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Monthly Archives: October 2015
Nancy Swanson, director of the County’s Transitional Assistance Department, was named Administrator of the Year during the California Food Policy Advocates 2015 CalFresh Forum in Sacramento.
San Bernardino County was also recognized with the Best in Class PAI – Large County for residents’ access and use of CalFresh.
The California Food Policy Advocates Freshy Awards honor the actions of individual Californians and organizations from across the state that have worked diligently in the last year to improve CalFresh.
The California Food Policy Advocates is a non-profit organization exclusively focused on food policy and works toward increasing low-income Californians access to healthy food.
Today, the Board of Supervisors honored nine award-winning County departments focused on providing innovative programs related to health and human services from homeless outreach support to child abuse prevention.
Each of the following departments were recognized during the Board meeting for awards received this year from the National Association of Counties (NACo) and the California State Association of Counties (CSAC):
• Aging and Adult Services
• Behavioral Health
• Children and Family Services
• Housing Authority
• Inland Counties Emergency Medical Agency
• Performance, Education and Resource Centers
• Preschool Services
• Public Health
• Transitional Assistance
“Our County departments have already been recognized on a statewide and national scale, but the Board wanted to honor them again for their hard work and commitment to the residents of San Bernardino County,” said Board Chairman James Ramos. “We are very proud of the work they do every day to improve lives and help achieve the Countywide Vision.”
The CSAC Challenge Awards are part of a competitive recognition program that honors the best and most innovative among California’s 58 counties. In September, CSAC received more than 250 entries and judges awarded 40 programs throughout the state. NACo recognizes groundbreaking county government programs throughout the nation in the areas of children and youth, criminal justice, county administration, planning, information technology and health. In June, NACo recognized 46 San Bernardino County programs – the most won by any of the nation’s 3,068 counties.
During the next several months, more departments will be honored by the Board of Supervisors for their NACo and CSAC wins.
The following are descriptions of each department’s awards:
Aging and Adult Services – Five NACo Achievement Awards
A Collaborative Effort
The In-Home Supportive Services program provides services regarding activities of daily living to elderly and disabled individuals in their own homes to avoid institutionalization. The Department of Aging and Adult Services administers IHSS by determining eligibility and establishing services for beneficiaries. In January 2014, Aging and Adult Services reassigned those services to the In-Home Supportive Services Public Authority. The services include enrollment, payroll, criminal background checks, employment verification and workman’s compensation activities. This collaboration has improved efficiency in processing IHSS applications, enhanced customer service and generated labor cost-savings.
IHSS Intake Process Improvement Plan
Aging and Adult Services implemented this initiative which resulted in a 77 percent improvement in the In-Home Supportive Services (IHSS) application processing rate. New applications for IHSS must be processed within 30 days, and IHSS applicants have 45 days to submit a Health Care Certification which is used to confirm the need for IHSS services. Due to the high volume of IHSS applications in the county and staff turnover, there was a monthly average of 1,250 pending applications prior to implementing the program. After implementation, IHSS applications are being processed at a faster rate resulting in timely delivery of IHSS benefits to more beneficiaries and a significant reduction in the monthly average of pending applications from 1,250 to 310.
“It’s Not your Fault” Campaign
Elders and dependent adults are reluctant to report abuse and neglect due to a false sense of guilt and fear. Aging and Adult Services started the It’s Not Your Fault campaign as an outreach to seniors and dependent adults to report any incidents of abuse and neglect that occur. The campaign includes posters, flyers, handouts for social workers, Facebook and bus advertisements. Through It’s Not Your Fault, social workers encourage their clients to follow through on making reports of abuse that are occurring either in their lives, or in the lives of others. The number referrals received throughout the county has grown slightly over 100 percent since the campaign was introduced.
Case Management System
This web-based application is designed to manage and track reports of abuse within the county’s adult community. Each call is logged as an intake record and later routed to the appropriate Aging and Adult Services agency to be further processed. Each step is monitored in the system, from the social worker’s initial face–to-face interview with the victim to identifying perpetrators validating all allegations, working with law enforcement, providing service plans for the victim, and providing case conclusion. The system manages all adult reports of abuse in the community and ensures victims receive the help and assistance they need.
