1. Staying Ahead of the Budget Shortfall: Serving More Youth with the Same Amount of Money (or Less) Monday, March 5, 2012 Shannon Van Deman, CFO

2. Economic Challenges Federal, state, and county budget cuts Medicaid budget cuts More families in need of services

3. Indiana’s Solution Focus on youth with the most intensive needs –20% of youth use 80% of the dollars –Prevent costly out of home placements Development of Choices, Inc.

4. Choices, Inc. Non profit care management organization created in 1997 Developed around a community need: “high cost youth” Blended system of care principles with wraparound values and managed care technology.

6. Hypotheses Serve more youth in the community Reduce expenses for out-of-home placements Improve outcomes for youth Save money

7. Methodology Time period: November 2008 through January 2010 Data obtained: –Indiana Department of Child Services (DCS) monthly indicator reports from Region 10 –The Clinical Manager (TCM) –Child and Adolescent Needs and Strengths Assessment (CANS)

8. Methodology Compared outcomes between youth that received services from Choices and those that did not Note that DCS data includes Choices youth Average monthly census –Choices 122 youth –DCS 3022 youth enrolled as CHINS

9. Results

12. Clinical Outcomes

14. Fiscal Outcome Service Cost per day for DCSLOS (Days) Total Cost Per Youth Episode Residential $ 293.24270 $ 79,174.80 Choices Tier 3 $ 126.94341 $ 43,286.54 In 2009, there were 102 youth referred by DCS that were not in RTC at enrollment. Of those 85 youth remained out of residential treatment. Savings per Youth= $79,174.80 (cost of residential treatment episode) - $43,286.54 (cost of a Choices episode) = $35,888.26 Savings to DCS = $35,888.26 * 85 youth = $3,050,502.10 Choices saves DCS approximately 3 million dollars for every 100 youth they divert from residential treatment.

15. Conclusions Intensive care coordination models can be used to: Serve more youth in the community Reduce expenses for out-of-home placements Improve outcomes for youth Save money

16. Questions? www.ChoicesTeam.org Choices, Inc. 4701 N. Keystone Ave. Suite 150 Indianapolis, IN 46205 (317) 726-2121