Attachment G-Reporting and Data Collection Form.pdf

PROGRAM NAME

CSS General System Development (GSD) Program

COMMUNITY SERVICES AND SUPPORT (CSS) 1-YEAR PROGRAM REPORT DATA:

FY2024 (JULY 1, 2023 – JUNE 30, 2024)

1. Program Description

Describe the program description, status, program priorities, priority/target population(s) and service category.

Per the CSS regulations 9 CCR § 3650 for each of the issues identified as a priority, describe any racial/ethnic gender disparities including, but not limited to access to services, quality of care, access disparities of Native Americans, rancherias and/or reservations, disproportionate representation in the homeless population, disproportionate representation in the juvenile and/or criminal justice systems, disproportionate representation in foster care, disproportionate representation in school achievement, and drop-out rates.

We suggest using the program description language and service category information published in the MHSA FY2025 Annual Plan Update linked here: fy24-mid-year-and-fy25-annual-final_plan.pdf (santaclaracounty.gov)

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2. Program Goals, Objectives & Outcomes

We suggest using the language utilized in the MHSA FY2025 Annual Plan Update linked here: fy24-mid-year-and-fy25-annual-final_plan.pdf (santaclaracounty.gov)

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3. Clients Served & Annual Cost per Client Data

Note: Please consult with BHSD Finance Team and CSS Manager (Rebeca Lopez) to verify the actual expenditures as reported in our Annual Revenue & Expenditure Reports (ARER). These costs should be utilized to calculate the cost per person.

We suggest using the language utilized in the MHSA FY2025 Annual Plan Update linked here: fy24-mid-year-and-fy25-annual-final_plan.pdf (santaclaracounty.gov)

FY 2024

Unduplicated N =

Number Served Program Expenditure Cost per Person

ATTACHMENT G

4. Evaluation Activities

All CSS GSD programs must be designed, implemented, and promoted using strategies that are non-stigmatizing and non-discriminatory, and they should focus on at least one or more of the areas below. Please indicate which area(s) your program focuses on and which strategies are used in the program. Refer to CCR § 3630 General System Development Service Category details.

Focus Areas including:

Access and Linkage

Providing one or more mental health services and supports specified in 9 CCR § 3630

Improving the county mental health service delivery system for all clients and their families

Developing and implementing strategies for reducing ethnic/racial disparities

Peer support and family education support services

Food, clothing, and shelter to engage unserved individuals, and when appropriate their families

Additionally, for the CSS annual report, detailed information on the outcomes and how outcomes were measured need to be described.

In narrative form, please describe the following:

For each Program, the methods of measuring outcomes, should be one or a combination of the following:

Evidence-based practice standard or promising practice standard o If the County used the evidence-based standard or promising practice standard to determine the Program’s effectiveness, explain how the practice’s effectiveness has been demonstrated and explain how the County will ensure fidelity to the practice according to the practice model and Program design in implementing the Program.

Community and or practice-based evidence standard o If the County used the community and/or practice-based standard to determine the Program’s effectiveness, describe the evidence that the approach is likely to bring about applicable Mental Health Services Act outcomes and explain how the County will ensure fidelity to the practice according to the practice model and Program design in implementing the Program.

Please explain which standard you used in detail and provide any supporting documentation, such as survey instruments, tools, peer-reviewed journals, etc., if available.

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5. Demographic Data

Please complete the demographic data below as required by the state regulations. Please use the demographic data provided by the Analytics & Reporting team at the dashboard linked HERE. If you have any questions about your program’s data, contact Fannie Stein at fannie.stein@hhs.sccgov.org. If you did not collect indicators for any of these variables for a given fiscal year, please write “Not available” and include a few sentences explaining why the data were not collected.

