Special Populations and How to Use Them 

Client data is often broken down by numerous data points, such as demographics, diagnosis, services and programs. Special populations were created to be able to meta-tag clients outside of these things.

Sometimes, a demographic or functional impairment is the impetus for data tracking, such as veteran status or clients experiencing homelessness. Any data point entered into a client’s chart can be used to organize data. In this case, data could be generated from the Client Information screen or state reporting document, or from the problem list or diagnosis document in the case of homelessness.

However, there are a few instances in which data tracking for a client population cannot be done elsewhere in SmartCare. This is why the Special Populations screens were created. This started with the ICC/IHBS population, which required billing rules to be placed based solely on the client who was being served, rather than the provider or program. When “ICC/IHBS” is added as a special population to a client, the “HK” modifier will be added to any appropriate claims sent to Medi-Cal for that client, based on the current billing manual. The “Katie A ICC/IHBS” will do the same but also add the “KTA” revenue tracking code to the claim as well.

Once these two were established, other special populations that were not tracked elsewhere were discovered and added to the special population list. A second, SUD-specific list was created that is only permissioned to the “SUD Add-On” user role in order to allow for client-level tracking and still abide by 42 CFR Part 2 restrictions.

Most of the time, if a client is part of a specific population, such as a Full-Service Partnership (FSP), they will be enrolled in a program that services that specific population. The client may also be enrolled in other programs, but the specialized program is a way to designate them as part of this specific population. With FSP, any client who is currently enrolled can be used to gather additional information for all clients who are considered FSP clients. This is why “FSP” is not available as a “special population” type.

As new state initiatives roll out, CalMHSA determines how to best implement them. If specific, client-level tracking is required and cannot be done in a different manner, CalMHSA will add to the special populations lists. This is rare, however, as most initiatives require specific program requirements, thereby rendering tracking via program enrollment much simpler.

If a county determines that they need a special population added to the list, CalMHSA recommends that the county reach out to their county liaison first. It’s likely that if one county wants to track a special population, then other counties do as well, and this tracking may be best handled at the CalMHSA level so all counties benefit. It’s also possible that CalMHSA has an alternative method for tracking this type of client rather than using Special Population. CalMHSA always strives to use data that’s entered during the regular clinical workflow, such as program enrollment, service information, and demographic information — and minimize double entry or extraneous entry of data.