Behavioral Health Cultural - Riverside University Health System

Riverside University Health System – Behavioral Health

Cultural Competency Program Plan

Annual Update FY 2022 -2023

A report on FY 2022-2023 and

an outlook for FY 2023-2024

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Land Acknowledgment

The Cahuilla (Íviullatem), Cupeño (Kúupangaxwichem), Luiseño (Payómkowichum), Serrano

(Marra‛yam), Gabrieleño (Tongva), and Chemehuevi (Nuwuvi) Peoples, and their ancestors have been

here since time immemorial. The Cultural Competency Program of Riverside University Health System-

Behavioral Health acknowledges the traditional, ancestral, and contemporary homelands of the first

Native Americans of Southern California whose land it occupies and serves. The Cahuilla, Cupeño,

Luiseño, Serrano, Gabrieleño, and Chemehuevi Peoples have cared for people, land, water bodies,

animals, plant beings, with great integrity, reciprocating care to each other.

The Cultural Competency Program acknowledges the reciprocal relationship of caring for one

another and extends wellness and behavioral health services to: Cahuilla, Cupeño, Luiseño, Serrano,

Gabrieleño, and Chemehuevi Peoples, all Indigenous Peoples, and all undeserved residents of

Riverside County. The Cultural Competency Program wants to create relationships built on trust and

accountability with its community members.

With this land acknowledgment, the Cultural Competency Program will be respectful and mindful to

tribal sovereignty, culture, and beliefs of the Native Americans of this land.

“Palm Canyon”, Agua Caliente Reservation, Riverside County

Photo courtesy of Dr. Sean Milanovich, Cahuilla

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Purpose

The Cultural Competency Program (CCP) works to continuously develop and improve the cultural and

linguistic service delivery within Riverside University Health System - Behavioral Health (RUHS-BH)

department. Its goal is to make certain the department is providing equitable behavioral healthcare for

all individuals within the diverse community of Riverside County. CCP strives to meet this goal by working

with the department’s entire system of care. While healthcare inequities exist, CCP works to identify and

remove barriers to access and links our underserved, underrepresented, and inappropriately served

populations to services to meet their needs. The work is guided by the national Culturally and

Linguistically Appropriate Services (CLAS) Standards.

Equity Statement

The RUHS-BH Cultural Competency Program is committed to equity, diversity, inclusion, justice,

accessibility, and belonging. The program aims to serve all community members throughout their

journey towards wellness and recovery. An additional goal is to increase access to services for

populations who were historically inappropriately served by healthcare systems. The CCP understands

the value in employing staff who possess life experiences and expertise to make certain the workforce is

culturally responsive and uses diversity to promote innovation and quality outcomes for the community.

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Accomplishments

The Cultural Competency Program (CCP) worked diligently in the fiscal year 2022-2023 to strengthen the

presence of Cultural Community Liaisons (CCLs) in the community. The program engaged community

members in various subcommittees to establish robust community representation and advocate for

underserved communities in Riverside County. Despite the challenges posed by the Program Manager's

position vacancy for several months, the CCP made significant progress in its mission of promoting

cultural awareness and inclusivity in the county.

Here are some highlights of the accomplishments:

• Hired a manager for the program in the first quarter of 2023.

o While the position was vacant for nine months of the fiscal year, a candidate was successfully

identified and hired to fill the role.

• The CCP facilitated initiatives to improve the quality of work within and outside the

department.

o The CCP continues to work with the Quality Improvement team to extend the dedication to

equity outside of department walls by ensuring that department contract organizations have

cultural competency plans and providing technical assistance to those organizations who need

to create or improve their existing plans to meet the required CLAS standards.

o Participated in the Quality Assurance/Quality Improvement (QI) Committee, helping to

identify ways to increase culturally sensitive services to our consumers.

• Actively participated in PEI Steering Committee.

o The CCLs are all members of the PEI Steering Committee and participate in the stakeholder

process.