The Department of Aging and Adult Services Mentoring Program was created to provide a networking opportunity for professional development. The program includes the pairing of participating mentor and mentee employees who work to create a career development plan that focuses on the mentee’s interests and goals. The department has benefitted from having more knowledgeable, well-rounded employees, which results in greater productivity, higher retention rates, and improved customer service. Participants have reported positive impacts such as going back to school, receiving a promotion, or taking on new duties in their current position.
Behavioral Health -Six NACo Achievement Awards
The Department of Behavioral Health has a community-driven Cultural Competency Advisory Committee with 12 Culture-specific Subcommittees. These advisory groups engage in policy advocacy, develop trainings and conduct outreach activities by recruiting members of the community and engaging them in program planning. Members attend scheduled forums to address the needs of their community and develop strategies to address those needs. This community outreach and engagement approach assists the department in designing programs and services that are community-driven and culturally informed.
Homeless Outreach Support Team (HOST)
The Department of Behavioral Health’s HOST team collaborates with the Sheriff’s Homeless Outreach Proactive Enforcement team to conduct outreach and engage the most difficult and hard to reach clients. Staff works with qualified individuals to complete the necessary applications and assessments in the field and, upon receipt of housing voucher, will assist the individual to locate and move into housing. HOST continues to offer recovery-based wraparound case management services to the individual to assist them to recover, gain wellness, and reintegrate into the community with the ultimate goal of independence and self-sufficiency.
Mountain Breeze Villas Housing Project
This project is an affordable adult (18-59 years of age) housing development in the city of Highland. It has 168 one- and two-bedroom units, 20 of which are reserved for individuals that meet the Mental Health Services Act housing criteria. The Phoenix Community Counseling FSP program provides support services and assists individuals in achieving wellness by maintaining self-sufficiency, increasing employment, reducing hospitalizations and incarceration, and successfully re-integrating into the community.
Remote Group Supervision for Rural Intern Placements
This pilot program was created to address placement challenges in rural community behavioral health settings. The purpose is to alleviate long distance travel for an intern to attend weekly group supervision and allow the intern to complete their education to be a clinical therapist in a location that traditionally has recruitment challenges. An employee intern was placed at a rural mental health clinic – Needles Behavioral Health Center, a four- hour drive to the group supervision location in San Bernardino.
Access Coordination and Enhancement
The Department of Behavioral Health’s ACE program seeks to have 100 percent of clients discharged from an inpatient psychiatric facility to have an appointment within seven days of discharge and a medication evaluation within 14 days of discharge.
Child and Adolescent Needs and Strengths
The Department of Behavioral Health has systematically implemented the Child and Adolescent Needs and Strengths (CANS) tool across children and youth mental health programs. The CANS is an international clinical tool that facilitates individual clinical services and assists in evaluating the aggregate impact of those services to aid in the assessment and treatment of children and youth. Clinical, administrative, and support staff working for 27 children’s mental health providers at 83 service units have entered approximately 21,600 assessments for 9,333 children and youth between January 2014 and February 2015.
Children and Family Services -Three NACo Achievement Awards
“Be A Hero” Campaign
The departments of Children and Family Services and Performance Education & Resource Centers photographed children alongside their heroes in hopes of inspiring others to become the ultimate heroes: adoptive parents. As a result, these community members were able to assist in finding adoptive homes for the children by creating awareness. Through the Be A Hero campaign, firefighters, police officers, medical professionals and members of the San Bernardino Symphony helped to find loving homes for foster children.
Child Abuse Prevention and Treatment Services – In-House Service Coordination
Children and Family Services consolidated previously private entity services using the In-House Service Coordination initiative. CFS hired five in-house service coordinators to connect children and families to services and entered into contracts with providers of therapeutic services and professional trainers in parenting, anger management, sexual abuse and domestic violence. The initiative has resulted in over 100 percent increase in the number of CFS clients receiving services promptly – from 25 percent in January 2014 to 56 percent in November 2014.
