Evaluation of Florida’s Sub-Acute Inpatient Psychiatric Program (SIPP)

In March 1998, the State of Florida received approval of a 1915 (b) waiver from the Health Care Financing Administration (HCFA) to implement an alternative, Sub-acute Inpatient Psychiatric Program (SIPP) for children under the age of 18, who had two or more psychiatric inpatient stays in a year, or a length of stay greater than thirteen days. For these high risk youth, who were typically served in general hospitals, the SIPP model was designed to improve the transition from inpatient care to community based care, in an effort to reduce the high rates of readmission and improve their chances of success in the community. For the Medicaid program, the SIPP model was designed to reduce the cost of psychiatric inpatient care by increasing the days in community and providing an alternative to general inpatient settings. Unique to the SIPP model are several core features, including family therapy, on-site education, an average length of stay up to 60 days, comprehensive assessment and treatment planning, case management and after care follow-up. The Louis de la Parte Florida Mental Health Institute conducted an evaluation of the SIPP program during the first year of implementation. The evaluation consisted of a three part design, including an analysis of historical administrative data, site visits and interviews with clients, families, program staff, and community agencies, and an examination of current enrollee characteristics and client satisfaction based on provider collected outcome data. Key aspects of the program were examined to understand how the sites interpreted the program model, developed the family involvement component, engaged in comprehensive assessment and treatment planning, delivered after care programming and case management, and established information systems for quality assurance and continuous improvement