FY 2024

Age Group # Served % of Served

0 – 15 years

16 -25 years

26- 59 years

60+ years

Prefer not to answer

Unknown

Unduplicated Total

Race # Served % of Served

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White/ Caucasian

Other

More than one race

Prefer not to answer

Ethnicity # Served % of Served

Hispanic or Latino:

Caribbean

Central American

Mexican/ Mexican-American/ Chicano

Puerto Rican

South American

Hispanic/ Latino (undefined)

Other Hispanic/ Latino

Hispanic or Latino Subtotal

Non-Hispanic or Non-Latino as follows:

African

Asian Indian/ South Asian

Cambodian

Chinese

Eastern European

European

Filipino

Japanese

Korean

Middle Eastern

Vietnamese

Non-Hispanic/ Non-Latino (undefined)

Other Non-Hispanic/ Non-Latino

Non-Hispanic or Non-Latino Subtotal

More than one ethnicity

Prefer not to answer

Gender (Assigned at Birth) # Served % of Served

Male

Female

Gender (Current) # Served % of Served

Male

Female

Transgender (Male to Female)

Transgender (Female to Male)

Transgender (Undefined)

Genderqueer

Questioning or Unsure

Another gender identity

Prefer not to answer

Sexual Orientation # Served % of Served

Gay or Lesbian

Heterosexual/ Straight

Bisexual

Questioning/ Unsure

Queer

Another sexual orientation

Prefer not to answer

Primary Language # Served % of Served

English

Spanish

Vietnamese

Chinese

Tagalog

Farsi

Other

Prefer not to answer

Military Status # Served % of Served

Active Military

Veteran

Served in Military

Family of Military

No Military

Disability* # Served % of Served

Difficulty seeing

Difficulty hearing or speaking

Other communication disability

Cognitive

Physical/ Mobility

Chronic Health Condition

Other non-communication disability

No Disability

Prefer not to answer

Unknown

Unduplicated Total

*Participants may choose more than one option for Disability.

6. Additional Data Collection Requirements

Per CSS regulations 9 CCR § 3620.10, the County shall collect the information below, as appropriate. If you did not collect indicators for any of these variables for a given fiscal year, please write “Not available” and include a few sentences explaining why the data were not collected.

Residential Status # Served % of Served

Educational Status # Served % of Served

Employment Status # Served % of Served

Sources of Financial Support # Served % of Served

Health Status # Served % of Served

Substance Abuse Issues # Served % of Served

Assessment of Daily Living Functions, when appropriate

# Served % of Served

Emergency Interventions # Served % of Served

7. Referrals

This section refers to the number of individuals referred to community-based providers and the kind of treatment or social services individuals or individuals’ families were referred to. Additionally, please include the number of individuals who followed through on the referral and engaged in (defined as the number of individuals who participated at least once in the Program to which they were referred. For referrals to treatment and/or services that are provided by or overseen by county mental health, please include the average duration of untreated mental illness.

Finally, in this section, please also include the average interval between the referral and participants in treatment, defined as participating at least once in the treatment to which referred.

Per CSS regulations, a referral is defined as the process by which an individual is given a recommendation in writing to one or more specific service providers for a higher level of care and treatment.

Unduplicated N =

Number of individuals with serious mental illness referred to treatment

(Separate out treatment that is provided, funded administered, or overseen by county mental health versus treatment that is not)

Kind of treatment to which the individual was referred

Number of individuals who followed through on the referral and engaged in treatment

(for treatment that is provided, funded administered, or overseen by county mental health)

Average duration of untreated mental illness

(for referrals to treatment that are provided by or overseen by county mental health)

Average interval between the referral and participants in treatment (defined as participating at least once in the treatment to which referred) and standard deviation

(for referrals to treatment that are provided by or overseen by county mental health)

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8. Group Services Delivered

This number refers to the unduplicated number of participants receiving group services per year. If group services are not offered by your program, please indicate “N/A”. For each fiscal year, please provide a summary narrative of the types of group services delivered and the target population(s) served.

Unduplicated N =

Number of Groups Attendance Average Attendance per Group

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9. Detailed Outcomes

Please include as much outcome information as you have available for your program by fiscal year. This should include:

The indicators utilized

Percent improvement (From pre- to post- results)

The names and references of the survey tools used to measure the outcomes

Any summary narrative explaining the outcome data, any information on data collection, and any observations made by the program in the outcome and data collection process

If you have any questions or need additional information, please contact the MHSA team.

10. Evaluation Summary

This is the narrative section to provide a summary of your program’s evaluation for FY2024. You may also include any qualitative data, such as client experiences; program success; program barriers and challenges; implementation challenges; and any other narrative information that you feel will help convey the program’s intentions and highlight the program’s efforts.

Please limit the summary section to no more than 3 paragraphs, if possible.