Family Visitation and Support Centers
As part of child welfare services, children are removed from their families under certain circumstances, and placed in foster care for safety reasons. When future reunification of such children with their families is part of their case plans, it is important to maintain ties between the children in foster care and their families. To maintain parent-child ties in preparation for reunification, Children and Family Services initiated and implemented the Family Visitation and Support Centers program in June 2013. The program provides children and families with enriching and lively visitation experiences in nine locations spread throughout the county.
Housing Authority -Two NACo Achievement Awards
Pilot Work Requirement
Through this unique new Housing Authority program, all non-disabled current and future adult household members between the ages of 18 and 61 must participate for a minimum of 15 hours a week in “work” activities. The Housing Authority’s Pilot “Work” Requirement is designed to provide families with both incentives and supportive services to help them achieve stable and meaningful employment. Since its implementation, the average earned income for families has increased by nearly 13 percent as a result of decreases in unemployment among heads of households.
Five-Year Lease Assistance
The Housing Authority implemented this program designed to help families achieve economic independence while they receive five years of housing assistance through the Housing Choice Voucher program. Nationally, a program of this type is expected to have a 25 percent success rate. In the county’s program, the percentage of families likely to become self-sufficient increased from 12.8 percent to 30.3 percent within the past year. This increase can be attributed to several positive changes over the last year for program participants: earned income increased by 12.3 percent, welfare income decreased by 13.6 percent, and 26 percent of unemployed families became employed.
Inland Counties Emergency Medical Agency (ICEMA)- Three NACo Achievement Awards, One CSAC Merit Award
(NACo Achievement Awards)
Medical and Health Operational Area Coordinator
The program includes a manual that provides detailed guidance to the Inland Counties Emergency Medical Agency, Department of Public Health, and Department of Behavioral Health staff responding to medical and public health emergencies. The manual follows the principles of the Incident Command System, the National Incident Management System, and California’s Standardized Emergency Management System. The MHOAC Program is based on guidance described in the California Public Health and Medical Emergency Operations Manual adopted in July 2011 by the California Department of Public Health and the California Emergency Medical Services Authority.
EMS Credentialing Portal
ICEMA implemented a paperless online EMS Credentialing Portal to complete credential applications from any location at any time. Emergency medical services personnel are credentialed by ICEMA to practice in San Bernardino, Inyo and Mono counties. The credentialing process required personnel to visit ICEMA’s office during normal business hours to submit a paper application and payment, which took about an hour. The online process improved efficiency by allowing staff to review and issue new credentials in less than 15 minutes. The process ultimately reduced costs and enhanced overall customer satisfaction.
Continuation of Specialty Care (CSAC Merit Award, NACo Achievement Award)
ICEMA designed a program for EMS providers to recognize the specialized needs of patients – particularly those with trauma, stroke and heart issues – and deliver them to a hospital that is best able to treat their needs. Through the end of 2014, approximately 25 percent of 8,000 patients included in the ICEMA registries with these specialized needs were transferred to specialty care and half of those transfers were made in under an hour. Now patients that may have otherwise had to wait longer for transfer to an appropriate medical facility will not have to endure a delay in treatment.
Performance, Education and Resource Centers – One NACo Achievement Award
“Be A Hero” Campaign (see above at Children and Family Services)
Preschool Services – One NACo Achievement Award
Community Partnership Project
The Preschool Services Department serves more than 5,500 children ages 0-5 and their families, the majority who live at or below the federal poverty income level. PSD has developed a comprehensive health services and long-term individualized parent health education program utilizing agreements with several universities, community colleges, non-profit organizations, and other county partners. These partners, including bachelor and graduate level students, provide thousands of hours of health services including parent education, health, nutrition, mental health, and disabilities assessment and care.
Public Health – Four NACo Achievement Awards
Friday Night Live
This Public Health Department program is a youth development and substance abuse prevention program designed to engage youth actively in decision making, planning, and implementation so that participants build on their strengths, develop skills, and engage as leaders in creating healthier schools and communities. Each year, Friday Night Live high school youth chapters sponsor prevention activities before prom to encourage their peers to make the right choices, especially when there will likely be peer pressure to drink alcohol.
