Behavioral Health & Recovery Services - Strategic Initiatives

The Health System's Behavioral Health and Recovery Services (BHRS) and its partners share a common vision, mission, and values. We believe that the people, families, and communities we serve and the members of our workforce should guide the care we provide and shape policies and practices. It is challenging for BHRS stakeholders to keep abreast of all the activities underway, much less participate in all of them!

We hope you will find this summary helpful as you hear about these initiatives or see them mentioned in Wellness Matters. It is not a comprehensive list of our ongoing programs and projects, but does list most of the boundary spanning development work that may impact you. We invite you to contact one of the leads for an activity to learn more about it, get involved, or share your thoughts.

For more information, or to get involved in a specific activity shown below, please refer to the contact list for the individual(s) whose initials follow each activity.  Download a PDF version.

Diversity & Equity: Promote cultural, linguistic and social health equity
Diversity & Equity

Elimination of health inequities, promoting cultural competence as a strategy to improve access and services to under/unserved and inappropriately served communities. Office of Diversity and Equity website.

Strategies:

  • Embed equity strategies and indicators in all areas of our work. 
  • Implement education, training, workforce development and hiring initiatives that increase organizational cultural competence and individual cultural humility system-wide.
  • Implement ethnically/linguistically focused welcoming and engagement strategies (see below).

Activities:

  • Diversity and Equity activities (PRIDE, African American, Chinese, Pacific Islander, Filipino, Latino, Spirituality) including education, workforce development, outreach and welcoming. Learn more about the Health Equity Initiatives).
  • Cultural Competence Committee and CC Steering Committee (JA) (RMo) (Abigail Endres)
  • Statewide Summit November 2009 (JA)
  • Organizational self assessment (JA, RMo, KD)
  • Workforce development: planning and implementation of education and training plan (KD, SK, SSM)
  • Revise hiring goals and updated state plan based on new data and requirements. (PM, JA, all mgrs)
  • Tracking of initiation and engagement of unserved and underserved population. (JA,PM, all mgrs)

Advance Prevention and Early Intervention

 Advance Prevention & Early Intervention

Preventing mental illness, substance abuse, and co-occurring disorders and promoting positive well-being for all people in the community.

Strategies

  • Implement Mental Health Service Act (MHSA) Planning and Early Intervention (PEI) activities.
  • Partner with ethnic and linguistic communities to develop culturally competent strategies for community education and outreach that reduces stigma and discrimination surrounding behavioral health problems and promotes early identification

Activities

  • Implement MHSA funded Prevention and Early Intervention plan. (SK)
  • Utilize BHRS Prevention framework to guide prevention and intervention activities. (SK)
  • Partner within Health to encourage collaboration on prevention/early intervention activities (SK)
  • Fully implement AOD community prevention partnerships. (SK, CB)
  • Anti-Stigma Initiative Kickoff – Oct 09 and follow –up Stigma Advisory (SK, SSM, Raja Mitry)
  • Suicide Prevention Initiative Kickoff – Jan 10 (KD, BC, TD) 
  • Prevention & Recovery in Early Psychosis (PREP) - Spring/Summer 2012 (BC)

Welcoming and Engagement

 Welcome & Engage

Develop a culturally competent and client sensitive entry system that connects clients and family members to appropriate services and supports at the right level and at the right time.

Strategies

  • System-wide entry redesign: establish more integrated, seamless entry process system wide.
  • Implement welcoming framework.
  • Outreach to client and families through culturally/linguistically focused activities.
  • Assure timely access to services and support for clients identified through partner systems.
  • Improve engagement of clients and families through integration of peer and family partners into client services and supports.

Activities

  • System-wide entry redesign.  (CM, SK, PM)
  • Promote implementation of welcoming and partnerships between MH and AOD providers. (MTF, KD, SK, all mgrs)
  • Client survey to measure welcoming experience. (PM, SK)
  • East Palo Alto Outreach Collaborative and related community education projects. (SK, JA, LG, CM, LC)
  • North County Outreach Collaborative – implemented outreach and linkage structure. (SK, JA, CM, LC)
  • Implementation of Puente Clinic (BC) and monthly case consultations with GGRC. (LC)
  • Complex family case consultation (LC, JD)
  • “Paving the Way,” Inspired at Work. (CC)
  • Pathways (TWR)
  • Engagement of administrative staff in training to support their roles in welcoming (KD, LD)

Empowering Clients and Families
Empower Clients & Families

Develop a culturally competent and client sensitive entry system that connects clients and family members to appropriate services and supports at the right level and at the right time.

