Los Angeles County Department of Mental Health

Designing Outcomes-Focused Mental Health Services in Los Angeles County

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

Project Overview

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.


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. Many of our most vulnerable people seeking help often encounter disorganized and siloed services, exacerbating their struggle to lead the lives they are striving to live. 

Los Angeles County is the epicenter of the nation’s mental health and homelessness crises. An estimated 66,000 LA Country residents are experience homelessness, and nearly a quarter of LA's jail population has an open mental health case. The Los Angeles County Department of Mental Health (LACDMH) is the largest county-operated mental health agency in the country, charged with serving more than 250,000 of LA County's most vulnerable residents every year and boasting an annual budget approaching $3 billion. Yet, like many mental health departments nationwide, LACDMH's existing model for provider contracts made it financially unsustainable for providers to provide the kind of wraparound supportive care that research shows is the most effective way to help those with the most challenging mental health needs.


In 2017, LACDMH Director Dr. Jonathan Sherin engaged Third Sector with funding from the Ballmer Group to help realign LACDMH's largest and most intensive outpatient supportive services program: the Full Service Partnership (FSP) program, which serves 15,000 clients with serious mental illness who are currently or at risk of experiencing homelessness, have a history of justice involvement and/or are high utilizers of emergency services. From 2017 to 2021, Third Sector and LACDMH worked collaboratively with providers and clinical experts to develop outcomes targets, data reporting, and incentive structures for a new service model that would more effectively improve the life trajectories of LA County's FSP clients. Third Sector engaged agency staff, providers, consumers, and other partners countywide to develop programmatic outcomes that focused on effectively serving high-acuity populations, metrics and processes to track outcomes achievement, and new contract financing mechanisms that included bonus payments to providers for 1) enrolling and retaining these individuals, and 2) achieving outcomes geared toward these populations, such as stable housing, reduced justice involvement, and reduced utilization of psychiatric emergency departments. 


As a result of this work, in July 2021, Third Sector and LACDMH launched the largest system of outcomes-focused mental health service provider contracts in the nation, covering 196 clinics whose combined contracts are valued at approximately $300 million. The new outcomes-focused contracts set specific client outcome goals for providers and reward providers who successfully enroll, retain and achieve the highest priority life outcomes (e.g., obtaining and maintaining stable housing, reducing recidivism, and reducing psychiatric emergency department visits) for clients with the highest needs. Third Sector's efforts in LA County culminated in new service design, data collection and sharing practices, and funding mechanisms that were aligned in supporting LA County's most vulnerable populations to access high-quality services and achieve meaningful outcomes. 

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 Multi-County Full Service Partnership Innovation ProjectCountyCAActive
Inspired by the groundbreaking work of the Los Angeles County Department of Mental Health, Third Sector lead a cohort of eight diverse California counties over two full years in transforming their Full Service Partnership (FSP) programs to improve client outcomes. Through data-driven approaches and cross-county collaboration Third Sector worked with the counties together and individually to a implement an outcomes-focused approach that will increase their overvall ability to use data to improve FSP services and outcomes.
Washington State 988 Implementation SupportStateWAClosed
In preparation for 988 hotline implementation as required by the National Suicide Hotline Designation Act of 2020, Washington State partnered with Third Sector to perform a landscape assessment exploring the features of a successful, culturally, and linguistically competent crisis response and management system.
Practice Area Managing Director of Behavioral Health