HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 05222017 - FHS Cte Agenda Pkt
FAMILY & HUMAN SERVICES
COMMITTEE
May 22, 2017
10:30 A.M.
651 Pine Street, Room 101, Martinez
Supervisor John Gioia, Chair
Supervisor Candace Andersen, Vice Chair
Agenda
Items:
Items may be taken out of order based on the business of the day and preference
of the Committee
1.Introductions
2.Public comment on any item under the jurisdiction of the Committee and not on this
agenda (speakers may be limited to three minutes).
3. CONSIDER recommending to the Board of Supervisors the appointment of Paul
Mikolaj to the Member-At-Large #10 seat on the Advisory Council on Aging with a
term expiring September 30, 2018, as recommended by the Council.
4. CONSIDER recommending to the Board of Supervisors the appointment of Deborah
Son to the At-Large #11 seat with a term expiring February 28, 2018 and Michelle
Brown to the At-Large #15 seat with a term expiring February 28, 2017 on the Contra
Costa Commission for Women, as recommended by the Commission.
5. CONSIDER recommending to the Board of Supervisors the appointment of Cynthia
Molander to the Community Representative #3 seat on the Local Planning and
Advisory Council for Early Care and Education with a term expiring April 30, 2018, as
recommended by the County Office of Education. (Ruth Fernández, Contra Costa
County Office of Education)
6. CONSIDER recommending to the Board of Supervisors the appointment of John
Montagh to the Additional #2 seat on the Workforce Development Board with a term
expiring June 30, 2020, as recommended by the Employment and Human Services
Department.
7. CONSIDER accepting the report from the Veterans Service Office on the Stand Down
on the Delta for Homeless Veterans event and forward to the Board of Supervisors for
their information. (Nathan Johnson, Veterans Service Officer; J.R. Wilson, Director of
Stand Down on the Delta)
8. CONSIDER accepting the report on the County's Laura's Law - Assisted Outpatient
Treatment Program (AOT) implementation for the period February through December
2016. (Warren Hayes, MHSA Program Manager)
F&HS Agenda Packet Page 1
9. CONSIDER accepting the report from the Employment and Human Services on the
Workforce Innovation and Opportunity Act and forward to the Board of Supervisors
for their information. (Kathy Gallagher, Employment and Human Services Director)
10.The next meeting is currently scheduled for June 26, 2017.
11.Adjourn
The Family & Human Services Committee will provide reasonable accommodations for persons
with disabilities planning to attend Family & Human Services Committee meetings. Contact the
staff person listed below at least 72 hours before the meeting.
Any disclosable public records related to an open session item on a regular meeting agenda and
distributed by the County to a majority of members of the Family & Human Services Committee
less than 96 hours prior to that meeting are available for public inspection at 651 Pine Street, 10th
floor, during normal business hours.
Public comment may be submitted via electronic mail on agenda items at least one full work day
prior to the published meeting time.
For Additional Information Contact:
Enid Mendoza, Committee Staff
Phone (925) 335-1039, Fax (925) 646-1353
enid.mendoza@cao.cccounty.us
F&HS Agenda Packet Page 2
FAMILY AND HUMAN SERVICES COMMITTEE 3.
Meeting Date:05/22/2017
Subject:Appointment to the Advisory Council on Aging
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Contact: Enid Mendoza, (925) 335-1039
Referral History:
On December 6, 2011 the Board of Supervisors adopted Resolution No. 2011/497 adopting policy governing appointments to
boards, committees, and commissions that are advisory to the Board of Supervisors. Included in this resolution was a
requirement that applications for at large/countywide seats be reviewed by a Board of Supervisors sub-committee.
The Advisory Council on Aging provides a means for county-wide planning, cooperation and coordination for individuals and
groups interested in improving and developing services and opportunities for the older residents of this county. The Council
provides leadership and advocacy on behalf of older persons and serves as a channel of communication and information on
aging.
The Advisory Council on Aging consists of 40 members servicing 2 year staggered terms each ending on September 30. The
Council consists of representatives of the target population and the general public, including older low-income and military
persons; at least one-half of the membership must be made up of actual consumers of services under the Area Plan.
The Council includes: 19 representatives recommended from each Local Committee on Aging, 1 representative from the
Nutrition Project Council, 1 Retired Senior Volunteer Program, and 19 Members at-Large.
Referral Update:
There are currently 33 seats filled on the Advisory Council on Aging and 7 vacancies. These vacant seats include: Local
Committee Martinez, Local Committee Pittsburg, and Member-At-Large seats 3, 6, 10, 11 and 19. The current membership is
as follows:
Seat Title
Term
Expiration
Date
Current
Incumbent
Incumbent
Supervisor
District
BoS
Appointment
Date
Number of
Meetings
Attended
Since
Appointment
Date
Total
Number of
Meeting
Held Since
Appointment
Total
Number of
Absences
Allowable
in By-laws
Nutrition Project
Council 9/30/2018 Garrett, Gail I 10/25/2016 6 6 3
At-Large 1 9/30/2018 Adams, Fred II 12/6/2016 5 6 3
At-Large 2 9/30/2018 Krohn, Shirley IV 10/25/2016 5 6 3
At-Large 3 9/30/2017 VACANT 3
At-Large 4 9/30/2018 Welty, Patricia V 10/25/2016 2 6 3
At-Large 5 9/30/2018 Card, Deborah V 10/25/2016 5 6 3
At-Large 6 9/30/2018 VACANT 3
At-Large 7 9/30/2018 Selleck, Summer V 12/6/2016 6 6 3
At-Large 8 9/30/2017 Richards, Sheri IV 10/6/2015 14 17 3
At-Large 9 9/30/2017 Xavier, Rita I 10/6/2015 17 17 3
At-Large 10 9/30/2018 VACANT 3
F&HS Agenda Packet Page 3
At-Large 11 9/30/2017 VACANT 3
At-Large 12 9/30/2018 Neemuchwalla,
Nuru
IV 10/25/2016 6 6 3
At-Large 13 9/30/2018 Dunne-Rose,
Mary D
II 10/25/2016 5 6 3
At-Large 14 9/30/2017 Jones, Ella I 10/6/2015 11 17 3
At-Large 15 9/30/2017 Bruns, Mary IV 10/6/2015 13 17 3
At-Large 16 9/30/2017 Leasure, Robert II 10/6/2015 13 17 3
At-Large 17 9/30/2018 Ames, Kathyrn IV 8/2/2016 6 9 3
At-Large 18 9/30/2018 Nahm, Richard III 10/25/2016 6 6 3
At-Large 19 9/30/2017 VACANT 3
At-Large 20 9/30/2017 Frederick, Susan I 10/25/2016 5 6 3
Local Committee
Lafayette 9/30/2017 MaCahan, Ruth II 3
Local Committee
Orinda 9/30/2017 Clark, Nina II 11/10/2015 12 17 3
Local Committee
Antioch 9/30/2018 Fernandez, Rudy III 9/13/2016 7 9 3
Local Committee
Pleasant Hill 9/30/2017 Van Ackern,
Lorna
IV 11/3/2015 15 17 3
Local Committee
Pinole 9/30/2018 Haegeland, Kristin I 9/13/2016 8 9 3
Local Committee
Concord 9/30/2018 Joslin, David IV 9/13/2016 1 9 3
Local Committee
Richmond 9/30/2018 Williams, Jenelle I 9/13/2016 6 9 3
Local Committee El
Cerrito 9/30/2018 Kim-Selby,
Joanna
I 9/13/2016 5 9 3
Local Committee
Hercules 9/30/2018 Doran, Jennifer I 4/18/2017 2 2 3
Local Committee
Pittsburg 9/30/2016 VACANT V 3
Local Committee San
Ramon 9/30/2018 Fehrenback, Anna II 3
Local Committee
Clayton 9/30/2017 Tervelt, Ron IV 11/10/2015 15 16 3
Local Committee
Alamo-Danville 9/30/2018 Donnelly, James
Robert
II 9/13/2016 7 9 3
Local Committee
Walnut Creek 9/30/2017 Doherty, C.
Joseph
IV 10/6/2015 12 17 3
Local Committee
Moraga 9/30/2017 Katzman, Keith II 11/10/2015 15 17 3
Local Committee San
Pablo 9/30/2018 Gantt, Dorothy I 9/13/2016 7 9 3
Local Committee
Martinez 9/30/2018 VACANT V 3
Local Committee
Brentwood 9/30/2017 Kee, Arthur III 11/10/2015 16 17 3
Local Committee
Oakley 9/30/2018 Smith, Grayce III 10/8/2015 12 17 3
Mr. Paul Mikolaj submitted an application to the Council, which later conducted an interview with Mr. Mikolaj and selected
him for appointment to the Member-At-Large SEat #10.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of Paul Mikolaj to the Member-At-Large #10 seat on
F&HS Agenda Packet Page 4
CONSIDER recommending to the Board of Supervisors the appointment of Paul Mikolaj to the Member-At-Large #10 seat on
the Advisory Council on Aging with a term expiring September 30, 2018, as recommended by the Council.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
ACOA Memo to F&HS
P.Mikolaj Application
F&HS Agenda Packet Page 5
1 of 1
Kathy Gallagher, Director
40 Douglas Dr., Martinez, CA 94553 Phone: (925) 313-1579 Fax: (925) 313-1575 www.cccounty.us/ehsd.
MEMORANDUM
DATE: 5-5-2017
TO: Family and Human Services Committee
CC: Victoria Tolbert, Director Aging and Adult Services
FROM: Jaime Ray, Staff Representative for the Advisory Council on Aging
SUBJECT: Advisory Council on Aging – Appointment Requested
The Contra Costa Area Agency on Aging (AAA) recommends for immediate appointment to the
Contra Costa Advisory Council on Aging (ACOA) the following applicant: Mr. Paul Mikolaj for the
Member at Large #10 seat. The MAL #10 seat is undesignated and has remained vacant since April
18, 2017. Jennifer Doran who previously was appointed to At Large #10 was reappointed to the
ACOA as the City of Hercules Representative.
Recruitment has been handled by both the Area Agency on Aging, the ACOA and the Clerk of the
Board using CCTV. AAA staff has encouraged interested individuals including minorities to apply
through announcements provided at the Senior Coalition meetings and at the regular monthly
meetings of the ACOA. The Contra Costa County EHSD website contains dedicated web content
where interested members of the public are encouraged to apply and are provided an application with
instructions on whom to contact for ACOA related inquiries, including application procedure.
Mr. Mikolaj had previously served on the ACOA as a Representative occupying the Alamo-Danville
Local Committee seat; appointed on March 3, 2015. On February 2, 2016 the Board of Supervisors
accepted his resignation that permitted him to pursue medical care. Mr. Mikolaj submitted a
subsequent and new application to re-establish ACOA membership on February 9, 2017; this
document is provided as a separate attachment. At the time of his selection by the ACOA
Membership Committee to fill one of two At Large vacancies, there was one other At Large
applicant; both At Large applicants were approved at the April 19, 2017 ACOA meeting.
Thank You
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FAMILY AND HUMAN SERVICES
COMMITTEE 4.
Meeting Date:05/22/2017
Subject:Appointments to the Contra Costa Commission for Women
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Contact: Enid Mendoza, (925) 335-1039
Referral History:
On December 6, 2011 the Board of Supervisors adopted Resolution No. 2011/497 adopting policy
governing appointments to boards, committees, and commissions that are advisory to the Board of
Supervisors. Included in this resolution was a requirement that applications for at
large/countywide seats be reviewed by a Board of Supervisors sub-committee.
The Contra Costa Commission for Women (CCCW) was formed to educate the community and
advise the Contra Costa County Board of Supervisors and other entities on the issues relating to
the changing social and economic conditions of women in the County, with particular emphasis
on the economically disadvantaged.
The Committee consists of 20 members and one alternate, including: five district representatives,
fifteen at large members; and one at large alternate.
The five district representatives are nominated for a three year term by each of the five members
of the Board of Supervisors. The fifteen at large members and one at large alternate are nominated
by the CCCW membership committee and forwarded to the full CCCW. All nominated
appointments to the CCCW are reviewed by the Family and Human Services Committee (F&HS)
and referred to the Board of Supervisors for approval. CCCW terms are for three years and they
are staggered across the membership.
Referral Update:
There are currently 17 seats filled on the Contra Costa Commission for Women and 4 vacancies.
These vacant seats include the Alternate-At-Large seat and Member-At-Large seats #11, 12, and
15.
The Commission interviewed Deborah Son and Michelle Brown and believe they will be a great
asset to the Commission. There are no other current applicants for seats on the Commission.
F&HS Agenda Packet Page 11
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of Deborah Son to the
At-Large #11 seat with a term expiring February 28, 2018 and Michelle Brown to the At-Large
#15 seat with a term expiring February 28, 2017 on the Contra Costa Commission for Women, as
recommended by the Commission.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
Memo from CCCW to F&HS
D.Son Application
M.Brown Application
F&HS Agenda Packet Page 12
CONTRA COSTA
COMMISSION FOR WOMEN
P.O. Box 6695
Concord, CA 94520
E-Mail: womenscommission@gmail.com
DATE: April 24, 2017, 2017 TO: Family and Human Services Committee
FROM: Phyllis L. Gordon, Membership Chair, Contra Costa Commission for
Women
SUBJECT: Recommended Appointments to the Contra Costa Commission for Women
The purpose of this memorandum is to forward to you the following recommendation from the Contra Costa
Commission for Women (CCCW):
Appoint Deborah Son to At Large Seat 11 on the CCCW
Michelle Brown to At-Large Seat 15 on the CCCW
Background
The Contra Costa Commission for Women was formed to educate the community and advise the Contra Costa
County Board of Supervisors and other entities on the issues relating to the changing social and economic
conditions of women in the County, with particular emphasis on the economically disadvantaged.
The Committee consists of 20 members and one alternate, including:
Five district representatives; (one from each supervisorial district)
Fifteen at large members; and
One at large alternate.
The five district representatives are nominated for a three year term by each of the five members of the Board of
Supervisors. The fifteen at large members and one at large alternate are nominated by the CCCW membership
committee and forwarded to the full CCCW. All nominated appointments to the CCCW are reviewed by the
Family and Human Services Committee (IOC) and referred to the Board of Supervisors for approval. CCCW
terms are for three years and they are staggered across the membership.
Current Status of Appointments
The CCCW have been actively recruiting applicants on an ongoing basis to fill the vacant seats.
