cdph office of health equity september 30, 2014 aimee sisson, md, mph california reducing...

CDPH Offi ce of Health Equity

September 30, 2014

Aimee Sisson, MD, MPH

CALIFORNIA REDUCING DISPARITIES PROJECT

UPDATE

OVERVIEW

CRDP Strategic Plan statusProposed Phase 2 program designSolicitation approach and opportunities

for stakeholder involvementNext steps

2

Phase 1: Develop strategic plan to reduce mental health disparities in 5 populations (African American, Asian Pacific Islander, Native American, Latino, Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning) Fund 5 Strategic Planning Workgroups to engage communities

Identify promising programs and practices Identify strategies to reduce disparities Prepare population report

Fund development of Strategic Plan Goals and strategies to reduce disparities Recommendations for use of Phase 2 funds

Phase 2: Implement strategic plan Focus on validating promising practices / community-defined

evidence* programs)

CRDP PHASES

*Set of practices that communities have used and determined to yield positive results as determined by community consensus over time, that may or may not have been measured empirically but have reached a level of acceptance by the community (Community Defined Evidence Project Working Group, 2007)

Draft Plan awaiting Agency approvalOnce approved

30 day public comment periodCommunity forums for feedback

Revision (1 ½ months)Finalization (1 month)

CRDP STRATEGIC PLAN

4

CRDP Draft Strategic PlanKey Informant Interviews

InternalExternal

CRDP Brain TrustPublic Vetting

PHASE 2 BASIS

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We envision a California in which all individuals, regardless of race, ethnicity, sexual orientation, or gender

identity, receive quality mental health prevention and treatment services delivered in a culturally and

linguistically competent manner.

Vision will not be achieved overnight, nor at end of CRDP Phase 2 However, we do envision the following near-term (5-10y) outcomes:

Numerous community-defined evidence programs funded in Phase 2 are demonstrated through rigorous, community participatory evaluation process to be effective in preventing or reducing severity of mental illness

Community-defined evidence programs validated in Phase 2 are funded by county mental health departments throughout California using county MHSA funds and/or reimbursable through MediCal

Relationship between underserved communities and county mental health departments is healing

Underserved communities advocate for individual and collective needs locally and statewide through advisory bodies and councils

PHASE 2 VISION

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Do business diff erently. Involves attentive listening and genuine consideration of community input in order to be responsive to community needs.

Build community capacity. Communities should taught to fi sh, not simply given a fi sh. Need to invest in creating community structures and supporting community-based organizations in order to sustain eff orts to reduce mental health disparities beyond the 4 years of CRDP Phase 2 funding.

Fairness. A program designed to reduce disparities must be certain to not perpetuate disparities. Contracts should be awarded based on merit, and only after all interested parties have been invited to apply, and if needed, provided with tools and services to support their application.

System change. If the eff ort to reduce disparities begun with CRDP Phases 1 and 2 is to be sustained beyond the next 4 years, Phase 2 needs to address the context and bigger picture within which CRDP exists.

GUIDING PRINCIPLES

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Pilot Projects (approx. 60% of funds)

Evaluation (25%)

Technical Assistance & Training (10%)

Infrastructure (5%)

Administration

PROGRAM COMPONENTS

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9

CRDP PHASE 2 FOREST

Statewide Evaluation

Team• Latino

Evaluator• NA Evaluator• API Evaluator• AA Evaluator

• LGBTQ Evaluator

CDPH OHE

Statewide

OutreachLatino TA

Provider

Pilot

Pilot

Pilot

Pilot

County Mental Health




Pilot


API TA Provide

r

Pilot

Pilot

Pilot

Pilot





Pilot


Pilot

NA TA Provide

r

Pilot

Pilot

Pilot

Pilot





Pilot





Local Outreach

1

AA TA Provide

r

Pilot

Pilot

Pilot





Pilot



Pilot

Pilot

Pilot

LGBTQ TA

Provider

Pilot

Pilot

Pilot





Pilot



Pilot

Pilot

Pilot

Local Outreach

2Local

Outreach 3

Local Outreach

4

Local Outreach

5

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One network (pod) for each of 5 populations Pilot sites (5-7/pop’n) geographically spread

across California

POPULATION APPROACHCounty

Mental Health

Latino TA Provider

Latino Pilot

1

Latino Pilot

6

Latino Pilot

5

Latino Pilot

3

Latino Pilot

2





Latino Pilot

4


Latino Evaluator

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Validate promising practices /community-defined evidence programs (closer to evidence-based practice)

