1. Mental Health Data Alliance, LLC (MHData) November 20, 2014 This webinar was funded by the Mental Health Services Oversight and Accountability Commission (MHSOAC). Audio portion will begin shortly Slides available at www.mhdata.org > Resources > FSP

2. MHData Introductions o Kate Cordell, PhD(c), MPH o Thomas Weitzel o Laura Hosier

3. List Serve MHSOAC maintains a list serve with information relevant to counties If you would like to receive announcements, go to MHSOAC home page to sign up: http://www.mhsoac.ca.gov/default.aspx http://www.mhsoac.ca.gov/default.aspx Resources also at MHData Website www.mhdata.orgwww.mhdata.org This presentation available at: http://www.mhdata.org/Pages/Resources-FSP.aspx http://www.mhdata.org/Pages/Resources-FSP.aspx

4. Purpose of Project Increase the ability to understand and improve upon the quality of services offered by Full Service Partnerships (FSPs) o Assist counties/providers to describe their FSP programs o Assist counties/providers to publically communicate program offerings o Assist state/counties/providers to assess FSP programs o Assist counties/providers to share information about FSP programs o Assist consumers and families to find appropriate FSP programs o How else can this project assist your goals?

5. Process within Project 1. Identify ways this project can assist counties, providers, programs, consumers, stakeholder and families 2. Identify important features of FSP programs 3. Create a common language to describe the components within an FSP 4. Utilize this common language to describe all FSP programs in the State 5. Create a system to help easily gather and disseminate information regarding important features of FSP Programs

6. Background – FSP Programs FSPs evolved from Assembly Bill (AB) 34 and AB 2034 programs which provided comprehensive services for adults who had serious mental illness and o were homeless, o at risk of becoming homeless, o recently released from a county jail or State prison, or o others who were untreated, unstable, and at significant risk of incarceration or homelessness without treatment The pilot and statewide implementation of AB 34 and AB 2034 focused on the Assertive Community Treatment (ACT) model: o outreach, o supportive housing and other housing assistance, o employment, o substance abuse, o and mental and physical healthcare

7. Background – FSP Programs FSPs are designed to provide comprehensive, recovery based services to the highest-need clients in the public mental health system Partners served in FSPs are living with serious mental illness or a serious emotional disturbance in addition to often having a history of homelessness, incarceration, and/or institutionalization Full Service Partnerships provide intensive case management on a 24/7 basis, doing “whatever it takes” for the client to promote progress on their road of recovery Services may also focus on crisis response and de-escalation, medication evaluation, establishment of benefits, and preparation for education and/or employment

8. Background – FSP Programs FSPs are required to provide both mental health and non mental health services, per the California Code of Regulations (CCR), Title 9 § 3620: ISSP: “Individual Services and Supports Plan” means the plan developed by the client and, when appropriate the client's family, with the Personal Service Coordinator/Case Manager to identify the client's goals and describe the array of services and supports necessary to advance these goals based on the client's needs and preferences and, when appropriate, the needs and preferences of the client's family.

9. Background – FSP Programs FSPs are required to provide both mental health and non mental health services, per the California Code of Regulations (CCR), Title 9 § 3620:

10. Background – FSP Programs Specific components of the FSP programs may be developed through a stakeholder process.

11. County Programs Counties FSP Programs Non-FSP Programs Providers Counties develop customized plans (Programs) for mental health services in accordance with State requirements, including providing for significant local stakeholder input and involvement Providers deliver Program’s identified offerings to consumers and families

12. FSP Programs Program Differentiation - as a result of significant local stakeholder input and involvement and varying community needs, programs vary widely between counties This project will create a classification system to allow for the creation of FSP Program profiles based on program characteristics

13. FSP Program Characteristics Some examples of characteristics include: o Target populations o Service offerings o Staffing o Resources o Support o Technology o Communication tools o Organization o Workflow processes and procedures o Program fidelity o Etc… Characteristics are attributes of Programs that describe similarity to or differences between other Programs

14. MHSOAC Research Questions 1. What are the most meaningful ways to classify FSP programs across the state that would be beneficial to clients, family members, providers, the State and other stakeholders? 2. What characteristics/factors should the classification system be based upon? What data is needed to measure those characteristics/factors? 3. What is the best method for various stakeholders throughout the state to view and utilize a classification system to improve quality and services provided by FSPs?