The membership committee unanimously approved the above recommendations.
F&HS Agenda Packet Page 13
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As of April 1, 2017 there are 3 at large vacancies (one recently open because of resignation at large seat 3)and
the At Large Alternate seat is also vacant.
If the appointments recommended in this memorandum are ultimately approved, two at large seats will be
filled. The vacancies remaining after approval would be 1 at large seats and one alternate. With several other
applicants in process (interviews) as of April 1,2017 .
Since May 2004, the CCCW has had extremely limited staff support and no budget provided by the County.
However, the CCCW Membership Committee is continuing its recruiting efforts and plans to fill the remaining
vacancies within the next few months.
cc without attachment : CCCW Membership Committee/Gordon,Chair
Enid Mendoza, CAO
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FAMILY AND HUMAN SERVICES COMMITTEE 5.
Meeting Date:05/22/2017
Subject:Appointments to the Local Planning Council
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 25
Referral Name: Child Care Planning/Development Council Membership
Presenter: Ruth Fernandez, LPC
Coordinator/Manager
Contact: Enid Mendoza, (925)
335-1039
Referral History:
The review of applications for appointments to the Contra Costa Local Planning Council for Child
Care and Development was originally referred to the Family and Human Services Committee by
the Board of Supervisors on April 22, 1997.
The Local Planning and Advisory Council for Early Care and Education (LPC) coordinates
programs and services affecting early child care and education, including recommendations for
the allocation of federal funds to local early child care and education programs.
The LPC consists of 20 members: 4 consumer representatives - a parent or person who receives
or has received child care services in the past 36 months; 4 child care providers - a person who
provides child care services or represents persons who provide child care services; 4 public
agency representatives - a person who represents a city, county, city and county, or local
education agency; 4 community representatives - a person who represents an agency or business
that provides private funding for child care services or who advocates for child care services
through participation in civic or community based organizations; and 4 discretionary appointees -
a person appointed from any of the above four categories or outside of those categories at the
discretion of the appointing agencies.
Referral Update:
There are currently 12 seats filled on the LPC and 8 vacancies. These vacant seats include 3
consumer representatives, 1 child care provider, 1 public agency representative, and 3 community
representatives.
Recently Daniel Safran submitted his resignation to the Discretionary 2 seat, which will result in
an additional vacancy once the Board of Supervisors approves his resignation.
F&HS Agenda Packet Page 21
Ms. Cynthia Molander submitted her application for consideration and her appointment to the
LPC was approved by Deputy Superintendent of Schools. Please see that attached memo and
correspondence for additional information.
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of Cynthia Molander to
the Community Representative #3 seat on the Local Planning and Advisory Council for Early
Care and Education with a term expiring April 30, 2018, as recommended by the County Office
of Education.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
LPC and COE Memo and C.Molander Application
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FAMILY AND HUMAN SERVICES
COMMITTEE 6.
Meeting Date:05/22/2017
Subject:Appointments to the Workforce Development Board
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: N/A
Referral Name: Appointments to Advisory Bodies
Presenter: Contact: Enid Mendoza, (925) 335-1039
Referral History:
On December 13, 2011, The Board of Supervisors adopted Resolution No. 2011/498 adopting
policy governing appointments to independent boards, committees, and commissions, and special
districts. Included in this resolution was a requirement that independent bodies initially
conducting interviews for At Large/Countywide seats provide appointment recommendations to a
Board Committee for further review.
The Workforce Development Board implements federal requirements for programs to address the
education, skills, and employment needs for a skilled workforce, and that lead to an increase in
the skills and earnings of Contra Costa residents.
Referral Update:
On March 14, 2016, the Family and Human Services Committee (F&HS) accepted the
Employment and Human Services Department's recommendation to decertify the then current
Workforce Investment Act local Board and recertify and new board structure in compliance with
the new Workforce Innovation and Opportunity Act (WIOA). F&HS approved these
recommendations, and the Board did the same at their March 29, 2016 meeting.
Under new standards in WIOA (2016) and as adopted by the Board on March 29, 2016, the new
Workforce Development Board structure is: a total of 23 required seats and 2 "optional seats",
consisting of: 13 Business representatives, 5 Workforce representatives, and 5 Education and
Training representatives as follows: (1) Adult Education/Literacy; (2) Higher Education; (3)
Economic & Community Devl; (4) Wagner Peyser representative; (5) Vocational Rehabilitation.
Also two additional/ "optional" seats that may be filled from any of the 3 categories above.
The Employment and Human Services Department is requesting an appointment to the Additional
#2 seat on the Workforce Development Board. Please see the attached memo, application and
roster for additional information.
F&HS Agenda Packet Page 33
Recommendation(s)/Next Step(s):
CONSIDER recommending to the Board of Supervisors the appointment of John Montagh to the
Additional #2 seat on the Workforce Development Board with a term expiring June 30, 2020, as
recommended by the Employment and Human Services Department.
Fiscal Impact (if any):
There is no fiscal impact.
Attachments
WDB Memo to F&HS
J.Montagh Application
WDB Roster
F&HS Agenda Packet Page 34
MEMORANDUM
DATE: April 18, 2017
TO: Family and Human Services Committee
CC: Kevin Corrigan, CAO Senior Management Analyst
Enid Mendoza, CAO Sr. Deputy County Administrator
FROM: Donna Van Wert, Interim Executive Director
SUBJECT: Appointment to Workforce Development Board
This memorandum requests the Family and Human Services Committee recommend to the Contra Costa County
Board of Supervisors the appointment of the following candidates to the new WIOA compliant Workforce
Development Board of Contra Costa County.
Background:
Local board structure and size:
Compared to predecessor legislation, the Workforce Innovation and Opportunity Act (WIOA) substantially
changes Local Board composition by reducing local workforce development board size while maintaining a
business and industry majority and ensuring representation from labor and employment and training
organizations.
The Executive Committee of the local WIOA board met January 21, 2016 and approved a recommended WIOA
Board configuration, subsequently approved by the Board of Supervisors on March 29, 2016. To meet the
categorical membership percentages, the WDB recommended a board of twenty-five (25) members. This option
represents the minimum required local board size under WIOA plus an additional six (6) optional representatives
in the following enumerated categories: 1) business; 2) workforce; 3) education and training.
Category – Representatives of Business (WIOA Section 107(b)(2)(A))
• Thirteen (13) representatives (52%)
Category – Representatives of Workforce (WIOA Section 107(b)(2)(A))
• Five (5) representatives (20%)
Category – Representatives of Education and Training (WIOA Section 107(b)(2)(C))
• One (1) Adult Education/Literacy Representative (WIOA title II)
• One (1) Higher Education Representative
• One (1) Economic and Community Development Representative
• One (1) Wagner Peyser Representative
• One (1) Vocational Rehabilitation Representative
Two (2) additional seats from the above categories, including constituencies referenced in
Attachment III of Training Employment & Guidance Letter (TEGL) 27-14.
DONNA VAN WERT
EXECUTIVE DIRECTOR
F&HS Agenda Packet Page 35
Recommendation:
a) Recommend approval of local board candidate for the vacant
Flex Additional seat to the new WIOA-compliant board (Attached application & board roster)
• Interview Date – January 30, 2017
• John Montagh - Approved on April 12,2017 at the Executive Committee Meeting
• No other candidate competed for the vacant Flex Additional Seats.
NEW APPOINTMENT
Seat Last Name First Name Address & District
#
Term of
Expiration
District
(Resident)
Flex Seat #2 Montagh John 1950 Park Side
Drive
Concod, CA 94519
District 4
6/30/2020 Not available
Thank you
DVW/rms
attachment
F&HS Agenda Packet Page 36
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BOARD MEMBERS
PUBLIC ROSTER
District #
(Resident)
District #
(Employment)
Michael McGill 1 3/29/2016 District #2 6/30/2020 Chairperson/Engineer MMS Design Associates District #2
Pamela Kan 2 3/29/2016 6/30/2020 Small Business/President Bishop-Wisecarver Corporation District #5
Bill Mahoney 3 Pending BOS Vacaville, CA 6/30/2020 Instumentation & Electrical Supervisor Shell Oil Company District #5
Maggie Carrillo 4 3/29/2016 District #3 6/30/2020 Human Resources Manager Ramar Foods International (MFG)District #5
Bhupen B. Amin 5 3/29/2016 District #4 6/30/2020 Chief Operating Officer & Counsel Lotus Hotels & Investments District #4
Jose Carrascal 6 3/29/2016 District #3 6/30/2020 Production Leader The Dow Chemical Company District #5
Jason Cox 7 3/29/2016 District #4 6/30/2020 Manager, Rolling Div. Maintenance USS-POSCO Industries District #5
Ashley Georgian 8 3/29/2016 Plesanton, CA 6/30/2020 Director, Government Affairs John Muir Health District #4
Robert Lilley 9 Pending BOS District #4 6/30/2020 Business Development Director Contra Costa Electric , Inc.District #5
Robert Rivera 10 3/29/2016 District #4 6/30/2020 Vice President of Sales The Staffing Solutions District #5
Justin Steele 11 3/29/2016 Berkeley, CA 6/30/2020 Human Resources Manager Chevron Richmond Refinery District #1
Paul Adler 12 3/29/2016 6/30/2020 Manager, Public Affairs Phillips 66 District #5
Vacant 13 6/30/2020
Vacant 1 6/30/2020
Robert III Williams 2 3/29/2016 District #1 6/30/2020 Labor Organization/Business Representative IUPAT 741 (Joint Labor Management Apprenticeship)Livermore, CA
Steve Older 3 3/29/2016 District #4 6/30/2020 Registered Apprentiship/Area Director Intl. Assoc. of Machinist & Aerospace Workers, AFL-CIO, District 190 District #5
Margaret Hanlon-Gradie 4 3/29/2016 District #1 6/30/2020 Executive Director Contra-Costa AFL-CIO Labor Council District #5
James Araby (RESIGNED)5 3/29/2016 District #5 6/30/2020 Executive Director UFCW Western States Council Buena Park, CA
Kathy Farwell 1 3/29/2016 District #5 6/30/2020 Adult Education & Literacy/Director Martinez Unified School Distriict/Martinez Adult Education District #5
Randal Tillery 2 3/29/2016 Berkeley, CA 6/30/2020 Inst. Higher Educ./Sr. Dean of Workforce & Eco. Dev.Contra Costa Community College District #5
Kristin Connelly 1 3/29/2016 District #2 6/30/2020 Economic & Community Dev./President & CEO East Bay Leadership Council District #4
Richard Johnson 2 3/29/2016 6/30/2020 Employment Service/Employment Prog.Manager ll California Employment Development Department District #4
Carol Asch 3 3/29/2016 6/30/2020 Rehabilitation Act of 1973/District Administrator California Department of Rehabilitation District #4
Yolanda Vega 1 3/29/2016 Distrtict #2 6/30/2020 Facilitator/Mediator Partnering Services Bay Area Rapid Transit Oakland, CA
Vacant 2 6/30/2020
BUSINESS
WORKFORCE & LABOR
EDUCATION AND TRAINING
GOVERNMENTAL AND ECONOMIC AND COMMUNITY DEVELOPMENT
FLEX ADDITIONAL MEMBERS
PENDING APPROVAL/CONFIRMATION
VACANT SEAT
Entity
Name Seat #Appointment
Date
Term End
Date Title Entity
Name Seat #Appointment
Date
Term End
Date Title
Entity
Name Seat #Appointment
Date
Term End
Date Title Entity
Name Seat #Appointment
Date
Term End
Date Title
EntityNameSeat #Appointment
Date
Term End
Date Title
F&HS Agenda Packet Page 42
FAMILY AND HUMAN SERVICES COMMITTEE 7.
Meeting Date:05/22/2017
Subject:Stand Down on the Delta for Homeless Veterans
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 56
Referral Name: East Bay / Delta Stand Down for Homeless Veterans
Presenter: Nathan Johnson, Veterans Service Officer; J.R.
Wilson, Director of Stand Down on the Delta
Contact: Enid Mendoza,
(925) 335-1039
Referral History:
On November 6, 2001, the Board of Supervisors referred to the Family and Human Services
Committee the review of the plans and preparations for the bi-annual East Bay Stand Down for
Homeless Veterans. The East Bay Stand Down occurs bi-annually on even numbered years, so
the Family and Human Services Committee considers the report from the Veterans Service Office
only every two years.
In September of 2015, the Delta Veterans Group held its first "Stand Down on the Delta" event,
which was a four-day, three-night event where Veterans were provided full medical treatments,
court and legal services, DMV, Chaplain services, housing, addiction and mental health
counseling, employment and other community services. The Veterans Service Officer presented
information on the first Stand Down on the Delta at the July 20, 2015 Family and Human
Services Committee (F&HS) meeting. Since this stand down was expected to continue as a
biannual event every odd numbered years, F&HS Referral No. 56 East Bay Stand Down for
Homeless Veterans was expanded to include biannual informational reports on the Stand Down
on the Delta events.
Referral Update:
Please see the attached memo and informational brochures regarding the Stand Down on the
Delta scheduled for August 11-14, 2017.
Recommendation(s)/Next Step(s):
ACCEPT the report from the Veterans Service Office on the Stand Down on the Delta for
Homeless Veterans event and forward to the Board of Supervisors for their information.
Fiscal Impact (if any):
There is no fiscal impact.
F&HS Agenda Packet Page 43
Attachments
VSO Memo to F&HS
Stand Down on the Delta Tri-fold Guide
Stand Down on the Delta Tri-fold Volunteer Info
Delta Veterans Group Poster
F&HS Agenda Packet Page 44
May 17, 2017
Supervisor John Gioia, District I, Chair
Supervisor Candace Andersen, District II, Vice Chair
Family and Human Services Committee
Stand Down on the Delta for Homeless Veterans
Background: The Stand down on the Delta is an extraordinary event serving 350 homeless
Veterans and their families from the San Francisco Bay Area. They have an opportunity to
receive invaluable and diverse services and care in a safe, secure environment. The goal is to
assist homeless veterans to end the cycle of homelessness by bringing into one location
transitional housing opportunity, medical/dental care, legal services, benefits counseling, food,
clothing, entertainment and many other services. Most important, our participants receive this
care in a respectful manner and we let them know they are not forgotten. This event is supported
by hundreds of dedicated community volunteers and agencies.