Strategies

  • System-wide entry redesign: establish more integrated, seamless entry process system wide.
  • Implement welcoming framework.
  • Outreach to client and families through culturally/linguistically focused activities.
  • Assure timely access to services and support for clients identified through partner systems.
  • Improve engagement of clients and families through integration of peer and family partners into client services and supports.

Activities

  • System-wide entry redesign.  (CM, SK, PM)
  • Promote implementation of welcoming and partnerships between MH and AOD providers. (MTF, KD, SK, all mgrs)
  • Client survey to measure welcoming experience. (PM, SK)
  • East Palo Alto Outreach Collaborative and related community education projects. (SK, JA, LG, CM, LC)
  • North County Outreach Collaborative – implemented outreach and linkage structure. (SK, JA, CM, LC)
  • Implementation of Puente Clinic (CMo) and monthly case consultations with GGRC. (LC)
  • Complex family case consultation (LC, JD)
  • “Paving the Way,” Inspired at Work. (CC)
  • Pathways (TWR)
  • Engagement of administrative staff in training to support their roles in welcoming (KD, LD)

Foster Total Wellness: Reduce Health Disparities For BHRS Clients
Foster Total Wellness

Increase access to prevention, disease management and heath care services. Develop creative client driven wellness and disease prevention/management programs.

Strategies

  • Improve health outcomes through access to chronic disease prevention, early intervention, health care.  Self-help and disease management approaches for high risk populations.
  • Reduce preventable physical conditions and improve health outcomes.

Activities

  • Enroll uninsured BHRS adult clients in ACE coverage initiative (SL, BL)
  • MHSA funded small scale consumer training on nutrition/wellness. (SK, SSM)
  • Applied for SAMHSA grant in partnership with SMMC and others to increase access to health care services and expand self help/wellness program. (CC, SSM, BC)
  • Linked to Health System Office of Chronic Disease to share training/education. (BC, JA)
  • Partnered with: HPSM to study health outcomes and Health Officer to study mortality rates for BHRS clients. (BC, SK, PM)
  • Engaged medical leadership in dialogue to improve client access to chronic disease management programs. (BC)
  • Support creation of edible gardens and the availability of healthy food choices. (CC)
  • Encourage self help consumer driven wellness, prevention, and disease management activities. (CC, LG)
  • Development of creative and innovative social programs that involve physical activity. (CC, LG)
  • Provide leadership for the statewide process to develop a new 1115 Medi-Cal waiver that promotes improved access to chronic disease prevention for people with mental illness and substance abuse conditions (SK).
  • Explore increased access to nurse practitioner services through training partnerships (CC)

System of Care Enhancements and Supports Towards Wellness and Recovery
Enhance Systems & Supports

Enhancements to service capacity, structure, policy, and procedure to support organizational values and desired client outcomes.

Strategies

  • Establish co-occurring capabilities as the expectation, not the exception.
  • Improve identification, welcoming/engagement, co-occurring capability, and collective responsibility for complex high need clients.
  • Recognize recovery is a lifelong process: Individualized planning (WRAP) for supports, self-help and resources that build a life worth living in the community.
  • Provide the most appropriate match of resources to meet client/family need.
  • Create appropriate alternatives to crisis care and hospitalization.
  • Increase housing options and reduce homelessness.
  • Continue implementing Older Adult System of Integrated Services (OASIS).
  • Continue to implement evidence based and promising practices identified through AOD Strategic Plan. implementation and MHSA expansion opportunities including Full Service Partnerships.

