Strategic Goals:

Prevention and Wellness:

• Enhance community outreach to diversify the participation and voice of residents who access services.
• Expand access to school-based services by building and maintaining relationships with all school districts
• Leverage public interest to expand informational campaigns
• Improve workforce retention and increase staff time spent providing services and programs in diverse communities.

Community Services: 

• Close gaps in access to community services among key underserved populations and communities.
• Identify opportunities for joint projects, collaboration, and information sharing with other public agencies
• Ensure county-wide understanding and knowledge for accessing resources, services, and supports.
• Augment the workforce with incentives and non-clinical personnel well positioned to provide culturally responsive and sustainable services in local communities.

Intensive Outpatient Services:

• Expand access to restructured facilities to integrate services and enhance coordination of whole-person care. ​
• Leverage CalAIM as an opportunity to develop and/or strengthen collaborations focused on coordination of outpatient supportive services, especially stepdown models that ease client transitions to less intensive and/or community-based care.
• Increase public education, services and resources of co-occurring (mental health and substance use) disorders.
• Develop more peer support and team-based approaches to strengthen clinical staff (shorter-term) while also developing career pipeline programs with higher education partners (longer-term).

Crisis Services:

• Build community understanding of crisis management to ensure equitable access to culturally appropriate and responsive services throughout the system of care.
• Enhance interagency collaboration focused on ensuring efficient, equitable access to crisis and intensive residential services.
• Clarify and standardize expectations of how best to navigate the crisis and acute services system.
• Bolster crisis staffing and capacity with peer and partnership staffing models.

Intensive Residential Services: 

• Expand access to residential facilities offering in-patient treatment including facilities for women and children.
• Identify and collaborate with partners to increase adult and youth access to longer-term facilities, including sober living and board-and-care homes.
• Develop a communication plan with hospitals, federally qualified health centers, and community partners on best practices for meeting the needs of patients with co-occurring (mental health and substance use) disorders.
• Increase opportunities for joint professional learning between staff focused on supporting individuals with co-occurring disorders, including shared use of evidence-based tools and exchange of data.

2024 Actions:

Prevention and Wellness:

• Expand prevention-oriented communication and destigmatization outreach in languages other than English (e.g., Spanish and Mixteco)
• Support the continued expansion of school-based wellness centers in the County that provide BH services to school-age children and youth.
• Expand and strengthen the Services Affirming Family Empowerment (SAFE) program to ensure access and an active program presence in all key geographic regions of the County.
• Build partnerships to expand efforts to destigmatize BH, focusing these efforts on key underserved constituencies such as non-English speaking adults, LGBTQ+ individuals, and adults age 60+.

Community Services:

• Increase the number of Community Action Teams (CATs) to ensure that this model is available in all key regions and communities in SLO County.
• Enhance communication and coordination of services with County community health centers (CHCs) to reinforce BHD’s focus on integrated care and expansion of MAT.
• Partner with school districts and the COE to encourage participation in the Multi-Payer Fee Schedule, a new opportunity (under the Children and Youth Behavioral Health Initiative of CYBHI) that offers a sustainable funding source for school-based and school-linked BH services at all MTSS tiers.
• Continue to focus on community based BH education and training (e.g., MH First Aid) that engages families, prioritizing the use of bilingual staff and promotores in communities where languages other than English are dominant.
• Increase public understanding of eligibility criteria and the multiple points of access to SUD services and programs available to county residents.

Intensive Outpatient Services:

• Restructure targeted BHD facilities so that MH and SUD services are co-located and/or in proximity to one another.
• Investigate option for increasing access to mobile BH services and field-based treatment to overcome transportation barriers.
• Continue to expand access to affordable community housing for BH clients transitioning from residential treatment, especially individuals living with SMI.
• Continue to collaborate with law enforcement, probation, and Wellpath to ease the transition of incarcerated individuals to step down models of transitional care with wraparound supports, including housing.
• Work with the COE to disseminate information and best practices to triage BH needs and coordinate student referrals to outpatient BH services from public schools. 
• Establish an internal task force to identify key opportunities and recommendations for improving work flexibility, supervision, and other factors driving employee job satisfaction and retention.