Recommendation: The Board of Supervisors endorses and supports the Stand Down on the
Delta to be held August 11 through 14, 2017 at the Contra Costa County Fairgrounds, Antioch,
CA.
As a volunteer and member of the Executive Board for Stand Down on the Delta, I am pleased to
present the opportunity to discuss an event that has a strong positive effect on our community.
J.R. Wilson, Board Chairman, is with us today and would like to make a few comments.
Thank you for your support on this worthy endeavor!
Nathan D. Johnson
County Veterans Service Officer
F&HS Agenda Packet Page 45
If I am a Wheelchair Bound veteran, will I be able to get transportation to Stand Down on the Delta?
Yes, you must obtain a blue bus pass during your
pre-registration for Stand Down on the Delta for
one of these three pick up sites.
San Francisco VA Medical Center: 4150 Clement St, San Francisco, CA 94121 Wheelchair Bound Veterans Pick Up ONLY! Must be pre-registered with a blue bus Pass
Oakland VA Outpatient Clinic: 2221 M.L.K. Jr Way, Oakland, CA 94612
Wheelchair bound Veteran Pick Up
Must be pre-registered with a blue bus pass
Martinez VA Outpatient Clinic 150 Muir Road, Martinez, CAWheelchair bound Veteran Pick Up Must be pre-registered with a blue bus passTransportation for Wheelchair
bound veterans is provided by the
Department of Veterans Affairs if you have a
Scooter you are asked to leave it where you
stay and request the use of a “Stand
Down on the Delta Scooter” during the
event. There are a limited number of
Motorized Scooter’s (first come first serve),
so please Identify your need during the
Registration and intake process for Stand
Down on the Delta.
Who can I contact with questions that come up after I register (ie: “I just found out my kids will be with me that weekend, can I add them to my registration?,” “Can I bring my girlfriend?”
Alex Alexander @ AlexA@shelterinc.org Cell
415-519-9983 Fax 925-335-9815
David Boatwright @ yeah4david@yahoo.com
Cell 707-782-6840
Contra Costa County Homeless
Veterans Stand Down
Information Guide
August 11-14 2017 F&HS Agenda Packet Page 46
Q&A
What items can I bring/not bring?
Please bring two sets of clothing (clothing will be
handed out to you at Stand Down on the Delta)
just in case we do not have your size readily
available. Please bring Identification if you have
an I.D. (This will help you obtain certain services
faster) NO WEAPONS, DRUGS or ALCOHOL!
How will my medications be stored/
handled?
Medications will be checked for Prescription and
I.D. during the medical triage process at Stand
Down on the Delta. If you have Medication that
needs to be refrigerated, Stand Down on the Delta
has refrigeration that will be secured and
available for your medication storage needs.
What is the parking arrangement at
Stand down if I wish to transport
myself?
There is a lot of Parking onsite, the entrance to
Stand Down on the Delta is the “O St” entrance.
Once inside the event you will not be able to have
access to your car until the end of the four days.
You must be across freedom bridge and starting
your intake process by 1pm on Friday August 11,
2017.
If I have a job interview and can’t stay
for the whole weekend, can I still
come for the day?
No there are NO ins and outs
What is the plan for minor children
who will be attending? Any special
scheduled activities?
Stand Down on the Delta welcomes Children and
Dependents of Veterans. Paradise Skate has
opened its doors for a night of fun Skating.
Children arts and craft activities are planned for
Saturday and Sunday of the event. Saturday night
is Family Movie night, come out and enjoy a movie
and Popcorn.
Are pets allowed, including service
animals, and what is their care and
transportation plan?
PET STAND DOWN: Stand Down on the Delta will
be accommodating Veterans with pets. While the
Veterans are given a respite from the street, their
pets will receive medical care, food and socializing.
Pet care will be provided on-site during the Stand
Down event. Please advise participants that they
will have daily access to their pets once inside the
Stand Down encampment during visiting Hours/
walking times as needed for Comfort, all in
controlled areas. Veterans that need bus
transportation to Stand Down and have a Pet must
be directed to and given a bus pass for one of the
three (3) "pet pick up" locations (S.F. downtown
clinic, Oakland VA OPC, or Martinez VA OPC).
Veterans with pets must be "pre-registered
Veterans must provide us with the number and type
of animal (dog/cat) that will participate. Under
“type” on the Eligibility Form please put (a) animal
name, (b) species, (c) estimated weight, (d) and
breed. All pets must be registered prior to Stand
Down to reserve a space on the pet shuttles that
will travel with each bus as needed. At check-in in
Antioch all Veterans will briefly reunite with their
pet and be asked about vaccinations and any
medical conditions.
What is the plan for CPAP machines?
If you have a CPAP/Bi PAP machine please alert the
Stand Down Medical team during the Triage
process. You will be assigned to the Medical Special
needs tent.
Will I be able to charge my motor scooters/
wheelchairs and cell phone that need charging
during Stand down?
• Electrical Charging stations will be available just
for charging Motorized Chair’s and Scooters.
• Electrical phone charging stations spread
throughout the encampment for your use.
Will showers be available?
Yes, Showers will be available for both Men and
Women!
DVG is undertaking again the challenge of bringing Contra Costa Counties Homeless Veterans “Stand Down on the Delta, 2017” August 11-14, 2017 at the Contra Costa Fairgrounds in Antioch, CA. DVG is a 501 (c) 3 nonprofit organization in its fourth year of operation, and is staffed 100% by volunteers who provide services to veterans from all over the Bay Area at our location in east Contra Costa County. It is estimated that between 1,500 and 2,000 volunteers will participate in the Stand Down on the Delta 2017, to help serve our Veterans, who have sacrificed and served us all.This Stand Down comes at a critical time for Contra Costa County, as nonprofits serving Veterans such as Delta Veterans Group, corporations and businesses, foundations, the faith community, County Health Services, the Veterans Administration, local hospitals, law enforcement, and other sectors dealing with homeless persons come together as a part of an attempt to end veteran homelessness. Contra Costa County’s BI-ANNUAL “Stand Down on the Delta” is a key vehicle to drive this effort.I’m sure you know that there is a disproportionately large percentage of Veterans in the homeless population, and homeless female Veterans are growing in number as their representation in the military has increased in recent years. But it doesn’t have to be this way, and you can be a vital part of the solution here in Contra Costa County in 2016-2017 as a Donor or Sponsor of Stand Down on the Delta, 2017.F&HS Agenda Packet Page 47
August 11-14 2017
Private $1-49 Corporal $50-99 Sergeant $100-199 Sergeant First Class $200-299 First Sergeant $300-399 Command Sergeant Major $400-499 Tent Sponsor $500-999 Brigadier General $1,000-2,499 Major General $2,500-4,499 Lieutenant General $4,500-9,999 General (Event Sponsor) $10,000+ Thank you for your contribution to Delta Veterans Group. Your support will help our veterans in the most need and their families make the toughest transition of their lives. Delta Veterans Group is a 501(c)(3) nonprofit organization, Tax ID #46-2650624. Your contribution is tax-deductible to the extent allowed by law. Please mail to: Delta Veterans Group P.0. Box 1692Pittsburg, CA 94565 Or Antioch VFW 815 Fulton Shipyard Rd Antioch, CA 94509 C/O Stand Down on the Delta
Contra Costa County Homeless
Veterans Stand Down
F&HS Agenda Packet Page 48
DVG is undertaking again the challenge of bringing Contra Costa Counties Homeless Veterans “Stand
Down on the Delta, 2017” August
11-14, 2017 at the Contra CostaFairgrounds in Antioch, CA. DVG is a501 (c) 3 nonprofit organization in itsfourth year of operation, and isstaffed 100% by volunteers whoprovide services to veterans from allover the Bay Area at our location ineast Contra Costa County. It isestimated that between 1,500 and2,000 volunteers will participate inthe Stand Down on the Delta 2017, tohelp serve our Veterans, who havesacrificed and served us all.This Stand Down comes at a critical time for Contra Costa County, as nonprofits serving Veterans such as Delta Veterans Group, corporations and businesses, foundations, the faith community, County Health Services, the Veterans Administration, local hospitals, law enforcement, and other sectors dealing with homeless persons come together as a part of an attempt to end veteran homelessness. Contra Costa County’s BI-ANNUAL “Stand Down on the Delta” is a key vehicle to drive this effort.
I’m sure you know that there is a disproportionately large percentage of Veterans in the homeless population, and homeless female Veterans are growing in number as their representation in the military has increased in recent years. But it doesn’t have to be this way, and you can be a vital part of the solution here in Contra Costa County in 2016-2017 as a Donor or Sponsor of Stand Down on the Delta, 2017.
Stand Down on the Delta Overview DVG Board members and volunteers have participated in numerous Stand Down events in the Bay Area over past years, and will be bringing experience, best practices, and key skills to the implementation of Stand Down on the Delta in 2017. Planning for the Stand Down has been ongoing during the past year. The event will integrate personal health and wellness care with housing, employment, legal and a myriad of support services, enlivened by bands and recreation opportunities for not only the men and women who are veterans, but for their families as well. Based on the number of attendees at regional Stand Downs in the Bay
Areas and Central California, and given that this Stand Down will occur on the “off year” of the East Bay Stand Down, DVG is anticipating 400 veterans will be attending. However we are planning for 450 participants so that no one will have to be turned away. DVG expects to serve single male and female Veterans, as well as dependents (spouses and children). Women Vets will have their own tent. dependents and children will have separate, fenced accommodations, as well as services and activities for each group. DVG will be serving both VA eligible and ineligible veterans at this event. VA eligibility will be ascertained through preregistration information obtained, and DD 214 status will be verified by the Veterans Administration and County Veterans Services. Veterans meeting VA eligibility criteria will receive VA medical and other services. Veterans not meeting the VA standards of eligibility will receive services from the Contra Costa County Health Care for the Homeless Team. F&HS Agenda Packet Page 49
Some of the Services Available at Stand Down Are:
• COMPLETE MEDICAL
• TRANSITIONAL HOUSING
• MENTAL HEALTH
• COURT/LEGAL SERVICES
• DMV I.D. SERVICES
• SUBSTANCE ABUSE ASSISTANCE
ON-SITE PET CARE •
EMPLOYMENT SERVICES •
VETERANS BENEFITS •
WELLNESS & CHAPLAIN SERVICES •
MEALS/ CLOTHING/ HYGIENE •
LIVE MUSIC ENTERTAINMENT •
stand down on the delta 2017for Homeless and at risk Veteran’sAugust 11-14, 2017Contra Costa Fairgrounds
DELTAVETERANSGROUP.ORG P.O. BOX 1692 PITTSBURG , CA 94565
DeltaVeteransGroup http://www.deltaveteransgroup.org
Stand Down on the Delta is a bi-annual, four-day encampment for homeless and/or at-risk Veterans to come together and receive support from their communities. While at Stand Down, veterans are provided with court and legal services, DMV, addiction counseling, clothing, food, shelter, hygiene services, wellness, medical, dental and a goal of Delta Veterans Group in hosting the
Stand Down on the Delta event is to treat the Veteran participants with respect and dignity, as well as honoring our female Veterans and families of the Veterans. Our Nation’s Veterans have made the ultimate sacrifices for our freedoms, which is why we strive to make Stand Down on the delta “All about the Veteran”. Please visit www.deltavetransgroup.org for more information on how you can contribute to our Nation’s fine Men and Women Veterans of the United States Armed Forces.
[Volunteers needed][Volunteers needed]
Registration open March 23rd - August 7th
Planning meetings are at 7pm on the 1st Thursday of the month
Location: Antioch Veterans Memorial Bldg, 403 W 6th st Antioch, CA
F&HS Agenda Packet Page 50
FAMILY AND HUMAN SERVICES COMMITTEE 8.
Meeting Date:05/22/2017
Subject:Laura's Law Implementation Update Report
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 107
Referral Name: Laura's Law
Presenter: Warren Hayes, MHSA Program
Manager
Contact: Enid Mendoza, (925)
335-1039
Referral History:
The Assisted Outpatient Treatment Demonstration Project Act (AB 1421), known as Laura’s
Law, was signed into California law in 2002 and is authorized until January 1, 2017. Laura’s Law
is named after a 19 year old woman working at a Nevada County mental health clinic. She was
one of three individuals who died after a shooting by a psychotic individual who had not engaged
in treatment.
AB 1421 allows court-ordered intensive outpatient treatment called Assisted Outpatient Treatment
(AOT) for a clearly defined set of individuals that must meet specific criteria. AB 1421 also
specifies which individuals may request the County Mental Health Director to file a petition with
the superior court for a hearing to determine if the person should be court ordered to receive the
services specified under the law. The County Mental Health Director or his licensed designee is
required to perform a clinical investigation, and if the request is confirmed, to file a petition to the
Court for AOT.
If the court finds that the individual meets the statutory criteria, the recipient will be provided
intensive community treatment services and supervision by a multidisciplinary team of mental
health professionals with staff-to-client rations of not more that 1 to 10. Treatment is to be
client-directed and employ psychosocial rehabilitation and recovery principles. The law specifies
various rights of the person who is subject of a Laura’s Law petition as well as due process
hearing rights.
If a person refuses treatment under AOT, treatment cannot be forced. The Court orders meeting
with the treatment team to gain cooperation and can authorize a 72 hour hospitalization to gain
cooperation. A Laura’s Law petition does not allow for involuntary medication.
AB 1421 requires that a county Board of Supervisors adopt Laura’s Law by resolution to
authorize the legislation within that county. AB 1421 also requires the Board of Supervisors to
make a finding that no voluntary mental health program serving adults or children would be
F&HS Agenda Packet Page 51
reduced as a result of implementation.
At its June 3, 2013 meeting, the Legislation Committee requested that this matter be referred to
the Family and Human Services Committee (F&HS) for consideration of whether to develop a
program in the Behavioral Health Division of the Health Services Department that would
implement assisted outpatient treatment options here in Contra Costa County.
On July 9, 2013, the Board of Supervisors referred the matter to F&HS for consideration. F&HS
received reports on the implementation of Laura's Law on October 16, 2013 and March 10, 2014,
and on February 3, 2015 the Board accepted the recommendations to implement Laura's Law. In
February 2016, Laura's Law was implemented and the Department provided F&HS with a
6-month implementation report on September 12, 2016 and a data report on the 6-month
implementation on December 12, 2016. Both reports were accepted by the Board on September
27, 2016 and December 20, 2016, respectively.
