ACCOMPLISHMENTS

ACHSA played a significant role in successfully fighting off the biggest threat ever to the Association’s nonprofit agencies in assisting to kill Assembly Bill 1250, legislation sponsored by public labor unions to expand county jobs at the expense and practical elimination of contract agencies. ACHSA prepared a detailed LA County impact statement; obtained an LA Times opposition editorial; got ACHSA agencies to write thousands of opposition letters; and had communication directly with Senate President Pro Tem Kevin De Leon, among other things.

ACHSA created the document entitled, “The Importance of Preserving California’s County Operated Mental Health Carve Out of Specialty Mental Health Services for Higher Needs Clients,” which was published by the National Council for Behavioral Health, and hired a public relations consulting firm in Sacramento, successfully advocating for the preservation of the counties’ specialty mental health services system for adults with serious mental illness and children with serious emotional disturbances in California.

ACHSA led County Department of Children and Family Service (DCFS) and Department of Mental Health (DMH) planning efforts toward the successful development of a groundbreaking comprehensive assessment system (known as MAT), endorsed by the County Board of Supervisors, which has allowed thousands of children entering the foster care system to have comprehensive assessments and related summaries of findings completed by ACHSA agencies, driving better service delivery and accountability.

ACHSA advocacy led Probation to take the unprecedented action of supporting ACHSA’s request to fund a new Probation aftercare services pilot, using a portion of Probation’s Title IV-E Waiver carryover funds. This was the first time that County funds were to be used to specifically pay for residential aftercare services, to be provided by those agencies from whose programs the youth were transitioning. This aftercare services model was used as the basis for ACHSA’s successful advocacy to make aftercare an integral part of the Short Term Residential Treatment Program (STRTP) model.

ACHSA was successful in its groundbreaking effort to secure Mental Health Services Act (MHSA) funding for ACHSA’s proposed new Community Integration Support (CIS) Program, the first time in the County MHSA funding process that funds were allocated for new outpatient type programs. The new CIS program has been extremely successful in allowing every Wellness Center program in the County to provide adjunct services to adult clients, including medication management and case management, acting as a lifeline to facilitate consumers’ transition from Wellness Centers back into the community.

ACHSA worked with DCFS to publish pioneering guidelines for the prevention of and response to allegations and incidents of abuse and neglect. These guidelines were provided to all DCFS and Probation group home providers in the County, along with the Department’s specific acknowledgement of ACHSA’s role in their development. Similar guidelines were also developed for Foster Family Agencies (FFAs). Both sets of guidelines were shared with the Board of Supervisors and their Deputies.

ACHSA, in coordination with DMH, developed a successful pilot to integrate Full Service Partnership and Field Capable Services programs. The benefits of the pilot included: better management of funds to ease client level of care transitions; expanded utilization of client supportive service funds; expanded admission guidelines; and the use of pilot specific clinical tools (the Milestones of Recovery Scale and Determinants of Care) to improve client care.

ACHSA advocacy resulted in significant changes to Assembly Bill 403, the State’s Continuum of Care Reform legislation. Included among the changes were: 1) the addition of language stating that placement decisions should be guided by a child’s individual needs and incorporate the concept of “first placement, best placement” in lieu of a fail first system for entry into residential care; 2) the expansion of eligibility language for future entry into residential care to go beyond safety alone and incorporate both well-being and trauma-related behaviors; and 3) the removal of a distinction between treatment and non-treatment Foster Family Agencies (FFAs) which would have severely limited the scope of services currently provided by FFAs.

ACHSA worked to change DMH’s longtime practice of funding high cost permanent supportive housing units in order to maximize the Department’s housing revenues. DMH proposed to spend $50 million for new MHSA permanent supportive housing units with extremely high per unit costs, significantly limiting the number of units that could be built. As a result of ACHSA’s advocacy, DMH ultimately agreed to shift $6.25 million of those revenues for low cost, innovative housing models, the first time the Department had shifted money away from funding high cost units. ACHSA is using this outcome to push for more innovative housing to be built with hundreds of millions of future State No Place Like Home dollars.

ACHSA successfully convinced DCFS and Probation to fund 1:1 behavioral aides for Short Term Residential Treatment Programs and Community Treatment Facilities in order to facilitate and stabilize the placement of the very high needs youth in these programs. ACHSA also developed criteria regarding the use of the 1:1 aides and a protocol outlining the steps to be taken to request a 1:1 behavioral aide.

ACHSA was heavily involved in addressing provider concerns related to the DMH implementation of its new Integrated Behavioral Health Information System (IBHIS). Among ACHSA’ accomplishments in this area were: delaying DMH’s timeline for IBHIS implementation to prevent manual data entry and address significant report generation issues before requiring providers to “go live”; convening special implementation meetings with DMH IT staff to assist ACHSA agencies in resolving operational issues before “go live” status; and getting DMH to agree to set up a dedicated web portal to consolidate all IBHIS related information.

ACHSA published best practice guidelines to address the significant problem of youth who run away from DCFS and Probation group homes. The guidelines describe in detail best practice strategies for intake and placement, to prevent imminent runaways, for long term prevention, and for a youth’s return to the group home. These guidelines were distributed to all DCFS and Probation group home providers in L.A. County, and both DCFS and Probation specifically acknowledged ACHSA for their development.

ACHSA negotiated significant changes to the DMH contract negotiation package, making life much easier for ACHSA contract agencies. Among the most significant changes negotiated were: the Department’s agreement to greatly reduce the number of copies that would be required to be submitted; the elimination of a very detailed and time consuming form asking for Subprogram Design information; and the elimination of another similarly time consuming form asking for Service Area Subprogram Budget information.

ACHSA developed FFA foster parent certification standards as part of its development of child welfare best practice guidelines, with the goal of ensuring greater protection for foster youth and enhanced quality of care. The final standards included the areas of in person orientation; foster parent application; criminal background checks; training; home inspection; and home study. These guidelines were shared by DCFS to all FFAs in Los Angeles County.