201272 Community-Based Alternative to Psychiatric Residential Treatment Facilities: Early Evidence of Mississippi's MYPAC Program Effect

Sunday, November 8, 2009

Ying Wang, PhD , IMPAQ International, Columbia, MD
Kristi R. Plotner, LCSW , Bureau of Mental Health Programs, Mississippi Division of Medicaid, Office of the Governor, Jackson, MS
Oswaldo Urdapilleta, PhD , IMPAQ International, Columbia, MD
Bonnie M. Windham, LMFT , Bureau of Mental Health Programs, Mississippi Division of Medicaid, Office of the Governor, Jackson, MS
Lacinda Jaynes , Bureau of Mental Health Programs, Mississippi Division of Medicaid, Office of the Governor, Jackson, MS
The New Freedom Commission on Mental Health recommended that the Centers for Medicare & Medicaid Services (CMS) conduct a demonstration evaluating the effectiveness of community placements for children and youths with serious emotional disturbances (SED) in Psychiatric Residential Treatment Facilities (PRTF). As a result, CMS awarded demonstration grants to Mississippi and eight other states to implement alternative community programs for children and youth with SED. The State began operating Mississippi Youth Programs Around the Clock (MYPAC) in November 2007. MYPAC provides an array of services to children and youth diverted or transited from PRTF, including case management and respite care and wraparound services.

Congress mandated local and national evaluations to test whether the program maintains or improves children's level of functional and is cost neutral. As a control group, Mississippi selected children in PRTF meeting the same level of care as those in MYPAC. Baseline, 6-month follow-up and discharge data were collected for all participants. An early pre-post comparison of 19 youths in MYPAC 6 months and longer suggests that since they joined MYPAC: 1) their school absence and substance abuse severity has been either maintained or reduced; 2) most had fewer arrests; 3) fewer had problems with law enforcement; however 4) more youths have been involved with Child Protective Services. These preliminary findings suggest that a community setting may improve children's functional outcomes. However, more data collection and analyses will be performed to gauge the program effect and help identity policy options for community health planning.

Learning Objectives:
With the increased interest in the effectiveness of community-based health services, it is crucial to understand whether children and youths with SED can perform well in the community so a more balanced Medicaid supports system can be arranged between the institutions and communities. This study analyzes a state’s data from a demonstration program, explains the program design, evaluates the early results of the program and that may help the state formulate policy or implementation changes that can be better targeted on the need for children and youths in the community. This demonstration also reflects CMS’s vision in rebalancing the institutional care with services provided in the communities.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The submission of the abstract was approved by the study sponsor and I was directly invovled in the project and abstrat development.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.