Referral Update:
In an effort to maintain ongoing communications with F&HS and the Board, the Health Services
Department, in partnership with Resource Development Associates, would like to share
information from the 2017 Report for the California Department of Health Care Services. This
report covers the County's first 11 months (February - December 2016) of Laura's Law AOT
implementation. The Department plans to return to F&HS later in the year, likely in August, to
provide implementation data for the period July 1, 2016 - June 30, 2017.
Recommendation(s)/Next Step(s):
CONSIDER accepting the report on the County's Laura's Law - Assisted Outpatient Treatment
Program (AOT) implementation for the period February through December 2016.
Fiscal Impact (if any):
There is no fiscal impact; the report is informational.
Attachments
2017 DHCS AOT Report
2017 DHCS AOT Report Summary
F&HS Agenda Packet Page 52
Contra Costa County Assisted Outpatient
Treatment (AOT)
2017 Report for the California Department of Health Care Services
F&HS Agenda Packet Page 53
Table of Contents
Introduction ......................................................................................................................................5
Contra Costa County’s AOT Program Model............................................................................................. 5
Organization of the Report ....................................................................................................................... 6
Section 1. Methodology .....................................................................................................................7
Data Sources ............................................................................................................................................. 7
Data Collection and Analysis ..................................................................................................................... 8
Section 2. Pre-Enrollment ................................................................................................................. 10
Referral for AOT ...................................................................................................................................... 10
Investigation, Outreach, and Engagement ............................................................................................. 11
Investigation ....................................................................................................................................................... 11
Outreach and Engagement ................................................................................................................................. 13
Section 3. Enrollment Period ............................................................................................................ 15
Consumer Profile .................................................................................................................................... 15
Demographic Information ................................................................................................................................... 15
Diagnosis and Substance Use .............................................................................................................................. 16
Employment and Financial Support .................................................................................................................... 16
Service Participation ............................................................................................................................... 17
Type, Intensity, and Frequency of Treatment ..................................................................................................... 18
Treatment Adherence and Retention .................................................................................................................. 18
ACT Consumer Outcomes ....................................................................................................................... 19
Psychiatric Hospitalizations and Crisis Episodes ................................................................................................. 19
Criminal Justice Involvement ............................................................................................................................... 21
Housing Status .................................................................................................................................................... 21
Employment Service Engagement....................................................................................................................... 22
F&HS Agenda Packet Page 54
Social Functioning and Independent Living ......................................................................................................... 22
AOT Enforcement Mechanisms ........................................................................................................................... 23
Consumer and Family Satisfaction ...................................................................................................................... 24
Violent Behavior and Victimization ..................................................................................................................... 24
Section 4. Summary of Findings ........................................................................................................ 25
Appendix I. AOT Eligibility Requirements .......................................................................................... 27
Appendix II. Description of Evaluation Data Sources ......................................................................... 28
F&HS Agenda Packet Page 55
Table of Figures
Figure 1. Consumers Referred to AOT by Month (N = 189) ........................................................................ 10
Figure 2. Referral to AOT Process ............................................................................................................... 12
Figure 3. Eligibility Determination of all Referred Consumers (Duplicated; N = 189) ................................ 12
Figure 4. Consumer Enrollment Process (N = 32) ....................................................................................... 13
Figure 5. Gender ......................................................................................................................................... 15
Figure 6. Race/Ethnicity .............................................................................................................................. 15
Figure 7. Primary Diagnosis ......................................................................................................................... 16
Figure 8. Substance Use .............................................................................................................................. 16
Figure 9. Employment 12 months before ACT (N = 29) .............................................................................. 17
Figure 10. Employment at ACT Enrollment (N = 29) ................................................................................... 17
Figure 11. Consumers’ Housing Status before and during ACT .................................................................. 22
Figure 12. Changes Life Skills, Relationships, and Community Involvement Domains during ACT ............ 23
F&HS Agenda Packet Page 56
Table of Tables
Table 1. DHCS Reporting Requirements and Corresponding Data Sources .................................................. 7
Table 2. Summary of Requestor Type ......................................................................................................... 11
Table 3. Status of All Eligible Consumers at Conclusion of Evaluation Period (N = 62) .............................. 13
Table 4. Care Team Investigation, Outreach, and Engagement Efforts ...................................................... 14
Table 5. Sources of Financial Support for ACT Consumers (N = 28) ........................................................... 17
Table 6. ACT Service Engagement (N = 31) ................................................................................................. 18
Table 7. Average Number of Face-to-Face ACT Encounters per Week (N = 31) ......................................... 18
Table 8. Consumer Psychiatric Hospitalizations and Crisis Episodes prior to ACT Enrollment ................... 20
Table 9. Consumer Psychiatric Hospitalizations and Crisis Episodes during ACT Enrollment .................... 20
Table 10. Incarcerations during to ACT Enrollment .................................................................................... 21
Table 11. Average Change in Social Function and Life Skills Domains among Consumers with Re-
Assessment (N = 13) .................................................................................................................................... 23
F&HS Agenda Packet Page 57
Introduction
In 2002, the California legislature passed AB 1421 (also known as “Laura’s Law”), which authorized the
provision of Assisted Outpatient Treatment (AOT) in counties that adopt a resolution to implement AOT.
AOT is designed to interrupt the repetitive cycle of hospitalization, incarceration, and homelessness for
people with serious mental illness who have been unable and/or unwilling to engage in voluntary services
through an expanded referral and outreach process, which may include civil court involvement, whereby
a judge may order participation in outpatient treatment. The Welfare and Institutions Code defines the
target population, intended goals, and the specific suite of services required to be available for AOT
consumers in California.
On February 3, 2015, the Contra Costa County Board of Supervisors adopted a resolution to authorize the
implementation of AOT. The County’s AOT program became operational on February 1, 2016 and
accepted its first consumer in March 2016. Contra Costa County Behavioral Health Services (CCBHS)
provides behavioral health services to AOT consumers through an Assertive Community Treatment (ACT)
team operated by Mental Health Systems (MHS), a contracted provider organization. ACT is an evidence-
based service delivery model for people with serious mental illness who are at-risk of or would otherwise
be served in institutional settings or experience homelessness. ACT has the strongest evidence base of
any mental health practice for people with serious mental illness and, when implemented to fidelity, ACT
produces reliable results for consumers. Such results include decreased negative outcomes (e.g.,
hospitalization, incarceration, and homelessness) and improved psychosocial outcomes (e.g., improved
life skills and increased involvement in meaningful activities).
Contra Costa County’s AOT Program Model
Contra Costa County has designed an AOT program model that exceeds the requirements set forth in the
legislation and responds to the needs of its communities. The Contra Costa County AOT program includes
a Care Team comprised of CCBHS and MHS staff, including a County clinician, family advocate, and peer
counselor, as well as an ACT team operated by MHS.
The first stage of engagement with Contra Costa County’s AOT program is through a telephone referral
whereby any “qualified requestor”1 can make an AOT referral. Within five business days, a CCBHS mental
health clinician connects with the requester to gather additional information on the referral, as well as
reaches out to the individual referred to begin to identify whether they meet AOT eligibility criteria (see
Appendix I).
1 Qualified requestors include: An adult who lives with the individual; Parent, spouse, adult sibling, or adult child of
the individual; Director of an institution or facility where the individual resides; Director of the hospital where the
person is hospitalized; Treating or supervising mental health provider; Probation, parole, or p eace officer.
F&HS Agenda Packet Page 58
If the person appears to initially meet eligibility criteria, a CCBHS investigator from the Care Team staff
facilitates a face-to-face meeting with the family and/or consumer to gather information, attempts to
engage the consumer, and develops an initial care plan. If the consumer continues to appear to meet
eligibility criteria, the Care Team provides a period of outreach and engagement while furthering the
investigation to determine eligibility. If at any time the consumer accepts voluntary services and continues
to meet eligibility criteria, they are immediately connected to and enrolled in ACT services; however, if
after a period of outreach and engagement the consumer does not accept voluntary services and
continues to meet eligibility criteria, the County mental health director or designee may choose to file a
petition with the court. Utilizing a collaborative court model that combines judicial supervision with
community mental health treatment and other support services, Contra Costa County then holds one to
two court hearings to determine if criteria for AOT are met. At this time, the consumer may enter into a
voluntary settlement agreement with the court for AOT or be ordered to AOT for a period of no longer
than six months; the ACT team, operated by MHS, provides the community mental health treatment for
AOT consumers. After six months, if the judge deems that the person continues to meet AOT criteria, they
may authorize an additional six-month period. At every stage of the process, CCBHS and MHS staff
continue to offer the individual opportunities to voluntarily engage in services and may recommend a 72-
hour hold, at any stage of the process, if the consumer meets existing criteria.
Organization of the Report
The following report of Contra Costa County’s AOT program implementation and outcomes is broken into
four sections, highlighted below:
Methodology
Pre-ACT Enrollment
ACT Enrollment Period
Summary of Findings
The “Methodology” section provides a brief description of the data sources and analysis techniques used
to address the required DHCS outcomes. This is followed by a discussion of Contra Costa County’s
processes for AOT referral, investigation, and outreach and engagement in the “Pre-enrollment” section.
Section 3, “Enrollment Period,” describes the consumer profile in Contra Costa County, as well as
consumers’ service engagement and outcomes during ACT enrollment. Finally, the “Summary of Findings”
section highlights key findings from the County’s first 11 months of AOT implementation (February –
December 2016).
F&HS Agenda Packet Page 59
Section 1. Methodology
The following sections highlight the data sources used to compile Contra Costa County’s 2017 AOT
program update report to DHCS, as well as the analysis techniques used for reporting the data in
meaningful ways. It should be noted that, given the current size of the AOT program, this document
reports findings for consumer groups of less than five consumers; therefore, this DHCS report cannot be
publicly disseminated without redaction of any consumer groups of less than five.
Data Sources
RDA worked with CCBHS and MHS staff to obtain the data necessary to address the DHCS reporting
requirements for the period spanning February 1, 2016 – December 31, 2016. Table 1 below presents the
data sources utilized for this report, highlighting which sources were used to report on each DHCS required
outcome. Appendix II provides a detailed description of each data source, including a description of the
data and how it was used in this report.
Table 1. DHCS Reporting Requirements and Corresponding Data Sources
DHCS Reporting Requirement Data Source
The number of persons served by the program Contra Costa PSP Billing System
The extent to which enforcement mechanisms are used
by the program, when applicable
CCBHS Care Team (FMH and ACT
teams) Interview
The number of persons in the program who maintain
contact with the treatment system
Contra Costa PSP Billing System
Adherence/engagement to prescribed treatment by
persons in the program
Contra Costa PSP Billing System
Substance abuse by persons in the program Contra Costa PSP Billing System
Type, intensity, and frequency of treatment of persons
in the program
Contra Costa PSP Billing System
The days of hospitalization of persons in the program
that have been reduced or avoided
Contra Costa PSP Billing System
The number of persons in the program with contacts
with local law enforcement, and the extent to which
local and state incarceration of persons in the program
has been reduced or avoided
FSP Partnership Assessment Form
(PAF) and Key Event Tracking (KET)
The number of persons in the program able to maintain
housing
FSP PAF and KET
The number of persons in the program participating in
employment services programs, including competitive
employment
FSP PAF and KET
Care Team and ACT Team
Communications
Social functioning of persons in the program Self Sufficiency Matrix (SSM)
Skills in independent living of persons in the program Self Sufficiency Matrix (SSM)
F&HS Agenda Packet Page 60
DHCS Reporting Requirement Data Source
Victimization of persons in the program MacArthur Violence Instrument2
Violent behavior of persons in the program MacArthur Violence Instrument2
Satisfaction with program services both by those
receiving them and by their families, when relevant
Focus Groups with Consumers and
Family Members
CCBHS Consumer Satisfaction Survey2
In addition to the data sources listed in Table 1, several other sources of data were used to understand
the Contra Costa County’s AOT investigation and outreach and engagement processes:
CCBHS AOT Request Log: This spreadsheet is populated by CCBHS forensic mental health staff
and includes the date of each AOT referral, demographic characteristics of those referred,
information on the individual making the referral (e.g., family, mental health provider, law
enforcement), and the team’s recommendations based on their investigation (e.g., AOT ineligible,
refer to MHS). For this report, this data source was used to inform discussion of how and when
consumers are referred to AOT and the disposition of each referral.
CCBHS Blue Notes Log: CCBHS staff converted all Blue Notes (i.e., field notes from successful
outreach events) into a spreadsheet tracking the date, location, and length of each CCBHS
Investigation Team outreach encounter. This source was used to assess the average number and
duration of investigation encounters with AOT consumers, as well as the locations of these
encounters.
MHS Outreach and Engagement Log: This spreadsheet tracks the date, location, length, and
outcome of each MHS outreach encounter, including information on who provided outreach (e.g.,
family partner, peer partner, clinician) to whom (consumer or collateral contact such as friend,
family, or physician). Data from this source were used to assess the average number and duration
of outreach and engagement encounters, as well as their location.
Data Collection and Analysis
RDA worked closely with CCBHS and MHS staff throughout the data collection process. Upon receiving
each data set, RDA performed a review of its contents and collaborated with CCBHS and MHS staff to
ensure the evaluation team understood each data element and could seek additional data as needed. RDA
matched clients across a number of disparate data sources and utilized descriptive statistics (e.g.,
frequencies, mean, median, and mode) for all analyses in this report to describe the data and highlight
pre and post-enrollment outcomes, wherever appropriate. In future reports with larger sample sizes and
longer enrollment periods for consumers, both descriptive and inferential statistics will be used to explore
AOT implementation and consumer outcomes.
2 The Care Team is in the process of implementing these assessments, so data were unavailable during this reporting
period. These assessment tools will be used for future reports.
F&HS Agenda Packet Page 61
As with all real-world evaluations, there are limitations to note. First, the evaluation period captures the
first 11 months of Contra Costa County’s AOT program implementation; natural programmatic
developments and modifications took placement over the initial months that have impacted data
accessibility and quality. In addition, only 31 ACT consumers had spent, on average, only 158 days enrolled
in ACT, with participation ranging from 15 to 302 days through December 31, 2016.3 This is important as
baseline data for outcome measures such as homelessness and psychiatric hospitalizations and crisis
stabilization episodes are recorded for 12 months and 36 months before enrollment, respectively. To
account for differences in the pre- and post-time periods, RDA standardized outcomes measures to rates
per 180 days. Nevertheless, because consumers have spent much less time, on average, in ACT compared
to their pre-enrollment periods, there is less opportunity for them to experience outcomes such as
hospitalization, arrest, and/or incarceration. As a result, these outcomes may be underestimated if a large
number of consumers experienced zero negative outcomes during shorter periods while they were
enrolled in ACT. On the other hand, if consumers experienced a number of negative outcomes for lengthy
periods during their ACT enrollment period, these estimations may be overestimated.
