Statewide Sub-Acute Inpatient Psychiatric Program (SIPP): Report 3

Publication Date: 6/1/2002

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Description:

With the approval of a 1915(b) waiver by the Health Care Financing Administration (HCFA), during the spring of 1999 the State of Florida implemented the Sub-Acute Inpatient Psychiatric Program (SIPP), an alternative, sub-acute treatment program for clinically eligible children under the age of 18 who are high utilizers of inpatient psychiatric services, in two regions of the state. During 2001-02 a revised SIPP program was implemented statewide with the approval of a second 1915(b) waiver that permits limits on services, prior authorization of services, selective provider enrollment through a competitive procurement process, and a phase-in of coverage by geographic areas. The federal waiver approval required that the state arrange for an independent evaluation of SIPP; the Agency for Health Care Administration requested that the Louis de la Parte Florida Mental Health Institute conduct the evaluation.

This report includes two major components: a continuation of the comparison study of youth discharged from the two sites of the original SIPP model and the first report of two sub-studies related to the new SIPP model. The comparison study of the original SIPP model is designed to describe the impact of the SIPP model on post-discharge treatment patterns by comparing the post-discharge patterns of care and cost of SIPP enrollees with a comparable sample of highrisk youth statewide that were discharged from a general hospital inpatient program. The study compared individuals discharged from SIPP within three post-discharge follow-up intervals (18 months, 12 months, and 6 months) with youth discharged from an acute hospital inpatient psychiatric program in terms of their rates of psychiatric inpatient readmissions, inpatient lengths of stay, patterns of post-discharge utilization of mental health services, costs of qualifying inpatient and post-discharge services, and post-discharge utilization and costs of pharmaceuticals. The study also provided demographic and diagnostic information regarding the SIPP enrollees. An analysis of Medicaid claims data for 109 SIPP enrollees and a matched comparison group of similar youth statewide was conducted to address these evaluation questions.