• Solidified the presence of cultural subcommittees to the Cultural Competency Reducing Disparities

(CCRD) committee for the identified underserved populations in Riverside County (Black/African

American, LGBTQIA+, Native American, etc.)

o The CCLs have well-established cultural advisory committees that meet monthly or bi-monthly

with mental health advocates, social influencers, community-based organizations, and

department employees. The cultural advisory subcommittees are:

 African American Family Wellness Advisory Group (AAFWAG)

 Asian Pacific Islander Desi American & Native Hawaiian (APIDANH)

 Community Advocating for Gender & Sexuality Issues (CAGSI)

 Deaf Collaborative Advisory Network (DCAN)

 Hispanic/Latinx (HISLA)

 Middle Eastern North African/Mecca (MENA/MECCA)

 Native American Wellness Advisory Committee (NAWAC)

 Spirituality & Interfaith

 Wellness and Disability Equity Alliance (WADE)

• Actively recruited culturally and ethnically diverse members for all program subcommittees.

o The CCP increased community involvement through the cultural subcommittees and selected

co-chairs from traditionally underserved populations to advocate for them.

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• Reviewed and improved the Translation Committee’s policies and procedures.

o The Translation Committee (English/Spanish) has undergone significant enhancements to

improve accessibility. The program is committed to continually improving its services to

ensure that the community can easily access the resources they need.

 The program has streamlined the system for submitting requests.

 Committee membership increased by 150% through recruitment of new members from

the Department.

 The Translation Committee created an approved glossary to aid translators in accessing

previously agreed terms.

• Meet on a quarterly basis with RUHS-BH Evaluation unit to assist with program evaluation.

o Quarterly meetings with RUHS-BH Evaluation unit started taking place to determine goal

progression and outcomes. These strategies are helping the unit reach the objectives

established on data collection and assessment of service needs. This goal had been unmet

since 2020.

o In collaboration with the Evaluation unit, a data protocol and forms were developed to collect

data and provide an assessment of services.

• Established a Cross-County Collaboration

o A 10-month cross-county collaboration with San Bernardino County’s Department of

Behavioral Health. The collaboration focused on assisting in the capacity-building of Black-

owned community-based organizations to fill gaps in the infrastructure.

The CCP has faced challenges in filling the vacant position of Veteran's Liaison, which has been unfilled

for a year now. The shortage of candidates is not unique to the CCP, as the department struggles to fill

vacancies for Clinical Therapists, making it challenging to provide quality mental health services to

underserved communities in the county.

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Highlights from Cultural Groups

The Cultural Competency Reducing Disparities (CCRD) subcommittees for cultural communities have

been established and convene on a monthly or bi-monthly basis, with the active participation of

community members. Through their collaboration with the CCLs, these subcommittees have secured

sponsorships worth approximately $160,000 to support community service providers in delivering

culturally appropriate mental health workshops and outreach events in the identified communities.

Community-driven event planning continues to be the focus, with CCLs and the subcommittees acting as

advisors and sponsors. The department's role is to educate, provide resources, and increase accessibility

to behavioral health services. This approach removes stigma and creates a space to discuss behavioral

health openly.

The 2022-2023 Cultural Community Liaisons were:

• Dakota Brown – People with Disabilities

• Riba Eshanzada, LCSW – Middle Eastern/North African

• Shirley Guzman – Hispanic/Latinx

• Hazel Lambert – Black/African American

• Dr. Sean Milanovich – Native American

• Dr. Ernelyn Navarro – Asian American/Pacific Islander

• Kevin Phalavisay – Lesbian, Gay, Bisexual, Transgender, Questioning/Queer, Intersex, Asexual +

• Rachel Postovoit, LCSW – Deaf/Hard of Hearing

• Rev. Benita Ramsey – Spirituality/Faith-Based

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African American Family Wellness Advisory Group

(AAFWAG)

Cultural Community Liaison, Hazel Lambert

AAFWAG implemented an annual Community Service Recognition Award

Ceremony. The recognition ceremony serves to support, encourage, and infuse

continuous quality improvement of activities performed by community-based

service providers. The recognition ceremony is in its second year and has seen

an increase in stakeholders’ participation and a pathway to re-establishing trust

among the Black/African American communities.