Finally, this report relies on consumer self-reported measures of criminal justice involvement to identify
criminal justice outcomes during ACT. While self-report measures may serve as an accurate proxy, they
are not ideal measures and limit the precision of the analyses. In future reports, Superior Court and
Sheriff’s Office data will be used to assess consumers’ criminal justice involvement before, during, and
after ACT.
3 Though 32 consumers were enrolled in AOT during the evaluation period, one was enrolled at the end of December
and received no ACT services in their brief enrollment; therefore, they are not included in any service engagement
or outcomes analysis in this report.
F&HS Agenda Packet Page 62
Section 2. Pre-Enrollment
The following sections report on Contra Costa County’s processes for AOT referral, investigation, and
outreach and engagement, and highlight key findings across each area.
Referral for AOT
A majority (64%) of AOT referrals came from consumers’ family members.
CCBHS received 189 total AOT referrals from February 1, 2016 – December 31, 2016 (see Figure 1). Of
these 189 referrals for AOT, 181 were for unique individuals. Those who were referred multiple times 1)
did not meet AOT eligibility criteria, 2) were connected with other services, or 3) were still under
investigation at the conclusion of the evaluation period.
Figure 1. Consumers Referred to AOT by Month (N = 189)
Table 2 below depicts the percentage of referrals made by each category of qualified requestor. Family
members made the majority of referrals (64%, n = 121), while smaller percentages were made by their
treating or supervising provider (17%, n = 33) and law enforcement (12%, n = 22), among others.
10, 5%
10, 5%
18, 10%
18, 10%
25, 13%
19, 10%
16, 9%
14, 7%
27, 14%
19, 10%
13, 7%
0 5 10 15 20 25 30
Dec.
Nov.
Oct.
Sept.
Aug.
July
June
May
April
March
Feb.
Number of Consumers Referred
F&HS Agenda Packet Page 63
Table 2. Summary of Requestor Type4
Requestor Percent of Total Referrals (N = 189)
Parent, spouse, adult sibling, or adult child 64%
Treating or supervising mental health provider 17%
Probation, parole, or peace officer 12%
Adult who lives with individual 2%
Director of hospital where individual is hospitalized 1%
Director of institution where individual resides 1%
Not a qualified requestor or “other” 4%
Investigation, Outreach, and Engagement
The Care Team conducts an investigation for each AOT referred consumer to determine each individual’s
eligibility for AOT (see Appendix I for AOT eligibility requirements) and then conducts intensive outreach
and engagement to enroll consumers in ACT services. Contra Costa County’s Care Team is responsible for
these efforts; CCBHS’s Forensic Mental Health team conducts the investigation, and MHS’s ACT team
conducts the outreach and engagement. On average, it took the Care Team about 84 days from the date
of initial referral to enroll consumers in ACT.
Approximately one-third (34%, n = 65) of consumers referred for AOT are identified as eligible
following initial investigation.
Following referral by a qualified requestor, the CCBHS forensic mental health staff conduct a screening of
the client’s information and face sheet. If the client appears to meet AOT eligibility criteria, CCBHS meets
with the qualified requestor. If the client continues to appear to meet eligibility criteria following a
meeting with the qualified requestor, CCBHS begins an investigation to determine eligibility. Investigation
consists of attempts to contact consumers via phone and in-person at various locations to determine if
referred consumers meet the criteria for AOT. Consumers’ family members are also included in this
process, when appropriate and as permitted by law. Figure 2 depicts the referral process for Contra Costa
County’s AOT program during the evaluation period.
4 Source: CCBHS Care Team AOT Request Log
F&HS Agenda Packet Page 64
Figure 2. Referral to AOT Process
As shown in Figure 3, approximately one-third of consumers were confirmed to be eligible for AOT (34%,
n = 65) and referred to MHS for outreach and engagement. An additional 13% (n = 24) were still under
investigation, while 53% (n = 100) were unavailable for the investigation or otherwise ineligible.
Consumers who were unable to be located or who were hospitalized or incarcerated for a period were
deemed unavailable. Consumers were determined to be ineligible because the qualified requestor
withdrew the request or was unable to be contacted; the consumer did not meet defined AOT eligibility
criteria; or the consumer had a previous or existing relationship with other mental health services likely
to meet the consumer’s needs and was willing to re-engage with the service provider. For those who did
not meet AOT criteria, CCBHS worked to connect those individuals to the appropriate level of mental
health treatment. For those who had previous or existing relationships with other mental health services
CCBHS worked with the referred consumer to reconnect the individual to the previous or current provider.
See Appendix I for a detailed description of the requirements that govern the AOT eligibility determination
process.
Figure 3. Eligibility Determination of all Referred Consumers (Duplicated; N = 189)
189 consumers referred
to AOT CCBHS investigation
24 consumers currently
being investigated for
AOT eligibility
65 consumers AOT-
eligible
100 consumers
ineligible/unavailable
24, 13%
100, 53%
65, 34%
0 20 40 60 80 100 120
Ongoing investigation
Ineligible/unavailable
AOT eligible
Consumers
F&HS Agenda Packet Page 65
MHS provided outreach and engagement to 62 consumers, 32 of whom enrolled in ACT.
Once CCBHS makes an eligibility determination, they connect eligible consumers with MHS, who provides
intensive outreach and engagement to enroll consumers in ACT services. Following investigation, 62
unique consumers (three of whom were referred twice) were identified as AOT-eligible and were
connected to MHS between February 1 and December 31, 2016.
Table 3 describes the status of the 62 unique consumers who received outreach and engagement services
from MHS during the evaluation period. Those who enrolled in ACT services did so 1) voluntarily without
court involvement, 2) with a voluntary settlement agreement with the court, or 3) with a court order.
Consumers considered “closed” are those who were closed by CCBHS’s Forensic Mental Health team
during the outreach and engagement period, typically for changes in eligibility status, including agreement
to re-engage with a previous service provider who could appropriately meet their needs.
Table 3. Status of All Eligible Consumers at Conclusion of Evaluation Period (N = 62)
Consumer Status Number of Consumers % of Total Eligible Consumers
Enrolled in ACT Services 32 52%
Enrolled Voluntarily 29 --
Enrolled Settlement Agreement 2 --
Enrolled with Court Order 1 --
Active Outreach and Engagement 10 16%
Closed 20 32%
As shown in Figure 4, the majority of consumers (91%, n = 29) enrolled in ACT services voluntarily. The
remaining 9% (n = 3) had some form of court involvement, either a settlement agreement or court order.
Figure 4. Consumer Enrollment Process (N = 32)
Accepted ACT Services
Voluntarily
29, 91%
Accepted ACT Services with
Settlement Agreement
2, 6%
Accepted ACT Services
with Court Order
1, 3%
F&HS Agenda Packet Page 66
The CCBHS Care Team conducts persistent investigation and outreach with consumers and their
families in order to enroll consumers in the County’s AOT program.
Table 4 shows the Care Team activities from investigation through outreach and engagement and the
total efforts made to enroll the 32 consumers in ACT. Successful encounters included both contacts with
consumers and collateral contacts (e.g., with family members or other providers). In total, it took an
average of 17 successful investigation and outreach encounters per consumer to connect them to ACT
services. These efforts lasted an average of 36 minutes per encounter. Outreach and engagement
occurred wherever the consumer was willing to meet, with the majority of the encounters occurring at
either the providers’ offices or any mental health clinic (n = 169), or in the field or community (n = 118).
Table 4. Care Team Investigation, Outreach, and Engagement Efforts
Investigation Outreach &
Engagement
Total
Total Successful Encounters 353 175 528
Average Number of Successful Encounters per
Consumer
11 per
consumer
5.5 per
consumer
16.5 per
consumer
Average Duration of Successful Encounters5 43 minutes 22 minutes 36 minutes
Location of Successful Encounters6
In Person - Field/Community 85 33 118
In Person – Court or Correctional Facility 17 19 36
In Person - Office/Clinic 126 43 169
In Person – Hospital, Inpatient, or Licensed Care
Facility 45 29 74
In Person – Shelter 3 6 9
In Person – Consumer’s Home 3 21 24
Phone or Email 68 15 83
Other or Unknown 26 0 26
5 Only some MHS outreach and engagement data accounted for travel time in the reported duration; therefore, RDA
calculated the proportion of time spent traveling for the available data and subtracted the sa me proportion from
the total duration of encounters that did not specify travel time.
6 Some CCBHS investigation encounters occurred at multiple locations, so the total exceeds the number of total
contact attempts.
F&HS Agenda Packet Page 67
Section 3. Enrollment Period
At the conclusion of the evaluation period, 32 consumers were enrolled in ACT services with MHS. The
Enrollment Period section provides information on the profile of enrolled consumers as well as service
engagement and consumer outcomes during enrollment.
Consumer Profile
The following section describes consumers’ demographic characteristics, as well as their diagnoses,
employment status, and sources of financial support prior to and at the time of enrollment.
Contra Costa County is reaching the identified target population.
As shown in Figure 5 and Figure 6, half of consumers are male and half are female. The majority of
consumers identify as White/Caucasian (58%, n = 19), while 25% (n = 8) identify as Black/African American
and 16% (n = 5) identify as Hispanic.
Figure 5. Gender
(N = 32)
Figure 6. Race/Ethnicity
(N = 32)
Male
16, 50%
Female
16, 50%
Black/African American
8, 25%
Hispanic
5, 16%
White/Caucasian
19, 59%
F&HS Agenda Packet Page 68
Figure 7 below demonstrates that enrolled consumers are reflective of the intended AOT population. The
majority of consumers (75%, n = 24) have a primary diagnosis of a psychotic disorder, including
schizophrenia and schizoaffective disorders; the remaining 25% (n = 8) have a primary diagnosis of a mood
disorder or another diagnosis combined with a co-occurring substance use disorder. As shown in Figure
8, 30% (n = 10) of consumers were diagnosed with some form of substance use disorder (e.g., alcohol
abuse or drug dependence) at the time of enrollment. The majority of consumers (70%, n = 22) had either
no secondary diagnosis or a deferred secondary diagnosis.
Figure 7. Primary Diagnosis
(N = 32)
Figure 8. Substance Use
(N = 32)
Data on consumers’ employment experiences were available for 29 consumers in Contra Costa County.
Of those 29 consumers, 83% (n = 24) were unemployed between four and 12 months prior to enrolling in
ACT (see Figure 9). As shown in Figure 10, 93% (n = 27) of the consumers with available data were
unemployed when they were enrolled in ACT services.
Psychotic Disorder, including schizophrenia and
schizoaffective disorders
24, 75%
Mood Disorder,
including
depressive and
bipolar disorders
6, 19%
Other
2, 6%
Consumers with a substance
use diagnosis
10, 30%
Consumers without a substance use diagnosis
22, 70%
F&HS Agenda Packet Page 69
Figure 9. Employment 12 months before ACT (N
= 29)
Figure 10. Employment at ACT Enrollment (N =
29)
Financial support data were available for 28 consumers. Table 5 depicts the different sources of financial
support and income for consumers in the 12 months before enrollment and at the time of enrollment.
The majority of consumers (66%, n = 19) received Supplemental Security Income (SSI) prior to and at the
time of enrollment. Fourteen percent (14%, n = 4) of consumers reported having no financial support or
income at the time of enrollment; this was the case for 10% (n = 3) of consumers in the 12 months prior
to enrollment as well.
Table 5. Sources of Financial Support for ACT Consumers (N = 28)
Source of Financial Support Received in the 12 Months
Prior to Enrollment
Receiving at
Enrollment
Supplemental Security Income 19 (66%) 19 (66%)
Support from family or friends 2 (7%) 2 (7%)
Retirement/Social Security 2 (7%) 2 (7%)
Other (including Tribal Benefits and Food Stamps) 2 (7%) 1 (3%)
No Financial Support 3 (10%) 4 (14%)
Service Participation
The following sections describe the type, intensity, and frequency of service participation, as well as
adherence to treatment. Of the 32 consumers enrolled in ACT from February 1, 2016 – December 31,
2016, one was enrolled at the end of December 2016 and did not receive any ACT services during the
evaluation period. This individual is omitted from the following service engagement analyses.
Unemployed before ACT
24, 83%
Some employment before ACT
5, 17%
Unemployed at Enrollment
27, 93%
Some form of Employment at Enrollment
2, 7%
F&HS Agenda Packet Page 70
The ACT team is providing intensive services to consumers.
Consumers in Contra Costa County receive services from a multidisciplinary ACT team who provide
intensive wrap-around behavioral health services. When implemented to fidelity, ACT produces reliable
results including decreased negative outcomes, (e.g., hospitalization, incarceration, and homelessness)
and improved psychosocial outcomes. From February – December 2016, the 31 consumers who were
enrolled in and receiving ACT services were enrolled for an average of 158 days. Table 6 indicates that
while enrolled in ACT, consumers received an average of 31 service encounters per month, lasting an
average of 54 minutes per encounter. The range of encounters per month varies substantially across
consumers, from three to 104 encounters per month.
Table 6. ACT Service Engagement (N = 31)
Average Range
Length of ACT Enrollment 158 days 15 – 302 days
Frequency of ACT Service
Encounters 31 encounters per month 3 – 104 encounters per month
Intensity of ACT Services
Encounters 54 minutes 1 – 422 minutes
The majority (94%) of consumers were adherent with ACT services.
Given that AOT provides a mechanism to compel eligible consumers to participate in outpatient mental
health services, consumers were considered “treatment adherent” if they engaged in at least one face-
to-face contact per week. As shown in Table 7, 94% (n = 29) of consumers met this baseline adherence
requirement, with the majority (52%, n = 16) receiving between five and seven contacts per week, on
average. Six percent (6%, n = 2) of the ACT population had less than one face-to-face encounter per week
and were determined to be “non-adherent.”