2 pilot types Capacity Building

3 per population (15 total) Fund for approx 6 months Average award $25,000 Continue to implementation if successful

Implementation 5-7 per population (35 total) Fund for 4 years Average award $200,000 per year

Eligibility: Non-profit or government entity with experience working directly with target population

PILOT PROJECTS

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PILOT PROJECTS

CAPACITYBUILDING

time

# of pilots

15

35

IMPLEMENTATION

1y 2y 3y 4y

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Support smaller organizations to

“apply” for implementation

funding

TECHNICAL ASSISTANCE

Population-Specific TA Provider

• One for each population• Culturally sensitive

Population-Specific

Evaluator• Culturally

sensitive• Part of

Statewide Evaluation team

Provider Capacity Building

Ad

min

istrati

ve

Evalu

atio

n

• Support in contract & program management, budgeting, HR, sustainability planning

• Broker with CDPH, county mental health

Support in evaluation

planning and design, evaluation implementation,

seeking evidence-based status

Implementation

Support smaller organizations to articulate theory of change / logic

model, begin evaluation planning

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Multilevel Approach Pilot site

Each pilot site, preferably by independent contractor Population

Common measures/methods across all pilot sites targeting same population

Statewide Common measures across all pilot sites Evaluate all Phase 2 components

Community participatoryMixed methods

EVALUATION

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Address policy and system change Implement “other 23 recommendations”

Create CRDP Advisory Committee Advise CDPH staff on mental health disparities and project

direction

Education, outreach, and awareness Multicultural, with additional population involvement

beyond 5 targets Increase involvement by community members in policy,

planning, and programming Statewide (1) Local (5)

INFRASTRUCTURE

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~60 contracts/grant agreements to be developed

Staff to oversee contracts

Staff for evaluation design, implementation, and oversight

Funded by annual MHSA state administrative dollars (not part of $60M)

ADMINISTRATION

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Inputs Activities Outcomes

Evaluation

MHSA Funding

Technical Assistance

Administrative Staff and Support

Validated Community

Defined Evidence Programs

and Practices (CDEPs)Population-

Specific TA Provider

Provide Technical Assistance,

Administrative Support, Broker Relationships

Statewide and Local Education,

Outreach, & Awareness

Provide Community Representation

Collaboration Between

Community and

Government

RFP Incentives

External Factors

Pilot Sites Build Organizational

Capacity, Implement and Evaluate Promising

Programs and Practices

Increased Funding for Validated

CDEPs

CRDP Strategic Plan

Implementation of Strategic

Plan Strategies

Increases in Culturally

and Linguistically Competent

Mental Health

Services

Policy and System ChangeAdvocacy

Reduced Mental Health

Disparities

Increased Community

Capacity

Improved Relationships Between Community

and Government

Validation of Promising

Programs and Practices

Outputs

County Mental Health Departments State Agencies

Local Decision-Makers

State Legislature

California Reducing Disparities Project, Phase 2

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Operationalize program designMultiple solicitations, rolled out in stagesStage 1

Statewide evaluation team (1) Population-specific technical assistance provider (5)

Stage 2 Capacity building pilot sites (15)

Stage 3 Implementation pilot sites (15 + 20 = 35)

Stage 4 Statewide education, outreach, and awareness (1) Local education, outreach, and awareness (5)

SOLICITATION APPROACH

PUBLIC INPUT

In keeping with guiding principle, “Do business diff erently”

Information gathering Subject matter expert interviews Brain Trust Community forums: facilitated sessions to gather information in a

structured manner Online survey of potential pilot sites

Draft solicitation review Especially for pilot solicitations, others as time permits Opportunity to comment on solicitation and requirements prior to formal

release of bid

Requirements protest Allow bidders an opportunity to provide feedback during the procurement

process

NEXT STEPS

Pilot project survey re: capacity and needs

Community forums for input on program and solicitation design

Solicit public input on draft solicitations Statewide evaluation team first

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CONTACT US

Please contact [email protected] with questions or comments

Visit CRDP Webpage http://www.cdph.ca.gov/programs/Pages/OHECaliforniaReducingDisparitiesProject.aspx

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mailto:[email protected]

http://www.cdph.ca.gov/programs/Pages/OHECaliforniaReducingDisparitiesProject.aspx




cdph office of health equity september 30, 2014 aimee sisson, md, mph california reducing...

Documents

community needs

community consensus

community structures

community capacity

mental health disparities

years of crdp phase

end of crdp phase

funds phase