Although there have been a number of planned operational changes and initiatives that have been a primary focus for the department since the fall of 2019, the Novel Coronavirus Pandemic (COVID-19) has understandably impacted the nation, the local community, and the department. Many of the departmental shifts due to COVID-19 involved both an early activation of the county’s emergency operations and ACBH’s Continuity of Operations Plan/Continuity of Government (COOP/COG) Plan. These activities included immediate policy changes based upon the advisements of local Health Officials, County Board of Supervisors (BOS), the California Department of Health Care Services (DHCS), Centers for Medicare & Medicaid Services (CMS), and the Centers for Disease Control (CDC). The principal COVID-19 related departmental shifts that occurred over the past several months involve four primary areas:

1. ACBH operational policies and procedures;
2. Employee operations;
3. Community outreach and engagement;
4. Clinical Services Delivery.

To date, ACBH is on track to pursue its next phase in strategic and operational planning. Due to the completion of the organizational restructuring, the department is now in a position to seek organizational consultation to engage in a comprehensive, system wide strategic planning effort. This effort is likely to require several months to complete and will seek first to formalize a more community-based approach to care delivery across the county. ACBH already possesses a contractual relationship with an organization who will serve as the fiscal agent and who may assist in securing the consultation. As stated previously, it is anticipated that the strategic planning process will be initiated in 2021.

Alameda County has expanded its designation of professionals for the placement and lifting of Lanterman-Petris-Short (LPS) holds (5150/5585). In the face of an infectious disease pandemic, it became essential that we reduce the time that clients facing mental health emergencies spent in community emergency departments. Therefore, we expanded our training and designation (using an emergency delegation granted by our Board of Supervisors) to include trained professional staff in these emergency departments (Alta Bates Summit Medical Center, Eden Medical Center, Stanford Valley Care Medical Center) with the goal of speeding transit to an appropriate receiving facility. As 2020 has brought an increased focus on the role of law enforcement in response to behavioral health crises, this expanded designation served a dual purpose in that it also reduced the frequency with which police would be called solely for the placement of LPS holds.

There have been significant changes to the way in which department delivers services to forensically involved individuals.

These changes are driven primarily by an intentional focus on health equity, quality, outcome driven metrics, and on how we support individuals and families who interact with the legal or forensic system across the life span. In order to address these needs, a new system of care was developed by the department: Forensic, Diversion, and Re-entry System of Care.

This system of care includes all of ACBH’s forensic programs across the age spectrum, and serves individuals who are living in the community, who are currently navigating the legal system, or those who are currently incarcerated as an adult or youth. ACBH believes that having a single consolidated system of care will prompt better care coordination, help to interrupt the cycle of repeated forensic involvement, and help to focus our supports on prevention and early intervention.

To better understand our efforts, please review the original ACBH/ HCSA Plan entitled, “A Systems Approach & Plan to Reduce Forensic involvement with Behavioral Health Clients” and the most recent departmental update: Alameda County Behavioral Health Services & Forensic System Redesign Plan Update.

For more information about our newest system of care, please visit our “Forensic Services” page.