LIFE
PATH
SYSTEMS

12. Same Data-Drilling Down Some More (cont.)
More detailed table of unique enrollees served in NorthSTAR in FY08, then by month, by county, by treatment reason Mental Health, by psychosocial rehab procedure type received, by diagnostic grouping, by treating provider, by City and Zip Code of Residence, by Gender, ethnicity, age group, Medicaid status, based on paid claims.
Month ID
City
Unduplicated
Count of
Claimants
Proc Type
Description
Provider
Name
Gender
Ethnicity
Age
Group
Med
Non Med
200803
ALLEN 3
Rehab
Psychosocial
Rehabilitation
Services
LIFEPATH
SYSTEMS
Female
WHITE
(NOT OF
HISPANIC
ORIGIN)
21 to 64
NON-
MEDICAID

13. County by County Comparison
Table 1: Number of Medicaid Persons Enrolled in NorthSTAR, Based on County of Residence in Medicaid Record
2007 Distribution by Numbers of persons <200% FPL within Counties Compared to all NorthSTAR Persons <200% FPL
FY06
FY09
Percent Change, FY06 to FY09
FY09 Percentage of FY09 Total
HUNT
13,066
12,481
-4%
2.5%
2.9%
ELLIS
16,558
17,860 8%
3.6%
3.7%
COLLIN
33,922
39,701
17%
8.1%
9.5%
DALLAS
369,513
405,634
10%
82.5%
78.0%
KAUFMAN
12,369
14,125
14%
2.6%
NAVARRO
8,724
8,938 2%
1.8%
2.1%
ROCKWALL
4,744
5,515
16%
1.1%
TOTAL
451,038
491,765 9%
100%
100.0%
Table 2: Number of Persons Who Received at Least One Service (Based on County of Residence at the time of Service)
2,010
2,376
18%
3.8%
2,236
2,487
11%
4.0%
4,218
4,770
13%
7.7%
36,434
48,643
34%
78.5%
1,549
1,873
21%
3.0%
1,211
1,308
481
618
28%
1.0%
47,729
61,932
30%

14. What Other Data Does the State Monitor
Expenditures (similar to how we look at people served)
Complaints (provider and enrollee)
Survey Data
Needs Assessment
Information from Provider and Other Stakeholder Forums
Clinical Outcomes-what happens to individuals-expanded Data Book (Performance Indicator Project)

15. Oversight and Monitoring
Adequate Outreach:  Is NorthSTAR known throughout community (MAXIMUS, Provider Directories, Outreach and Education events)
Adequate Accessibility:  Is there a broad array of accessible providers (must have critical mass to support operations)
Adequate Provider Reimbursement:  Reimbursement Rates must be at a level that at least covers providers costs.
Adequate Services Coordination: Do systems and providers coordinate with one another.
Provider operations:  Do providers deliver services that are responsive to the community's needs?
Collection of Data: Data must be complete and accurate
Monitoring of Data: Comprehensive approach to monitoring performance

16. Questions?