15. FSP Classification Project Aims Over the next 2 years: 1. Develop a schema to identify FSP Program Characteristics for classifying program components 2. Develop an online system to allow counties and their providers to create profiles for FSP Programs using the developed schema  The online system is intended to be easy to use, require infrequent updates and support county, provider or program needs (for example, assist with the creation of a program logic models, program plans, or create useful reports, etc.) 3. Develop an online system to allow county, provider, consumer and community member to better understand the features of FSP Programs statewide  The online system is intended to be easy for public users to query in order to locate programs, identify program offerings or compare components between programs

16. Volunteer Involvement Project Advisors (volunteers) o Provide guidance and feedback for this project:  Help identify ways this project can benefit counties, providers, programs, stakeholders and consumers and their families  Help develop relevant questions to ask county, provider and program staff; consumers and families; and stakeholders, etc.  Help identify areas of focus and areas overlooked  Provide feedback on plans, presentations and reports  email info@mhdata.org with words “Advisor Volunteer”info@mhdata.org 3 Volunteer Counties: o Help coordinate on-site meetings for MHData and county mental/behavioral health director, MHSA Coordinator, and other relevant county and FSP provider staff o Help identify whether inclusion by local clients, family members, and other stakeholders in these site visits would be advantageous o Help us understand and describe your county’s FSP Programs features, workflow and characteristics o Provide feedback on the proposed schema as it applies to your county’s programs, developed by MHData as a PowerPoint slide set o email info@mhdata.org with words “County Volunteer”info@mhdata.org

17. Classification Schema We are developing a structure to capture program classification data o Logic Model framework o Defining Main Categories o Defining each program characteristic or feature as Components and their Elements

18. W. K. Kellogg Foundation Logic Model Resources / Inputs ActivitiesOutputsOutcomesImpact Reference: http://www.wkkf.org/resource-directory/resource/2006/02/wk-kellogg-foundation-logic-model- development-guide “A logic model is a systematic and visual way to present and share your understanding of the relationships among the resources you have to operate your program, the activities you plan, and the changes or results you hope to achieve.”

19. FSP Programs’ Preliminary Logic Model ResourcesTargetsActivitiesGoals Program Categories:

20. Characteristic Categories CountyPrograms ResourcesTargetsActivitiesGoals Provider Organizations

21. Resources Staff Trained Volunteers Certified Clinicians Medical Psychiatrist Service Provider Organization Outpatient Center Crisis Center Respite Care Center Model Housing First Model Process and Procedure Wellness and Recovery Plan Process Individualized Service Plan Process Targets Culture / Ethnic Focus Latino Native American Issues/Disorder Homeless Co-occurring Substance Referral Source Psychiatric Hospital Jail Institution for Mental Disease (IMD) Age Group Older Adult Activities Services Housing Retention Support Permanent Housing Support Group Skill Training Employment Services Recovery Services Alcohol and Drug Treatment Individual Therapy Family Therapy Interventions Address social skills Address Anger Management Address Stress Management Outreach Advertising Education / Training Community Events Community Groups Goals Aims Reduce Isolation Reduce Discrimination Promote Self- Sustainability Provide Culturally Sensitive Service Measured Objectives Decrease Stress Decrease Incidence of Crisis Recovery (MORS) Increase Quality of Life Index Staff Cultural Awareness (Survey)

22. 3-Tiered Classification Schema Starting with a 3-tier characteristic classification schema o Category Component Element Example o A characteristic of some programs is that they focus on a target population who are referred by a jail to the program: o Targets (Category) Referral Source (Component) Jail (Element) Flexible approach Counties will be able to participate and provide feedback on all Categories, Components, and Elements

23. Project Status Characteristic Tracking System o Category o Component o Elements Commenced data discovery

24. Data Discovery To start, we have reviewed a number of publicly available county 3-year plans o This has provided us with some starting sample data to begin to formulate how data might be structured in the proposed classification system o Feedback and suggestions are welcome

