The county teams form a cohort as they go through the three progressions over approximately nine months. Multiple counties work on a similar issue and develop a related project throughout the cohort. County teams are made from a variety of positions within their organizations, as well as other public agencies and community partners. Every three months, the county teams gather for in-person learning sessions with virtual sessions in between to provide additional tools and continue the development of their work plans. Despite the enormous burdens placed on county behavioral health agencies to implement a series of significant reforms, the participants are finding value in the program’s efforts to help them build the capacity to implement projects with the potential for transformational change.
Stages of Cohort Progression
Cohort Two
May 2024 to Feb. 2025
Placer joins the Partnership once again in Cohort Two along with Yolo County. Both counties focused their projects on justice-involved individuals who are better served by working with other agencies outside of health and human services (HHS). The Yolo's team includes the sheriff's and probation departments and the public defender and is working to better serve those individuals with serious needs who are not already served through various diversion programs. Placer County is working to better assess and meet the needs of individuals who are quickly released from their county jails. The TCP team has adapted the "change building blocks" of skills and abilities to align with the counties' projects.
Progression 1
The progression one collective learning session was held on the McGeorge campus in Sacramento, California where Placer and Yolo convened for the first time in-person in . Both counties participated in virtual session prior to the in-person session and continued to build out their goal and hypothesis statements further. The CIBHS team encouraged the county participants to engage community members as they think about their preliminary goal and hypothesis.
Oct. 2023 to May 2024
The Transformational Change Partnership launched its pilot cohort in September 2023. The pilot cohort included two adjacent counties—Nevada and Placer—each bringing 10 team members who reflect the intended team design: leadership as well as client-facing staff and additional partner organizations related to the project of focus.
Both counties selected payment reform as the focus of their projects with the intent to implement the new billing system in ways that provide more efficient and higher quality services. By early spring, the pilot cohort had completed Progression 1 and 2 and had established their goal statement, working hypothesis and work plan for their selected improvement projects.
The pilot gave Partnership members insights about the structure of the program, effective ways to engage counties and new opportunities to bring client and community involvement into county projects. As intended, the pilot cohort provided valuable learning and accelerated the development of the program.
Progression One: Progression One’s in-person session was held in Sacramento at the University of the Pacific McGeorge School of Law. Nevada and Placer refined their project plans to be more responsive to community needs with the intent of improving outcomes and reducing disparities. The counties participated in a fish bone activity that helped them identify the root cause of system failures. This activity helps counties develop a goal and working hypothesis to measure the success and come to a consensus on their focus for the entirety of the cohort.
Progression Two: Progression Two was held in Nevada County. The Partnership team acquired an impressive group of co-facilitators to provide strategies and methods to both counties. Activities were focused on engaging the cohort in meaningful approaches to implement their project plans while providing direct examples. Both counties left with paths to engaging community stakeholders and improving efficiencies and a strong understanding of PDSA.
Progression Three: Progression Three was held in Placer county in their newly built HHS building in Auburn, California. Learning sessions and breakout activities were facilitated by the internal TCP partners. The third progression focused on how to use change tools in their improvement projects while also developing measurable goals using data and metrics. This in-person collective learning session also helped teams evaluate available resources and how they can be combined to maximize the investment in necessary services and supports for clients.
Cohort Close: We gathered Placer and Nevada county teams one last time to close out the inaugural cohort. It was held in Auburn, California. The main focus of this session was to gather feedback for future cohorts, reflect on the previous nine months, and most importantly how the counties will continue their work outside of the TCP. Both counties provided valuable insight on how to improve facilitation and session buildout.