There were many initiatives to strengthen local and civic engagement with

elected officials that took place, such as the instrumental passage of state

legislation for "Black Health Equity Week."

Increased AAFWAG membership with stakeholders from community colleges,

universities, senior centers, and parent groups.

AAFWAG sponsored events, workshops, and outreach to provide mental health

discussions in the community, such as Black History Month events, Juneteenth

events, Mental Health Awareness “Tea for the Soul” event, “Laughing for the

Health of It” event, and “Celebrating Recovery” with Hemet Black Voices of the

Valley.

Asian Pacific Islander Desi American & Native Hawaiian

(APIDANH)

Cultural Community Liaison, Dr. Ernelyn Navarro

In September 2022, for Suicide Prevention Month, the Asian Pacific Islander Desi

American & Native Hawaiian (APIDANH) subcommittee, along with partnering

agencies and stakeholders, implemented a suicide prevention campaign which

included a World Suicide Day "Light a Candle" photo contest, a webinar on

"Culture-Based Depression Screening and Evaluations in Chinese American

Immigrants,” an online panel discussion about lived experiences, and an in-

person event focused on “Senior Blues” in the Korean community.

Co-hosted the first Neurodiversity Resource Fair and

Workshop for Autism Awareness Month (April 2023), in collaboration with the

WADE Alliance.

Supported community partners to apply for the “Stop the Hate” grant funding

to support efforts in educating Riverside County residents about violence

against Asians and available resources for victims of hate crimes.

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Deaf Collaborative Advisory Network (DCAN)

Cultural Community Liaison, Rachel Postovoit, LCSW

Through continued collaboration between RUHS-BH "Help@Hand" Innovation Program, Cultural

Competency Program, and the Center On Deafness Inland Empire (CODIE), the TakemyHand live peer

chat now has a video chat capability to access live peer support services in ASL. It has hosted 11 chats

since it became available in the second half of 2023 with the objective to provide an inclusive and safe

space to everyone in our community.

Hispanic/Latinx (HISLA)

Cultural Community Liaison, Shirley Guzman

The efforts to support the RUHS Mental Health Clinic in Blythe have continued throughout the year to

improve service quality. The community has seen positive improvements. Consumers report that clinic

staff treat them with dignity and respect, give them appointments promptly, return their phone calls,

and are satisfied with the services.

The subcommittee participated in the 20th anniversary of the "Dia de los

Muertos" (Day of the Death) event in Riverside, where they celebrated the

traditions and culture of the Latinx community. The event was a vibrant and

colorful celebration filled with music and dance performances that honored

and remembered the departed loved ones. It was an enlightening and

enriching experience for those who attended, and the subcommittee was

grateful for the opportunity to participate in this beautiful celebration.

In July, a donation was made to the Backpack

Giveaway & Resource Event at the Magnolia

Community Health Center in the city of

Riverside. The event provided residents with

backpacks, school supplies, groceries, and community resources to help

them prepare for the upcoming school year. Thanks to the event, many

families were able to benefit from the giveaways and ensure that their

children had the tools they needed to succeed in school.

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Community Advocating for Gender & Sexuality Issues

(CAGSI)

Cultural Community Liaison, Kevin Phalavisay

The Community Advocating for Gender & Sexuality Issues (CAGSI) continued

work throughout the community. Additionally, CAGSI continued collaborating

with several community organizations, including Rainbow Youth Coalition,

Borrego Health, The Center, San Bernardino Department of Behavioral Health,

Trevor Project, and many other community groups.

To increase accessibility

and celebrate diversity,

CAGSI provided ASL

interpretation services for the Riverside Pride

event.

CAGSI and Rainbow Youth Alliance came together

to organize the inaugural Black Identity

Development Conference to celebrate the

intersections of Black identity.

Middle Eastern and North African (MENA/MECCA)

Cultural Community Liaison, Riba Eshanzada, LCSW

Inclusive Research with UCR School of Public Policy: By partnering with the UCR School of Public Policy,

efforts were made to make sure that MENA communities were not overlooked or marginalized in

research efforts. This inclusive approach allowed for a more accurate understanding of the challenges,

needs, and strengths of the MENA population, ultimately informing policies and programs that better

serve the community.

