A Continuum of Outcomes Across MHSA Programs

1. A Continuum of Outcomes Across MHSA Programs Debbie Innes-Gomberg, Ph.D. District Chief, MHSA Implementation and Outcomes Division Los Angeles County Department of Mental Health

3. MHSA Program Outcome Domains Domain FSP FCCS Alt. Crisis WC/CRC PEI Living arrangements X X X Social Support X X X Financial X Daily Activities X X X (emp., edu) Physical Health X X X Crisis Stabilization X X Legal Involvement X Therapeutic Alliance X Symptom Reduction X X Recovery orientation X General Functioning X X

4. The Impact of FSP on MHSA Outcomes

5. The Impact of FCCS on MHSA Outcomes

6. The Impact of Wellness & Client Run Centers on MHSA Outcomes

7. The Impact of PEI on MHSA Outcomes

8. The Impact of Innovation on MHSA Outcomes

9. The Impact of Alternative Crisis Services on MHSA Outcomes

10. Outcomes Through a Wide Angle Lense • Levels of evaluation • Quality improvement • Reports • Creating opportunities for provider-to-provider learning • Improving Data Quality and User Support

11. Levels of Evaluation • Practice level – across providers • Focus of Treatment (PEI) • Agency • Team or Practitioner

12. Quality Improvement • Focus on learning – get curious • Goal – improving practice and client lives • When the outcomes are not what was hoped for: • Target population aligned with the practice? • Are practitioners adequately trained? • Is practice used to sufficient fidelity? • What is the experience of the client or family? • What is the experience of the practitioner?

13. Reports - FSP • Living Arrangements (includes hospital, incarcerations) • Current vs. At enrollment • Annualized Summary by Provider & Program (age group) • Employment • Current • Inclusion/exclusion/error

14. Reports - PEI • Demographics (age, gender, ethnicity) by practice and provider site • Missing/incomplete data • Service Delivery Information by practice, with session range number and average # of sessions, with a drill-down to the provider site level and a roll-up to the Focus of Treatment level • Pre-treatment/post-treatment differences by program • Pre-treatment/post-treatment differences by focus of treatment

15. PEI Outcome Measures

16. PEI Practice General Measure Results Comparisons

17. Using Reports and Data for Quality Improvement:PEI Practice and Learning Networks

18. Using Reports and Data: Service Area Outcome Data Workgroups • Funded through PEI Training, Technical Assistance and Capacity Building funds through a contract with CalMHSA, RAND Corporation staff will facilitate workgroups comprised of providers and DMH administrative staff interested in reviewing Service Area outcome data for purposes of improving service quality and for developing strategies to make decisions based on the outcome data. • Goals of the workgroups include: • Provide a forum for Service Area providers to learn from each other in terms of practices that improve data quality and improve the use of data to make systems as well as clinical decisions within a Service Area. • Provide a forum for DMH administrative Service Area staff to develop their skills in utilizing reports to inform decision-making at the local level. • Strengthen Service Area capacity to formulate and conduct evaluations and to use appropriate data and analytic techniques to inform planning and resource allocations. • To develop strategies to review outcome data across programs and to use the analysis to help inform Service Area level decision-making.

19. Improving Data Quality and User Support Direct Support: • Outcome Measure Application (OMA) Labs Offered bi-weekly: all OMA staff are available in a one-stop lab to address user issues and train on reports. • OMA Users Group (In person and via Webinar) Meets Bi-Monthly (alternates with Newsletter): all MHSA staff as well as CIOB and others meet and update interested users. The Users Group is also broadcast via WebEx for those who want to participate from their offices.

20. Improving Data Quality and User Support Publications and Broadcasts: • Egroups (OMAChat, PEI Alert, FCCS Alert) Specialized email announcement/ discussion groups for important and timely announcements, including system alerts. • OMA Newsletter Bi-monthly reports on the state of the OMA offering tips and features about new aspects of the Outcomes effort. • “Canned” Users Groups and Trainings Pre-recorded Users Group sessions and special presentations are available through WebEx, Adobe Captivate, or as Windows Movie files.

21. Improving Data Quality and User Support References and Aids: • DMHOMA Wiki - Project Website, covering all aspects of Outcomes (FSP, FCCS, SFC, Wraparound, PEI, and MHIP). As a “wiki” it is editable by any staff member. • Quick Guides Reference handouts, featuring tips for completing PEI questionnaires. • Worksheets, Spreadsheets, and other aides Fillable PDF and Excel files that help users calculate needed values and record dates and scores correctly.

22. Improving Data Quality and User Support References and Aids: • DMHOMA Wiki - Project Website, covering all aspects of Outcomes (FSP, FCCS, SFC, Wraparound, PEI, and MHIP). As a “wiki” it is editable by any staff member. • Quick Guides Reference handouts, featuring tips for completing PEI questionnaires. • Worksheets, Spreadsheets, and other aides Fillable PDF and Excel files that help users calculate needed values and record dates and scores correctly.

23. Improving Data Quality and User Support Accessing the Data and Reports: • Internet Reports DMH-developed application to deliver specialized outcome data reports for providers on demand. • Electronic File Transfer: Legal Entity Extracts A secure transfer of a Legal Entity’s outcome data allowing providers to analyze and manipulate their own data.

24. For more information Contact Debbie Innes-Gomberg at DIGomberg@dmh.lacounty.gov or Kara Taguchi at KTaguchi@dmh.lacounty.gov