Activities

  • Co-Occurring Disorder/Change agent initiatives on welcoming, screening and partnering. (MTF and partners)
  • Link to entry redesign and level one and two resource planning. (CC, PS, CM)
  • Primary care based behavioral health services expansions (BJ, SK)
  • WRAP master training – Spring 09 (CC)
  • Draft person centered resource allocation manual. (KC)
  • Pilot of North Adult conceptualized, planning for implementation. (KC)
  • Implemented system-wide monthly peer chart review/training model with QI in child/youth services. (PS, KC).
  • Draft LOCUS reports for process available. (KC)
  • Implementation of Teaching Pro Social Skills. (LC)
  • Health Care Redesign LLO Care Group in collaboration with SMMC. (CC, BC, SK)
  • Released MHSA housing RFA. Proposal in pipeline: Cedar St. Apartments. Proposals considered on an ongoing basis. (CC, JD)
  • Expanded senior peer counseling through Family Service Agency. (DD)
  • Seek partner for primary care based IMPACT model. (DD)
  • New integrated FSP model RFP for child/youth/TAY focused on school-based and clinic-based populations 7/09. (PS, LS, LC)
  • New integrated FSP model for adult and FSP expansions for adult/older adults (CC, DD, TWR)
  • Transition Age Youth planning (LS)
  • Convened cross-divisional Forensic Policy Group to target shared policy agenda. (SK)
  • Alcohol and Other Drug pilot with Women’s Recovery Association to experiment with stronger continuity of care models. (SK, CB)

Cultivate Continuous Learning and Improvement
Cultivate Learning & Improvement

Incorporate best clinical, administrative and policy practices into developing customized training and education.  Support the development of core competencies necessary to promote wellness/recovery and fully integrated treatment within BHRS and contract agencies.

Strategies

  • Plan and implement 3 yr training, education and consultation plan for entire workforce including contractor providers, consumers and families.
  • Plan and implement MHSA workforce development plan.
  • Promote/learn how to be more effective from community partnerships.
  • Promote/learn how to be more effective from Labor/Mgmt partnership process and Contractor Association discussions focused on needs of workforce.
  • Integrate skills and values from all strategic initiatives (e.g. Cultural Competence, Co-Occurring Initiative, and Prevention-Early Intervention) into core competency training.

Activities

  • Improved self assessment of organizational supports for learning and development. (KD, SK)
  • Hiring and retention of workforce reflective of population. (All mgrs, JA, PM, SK, KD)
  • Completion and implementation of multi-year Training Plan and MHSA Workforce Education and Training plan. (SK, KD, SSM)
  • Development of workforce supports for admin and support staff (KD, LD)
  • Training in large and small groups to improve core clinical, administrative and supervisory practices (KD).
  • Outreach and collaboration with partner universities, community colleges, schools, as well as other California counties on mental health pathways, and training development and implementation. (KD)
  • Participation in statewide loan forgiveness program through MHSA (http://www.healthprofessions.ca.gov/). (KD)
  • Implemented monthly supervisory training seminars with HR for child/youth supervising MH clinicians and program specialists. (PS)
  • Implementation of electronic Learning Management System (county-wide) (PM).
  • Implement online Training & Education calendar.

Anticipate and Prepare for Disasters
Disaster Preparedness

Provide information, procedures and training to prepare for emergencies and disasters.

Strategies

  • Complete and train to disaster plan and scenarios.

Activities

  • Continuing to work towards full preparedness in all sites. (BC, all managers)
  • Response to H1N1 (participation in Dept level team by BHRS mgmt)

Build Organizational Capacity and Support Transformation
Build Organizational Capacity

Implement electronic innovations and administrative best practices to increase efficiency, quality, and effectiveness of service delivery, program planning, and accountability of BHRS.

Strategies

  • Implement electronic health record.
  • Streamline contracts process and improve monitoring.
  • Data driven, plan, do, study, act cycles for program planning and implementation.
  • Standards and protocols for integrated MH/AOD charting and billing.  Arrangements with payers for integrated paying.
  • Maximize revenue for service across BHRS.
  • Maximize eligibility/coverage for clients and follow-up when lapses occur.
  • Organizational structures and processes support efficient and effective outcomes.

Activities

  • Launch eCC pilot for new electronic health record and billing system Nov 2009. (SK, PM, RM, LS)
  • Increase eligibility for BHRS clients (SL with partners)
  • Achieve savings in pharmaceutical costs through collaboration with HSPM, access to 340 b pharmacy program (SK, BC, BL, SL)
  • Closer, more accurate monitoring of contracts. (PM, SR, all managers)
  • Achieve smoother replication of projects through PDSA cycles. (PM)
  • Complete policy on documentation for MH billing. (KD, KC, PM)
  • Expect HPSM concept for AOD services winter 10. (PM, SK).
  • Introduced parity agenda to contractors who developed a parity committee to work w/us on advocacy. (SSM, SK)
  • Mental Health Board adopted parity as one focus for this year.
  • Expansion of MAA billing in MH and implementation of MAA billing in AOD. (SK, JK)
  • Restructure of organization to support MH/AOD integration. (SK)