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⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 10 findings
F1
The County Executive Office and County Behavioral Health did not complete the requested financial plan (Operations Plan #550) by December 31, 2025, depriving the Board of Supervisors and the public of critical information needed to make informed decisions about program sustainability, resource allocation, and performance expectations.
F2
The County Executive Office and County Behavioral Health do not have an aligned understanding of baseline requirements for Federal funding, resulting in allocations from the General Fund that might be more than needed.
F3
County Behavioral Health has not implemented a Level of Care (LOC) tool, resulting in missed opportunities to efficiently manage high-cost beneficiaries.
F4
County Behavioral Health has not applied actuarial tools concerning the utilization and severity of the Medi-Cal population receiving behavioral health services, resulting in an inability to plan for its key cost drivers.
F5
County Behavioral Health has not applied financial measurements to Quality Improvement Initiatives, resulting in an inability to make informed decisions about where to invest resources, which interventions produce the greatest measurable impact, and which services may require redesign.
F6
Santa Cruz County has not implemented the CalAIM Justice Involved Reentry System, potentially resulting in the loss of Care Management services through Medi-Cal and costly gaps in care as people transition from the justice system.
F7
County Behavioral Health has several projects that are not essential to core services, resulting in expenditure of resources that might be better directed to addressing more urgent core priorities.
F8
A review on the outcomes of the Sheriff’s Office Focused Intervention Team has not been completed, resulting in a lack of knowledge on whether the program has achieved the goals concerning recidivism or a reduction in emergency resources.
F9
The current jail facilities are not physically designed to address the incarcerated population experiencing severe behavioral health and/or substance used disorder illness, resulting in ineffective treatment and recidivism.
F10
Incarcerated individuals who may have been patients seen through County Behavioral Health experience gaps in treatment plans, resulting in resource duplication.
Recommendations 10
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R1The Grand Jury recommends that the Board of Supervisors direct the County Executive Office and County Behavioral Health to complete the financial plan report no later than September 30, 2026. Required Respondent: Santa Cruz County Board of Supervisors
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R2The Grand Jury recommends that the Board of Supervisors direct the County Executive Office and County Behavioral Health to complete a report to the Board of Supervisors on the minimum County funding requirements for meeting federal and state matching fund requirements for behavioral health services by December 31, 2026. Required Respondent: Santa Cruz County Board of Supervisors
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R3The Grand Jury recommends that the Board of Supervisors directs County Behavioral Health, in conjunction with its system conversion to SmartCare, to implement the LOC tool after the go-live of the SmartCare system, as recommended in the 2023-2024 External Quality Review for the California Department of Healthcare Services. Required Respondent: Santa Cruz County Board of Supervisors
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R4The Grand Jury recommends that the Board of Supervisors direct County Behavioral Health publish a report that summarizes the utilization and costs of the assigned Medi-Cal population for the fiscal year ending June 2026 by December 31, 2027. The report can be used as a tool to identify targeted improvements for the 2027-2028 fiscal period. Required Respondent: Santa Cruz County Board of Supervisors
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R5The Grand Jury recommends that the Board of Supervisors direct County Behavioral Health to apply targeted financial measurements that demonstrate potential reductions in costs and/or increases in revenues for each of its Quality Initiatives beginning with the reporting period ending on December 31,2026. Required Respondent: Santa Cruz County Board of Supervisors
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R6The Grand Jury recommends that the Board of Supervisors direct County Behavioral Health, in collaboration with the Santa Cruz County Sheriff to prepare a report no later than December 31, 2026 to the County Board of Supervisors summarizing the steps taken to support the implementation of the CalAIM Justice Involved Reentry Program (which has a state mandated implementation date of September 30, 2026). The report shall provide a summary of key metrics that will be measured and regularly reported on to demonstrate program effectiveness or areas of opportunity. Required Respondent: Santa Cruz County Board of Supervisors
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R7The Grand Jury recommends that the Board of Supervisors direct County Behavioral Health to prepare a report to the County Executive Officer that identifies non-core projects, the associated costs, and the earliest timeframe for elimination of the non-core service by December 31, 2026. Required Respondent: Santa Cruz County Board of Supervisors
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R8The Grand Jury recommends that the Sheriff produce a report to the County Board of Supervisors summarizing the progress of the Focused intervention Team in achieving its stated goals concerning recidivism and impact on emergency services by December 31, 2026. The report shall also include a discussion of future resource deployment of the FIT considering the CALAim Justice Involved Reentry program. Required Respondent: Sheriff, Santa Cruz County
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R9The Grand Jury recommends that the Sheriff, in collaboration with County Behavioral Health produce a report concerning the current condition of the jails where the physical space may be deficient in the treatment of incarcerated individuals experiencing severe behavioral health issues by March 31, 2027. The report should include: a. A list of the current physical space deficiencies b. An estimate on the number of inmates who might be served on a typical day. c. A discussion on how County Behavioral Health might collaborate on the use of a facility. d. An estimate of the potential benefits of the facility (such as reduced recidivism or reduction in high-cost cases for County Behavioral Health). e. A discussion on potential sites that are currently operated by local government agencies that might be repurposed. f. A discussion on potential alternative sources of capital funding (if needed) such as Medi-Cal Managed Care initiatives or Housing for Health initiatives. Required Respondent: Sheriff, Santa Cruz County
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R10The Grand Jury recommends that the Board of Supervisors direct County Behavioral Health, in collaboration with the Sheriff, to author a report to the County Board of Supervisors concerning the identification of the barriers preventing the ongoing mutual sharing of clinical data between the jail and County Behavioral Health and possible solutions, by March 31, 2027 Required Respondent: Santa Cruz County Board of Supervisors Commendation County Health Services and Sheriff’s office leadership, staff and associated service providers are dedicated individuals who are devoted to the principles of compassionate care.