Innovation is Essential to Achieve Wellbeing
The Mental Health Services Act (MHSA) includes a rare and explicit commitment to fostering innovation in providing services and supports. The Governor and the Legislature in 2017 authorized the Incubator and directed the Commission to work collaboratively with counties to find breakthrough solutions to enable better provision of mental health services.
Created in 2018 with $5 million in one-time funding, the Incubator has supported county efforts in building and implementing unique strategies that reduce unnecessary involvement in the criminal justice system by providing more effective behavioral health responses for individuals with behavioral health needs. The Incubator also assists counties with building core capacities for innovation and continuous improvement.
The Innovation Incubator seeks to help counties build the capacity to innovate new solutions, continuously improve essential programs, and sustain programs that provide the most value to clients and communities.
While California is known globally for its innovative spirit, most local governments have never been expected to design, launch, and evaluate new approaches for providing mental health services and, as a result, have not built the capacity for such innovation.
The Incubator supports and links counties that have identified an opportunity for improvement with subject matter experts and experienced practitioners to adapt, test, and assess novel strategies and services. In addition to developing specific advances in service delivery, the incubator supports cross-county collaboration, and building capacities within counties for performance management and continuous improvement.
The MHSA is one of few mechanisms in state government that explicitly supports innovation in the delivery of services. The law requires counties to spend a portion of their MHSA funds on innovation projects and charges the Commission with approving those projects.
The MHSA’s Innovation component responds to the high costs and profound suffering associated with unaddressed mental health needs and the limitations of current services on those adverse outcomes.
The Governor and the Legislature directed the Commission to focus the Incubator on reducing criminal justice involvement among individuals with unmet mental health needs.
Five multi-county collaboratives are exploring ways to prevent or reduce justice involvement among clients. A sixth project is exploring ways the Commission can better support innovation in the counties.
The Incubator is working to disseminate knowledge of best practices and evaluate how the Incubator can better support innovation.
The Data-Driven Recovery Project
Ten counties working through two cohorts linked criminal justice and behavioral health data to better understand the mental health needs of people in the criminal justice system. The first cohort comprises Sacramento, San Bernardino, Nevada, Plumas, and Yolo counties. The second cohort includes Calaveras, El Dorado, Lassen, Marin, and Modoc counties.
Eight counties are evaluating and refining their Full-Service Partnerships (FSPs) to improve the results from this “whatever it takes” approach. More than $1 billion is spent annually on FSPs statewide. Fresno, Sacramento, San Bernardino, San Mateo, Siskiyou, Stanislaus, Lake and Ventura counties are working together to assess their programs and develop metrics for improvement efforts.
Psychiatric Advanced Directives (PAD)
Five county teams – Fresno, Orange, Shasta, Mariposa and Monterey counties – are exploring options to deploy advanced directives to improve the response from law enforcement to individuals who are in crisis and physical and behavioral health workers.
Ten counties – Butte, Inyo, Mono, Nevada, Placer, Plumas, Sacramento, Shasta, Solano, and Yolo – and the city of Berkeley are developing comprehensive and financially sustainable crisis response systems designed to meet people’s needs better and reduce incarcerations and hospitalizations.
Three counties – Sacramento, San Luis Obispo, and Santa Barbara – are assessing the effectiveness of interventions to reduce the criminal justice involvement of people with unmet mental health needs and develop strategies for improving performance and financial sustainability. All three counties received significant one-time funds from the Department of State Hospitals.
This project is identifying, assessing, and developing existing revenue streams that counties can be tapping and to develop policy options that would lead to more manageable and sustainable funding streams to support cost-effective strategies and services for preventing and reducing criminal justice involvement among those with mental health needs.
Incubator Lesson Dissemination
Two projects focused on the dissemination of learnings. The first project disseminated to state and county leaders the lessons and key issues identified by the Commission’s multi-county collaboratives seeking to reduce justice involvement of individuals with mental health needs.
The second project worked with other Incubator contractors, state agencies, and participating counties to develop, in consultation with state and local agencies, a policy framework to support a more coherent approach to policymaking and program implementation by state agencies and provided targeted technical assistance to counties interested in deploying the practices and lessons learned through the Innovation Incubator and related projects.
System Change Analysis
The Commission partnered with Social Finance, a national nonprofit, to work with county leaders, stakeholders, and the Commission to assess and recommend ways to support effective innovation projects.
The Incubator’s projects are intended to have three cross-cutting outcomes:
- New capacities to integrate data across criminal justice, mental health, and other systems to improve services for consumers and reduce arrests and re-arrests.
- New capacities to assess programs such as Full Service Partnerships and establish performance management approaches to improve outcomes over time.
- New capacities to develop comprehensive crisis response plans that provide alternatives to law enforcement for responding to people in mental health distress.
As the Incubator projects are winding down, Commission staff are leading efforts to evaluate the Incubator model as a method of supporting transformational change through innovation. The goals of the evaluation are to understand the outcomes of the Incubator projects, identify the strengths of the Incubator model, and determine how to foster and facilitate innovation going forward.
These efforts include gathering information from county behavioral health staff, subject matter experts, clients and family members, advocates, and other stakeholders. Staff are collecting this information through convenings, forums, surveys, and interviews, as well as reviewing project deliverable and final reports.
Evaluate the Incubator Model – County Exit Interviews
The Commission is conducting exit interviews with counties who participated in Incubator projects to assess project outcomes and evaluate the Incubator model.
Innovation System Change Recommendations
Planning for the Innovation Subcommittee to recommend to the Commission the actions that should be taken to implement some or all of the System Change recommendations resulting from the Social Finance barriers analysis.
Reach out to learn more about the Innovation Incubator