The Systems Change Framework was developed to address the challenge of assessing and documenting systems change accomplishments of grantee organizations that vary considerably in terms of their intervention models, community contexts, partnership relationships, and knowledge of how to make systems change happen.
Our work spans evaluation, applied research, strategic planning, and other consulting services. The following projects offer a sampling of our work with clients to strengthen the effectiveness of health and behavioral health providers to improve care delivery, demonstrate the effectiveness of programs and services, and document promising models and practices that lead to sustainable systems change.
We have grouped our projects within two broad categories. Please select a category below.
The attached slides provide an overview of the results of an Integrated Behavioral Health Capacity Assessment conducted for the Community Clinic Association of San Bernardino County Integrated Safety Net Partnership. The goals of this project were for San Bernardino County safety net partners to work together to create a streamlined, accessible continuum of care that puts the patient and their goals at the center of care across all systems, and advances a whole health orientation across the community.
The Outcomes identified if the Vision of this project is achieved include :
For the California HealthCare Foundation, DVC is providing expert guidance on the foundation’s strategic planning process to incorporate behavioral health into their investment portfolio. In this effort, DVC is synthesized research and findings from 40 key informant interviews to develop a summary of key funding opportunities that will align the with the foundation strengths, priorities and goals to achieve the Triple Aim.
For the Health Improvement Partnership of Santa Cruz, DVC is providing technical assistance, consulting and evaluation services to a Learning Community of four health centers currently implementing behavioral health and primary care services. DVC is responsible for facilitating a cross-sector meeting where various stakeholders including health plans, provider organizations, academic institutions and county agencies discuss their collective activities related to integrated care and develop a strategic vision for the safety net system of care in Santa Cruz County.
For the UniHealth Foundation, DVC documented the current and emerging care transition resources for medically vulnerable insured homeless patients following an acute-care stay at Los Angeles hospitals. We developed a pragmatic tool that will enable providers across the system to understand the service delivery and financing landscape, and build capacity to complement and support a post-acute system of care, without duplicating activities that are the responsibility of other entities.
For the Commonwealth Fund, in collaboration with DMA Health Strategies, DVC examined “Enabling Services for Vulnerable Populations” through a comprehensive literature review, stakeholder interview and an advisory group process, to: 1) develop a conceptual framework for the role of enabling services in a health care system; and 2) make recommendations for expanding and financing enabling services so that vulnerable individuals are able to access the spectrum of supports needed to maintain health and wellness.
In collaboration with the California Institute for Mental Health, DVC completed the Integrated Behavioral Health Measurement Project, which assessed the current status of process, quality and clinical outcome measurement and data systems that concern and support integrated behavioral health care delivery.
For the University of California-Davis Broadband Technologies Opportunity Project, Karen and Jennifer collaborated on the development of a 4-module, online training curriculum on Community Change Management to support the transition to technology-enabled healthcare. The Change Management training curricula provided supportive resources on planning for, implementing and evaluating sustainable systems change to help Model e-Health Communities transform how they deliver health care.
We are currently assisting the Sunflower Foundation in Kansas with the development of a policy and evaluation strategy for their newly launched Integrated Care Initiative. We will be advising foundation leadership on how to position the Sunflower Foundation and leverage the work of it’s grantees in the larger context of the Health Care Reform work underway in Kansas.
Under the California Mental Health Services Authority (CalMHSA), Stigma and Discrimination Reduction grant, we conducted a statewide needs assessment of the status of integrated behavioral health training in California.
In collaboration with Human Services Research Institute (HSRI), Desert Vista Consulting recently evaluated the Minnesota PIN program, a managed care organization (MCO)/county partnership involving Medica Health Plan, Dakota County, and Medica Behavioral Health. A key component of the PIN program model involves a Patient Navigator model that provides case management and coordination of physical and mental health care and social services for individuals with serious mental illness.
For the Community Clinics Initiative and the Tides Center, Desert Vista Consulting conducted an evaluation of the Health Home Innovation Fund, an initiative focused on implementation of Health Homes for safety net populations across 8 regional partnerships in California. Through this evaluation, we are documenting the transformation process across broad systems of care that include health plans, hospitals, community health centers and community-based organizations.
For The California Endowment and the California Healthcare Foundation, Karen and Jennifer conducted a state-wide evaluation of the California Frequent Users of Health Services Initiative, which was designed to create a cost-effective, comprehensive, and coordinated health care delivery system to improve care and reduce inappropriate use of high cost emergency and inpatient services.
For The California Endowment, Jennifer and Karen developed case studies of 5 counties participating in the Healthy Returns Initiative, a program designed to strengthen the capacity of county juvenile justice systems to enhance access to health and mental health services and ensure the continuity of care for youth during their transition back to the community. The case studies aim to document and assess the implementation process in each county, including systems change and sustainability issues.
For The California Endowment and The Tides Foundation, we conducted an evaluation of the Integrated Behavioral Health Project, which aimed to increase and enhance the integration of behavioral health services in CA’s community clinics to improve access to behavioral health services and improve treatment outcomes for underserved populations. This four-year Project involved evaluating three core strategies:
For the Minnesota Department of Human Services, Karen and Jennifer served as principal investigators for the evaluation of the Demonstration to Maintain Independence and Employment (DMIE), funded by the Centers for Medicare and Medicaid Services, that targets people with serious mental illness. Using a randomized experimental design, we examined the effectiveness of providing integrated health, behavioral health, and employment support services, using a personal navigation model, to working individuals at risk of migrating to Social Security Disability.