Table 7. Average Number of Face-to-Face ACT Encounters per Week (N = 31)
Adherence Number of Contacts Consumers
Not adherent < 1 6% (n = 2)
Adherent
1 – 4 13% (n = 4)
5 – 7 52% (n = 16)
8 – 10 10% (n = 3)
11+ 19% (n = 6)
Ten percent (10%, n = 3) of consumers were discharged from ACT during the evaluation period. According
to the ACT team, one of these discharges was the result of successful completion of the program. The
remaining two consumers had changes in their service engagement and may be re-enrolled in the future.
F&HS Agenda Packet Page 71
ACT Consumer Outcomes
The following sections provide a summary of consumers’ experiences with psychiatric hospitalizations,
crisis episodes, criminal justice involvement, and homelessness before and during enrollment. Readers
should note that, on average, consumers were enrolled for 158 days in the ACT program, with
participation ranging from 15 - 302 days through December 31, 2016. This is important because baseline
data for outcomes measures such as homelessness, arrests, and incarcerations are recorded for the entire
year prior to enrollment (and for three years prior to enrollment for psychiatric hospitalizations and crisis
stabilization episodes). To account for differences in the pre- and post-time periods, RDA standardized
outcomes measures to rates per 180 days. Nevertheless, because consumers have spent much less time,
on average, in ACT compared to their pre-enrollment periods, there is less opportunity for them to
experience outcomes such as hospitalization, arrest, and/or incarceration.
Additionally, given the current size of the ACT program in Contra Costa County, some consumer outcome
categories in this report include less than five consumers; therefore, this DHCS report cannot be publicly
disseminated without redaction of any consumer groups of less than five.
This section describes consumers’ psychiatric hospitalizations and crisis stabilization episodes before and
during ACT enrollment. The County’s PSP Billing System was used to identify consumers’ hospital and crisis
episodes in the 36 months prior to and during AOT enrollment.
The majority of consumers experienced fewer psychiatric hospitalizations and crisis episodes
during ACT, although a subset of consumers continues to experience hospitalization.
The majority (74%, n = 23) of ACT consumers were hospitalized at least once during the 36 months prior
to enrollment. Almost all consumers (97%, n = 30) also had at least one crisis episode before ACT
enrollment. Table 8 below depicts the following key findings about ACT consumers’ hospitalization and
crisis episodes prior to ACT enrollment:
Among consumers with at least one hospitalization prior to enrollment (n = 23, 74%), each
consumer experienced an average of 1.07 hospitalization episodes per 180 days, lasting
approximately one week per episode.
On average, consumers experienced over three (3.31) crisis episodes per 180 days, for
approximately one day per episode.7
7 The average crisis episodes per consumer are slightly inflated due to three consumers who had more crisis episodes
than the other consumers.
F&HS Agenda Packet Page 72
Table 8. Consumer Psychiatric Hospitalizations and Crisis Episodes prior to ACT Enrollment
Average Range
Hospitalizations (n = 23)
Episodes 1.07 episodes per 180 days < 1 – 8 episodes per 180 days
Length of Episodes 7 days 1 – 95 days
Crisis Stabilization (n = 30)
Episodes 3.31 episodes per 180 days < 1 – 16 episodes per 180 days
Length of Episodes 1 day 1 – 5 days
During enrollment, 22% (n = 5) of the 23 consumers hospitalized prior to ACT were hospitalized again
during ACT. An additional two consumers who were not hospitalized prior to ACT were hospitalized after
enrolling in ACT, for a total of seven consumers who experienced psychiatric hospitalizations during ACT.
Of the 30 consumers who experienced a crisis episode before ACT, almost two-thirds (63%, n = 19)
experienced a crisis episode during ACT. Table 9 highlights the following key findings about consumers’
hospitalization and crisis episodes after enrolling in ACT:
Consumers who were hospitalized during ACT (23%, n = 7) experienced approximately 2.86
episodes per 180 days, with each episode lasting approximately 11 days per consumer. 8
Consumers who experienced a crisis episode during ACT (61%, n = 19) had less than one episode
(0.53) per 180 days, and each episode lasted approximately one day.
Table 9. Consumer Psychiatric Hospitalizations and Crisis Episodes during ACT Enrollment
Average Range
Hospitalizations (n = 7)
Episodes 2.86 episodes per 180 days < 1 – 8 episodes per 180 days
Length of Episodes 11 days 3 – 30 days
Crisis Stabilization (n = 19)
Episodes .53 episodes per 180 days < 1 – 2 episodes per 180 days
Length of Episodes 1 day 1 – 2 days
Taken together, the findings from this section preliminarily suggest that ACT participation is helping to
stabilize consumers. In particular, fewer consumers experienced psychiatric hospitalization and/or crisis
episodes during their ACT enrollment compared to prior; however, there is a subset of consumers who
continue experiencing hospitalization. As the program matures and there are longer periods of
enrollment, inferential analyses can help isolate the effects of service participation on these outcomes.
8 The average number of episodes during ACT is slightly inflated due to three consumers who were hospitalized more
frequently than the other consumers.
F&HS Agenda Packet Page 73
A small subset of consumers is continuing to experience criminal justice involvement after ACT
enrollment.
Given limitations in self-reported criminal justice data, the following section describes consumers’ arrest
and incarceration experiences during ACT. Data were unavailable for one consumer; therefore, findings
are reported for 30 consumers.
Of the 30 consumers for whom there were data, 23% (n = 7) were arrested and incarcerated during ACT.
All consumers who were arrested during ACT were also incarcerated; therefore, the average number of
arrests and incarcerations among individuals who were arrested and incarcerated while enrolled in ACT
were the same. Table 10 highlights the following findings:
Consumers who were arrested and then incarcerated during ACT (23%, n = 7) were arrested and
incarcerated at a rate of 4.13 times every 180 days. 9
The length of consumers’ incarcerations ranged between one and 19 days, for an average of 17
days per incarceration.
Table 10. Incarcerations during to ACT Enrollment
Average Range
Arrests (n = 7)
Average 4.13 arrests per 180 days 1 – 9 arrests per 180 days
Incarcerations (n = 7)
Average 4.13 incarcerations per 180 days 1 – 9 incarcerations per 180 days
Length of incarcerations 17 days 1 – 19 days
Future investigation of consumers’ criminal justice involvement will use data from the Sheriff’s Office and
Superior Court; therefore, future reports will explore consumers’ justice involvement before and during
enrollment.
Half of consumers were in stable housing at the conclusion of the evaluation period.
Self-reported housing data from before and during ACT were available for 26 consumers.10 As shown in
Figure 11, 23% (n = 6) of consumers obtained housing while enrolled in ACT, while 27% (n = 7) maintained
the housing they had before enrollment. The remaining 50% of consumers either lost their housing while
in ACT (n = 3) or never had nor gained stable housing (n = 10).
9 The average number of incarcerations is slightly inflated due to some consumers who experienced more
incarcerations during ACT.
10 RDA used the Department of Housing and Urban Development (HUD) definition of stable housing to determine
which categories from the FSP PAF and KET forms should be considered “housed.”
F&HS Agenda Packet Page 74
Figure 11. Consumers’ Housing Status before and during ACT
All ACT consumers have access to employment services provided by the ACT team. During the evaluation
period, nine ACT consumers accessed employment services through ACT. Employment services included:
support developing résumés, searching for job openings, preparing for interviews, and submitting
applications. The ACT team also worked with consumers to identify their vocational goals and discuss how
employment can lead to independent living for consumers.
Consumers experienced positive changes in their life skills, relationships with friends and
family, and community involvement.
The Self Sufficiency Matrix (SSM) was used to assess consumers’ social functioning and independent living.
The SSM consists of 18 domains scored on a scale of one (“in crisis”) to five (“thriving”). Clinicians assessed
consumers at intake, every 90 days, and upon discharge. Intake data were available for just over half (56%,
n = 18) of the ACT consumers, 13 of whom also had a reassessment. Figure 12 below shows consumers’
average scores at intake, and for those who were reassessed, their most recent average scores on the life
skills, family and social relationships, and community involvement domains.11 The “life skills” domain
evaluates the extent to which consumers are able to meet basic activities of daily living. The “family/social
relations” domain assesses the level of support consumers receive from family and friends, while the
“community involvement” domain evaluates the degree to which consumers are socially isolated or
actively involved in their community. On average, consumers with a reassessment increased across each
domain, indicating that consumers are experiencing increases in social functioning and independent living
skills during program enrollment.
11 The most recent assessment was either consumers’ 90-day or 180-day assessment, depending on their length of
enrollment.
Consumers who obtained
housing
•23% of consumers who
were not housed before
ACT obtained housing
while enrolled
Consumers who
maintained housing
•27% of consumers who
were housed before
ACT continued to
maintain housing while
enrolled
Consumers who were not
stably housed
•12% of consumers were
housed before ACT but
did not maintain
housing during ACT
•38% of consumers were
not housed before or
during ACT enrollment
F&HS Agenda Packet Page 75
Figure 12. Changes Life Skills, Relationships, and Community Involvement Domains during ACT
Change scores were calculated for consumers who had both an intake and re-assessment (n = 13). As
shown in Table 11, consumers experienced positive change in each domain, with the greatest increase in
community involvement.
Table 11. Average Change in Social Function and Life Skills Domains among Consumers with Re-
Assessment (N = 13)
Domain Average Change
Life Skills 1.42
Family and Social Relationships 1.08
Community Involvement 1.67
Taken together, these findings indicate that, at the time of reassessment, consumers had made some
improvements in social function and independent living. According to the SSM scoring, consumers were
able to, on average meet most of their daily living needs without assistance (life skills). They also had some
support from family and friends (family and social relationships). Finally, though they made some
improvement in their community involvement (i.e., improving from social isolation and an absence of
motivation), they still lacked knowledge of ways to become involved in their community, on average.
No AOT enforcement mechanisms were used during the first 11 months of program
implementation.
The primary enforcement mechanism occurs when AOT consumers (e.g., consumers who have a voluntary
settlement agreement or AOT court order) refuse to engage and a judge issues a mental health evaluation
order at a designated facility for a consumer who does not meet 5150 criteria established in the Welfare
and Institutions Code. No enforcement mechanisms have been used.
2.56
2 2.28
3.77
2.92
3.62
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Life Skils Family and Social Relationships Community Involvement
Intake (N = 18)Most Recent Assessment (N = 13)
F&HS Agenda Packet Page 76
RDA conducted focus groups with ACT consumers and their family members in August 2016. Feedback
from consumers and their families suggest that they are generally appreciative of the ACT program and
believed that participating in ACT was beneficial. Consumers highlighted several strengths of the program,
including staff responsivity and emphasis on shared decision-making; the professionalism of the ACT
team; and the ACT team’s inclusive approach to services, including their ability to support consumers
obtaining and attending appointments, taking medication, navigating the legal system, and engaging in
activity-based and recovery-oriented groups. Consumers and their family members also provided
feedback on program improvement, suggesting that the ACT team could provide additional meaningful
activities to reduce the amount of consumers’ free time; more support for family members; and more
support with housing supervision.
Future reports will include consumer and family satisfaction survey results, in addition to focus group data
collected from annual ACT fidelity assessments.
CCBHS and MHS attempted to implement the Abbreviated MacArthur Community Violence Tool to assess
violence and victimization. However, administering the tool with consumers has been challenging. At the
time of this report, no consumers had completed the MacArthur tool. In Contra Costa’s experience, this
consumer population, who is often in the early stages of accepting treatment and recovery, has resisted
the administration of additional assessments and refused to answer violence and victimization questions.
The County and MHS will continue to try to implement the MacArthur tool as well as find new ways to
obtain this information. However, given the commitment to engaging consumers in treatment and helping
consumers progress in their recovery, they have focused more on administering the required assessments
rather than disrupting relationship-building with additional tools and scales. If consumers consent to
violence and victimization assessments in the future, this information will be included in later reports.
F&HS Agenda Packet Page 77
Section 4. Summary of Findings
In its first 11 months of AOT implementation, Contra Costa County received 189 total referrals for AOT
from all categories of potential qualified requestors. The majority of consumers were referred by family
members (64%, n = 121). Through investigation that involved engaging both consumers and their families,
CCBHS connected 62 unique eligible referred consumers to MHS for outreach and engagement services.
Of those who were not connected to MHS, 24 were still under investigation to determine their eligibility.
The remaining 100 consumers were either unavailable (i.e., the qualified requestor withdrew the request
or could not be reached; the consumer could not be found, was hospitalized or incarcerated; or the
consumer re-engaged in other FSP services) or they did not meet AOT eligibility criteria.
Following referral to MHS, 62 consumers received intense outreach and engagement services from the
ACT team, with the goal of connecting consumers and their families to voluntary mental health services.
At the conclusion of the evaluation period, MHS successfully enrolled 32 consumers in ACT.12
ACT consumers reflected the target population for the AOT program. The majority (75%, n = 24)
had a primary diagnosis of a psychotic disorder and 30% (n = 10) had a co-occurring substance
disorder. The majority of consumers experienced a psychiatric hospitalization (74%, n = 23) and
crisis stabilization episode (97%, n = 30). Housing data were available for 26 consumers, 19 of
whom (73%) were homeless in the 12 months before enrollment.
The majority (94%, n = 29) of consumers were adherent to ACT services. In other words,
consumers consistently averaged at least one face-to-face contact with the ACT team per week
and received a range of services, including individual and group therapy, case management,
employment and housing assistance, medication management, and support building independent
living skills, wellness, and community engagement.
Overall, consumers experienced fewer hospitalizations and adverse outcomes; however, there
remains a small subset of consumers experiencing hospitalizations and justice involvement.
Fewer consumers experienced psychiatric hospitalizations (23%, n = 7) and crisis stabilization
stays (61%, n = 19) during ACT. Additionally, seven consumers were arrested and incarcerated
while enrolled in ACT.
Housing support and assistance efforts can be improved. While six consumers obtained housing
and another seven maintained their housing while in ACT, half of consumers for whom there was
data (n = 13) were not in stable housing at the end of the evaluation period.
Consumers experienced improvement in their social functioning and independent living. On
average, consumers who were in the program for at least 90 days and received an SSM
assessment experienced positive changes in their life skills, family and social relationships, and
community involvement.
12 One consumer was enrolled at the very end of the evaluation period and therefore had not received any ACT
services at the time of this evaluation).
