Report 2012-122 Recommendation 20 Responses

Report 2012-122: Mental Health Services Act: The State's Oversight Has Provided Little Assurance of the Act's Effectiveness, and Some Counties Can Improve Measurement of Their Program Performance (Release Date: August 2013)

Recommendation #20 To: Santa Clara County Mental Health Department

Santa Clara County should review its existing MHSA contracts and by December 31, 2013, or as soon as is feasible, amend them as necessary to include plan goals.

Annual Follow-Up Agency Response From October 2014

Please refer to our one-year response.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

1-Year Agency Response

Per the County's February 2014 update response, the County has incorporated plan goals and performance measure requirements into FY15 MHSA contracts. The program description section of service contracts (Exhibit A) has been redesigned to clearly specify program goals, objectives, process measures, outcomes to be achieved and the methods/approaches that will be utilized to evaluate if outcomes were achieved. The goal(s) listed in an MHSA contract is/are linked to the MHSA component level goal(s) reflected in the County's MHSA plan. This process has been completed and contracts are in final stages of execution for FY15.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

The County continues to collaborate with the three other counties audited, Los Angeles County, Sacramento County, and San Bernardino County on creating a framework/tool incorporating plan goals in MHSA funded contracts. We are all in the process of testing the tool and applying it to MHSA funded contracts. Attached is the current draft of the tool. The Counties plan to share the work we have done on addressing this audit recommendation and provide an overview of the conceptual model/tool with our sister counties. The process will also involve vetting the tool with the Countys MHSA contracted providers and local stakeholders. The County will be incorporating the plan goals and performance measure requirements into the Countys FY2014-15 MHSA contracts; and anticipates completing the work related to the audit recommendation by July 1, 2014.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

60-Day Agency Response

The County is currently working on a creating a framework incorporating plan goals in MHSA funded contracts in collaboration with the three other counties audited, Los Angeles County, Sacramento County, and San Bernardino County. All are in agreement that a common approach to the audit recommendation would align with the broader concept regarding consistent statewide approach to evaluation. The four counties participated in a teleconference on September 30, 2013 and agreed to develop a common approach to the determination of MHSA program goals and performance measures. A second teleconference took place on October 8, 2013 to outline the steps to MHSA program goal identification. The work is conceived to be conducted in three phases. The first phase involves the creation of a conceptual model to be developed in collaboration with the four audited counties; the second phase will involve the application of the model by each county to their MHSA contracts; and the third phase will involve each county executing contract amendments as needed to their MHSA contracts. Santa Clara County anticipates implementing the conceptual model into our FY2014-15 contract amendments. The process will include input on the proposed conceptual model from the County staff, MHSA stakeholders, and the Mental Health Board. To that end, the County MHD Director reported the proposed approach to the County's Performance Quality Improvement Committee (PQIC) on October 3, 2013. The PQIC, comprised of 40+ County and Contract Provider representatives, responded favorably to the proposed three phased approach to the audit recommendation.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

All Recommendations in 2012-122

Agency responses received are posted verbatim.