Advocacy and Awareness: Through presentations, meetings, and

collaborations with key stakeholders such as PEI providers,

Assemblymember Eloise Gómez Reyes, and the Riverside County

Sheriff's Department, advocacy efforts were made for the specific

needs of the MENA community. These efforts aimed to raise

awareness, build bridges, and ensure that the voices of the community

were heard and respected in decision-making processes.

Allyship and Interfaith Engagement: Through allyship presentations,

interfaith events such as Sahaba Initiative’s Interfaith Brunch and

Ramadan Dinner, and participation in conventions like the Muslim

American Society annual convention, there was promotion of dialogue,

respect, and solidarity among different religious and cultural groups within the community.

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Native American Wellness Advisory Committee

(NAWAC)

Cultural Community Liaison, Dr. Sean Milanovich

Dr. Milanovich stablished the Native American Wellness Advisory Committee (NAWAC) to bring

awareness about mental health and reduce disparities through integration of traditional Native

American and Western methodologies. Through NAWAC, Dr. Milanovich has collaborated with over 38

groups in FY2022-2023. The group has focused on reaching out to tribes, individuals, agencies, and non-

profit organizations to establish relationships and assist in providing access to mental health services

and wellness to the greater community.

There is an understanding that everyone is unique and so is their treatment and care. NAWAC

recommends using Native American cosmology and healing practices. NAWAC and the Cultural

Competency Program have brought on Cahuilla elder, Kim Marcus from the Santa Rosa Indian

Reservation to help open events with traditional prayer, songs, and stories, and share in the

transmission of knowledge. Additionally, Mr. Marcus has provided traditional knowledge, healing

practices, and training to the Native American community and providers of Riverside County to break

down barriers, bring awareness, and destigmatize the American Indian. Based on the recommendations

from NAWAC, the Cultural Competency Program has worked to get another vendor to supply culturally

appropriate SWAG and materials.

Spirituality & Interfaith

Cultural Community Liaison, Rev. Benita Ramsey

The subcommittee collaborated with the Riverside County Suicide

Prevention Coalition to plan their 2nd Annual Conference, which was

attended by more than 300 county residents, including providers,

community leaders, and educators interested in expanding their knowledge

on how to integrate spirituality and religion in suicide prevention efforts.

The subcommittee is developing a training program for mental health

professionals in collaboration with RUHS-BH’s Workforce Education and

Training (WET), focusing on spirituality's significance in person-centered

mental health care. The launch of the program is planned for the start of

2025.

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Wellness and Disability Equity Alliance (WADE)

Cultural Community Liaison, Dakota Brown

WADE created partnerships with Inland Empire Disability Collaborative, Building Bridges for Special

Needs, HARP Positively Aging Project, SoCal Adaptive Sports, Let’s Kick Aids Survivor Syndrome,

Riverside County Office on Aging, California Department of Rehabilitation, and Public Health Equity

Coalition.

WADE sponsored “World Disability Day” at The Living Desert,

Building Bridges/Fenixia adaptive Gala: “The Stars Come Out

Tonight”, and “Autism Acceptance Walk CV” in Palm Desert.

Co-hosted the first Neurodiversity Resource Fair and Workshop for

Autism Awareness Month (April 2023), in collaboration with the

Asian Pacific Islander Desi American & Native Hawaiian (APIDANH)

subcommittee.

In the current fiscal year, WADE is working on adapting products

and services for people with low or no vision. They met with the

Blind Support Services (BSS) leaders and technicians to brainstorm

solutions and learn how to adapt products and services to people

with low or no vision. RUHS-BH is now building a BSS Emotional Wellness Hub which includes a county

kiosk, charging station, brochure stand, and high-contrast materials accessible to screen readers.