F&HS Agenda Packet Page 78
Overall, consumers and their family members are satisfied with the ACT program. While there
is room for program improvement (e.g., providing additional opportunities for meaningful activity
engagement, family support, and housing assistance), consumers and their families are pleased
with the professionalism of the ACT team, the opportunities for self-determination and decision-
making, and the team’s comprehensive approach to services.
As Contra Costa County’s AOT program matures, and larger numbers of consumers enroll in the program
for longer periods, future reports will include additional information on consumers’ outcomes and allow
for more advanced statistical analyses to be utilized in order to better explore changes in Contra Costa
County’s ACT consumer outcomes over time.
F&HS Agenda Packet Page 79
Appendix I. AOT Eligibility Requirements13
In order to be eligible, the person must be referred by a qualified requestor and meet the defined criteria:
The person is 18 years of age or older.
The person is suffering from a mental illness.
There has been a clinical determination that the person is unlikely to survive safely in the
community without supervision.
The person has a history of lack of compliance with treatment for his or her mental illness, in that
at least one of the following is true:
a. At least 2 hospitalizations within the last 36 months, including mental health services in a
forensic environment.
b. One or more acts of serious and violent behavior toward himself or herself or another, or
threats, or attempts to cause serious physical harm to himself or herself or another within
the last 48 months.
The person has been offered an opportunity to participate in a treatment plan by the director of
the local mental health department, or his or her designee, provided the treatment plan includes
all of the services described in Section 5348, and the person continues to fail to engage in
treatment.
The person's condition is substantially deteriorating.
Participation in the assisted outpatient treatment program would be the least restrictive
placement necessary to ensure the person's recovery and stability.
In view of the person's treatment history and current behavior, the person is in need of assisted
outpatient treatment in order to prevent a relapse or deterioration that would be likely to result
in grave disability or serious harm to himself or herself, or to others, as defined in Section 5150.
It is likely that the person will benefit from assisted outpatient treatment.
13 Welfare and Institutions Code, Section 5346
F&HS Agenda Packet Page 80
Appendix II. Description of Evaluation Data Sources
CCBHS AOT Request Log: This spreadsheet includes the date of each AOT referral, as well as the
demographic characteristics of each individual referred to AOT and the disposition of each referral upon
CCBHS’ last contact with the individual referred (e.g., unqualified requestor, open AOT investigation,
voluntarily accept MHS services, court involved MHS participation).
These data were used to identify the total number of referrals to the County’s AOT program from February
1, 2016 – December 31, 2016, as well as the number of referrals made to AOT each month, and the
number of individuals who received more than one AOT referral.
CCBHS Blue Notes: CCBHS staff converted the Blue Notes (i.e., field notes from successful outreach
events) into a spreadsheet tracking the date, location and length of each CCBHS Investigation Team
outreach encounter. These data were used to assess the average length (i.e., days and encounters) of
investigation attempts provided by the CCBHS Investigation Team per referral.
MHS Outreach and Engagement Log: This spreadsheet tracks the date and outcome of each MHS
outreach encounter, including information on who provided outreach (e.g., family partner, peer partner,
clinician) to whom (consumer or collateral contact such as friend, family, or physician), and the location
and length of each outreach encounter.
Data from this source were used to calculate the average number of outreach encounters the MHS team
provided each consumer, as well as the average length of each outreach encounter, the location (e.g.,
community, secure setting, telephone) of outreach attempts, and the average number of days of outreach
provided for reach referral.
Contra Costa County PSP Billing System (PSP): These data track all services provided to ACT participants,
as well as diagnoses at the time of each service. PSP service claims data were used to identify the clinical
diagnoses of ACT participants at enrollment, as well as the types and costs of services consumers received
pre- and during-ACT enrollment (e.g., outpatient, inpatient, residential, and crises), the average frequency
with which consumers received ACT FSP services, and the average duration of each service encounter.
FSP Partnership Assessment Form (PAF), Key Event Tracking (KET), and Quarterly Assessment Form
(3M): Though the PAF, KET, and 3M are entered into the Data Collection and Reporting (DCR) system, data
queries were unreliable and inconsistent; therefore, MHS staff entered PAF, KET, and 3M data manually
into a Microsoft Access database. These data were used in this report to generate consumer profile
measures and self-reported changes in outcome measures such as homelessness before and during ACT.
MHS Outcomes Files: These files include assessment data for a number of clinical assessments MHS
conducts on ACT participants. For the purposes of this evaluation, the Self Sufficiency Matrix (SSM) was
used to assess consumers’ social functioning and independent living. Future reports will include findings
F&HS Agenda Packet Page 81
from the MacArthur Abbreviated Community Violence Instrument to address consumers’ experiences of
victimization and violence.
F&HS Agenda Packet Page 82
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 1
What is ACT?
ACT is an evidence-based behavioral health
program for people with serious mental
illness who are at-risk of or would otherwise
be served in institutional settings such as a
hospital or jail, or experience homelessness.
Contra Costa County Assisted Outpatient
Treatment – 2017 DHCS Report
Summary
Background
On February 5, 2015, the Contra Costa County Board of Supervisors adopted a resolution to authorize
the implementation of AOT in accordance with the Welfare and Institutions Code, Sections 5345-5349.5.
Figure 1 below shows the implementation timeline of AOT in Contra Costa County.
Figure 1. Contra Costa County AOT Program Implementation Timeline
The County has designed an AOT program model that exceeds AB 1421 requirements and responds to
the needs of its communities. CCHBS and Mental Health Systems (MHS) collaborate as the Care Team to
conduct investigation, outreach, and engagement
activities. MHS provides Assertive Community
Treatment (ACT) services for individuals enrolled
in ACT. When implemented to fidelity, ACT
produces reliable results for consumers, including
decreased negative outcomes, such as
hospitalization, incarceration, and homelessness,
and improved psychosocial outcomes, such as
increased life skills and involvement in
meaningful activities.
This summary reports on the activities and outcomes of the first 11 months of AOT implementation and
ACT service provision in Contra Costa County (February 1, 2016 – December 31, 2016).
Methodology
RDA worked with CCBHS, MHS, and other County partners to gather a variety of data, as shown in Table
1. RDA matched clients across a number of County and MHS data sources and utilized descriptive
F&HS Agenda Packet Page 83
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 2
32 Enrolled in ACT
29 enrolled
voluntarily
2 enrolled with
settlement agreement
1 enrolled
with court
order
62 Individuals Received Outreach and Engagement
32 enrolled in
ACT
10 still receiving outreach
and engagement
20 closed by
CCBHS
189 Referrals Investigated
65 eligible
for AOT
100
ineligible/unavailable
24 still being
investigated
statistics (e.g., frequencies, mean, median, and mode) for all analyses to describe the data and highlight
pre- and during-enrollment outcomes, wherever appropriate.
Table 1. Evaluation Data Sources
Source Data Elements
CCBHS
Referral and investigation information
Service utilization data for all specialty mental health services
provided or paid for by CCBHS, including ACT
Consumers’ mental health diagnoses and substance abuse
MHS
Outreach and engagement encounters
Clinical assessments/outcomes
Homelessness, criminal justice involvement, and employment
outcomes (FSP PAF, KET, and 3M assessments)
RDA-facilitated focus groups with ACT consumer and family
focus groups (August 26, 2016)
Pre-Enrollment
In the first 11 months of implementation, Contra Costa County received 189 total referrals for AOT from
all categories of potential qualified requestors, with the majority (64%, n = 121) made by family
members.
65 eligible consumers were referred
to MHS for outreach and engagement
services.
24 were still under investigation to
determine their eligibility.
100 consumers were either
unavailable (i.e., the qualified
requestor withdrew the request or
could not be reached; the consumer
could not be found, was hospitalized,
or incarcerated; or the consumer re-
engaged in other FSP services) or
they did not meet AOT eligibility
criteria.
Figure 2. Consumer Progress from Referral through
ACT Enrollment
F&HS Agenda Packet Page 84
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 3
Of the 65 referrals, there were 62 unique consumers. They received
intense outreach and engagement services from the ACT team, with the
goal of connecting consumers and their families to voluntary mental
health services (see Enrollment Period
Contra Costa County is reaching the identified target population for ACT.
The majority are White (59%) or Black/African American (25%) and are individuals with a
psychotic disorder (75%).
Of the consumers for whom
there was data (n = 29), 83% (n =
24) were unemployed between
four and 12 months prior to
enrolling in ACT and 93% (n =
27) were unemployed when
they were enrolled in ACT
services.
The majority of consumers with
data (66%, n = 19) received
supplemental security income in
the 12 months before ACT
enrollment and when they
enrolled in ACT.
).
Enrollment Period
Contra Costa County is reaching the identified target population for ACT.
Characteristic % (N)
Gender
Male 50% (16)
Female 50% (16)
Race/Ethnicity
Black/African American 25% (8)
Hispanic 16% (5)
White/Caucasian 59% (19)
Primary Diagnosis
Psychotic Disorder, including schizophrenia and
schizoaffective disorders
75% (24)
Mood Disorder, including depressive and bipolar
disorders
19% (6)
Other 6% (2)
Substance Use
Consumers with a substance use diagnosis 30% (10)
Consumers without a substance use diagnosis 70% (22)
Characteristic % (N)
Gender
Male 50% (16)
Female 50% (16)
Race/Ethnicity
Black/African American 25% (8)
Hispanic 16% (5)
White/Caucasian 59% (19)
Primary Diagnosis
Psychotic Disorder, including schizophrenia and
schizoaffective disorders
75% (24)
F&HS Agenda Packet Page 85
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 4
Table 4. ACT Service Engagement (N = 31)
Table 2. ACT Consumer Characteristics (N = 32)
Characteristic % (N)
Gender
Male 50% (16)
Female 50% (16)
Race/Ethnicity
White/Caucasian 59% (19)
Black/African American 25% (8)
Hispanic 16% (5)
Primary Diagnosis
Psychotic Disorder, including
schizophrenia and schizoaffective
disorders
75% (24)
Mood Disorder, including depressive
and bipolar disorders
19% (6)
Other 6% (2)
Substance Use
Consumers with a substance use
diagnosis
30% (10)
Consumers without a substance use
diagnosis
70% (22)
Table 3. ACT Consumer Characteristics
The majority are White (59%) or
Black/African American (25%)
and are individuals with a
psychotic disorder (75%).
Of the consumers for whom
there was data (n = 29), 83% (n =
24) were unemployed between four and 12 months prior to enrolling in ACT and 93% (n = 27)
were unemployed when they were enrolled in ACT services.
The majority of consumers with data (66%, n = 19) received supplemental security income in the
12 months before ACT enrollment and when they enrolled in ACT.
The ACT team is providing intensive services to consumers. From February through December 2016, 31
consumers were enrolled in and receiving ACT services for an average of 158 days.1 The majority (94%, n
= 29) of consumers adhered to treatment, which means they received at least one face-to-face contact
from MHS staff per week.
While enrolled in ACT,
consumers received an average
of 31 service encounters per
month.
1 One consumer who enrolled at the conclusion of the evaluation period had not yet received any ACT services and
was not included in the following analyses.
Mood Disorder, including depressive and bipolar
disorders
19% (6)
Other 6% (2)
Substance Use
Consumers with a substance use diagnosis 30% (10)
Consumers without a substance use diagnosis 70% (22)
Average Range
Length of ACT
Enrollment 158 days 15 – 302 days
Frequency of ACT
Service Encounters
31 encounters
per month
3 – 104 encounters
per month
Intensity of ACT
Services Encounters 54 minutes 1 – 422 minutes
F&HS Agenda Packet Page 86
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 5
Encounters lasted an average of 54 minutes per encounter.
Encounters per month varied across consumers, from three to 104 encounters per month.
F&HS Agenda Packet Page 87
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 6
The majority of consumers experienced fewer psychiatric hospitalizations and crisis episodes during
ACT, although a subset of consumers continues to experience hospitalization. As depicted in Figure 3,
high levels of hospitalization and crisis episodes among a small subset of consumers resulted in slightly
inflated averages of both outcomes during enrollment.
Figure 3. Consumer Crisis Episodes and Hospitalizations before and during ACT
A small subset of consumers is continuing to experience criminal justice involvement after ACT
enrollment. Given limitations to self-reported criminal justice data, RDA reports on consumers’ arrests
and incarcerations during ACT enrollment. As with hospitalizations and crisis episodes, a few consumers
with high levels of justice involvement resulted in slightly inflated averages.
Consumers who were arrested and then incarcerated during ACT (23%, n = 7) were arrested and
incarcerated at a rate of 4.13 times every 180 days.
The length of consumers’ incarcerations ranged between one and 19 days, for an average of 17
days per incarceration.
Consumer Crisis Episodes
and Hospitalizations
Before ACT
•97% (n = 30) had at least one crisis episode
before ACT enrollment
3.31 episodes per 180 days for an average 1 day
per episode
•74% (n = 23) were hospitalized at least once
during the 36 months prior to enrollment
1.07 hospitalizations per 180 days for an average
7 days per episode
Consumer Crisis Episodes
and Hospitalizations
During ACT
•63% (n = 19) of those with an episode
before ACT experienced a crisis episode
during ACT
0.53 episodes per 180 days for an average 1 day
per episode
•30% (n = 7) of the 23 hospitalized prior to
ACT were hospitalized during ACT
2.86 hospitalizations per 180 days for an average
11 days per episode
F&HS Agenda Packet Page 88
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 7
6 consumers obtained
housing
•23% of consumers who
were not housed before
ACT obtained housing while
enrolled
7 consumers maintained
housing
•27% of consumers who
were housed before ACT
continued to maintain
housing while enrolled
13 consumers were not
stably housed
•12% of consumers were
housed before ACT but did
not maintain housing
during ACT
•38% of consumers were
not housed before or
during ACT enrollment
Table 5. Average Change in Social Function and Life
Skills Domains (N = 13)
Half of consumers were in stable housing at the conclusion of the evaluation period. Figure 4 reports
the housing status of consumers during ACT. Self-reported housing data from before and during ACT
were available for 26 consumers.
Figure 4. Summary of ACT Consumers’ Housing during ACT (N = 13)
Consumers experienced positive changes in their life skills, relationships with friends and family, and
community involvement. The Self Sufficiency Matrix (SSM) was used to assess consumers’ social
functioning and independent living. The SSM consists of 18 domains scored on a scale of one (“in crisis”)
to five (“thriving”). Intake data were available for just over half (56%, n = 18) of the ACT consumers, 13
of whom also had a reassessment. According to the SSM scoring, consumers on average:
Met most of their daily living needs
without assistance (life skills)
Maintained some support from family
and friends (family and social
relationships).