Crisis Services:

• Work with community partners to define the crisis continuum and establish a process to define, develop, review, monitor, and improve equitable crisis access
• Investigate the development of a CSU or equivalent facility to serve children and youth.
• Expand the number and distribution of sobering centers and/or PHF for individuals in need of SUD-related crisis services.
• Solidify the relationship between hospitals/FQHCs, law enforcement, and mobile crisis teams to make timely response more efficient and streamlined.
• Expand Mobile Crisis and Community Action Teams, drawing on the assets and expertise of collaborative partnerships.
• Launch an awareness campaign to help community leaders and key partner agencies and organizations (e.g., hospitals, law enforcement, schools, etc.), understand how the crisis system is intended to work. 
• Develop and implement communication strategies to improve service access that are culturally and linguistically appropriate. 
• Establish a crisis services agency to oversee programs and contractors. 

Intensive Residential Services:

• Establish a sobering center within the behavioral health crisis continuum with low-barrier entry criteria, and connection to outpatient SUD treatment.       
• Identify and collaborate with partners to increase adult access to longer-term sober living programs and board and care housing compatible with MAT throughout SLO County.
• Increase public understanding of eligibility criteria (i.e., Medi-Cal) and the points of access to residential BH services and programs available to county residents.

2025-2026 Actions:

Prevention and Wellness:

• Expand prevention-oriented communication and destigmatization outreach in languages other than English (e.g., Spanish and Mixteco).
• Organize differentiated outreach on accessing prevention and wellness services tailored to needs of LGBTQ+ and older (age 60+) adults.
• Expand and strengthen the Services Affirming Family Empowerment (SAFE) program to ensure access and an active program presence in all key geographic regions of the County.
• Reinforce the implementation of Tier 1 (universal) MTSS services such as diagnostic screening and early identification, as well as proactive education and training for families and school staff on BH signs and symptoms.
• Work cooperatively with County Public Health and County Office of Employment to strengthen connections to CBOs and faith-based organizations involved in addressing the social drivers or determinants of health (i.e., upstream factors associated with where people live, work, and play).
• Build partnerships to expand efforts to destigmatize BH, focusing these efforts on key underserved constituencies such as non-English speaking adults, LGBTQ+ individuals, and adults age 60+.
• Expand access to community-based training and information on preventive BH strategies and resources for families and community members.
• Design a communication and outreach plan that highlights the importance and availability of harm reduction services and resources among unhoused populations throughout the County.
• Work closely with partners in public health and education to impart a consistent set of messages and informational campaigns on understanding and addressing critical issues such as youth mental health access, suicide, and opioid overdose.
• Explore opportunities for greater efficiency in data and reporting functions, as well as possibilities for outsourcing grant writing.
• Expand opportunities for cross-training, certification, and education supports to better position non-clinical staff to enhance the operations of the Department.

Community Services:

• Increase the number of Community Action Teams (CATs) to ensure that this model is available in all key regions and communities in SLO County.
• Accelerate existing efforts aimed at expanding BH access for LGBTQ+ youth and adults in SLO County in tandem with a network of CBOs, other public agencies, and community allies.
• Continue to expand and incentivize access to community housing for justice involved BH clients upon release from jail.
• Establish a task force focused on assessing the BH needs specific to aging and older adults (60+ years old); conduct a gaps analysis to discern adaptation of community services and supports for this growing county population.
• Partner with school districts and the COE to encourage participation in the Multi-Payer Fee Schedule, a new opportunity (under the Children and Youth Behavioral Health Initiative of CYBHI) that offers a sustainable funding source for school-based and school-linked BH services at all MTSS tiers.
• Improve collaboration with Law Enforcement to advance alternatives to incarceration and further de-stigmatize BH.
• Continue to focus on community based BH education and training (e.g., MH First Aid) that engages families, prioritizing the use of bilingual staff and promotores in communities where languages other than English are dominant.
• Organize a publicity and awareness campaign centered on the message of “No Wrong Door” to showcase the multiple community access points and integrated nature of community-based BH services in the County, especially those that encourage greater participation in prevention and mild to moderate BH services.
• Develop a communication plan with the COE to streamline BH outreach and information dissemination to families of school-age children and youth in response to the youth mental health crisis.
• Assemble data and develop accompanying social marketing materials that communicate the story of increased accessibility of BH services in SLO County, emphasizing key foci, rationale, and measures of impact.
• Increase public understanding of eligibility criteria and the multiple points of access to SUD services and programs available to county residents.
• Advance education and training with community-based and faith-based organizations to destigmatize SUD and MAT.
• Explore an increase in the stipend paid to bilingual staff to increase BH access in communities where languages other than English are more prevalent (i.e., geographic concentrations of Spanish and/or Mixteco speakers).
• Recruit and train additional cohorts of promotores to enhance their capacity to conduct effective BH outreach in targeted communities; supplement and/or share personnel costs for promotores employed by other public agencies.
• Partner with school districts and community nonprofits to apply for CYBHI funding aimed at catalyzing wellness coaches, a new, unlicensed BH job classification capable of providing reimbursable, school-based and school-linked services.
• Explore and expand the involvement of peers and people with lived experience in community wellness centers, drop-in programs, and outpatient treatment teams.

