Mental Health Services Oversight and Accountability Commission (MHSOAC)

Building a Shared Vision in California for Improving Outcomes for Individuals with Serious Mental Illness

Practice Area: Behavioral Health Scope: County Location: CA Status: Active

Project Overview

Inspired by our groundbreaking work with the Los Angeles County Department of Mental Health, Third Sector is leading a cohort of nine diverse California counties over 4.5 years in transforming their Full Service Partnership (FSP) programs to improve client outcomes. Through data-driven approaches and cross-county collaboration Third Sector is working with the counties both collectively and individually to implement an outcomes-focused approach that will increase their overall ability to use data to improve FSP services and outcomes

Challenge

We believe in a society where all people, no matter their race, background, or circumstance, can receive the behavioral health supports they need through responsive and functional public systems. Too often, we have failed to build robust behavioral health service delivery systems that provide the critical access, resources, and data necessary to support those needing services most optimally. 

In California, $1 billion in public funds are invested annually in Full Service Partnerships (FSPs), which provide comprehensive community-based services for more than 60,000 individuals facing severe and persistent mental illness. The FSP philosophy is to do "whatever it takes" to help people on their path to recovery and wellness.

FSPs have tremendous potential to reduce psychiatric hospitalizations, homelessness, incarceration, and prolonged suffering by Californians with severe mental health needs. However, FSP programming varies significantly from county to county, with different operational definitions and a lack of consistent data processes that make it challenging to understand and tell a statewide impact story.

Process

To address these challenges, the California Multi-County Full Service Partnership Innovation Project brings together nine diverse counties to change how they develop, implement, and evaluate critical mental health services using a more data-driven and person-centered approach. Beginning in early 2020, Fresno, Sacramento, San Bernardino, San Mateo, Siskiyou, and Ventura counties launched the first 'wave' of the cohort. In August 2021, Lake and Stanislaus counties joined the project, followed by Napa County in October 2022, to form 'wave 2' of the cohort.

Third Sector provides technical assistance and expertise in outcomes-focused approaches to the counties and works in partnership with California's Mental Health Services Oversight and Accountability Commission (MHSOAC), CalMHSA (fiscal intermediary), and the RAND Corporation (evaluator) to identify and implement changes to data collection and reporting, service guidelines, eligibility and graduation requirements, and other program elements to improve FSP programs across the state. 

The project builds on work Third Sector and LA County's Department of Mental Health conducted to transform that county's FSP program by building on their initial groundbreaking data and outcomes efforts to new geographies and localities with a statewide perspective. Counties leverage the cohort's collective power and shared learnings to maximize FSP program impact and ultimately drive transformational change in the delivery of mental health services.

Results

The Multi-County FSP Innovation Project is enhancing counties' ability to use data to improve FSP services and outcomes. While RAND's project evaluation is still underway, Third Sector has already observed several benefits, including:

  • Improved collaboration across participating counties: Regular cohort meetings served as a valuable opportunity for counties to formally and informally learn from one another and share best practices. Participating counties have also held two state-wide Learning Communities to encourage feedback and knowledge-sharing across the state.
  • Standardized data reporting: Counties worked together to identify standardized performance measures for tracking the services individuals receive and how successful those services are for specific populations. Guided by both evidence-based practices and extensive community engagement, the counties selected and defined five outcome and process measures and then built automated reports to track these measures. As a result, counties have more consistent and actionable FSP data that they can use to compare and share outcomes across counties and better tell a statewide impact story.
  • Increased consumer input in service changes and outcomes: With the input of more than 200 consumer interviews, each county made customized changes to their local service delivery, such as building more consumer-centered step-down processes and criteria. In addition, counties collectively created a new standardized performance measure around social connectedness.
Practice area:

Behavioral Health

Third Sector works with communities and our government agencies to transform how we deliver mental and behavioral health services to support people’s recovery and well-being.
Project NameScopeLocationStatus
California Interagency Council on HomelessnessStateClosed
From March 2022 to December 2023, Third Sector advised counties receiving Homeless Housing, Assistance and Prevention (HHAP) funds on how to improve state performance goals through various outcomes contracting and continuous improvement strategies. Third Sector also advised the 13 state departments in the state's Funding and Programs Working Group to act on various policy and program priorities by developing a racial equity data plan to improve system coordination and administrative efficiency, a pathway for counties to escalate persistent challenges that require more state support, guidance, or collective problem-solving; and peer-learning forums across state and county departments.
Designing Outcomes-Focused Mental Health Services in Los Angeles CountyCountyCAClosed
Third Sector partnered with the Los Angeles County Department of Mental Health (LACDMH) to transform approximately $300 million in service provider contracts, creating the nation's largest system of outcomes-focused mental health provider contracts. This multiyear, data-driven process focused on LACDMH's Full Service Partnership program, which supports a "whatever it takes" approach to caring for individuals with the most challenging mental health needs. As a result, LACDMH was able to deliver better outcomes for the more than 15,000 clients they serve each day.
Practice Area Managing Director of Behavioral Health
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