100% Food Handler Card Compliance
The California Retail Food Code and San Bernardino County code requires all food handlers to have valid food safety certifications. The Division of Environmental Health Services created the
100% Food Handler Card Compliance Program to ensure compliance. Food facilities now must provide proof of compliance with the County ordinance. Facilities which fail will face billable re-inspections and permit suspension/revocation hearings – which ultimately guarantee compliance. Facilities which are fully compliant with the food handler card ordinance have lower violation rates, including lower rates of critical CDC risk factor violations, as compared to facilities that are not compliant.
Customer Service Portal
The Division of Environmental Health Services implemented a web-based portal which features a service that allows customers to subscribe to information about any facility within the county. Once subscribed, the individual will automatically receive a link to newly generated inspection reports; complaints regarding environmental health concerns can be submitted through the web portal, where the customer will receive automated status updates on the complaint; and facility operators can effortlessly submit electronic payments for health permits through the web portal. The Customer Service Portal provides accessible services and information that meets customers’ needs, further protecting public health, promoting safety and preventing environmental hazards.
Electronic Pesticide Use Reporting Program
For a mosquito and vector control program, pesticide use and tracking is a necessity, as well as a mandate by the state. The volume of pesticide used to conduct daily operations adds up quickly, and keeping accurate records that are easily manageable can become overwhelming. For this reason, the County’s Mosquito and Vector Control Program looked toward technology to develop an innovative and unique way of logging all of its pesticide use in an electronic database. This advancement has also enabled the quick and easy reporting of pesticide use to outside agencies (such as the Department of Agriculture), and saved hundreds of staff hours.
Transitional Assistance – Five NACo Achievement Awards
CalWORKs Youth Employment
The Transitional Assistance Department and Workforce Development Department partnered to provide subsidized employment to Transitional Assistance for Needy Families youth, ages 16 to 24. The goal is to provide 1,500 youth with work readiness training and up to 485 hours, or six months, of successful work experience to assist them with learning workplace skills. Outcomes for the program are very positive: Since January 2015, of the 848 youth served, 128 have successfully transitioned to unsubsidized employment, of which 22 have transitioned off aid due to earnings from employment, and an additional 43 are enrolled in further workforce training.
Preventing Fraud through Analytics
The Transitional Assistance Department developed an analytics predictive model to prevent fraud and improve efficiency of the investigation process. Statistical analyses were performed on a set of cases which had confirmed findings of fraud in the past. The data from these cases was obtained from the county’s database and the California Statewide Electronic Benefit Transfer (EBT) System. An analytics predictive model was developed from these analyses and applied to current Supplemental Nutritional Assistance Program cases. Investigations were performed on 500 random cases to determine the percentage of discrepancies found. The identification of discrepancies significantly increased from 6.1 percent to 20.8 percent. The use of analytics has resulted in increased fraud prevention activities, earlier identification of fraud, and a proactive approach to identifying potential cases to investigate.
Customer Video Interviewing
The Transitional Assistance Department and the Department of Child Support Services developed a Customer Video Interviewing approach to obtaining mandatory child support enforcement information required for eligibility to the Temporary Assistance to Needy Families program. The county is 20,000 square miles, much of which is remote desert land that poses a significant problem for customers lacking private or public transportation, and County staff needing to travel to remote offices to obtain required information through an interview. Customer Video Interviewing is customer friendly, flexible, efficient and reduces environmental impact by eliminating unnecessary travel.
The Transitional Assistance Department developed Trigger Alerts to provide notification to supervisors, managers, deputies and the director specific case actions deemed high priority for the Temporary Assistance for Needy Families, Supplemental Nutrition Assistance Program, Child Care, Medicaid, and Welfare-to-Work programs. Trigger Alerts give management the ability to access information at the county, region, office, unit, worker, and case level. Trigger Alerts have proven to be a very effective tool for managing workflow in a task-based environment and preventing delinquencies, as well as preventing case processing errors.
The Transitional Assistance Department created Work@Home as a solution to improve customer service, process the influx of health care program applications generated by the implementation of the Affordable Care Act, and meet service level agreements mandated by the state. In addition, this program allows the County to efficiently increase its workforce, without the need to build additional offices or restructure existing locations. Work@Home enables eligibility workers to work from a designated space within their home. Performance results show that more than 40 percent of total calls were answered by Work@Home employees, proving that a small group of dedicated staff can make a significant impact to overall workload and productivity.