Intensive Outpatient Services:

• Restructure targeted BHD facilities so that MH and SUD services are co-located and/or in proximity to one another.
• Investigate option for increasing access to mobile BH  services and field-based treatment to overcome transportation barriers.
• Continue to expand access to affordable community housing for BH clients transitioning from residential treatment, especially individuals living with SMI.
• Enhance communication and coordination with the County Office of Education and two to three school districts to increase the availability of the intensive outpatient BH services (Tier 3 of MTSS) tailored to the needs of school-age youth.
• Collaborate across partners (Department of Social Services, Probation, Public Health, etc.)  to develop a stepdown approach that eases transitions from residential treatment to outpatient care and wraparound supports. A person-centered system of care allows people to move up and down the continuum and across systems. Assess and strengthen transitions of care and support for people as they transition to different levels of care.
• Continue to collaborate with law enforcement, probation, and Wellpath  to ease the transition of incarcerated individuals to stepdown models of transitional care with wraparound supports, including housing.
• Provide a forum for case managers from BHD to meet regularly with peers employed by key contracted partners to engage in case conferencing, including enhanced data sharing and use of data for continuous improvement.
• Organize a social marketing campaign that explains and highlights the nature of co-occurring disorders and availability of outpatient services for these individuals.
• Collect and publicize data from intensive outpatient clients (e.g., surveys and focus groups) on their experiences to drive responsive, continuous improvements at key points in the delivery system.
• Work with the COE to disseminate information and best practices to triage BH needs and coordinate student referrals to outpatient BH services from public schools.
• Develop a cadre of certified outpatient peer specialists to assist with BH service navigation and accompanying wraparound supports.
• Partner with the COE to encourage the development and/or scaling of career technical education (CTE) pathways in health and human services for high school students to get exposure to and prepare for careers in BH or related health professions.
• Work with institutions of higher education (e.g., Cuesta College and Cal Poly) to expand opportunities for career development, certificate and credential programs, and other employment preparation and training for key entry and mid-level career positions in the BH ecosystem.
• Increase professional learning and interaction between MH and SUD staff focused on supporting individuals with co-occurring disorders, including cross-referrals, sharing of information and data, and joint use of evidence-based tools.

Crisis Services:

• Conduct the feasibility study for a BH Urgent Care Center for emergency BH services, walk-ins and alternative drop-off, medical clearance, and prescription and medication services.
• Investigate the development of a CSU or equivalent facility to serve children and youth.Work with managed care partners to allow individuals with health insurance to use CSU and/or other County crisis services.
• Expand the number and distribution of sobering centers and/or PHF for individuals in need of SUD-related crisis services.
• Expand Mobile Crisis and Community Action Teams, drawing on the assets and expertise of collaborative partnerships.
• Convene a multi-stakeholder workgroup to review practices and resources to improve mobile crisis team configuration, dispatch and response protocols, and cross-agency coordination and data sharing.
• Engage people who have accessed the crisis system to better understand the challenges associated with crisis services; distill implications for revisions to services delivery.
• Increase crisis intervention education and training to share best practices and clarify protocols and processes among staff, key partners, and local government leaders.
• Develop and implement communication strategies to improve service access that are culturally and linguistically appropriate.
• Develop new staffing models in partnership with hospitals to embed BH crisis staff in medical settings.
• Explore the expanded use of peers and other allowable paraprofessionals on crisis teams.
• Investigate the feasibility of crisis respite services staffed by trained counselors and peer support specialists. 

Intensive Residential Services:

• Investigate the development of BH and SUD residential treatment facilities and/or cooperative agreements to ensure access for youth (ages 13-18) and women within SLO County.
• Develop partnerships with local and nearby partners to increase step-down opportunities.
• Identify and collaborate with partners to increase adult access to longer-term sober living programs and board and care housing compatible with MAT throughout SLO County.   
• Explore the feasibility of a multi-county, regional approach to expanding access to intensive residential treatment services for the Central Coast.
• Increase public understanding of eligibility criteria (i.e., Medi-Cal) and the points of access to residential BH services and programs available to county residents.
• Identify and map key personnel gaps in staffing SUD residential programs and services.