Joint Effort

Cultural Competency Team

The Caring Across Cultures: Multicultural Symposium on Mental

Health was a significant event in the field of cultural competency

this fiscal year. The symposium was organized in collaboration

with the National Alliance on Mental Illness (NAMI) and

celebrated the diverse cultures within Riverside County. The

event featured an expert panel, a keynote speaker, resource

tables, music, food, and festivities that highlighted the various

traditions of the cultures present. As a result of the success,

there is a plan to conduct a symposium in the Western and

Desert regions of the County.

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THE ENHANCED NATIONAL CLAS STANDARDS

The Enhanced National Culturally and Linguistically Appropriate Standards are organized as one Principal

Standard and three themes:

Principal Standard:

1. Provide effective, equitable, understandable, and respectful quality care and services that are

responsive to diverse cultural health beliefs and practices, preferred languages, health literacy,

and other communication needs.

Governance, Leadership and Workforce:

2. Advance and sustain organizational governance and leadership that promotes CLAS and health

equity through policy, practices, and allocated resources.

3. Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and

workforce that are responsive to the population in the service area.

4. Educate and train governance, leadership, and workforce in culturally and linguistically

appropriate policies and practices on an ongoing basis.

Communication and Language Assistance:

5. Offer language assistance to individuals who have limited English proficiency and/or other

communication needs, at no cost to them, to facilitate timely access to all health care and

services.

6. Inform all individuals of the availability of language assistance services clearly and in their

preferred language, verbally and in writing.

7. Ensure the competence of individuals providing language assistance, recognizing that the use of

untrained individuals and/or minors as interpreters should be avoided.

8. Provide easy-to-understand print and multimedia materials and signage in the languages

commonly used by the populations in the service area.

Engagement, Continuous Improvement, and Accountability:

9. Establish culturally and linguistically appropriate goals, policies, and management

accountability, and infuse them throughout the organization’s planning and operations.

10. Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-

related measures into measurement and continuous quality improvement activities.

11. Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact

of CLAS on health equity and outcomes and to inform service delivery.

12. Conduct regular assessments of community health assets and needs and use the results to plan

and implement services that respond to the cultural and linguistic diversity of populations in the

service area.

13. Partner with the community to design, implement, and evaluate policies, practices, and services

to ensure cultural and linguistic appropriateness.

14. Create conflict and grievance resolution processes that are culturally and linguistically

appropriate to identify, prevent and resolve conflicts or complaints.

15. Communicate the organization’s progress in implementing and sustaining CLAS to all

stakeholders, constituents, and the public.

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2022 – 2023 Update on 3-Year Plan Goals

Table 1: COMMITMENT TO CULTURAL COMPETENCE IN BEHAVIORAL HEALTH & SUBSTANCE USE PROGRAMS

Objective Ensure that RUHS Behavioral Health and Substance Use service delivery system meets the

cultural and linguistic needs of target populations by developing cultural competency plan

requirements that will be distributed to all department clinics and contractors on an

annual basis.

Strategies for

implementation

•

Post cultural competency plan requirements on website

Complete

•

Conduct presentations on requirements at directors’ meetings

Complete

•

Conduct presentations on requirements with contract agencies

Complete

•

Develop a monitoring system of compliance with plan

Complete

requirements

•

Prepare a list of nontraditional, community-based, and culturally

Complete

and linguistically appropriate behavioral health and substance use

providers. The Cultural Competency Reducing Disparities

committee and each of the cultural subcommittees work to identify

programs in the community

•

Create a resource list of consumer operated programs that are

Complete

culturally, ethnically, and linguistically specific for distribution in the

community. Cultural Competency Program Manager works with

Consumer Affairs, Family Advocate, and Parent Partner programs

to list their programs/activities available for cultural and linguistic

specific populations

CLAS Standards

Met

1: Provides effective, equitable, understandable, and respectful quality care and services

that are responsive to diverse cultural health beliefs and practices, preferred languages,

health literacy, and other communication needs.

9: Establishes culturally and linguistically appropriate goals, policies, and management

accountability and infuses them throughout the organizations planning and operations.

10: Conducts ongoing assessments of the organization's CLAS-related activities and

integrate CLAS-related measures into measurement and continuous quality improvement

activities.

12: Conducts regular assessments of community health assets and needs and uses the

results to plan and implement services that respond to the cultural and linguistic diversity

of populations in the service area.