Still lacked knowledge of ways to
become involved in their community.
Additionally, nine consumers utilized the employment services provided by the ACT. Services included:
support developing résumés, searching for job openings, preparing for interviews, and submitting
applications.
Overall, consumers and their family members are satisfied with the ACT program. While there is room
for program improvement (e.g., providing additional opportunities for meaningful activity engagement,
family support, and housing assistance), consumers and their families are pleased with the
professionalism of the ACT team, the opportunities for self-determination and decision-making, and the
team’s comprehensive approach to services.
As Contra Costa County’s AOT program matures, and larger numbers of consumers enroll in the program
for longer periods, future reports will include additional information on consumers’ outcomes and allow
for more advanced statistical analyses to be utilized in order to better explore changes in Contra Costa
County’s ACT consumer outcomes over time.
Domain Average Change
Life Skills 1.42
Family and Social Relationships 1.08
Community Involvement 1.67
F&HS Agenda Packet Page 89
Contra Costa County Behavioral Health Services
Assisted Outpatient Treatment Program – 2017 DHCS Report Summary
May 11, 2017 | 8
Evaluation Next Steps
RDA will conduct the following next steps for its evaluation of the Contra Costa County AOT program:
ACT Fidelity Assessment
o ACT Fidelity Assessment Activities: July 2017
o ACT Fidelity Assessment Report: August 2017
Evaluation Report
o Data collection and analysis: June – August 2017
o AOT Evaluation Report (July 1, 2016 – June 30, 2017): September 2017
o Presentations of Evaluation Report findings: October-November 2017
2018 DHCS Report
o Data collection and analysis: December 2017 – February 2018
o DHCS Report (January 1, 2017 – December 31, 2017): March 2018
o Presentation of DHCS report findings: April – May 2018
F&HS Agenda Packet Page 90
FAMILY AND HUMAN SERVICES COMMITTEE 9.
Meeting Date:05/22/2017
Subject:Workforce Innovation and Opportunity Act Annual Report
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 109
Referral Name: Workforce Innovation and Opportunity Act
Presenter: Kathy Gallagher, Employment and Human
Services Director
Contact: Enid Mendoza, (925)
335-1039
Referral History:
On January 6, 2015 the Board of Supervisors referred oversight and receipt of updates on the
Workforce Innovation and Opportunity Act (WIOA) to the Family and Human Services
Committee (F&HS).
WIOA was signed into law on July 22, 2014. WIOA is designed to help job seekers access
employment, education, training, and support services to succeed in the labor market and to match
employers with the skilled workers they need to compete in the global economy. Congress passed
the Act by a wide bipartisan majority; it is the first legislative reform in 15 years of the public
workforce system. WIOA was expected to significantly impact the Employment and Human
Services Department (EHSD) and the way the Workforce Development Board does its work.
Therefore, updates on the impacts and changes was referred to F&HS.
Referral Update:
On September 14, 2015 and March 14, 2016, F&HS received reports on the impacts of WIOA
report from EHSD. At the March 14, 2016 meeting, F&HS approved the Department's
recommendation to decertify the Workforce Development Board and recertified a new
recommended structure in compliance with the new WIOA requirements. At that time, the
Department was awaiting further guidance from the State on other WIOA rules. Therefore, F&HS
asked the Department to return with additional information once sufficient information and
guidance was received from the State and the Department was able to provide further analysis of
the impacts of WIOA.
Recommendation(s)/Next Step(s):
CONSIDER accepting the report from the Employment and Human Services on the Workforce
Innovation and Opportunity Act and forward to the Board of Supervisors for their information.
Fiscal Impact (if any):
F&HS Agenda Packet Page 91
There is no fiscal impact; the report is informational.
Attachments
WIOA Report to F&HS
F&HS Agenda Packet Page 92
1 | P a g e
Workforce Development Board of Contra Costa County Family & Human Services
Presentation May 2017
The most important and pressing work that is before the Workforce Development Board of Contra Costa
County (WDBCCC) at this point in time is the full implementation of the Workforce Innovation and
Opportunity Act (WIOA). Although WIOA was signed into law in July of 2014, the final rules were not
issued until August 19, of 2016. While the WDBCCC has been moving towards this implementation since
the later part of 2014, it is only within the last 4 months that the state has issued directives with enough
clarity, direction and deadlines (of which there are many) to fully implement. The WDBCCC continues to
move forward with a number of key priorities and activities, with particular emphasis on preparation for
the full implementation of the WIOA.
The WDBCCC is serving as the lead Local Workforce Development Area (LWDA) for the newly
established “East Bay Planning Region” under WIOA. As a part of this, the WDBCCC will be responsible
for administering funds to help support and coordinate regional planning activities in conjunction with
the other three (3) regional LWDAs from Alameda County, the City of Oakland, and the City of
Richmond. Regional plans must be completed and submitted to the California Workforce Development
Board (CWDB) by March 31, 2017. Planning efforts around this work will be leveraged through the
regional EASTBAY Works partnership that has been operating since 1998.
The Workforce Development Board of Contra Costa County exceeded both service-level and
performance targets for services to job seekers and businesses, thus receiving the “High Performing
Board” certification by the CWDB again.
The WDBCCC continues to serve as the lead organization for the East Bay “Slingshot” initiative, which
brings together stakeholders from economic development, education, and workforce development to
support industry sector partnerships that are driving the growth and prosperity of the regional
economy. Targeted industry sectors include advanced manufacturing, biomedical, healthcare,
information communication technology (ICT), and transportation / logistics.
Workforce Innovation & Opportunity Act implementation items requiring Board of Supervisor
approval:
Regional and Local Plans:
March 15th Local and Regional Plans submitted to State Board
May 1st WDBCCC received conditional approval; additional information requested
June 15th Revisions due to State Board
June/July Plans submitted for BOS approval
August 1st Final corrected and signed plans due to State Board
Adult DW Career Services Provider App:
Approved by BOS and signed by Supervisor Glover March 9th; the WDBCCC has received
conditional approval along with a request for additional information.
F&HS Agenda Packet Page 93
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One-Stop Operator Selection
An RFI was released March 26th and closed on April 24th; the responses received did not meet the needs
of this procurement and it was determined to be a failed procurement. The WDBCCC will revise and re-
post the procurement but must submit an application to be the AJCC Operator per WSB Directive 16-14
in order to meet the required deadline of July 1, 2017.
Mandated Partner MOU Phase I
o Scheduled for approval at May 23rd BOS
Mandated Partner MOU Phase II – cost allocation
o The WDBCCC is working with Fiscal to establish a cost allocation method
o May/June - the cost allocation is being presented to mandated partners for approval
o June - submit to BOS for approval
o September 1st - deadline to submit to the state
o January 2018 - Implementation
WIOA Youth Programs
WDBCCC staff members have been working on implementing changes regarding the administration and
implementation of WIOA youth programs, the most notable of which include increased funding
percentages for out-of-school youth and a new age range for services from 16-24 years old. There is also
a requirement that at least 20% of WIOA youth funds be spent on helping youth gain work-based
learning experiences.
To meet the new WIOA youth requirements and in accordance with procurement policy, an RFP to
solicit competitive proposals for the delivery of year-round youth program services was released on
December 23, 2016, with proposals due February 13th, 2017. Three proposals were received and
negotiations are taking place to award these contracts effective July 1, 2017.
Earn & Learn East Bay is an engagement and recruitment campaign coordinated by the WDBCCC, the
Contra Costa Economic Partnership (CCEP) and Diablo Gateways to Innovation (DGI). DGI is a
collaborative effort among a wide range of educational and workforce partners actively supporting
career pathways for youth and young adults in our region. The Earn & Learn East Bay initiative provides
compensated work-based learning opportunities to youth through meaningful workplace experiences,
summer and year-round placement, internships and apprenticeships, or in industry-led summer learning
experiences. Moving forward, the WDBCCC will continue to facilitate employer participation on Industry
Advisory Boards to advise and assist educators with career pathway programs, and as guest speakers in
high school and community college classrooms. The WDBCCC will also support teachers by helping them
gain a deeper understanding of industry needs and by arranging externships in which teachers directly
experience the workplace.
Business Services
The WBD is revising its business services to align with our sector priorities, support priority populations,
and support regional partnerships as defined in WIOA. These include working with our regional sector
F&HS Agenda Packet Page 94
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partnerships (EB Advanced Manufacturing Partnership, EB Health Workforce Partnership, EB
Transportation and Logistics Partnership, and EB Information and Communications Technology
Partnership), the CCWORKS Program, Earn & Learn East Bay (a youth focused initiative), and AB 109/AB
2060 focusing on serving the reentry population through increased employer engagement.
In collaboration with Contra Costa College the WDBCCC Business Services team hosted a career fair at
Contra Costa College on October 5, 2016. Thirty-six employers participated, 20 community resource
providers, and 252 job seekers attended this event.
Feedback shows that the majority of respondents believed the Career Fair to be a huge success. Our
analysis shows that job seekers were “very satisfied” with the event’s accessibility, staff assistance,
employers and resources, and their overall satisfaction. Agencies were also pleased in their feedback. A
number commented on how well the fair was organized. In addition, these agencies represent hard to
serve populations, which include returning citizens, low-income seniors, the disabled, veterans, and
disadvantage youth. They indicated that their clients also had a positive experience.
In accordance with the WDBCCC’s work with AB109 and our recent AB2060 Forward Focus grant, the
WDBCCC will be hosting a Second Chance Employer Summit on May 24th at the Pleasant Hill Community
Center. This event has garnered tremendous attention from businesses in our community and is
expected to be at full, if not over, capacity.
Small Business Development Center
Partially funded by the Small Business Administration (SBA), this program, hosted by the WDBCCC,
delivers individualized advising and group training to current and aspiring business owners in English and
Spanish throughout the County. The SBDC actively partners with myriad public, nonprofit, and private
sector organizations to attract “high-impact” employers as well as community-based agencies to reach
and serve low-to-moderate income (LMI) residents.
The Contra Costa SBDC is one of the highest functioning SBDCs in the State of California serving over
2,000 small businesses annually.
CCWORKS
Under the direction of the WDBCCC the CCWORKS subsidized employment program continues to have a
high success rate of finding work experience opportunities for CalWORKS recipients with over 126
placements through April 2017. The WDBCCC is conducting satisfaction surveys from both business and
participants for continuous improvement. The results of recent Business Partnership Satisfaction Survey
are currently being evaluated.
One-Stop/AJCC Operations
Continued strong participation from the Workforce Integration Network (WIN) teams, which are
comprised of community-based organizations and other public sector partners to examine ways to
better coordinate and align resources and efforts around employment and other services. Three (3)
different teams, representing the West, Central, and East Contra Costa sub-regions are continuing to
meet, share information, coordinate referrals, and plan events. These groups are expected to play an
F&HS Agenda Packet Page 95
4 | P a g e
important role as the WDBCCC continues to evolve its services under WIOA and begins to work on
adoption of a new strategic workforce development plan.
The WDBCCC continues to maintain strong linkages with educational partners to support a variety of
services and initiatives at the AJCCs and other locations.
Number of Work Experience Hours Provided to Interns: 22,754 TOTAL at PY 2016-2017 Q3
WIOA: 9,114 CCWorks: 10,360 SCSEP: 1,524 Adult Ed: 336 Other: 1,420
The WDBCCC, through its America Job Centers of California and contracted services, provides basic
career serves to approximately 11,000 customers annually.
The following are indicators for people who received intensive services through the WDBCCC PY 2015-
2016:
ENTERED EMPLOYMENT RATE
During FY 15-16, 74% of adults entered employment compared to the negotiated performance
level of 75%. 85% of Dislocated Workers entered employment, well above the negotiated
performance level of 77.5%.
RETENTION RATE
During FY 15-16, 86% of adults remained employed for at least 3 quarters compared to the
negotiated performance rate of 82.5%. 86% of Dislocated Workers retained employment exceeding
the negotiated performance level of 85%.
AVERAGE EARNINGS FOR SIX MONTHS
During FY 15-16, the average earnings for adults participating in WDBCCC programs were $14,797
compared to the negotiated performance level of $14,950. The average earnings for Dislocated
Workers were $22,507 compared to the negotiated performance rate of $20,250.
The WDBCCC administers several programs targeting youth ages 14-24 in Contra Costa County. The
WDBCCC youth programs focus on improving their educational attainment and skills along with
their career readiness to strengthen their future employment opportunities.
PLACEMENT IN EMPLOYMENT OR EDUCATION
72% of youth participants were placed in employment or educational opportunities, an impressive
success rate which exceeded the negotiated performance level of 60%.
YOUTH CREDENTIAL ATTAINMENT
68% of youth attained a high school diploma, GED or occupational certificate as compared to the
negotiated performance level of 51.5%.
LITERACY NUMERACY GAINS
Due in large part to a transition in contracted service providers for the WDBCCC’s youth programs
only 9% of youth participants increased their basic reading and math skills while the negotiated
performance level was 40.5%. Corrective action is underway. This program is aimed at increasing
skills for out-of-school youth who read, write, or compute below the 9th grade level.
F&HS Agenda Packet Page 96
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To date for PY 2016-2017 the WDBCCC has provided intensive career services to 1,141 customers of
which 159 attained a certificate/diploma/degree and 200 have entered unsubsidized employment.
Budget/Grants/Funding Opportunities
The WDBCCC is entering into a very austere budget period with federal allocations down 13% in
the past 3 years coupled with the decrease in CalWORKS funding that has had a residual impact
on the WDBCCC/ AJCCs funding resulting in the loss of several positions.
AB 109: The WDBCCC has been receiving $200,000 annually AB 109 funds for each of the past
three (3) years, with another allocation of $200,000 anticipated in FY 2017-2018. These funds
have primarily been used for two purposes: 1) to deepen connections between the re-entry
community and businesses/employers; 2) to strengthen partnerships between the WDBCCC and
other public agencies, as well as the contracted nonprofit service providers that are helping AB
109 participants reenter the community.
AB2060-Forward Focus: The WDBCCC was able to leverage AB109 funds for a grant opportunity
and was awarded a $400,000 to support the needs of the re-entry population in Contra Costa
County, one that goes beyond the requirements of AB 109 to include other supervised
populations.
The WDBCCC is pursuing additional grants and funding opportunities.
F&HS Agenda Packet Page 97