25. Initial Model Structure Initial Categories and Components based on 3-Year Plans: Activities Community Activities Interventions Outreach Service Locations Services Target Population Cultural/Ethnic Focused Geographical Focus Income Level Issues/Disorders Referral Source Special Population Unmet Needs Unserved or Underserved Resources Models Organization Process and Procedure Service Provider Organization Staff Support Goals Aims Measured Objectives

26. Initial Model Structure (Component & Element Example) Goals o Aims  Reduce emergency room visits  Decrease exposure to alcohol, tobacco and other drugs  Decrease isolation  Improve communication skills  Improve conflict resolution skills  Decrease exposure to violence  Reduce the subjective suffering from serious mental illness  Teach responsibility  Reduce substance abuse  Reduce recidivism  Reduce long-term hospitalization  Improve peer relationship building skills  Enhance suicide prevention efforts  Reduce discrimination  Teach group participation  Increase well-being  Improve life skills  Academic Focused  Promote Consumer Self- Sustainability  Reduce further de-compensation  Reduce the need for additional services  Improve coping skills  Increase quality of life  Provide culturally sensitive mental health services  De-stigmatize mental health symptoms  Reduce psychiatric hospitalizations

27. Program Classification Example Activities o Community Activities  Workshops/Group Sessions  Community service  Youth Activities  Special events o Services  Outreach  Linkage Goals o Aims  Improve peer relationship building skills  Improve conflict resolution skills  Improve communication skills  Academic Focused  Decrease isolation  Increase well-being  Decrease exposure to alcohol, tobacco and other drugs  Decrease exposure to violence  Reduce discrimination  De-stigmatize mental health symptoms o Measured Objectives  Increase and maintain emotional health  Increase and maintain mental health  Participate in community groups/activities One example county profile based on information obtained from the public county’s 3-year plan for illustration purposes only

28. Other Factors to Consider Staff ratio Number of individual served Client and staff turnover Recidivism Evidence based practices Staffing Staff training, tools and support Costs Technology Information workflow Communication workflow Organization hierarchy / workflow Desired vs. actual outcomes Fidelity Philosophies Funding Client Feedback Quality assurance Feedback processes Measures of success Program improvement efforts

29. Other Factors to Consider Priority of Element in Program: o Core feature o Supplemental feature as needed o etc. Frequency of Element’s Use in Program: o Always, usually, sometimes, rarely, never

30. Next Steps… 1. Identify project advisor volunteers (email info@mhdata.org with words “Advisor Volunteer”)info@mhdata.org 2. Identify an appropriate list of guiding questions for county visits and focus groups 3. Identify at least 3 participating counties (email info@mhdata.org with words “County Volunteer”)info@mhdata.org o Coordinate with county lead to plan a visit o Schedule on-site visits to meet with staff, providers, stakeholders, and families/consumers (as necessary) o Review programs and program characteristics with broad staff participation o Present program profiles to each county program based on initially identified characteristics for feedback o Develop Preliminary FSP Schema based on 3 counties

31. Next Steps… 4. Hold a series of focus groups o Category and Component Definition Discussion o Element Definition Discussion o Identify ways this project can benefit counties, providers, programs, stakeholders, and consumers and their families 5. Present the Preliminary Statewide FSP Classification System as PowerPoint Presentation (February, 2015)

32. Project Timeline o February, 2015  Preliminary Statewide FSP Classification System Presentation Based on Focus Groups, Advisors and 3 Volunteer Counties o March – June, 2015  Webinar Series to Gather Stakeholder Input and Present Schema Development / Evolution o July, 2015  Report of Proposed Statewide FSP Classification System Based on Stakeholder Input o July –Aug, 2015  Public Comment Period o September, 2015  Final FSP Classification System Report

33. Project Timeline o August – November, 2015  Develop Design Specification for Online Statewide FSP Classification System o November, 2015  Online Statewide FSP Classification System V1.0 Design Specification Document o May, 2016  Online Statewide FSP Classification System V1.0 Beta Release  30-day Beta testing with set of volunteer counties o July - Aug, 2016  Online Statewide FSP Classification System V1.0 Release  Administrator Training  User Training

34. The floor is open for questions and discussion Need to have a more in depth conversation? Email info@mhdata.org with 3 available times you can meet via phone conference.info@mhdata.org

35. Thank You! info@mhdata.org