15: Communicates the organization’s progress in implementing and sustaining CLAS to all

stakeholders, constituents, and the public.

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Table 2: DATA COLLECTION AND ASSESSMENT OF BEHAVIORAL HEALTH & SUBSTANCE USE SERVICE NEEDS

Objective Provide measurable, quantifiable analysis of services by race, ethnicity, language, age,

gender, and other relevant areas of the target population to ensure that consumers and

family members are receiving comprehensive and respectful care in a manner compatible

with their cultural health beliefs, practices, and preferred language on an annual basis.

Strategies for

implementation

•

Penetration rates for unserved, underserved and inappropriately

served populations increase 1.5 to 2% over prior year’s rate

•

Develop a Data Protocol and forms for the Cultural Community

Liaisons Program

- Summarize results and incorporate into program planning

operations

•

Meet on a quarterly basis with RUHS-BH Evaluation unit to review

progress towards outcome goals

•

Identify populations with higher levels of disparities/low

penetration rates

•

Create list of activities targeting hard to reach populations

•

Cultural Competence Program Manager collaborates with Quality

Management in developing a cultural competency contract

monitoring tool

Complete

CLAS Standards

Met

4: Educates and trains workforce in culturally and linguistically appropriate policies

and practices on an ongoing basis.

10: Conducts ongoing assessments of the organization's CLAS-related activities and

integrate CLAS-related measures into measurement and continuous quality

improvement activities.

11: Collects and maintains accurate and reliable demographic data to monitor and

evaluate the impact of CLAS on health equity and outcomes and to inform service

delivery.

12: Conducts regular assessments of community health assets and needs and uses the

results to plan and implement services that respond to the cultural and linguistic

diversity of populations in the service area.

14: Creates conflict and grievance resolution processes that are culturally and

linguistically appropriate to identify, prevent and resolve conflicts or complaints.

15: Communicates the organization’s progress in implementing and sustaining CLAS

to all stakeholders, constituents, and the public.

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Table 3: COMMUNITY ENGAGEMENT

Objective Increase community outreach and engagement activities in RUHS Behavioral Health and

Substance Use system of care by 5%, as recommended by the Cultural Competency

Reducing Disparities Committee’s ethnic and cultural subcommittees and determine how

they will be allocated to the program budget.

Strategies for

implementation

•

The nine Cultural Community Liaisons continue to outreach Ongoing

and engage members of their targeted populations

•

The subcommittees identify and sponsor events and Ongoing

initiatives that increase the representation of different

communities in Riverside County

•

Monthly meetings with Staff Analyst regarding allocation In-progress

of funds/budget

•

Staff Analyst to develop Budget Expenditure Reports as needed Complete

CLAS Standards

Met

1: Provides effective, equitable, understandable, and respectful quality care and services

that are responsive to diverse cultural health beliefs and practices, preferred languages,

health literacy, and other communication needs.

9: Establishes culturally and linguistically appropriate goals, policies, and management

accountability and infuses them throughout the organizations planning and operations.

13: Partners with the community to design, implement and evaluate policies, parties,

and services to ensure cultural and linguistic appropriateness.

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Table 4: INTEGRATION OF STAKEHOLDERS WITHIN BEHAVIORAL HEALTH AND SUBSTANCE USE SYSTEM

Objective Continuously recruit members for the Cultural Competency Reducing Disparities

Committee (CCRD) and the ethnic and cultural subcommittees. Ensure committee

members are representative of the diversity in the community and that they have active

participation in the MHSA stakeholder process.

Strategies for

implementation

•

The nine ethnic and cultural subcommittees are established Ongoing

and continue to increase membership of key stakeholders from

their targeted populations

•

Cultural Competency Program Manager maintains a list of Complete

members of the committees by organization/ agencies, their self-

identified membership affiliation, and language preference

•

Cultural Competency Program Manager participates in Quality Complete

Assurance/Quality Improvement (QI) Committee

•

CCRD committee and subcommittee members review and provide

Complete

feedback on MHSA planning

•

CCRD committee and subcommittee members review

Complete

the implementation and outcomes of MHSA programs

•

Members of the Cultural Competency unit actively participate in

Complete

PEI Collaborative Meetings

CLAS Standards

Met

5: Offers language assistance to individuals who have limited English proficiency, at no

cost to them, to facilitate timely access to all healthcare and services.

6: Informs all individuals of the availability of language assistance services clearly and in

their preferred language, verbally.

9: Establishes culturally and linguistically appropriate goals, policies, and management

accountability and infuses them throughout the organizations planning and operations.

13: Partners with the community to design, implement and evaluate policies, parties,

and services to ensure cultural and linguistic appropriateness.

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Table 5: WORKFORCE DEVELOPMENT

Objective Develop strategies for recruiting and retaining ethnically, culturally, and linguistically

diverse staff at all levels of the department through continuous collaboration with

Human Resources and Workforce Education and Training (WET) to better serve the

underserved populations identified in the MHSA's WET component.

Strategies for

Implementation

• Develop a variety of training for staff with the support of the

Cultural Community Liaisons to educate the department's direct

service staff in ways to improve the delivery of services under a

cultural humility perspective and with practical tools to understand

and assist the needs of the different identified communities.

-

Stronger Together: A Positive Approach to Serving

People with Disabilities, Dakota Brown

-

Integrating Spirituality in Clinical Settings, Rev. Benita

Ramsey

-

Clinical Skills for Spanish Speaking Therapists, in

collaboration with The Lehman Center

• Cultural Competency Program Manager tasked with assessment of

current workforce and participates as member of WET Steering

Committee

• Include a Human Resources department representative at monthly

CCRD meetings for the next fiscal year to identify and implement

effective strategies for recruiting and retaining ethnically, culturally,

and linguistically diverse staff within the department.

Complete

In Progress

Not Met

CLAS Standards

Met

2:

Advances and sustains organizational governance and leadership that promotes

CLAS and health equity through policy, practices, and allocated resources.

3. Recruits, promotes, and supports a culturally and linguistically diverse governance,

leadership, and workforce that are responsive to the population in the service area.

4: Educates and trains workforce in culturally and linguistically appropriate policies

and practices on an ongoing basis.

9: Establishes culturally and linguistically appropriate goals, policies, and

management accountability and infuses them throughout the organizations planning

and operations. 10: Conducts ongoing assessments of the organization's CLAS-related

activities and integrate CLAS-related measures into measurement and continuous

quality improvement activities.

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Table 6: WORKFORCE NEEDS ASSESSMENT

Objective Collaborate with Workforce Education and Training (WET) unit to plan, organize, and

implement an assessment that captures the diversity of the current workforce and

identify cultural competency training needs.

Strategies for

implementation

•

Use CLAS Standards and other tools to design a survey that Complete

will gather feedback from RUHS-BH staff regarding training

needs and providing culturally responsive services

• Conduct focus groups and administer survey to RUHS-BH staff Complete

• Prepare a summary report of the focus groups as well as results Complete

from the survey that will be presented to Directors and

Managers

CLAS Standards

Met

2:

Advances and sustains organizational governance and leadership that promotes CLAS

and health equity through policy, practices, and allocated resources.

4: Educates and trains workforce in culturally and linguistically appropriate policies and

practices on an ongoing basis.

10: Conducts ongoing assessments of the organization’s CLAS-related activities and

integrates CLAS- related measures into measurement and continuous quality

improvement activities.

11: Collects and maintains accurate and reliable demographic data to monitor and

evaluate the impact of CLAS on health equity and outcomes and to inform service

delivery.

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Table 7: WORKFORCE TRAINING

Objective Provide annual cultural competency training for RUHS-BH staff and contract agencies

including management, clinical, and support staff. By the end of 2020, 50% of direct

services staff and supervisors will have completed cultural competency training.

Strategies for

implementation

•

Develop cultural competency foundations training

•

Make workforce training recommendations to Executive

Management and secure approval to create cultural

competence training policy.

•

Provide RUHS-BH staff and contract agencies staff with

culturally specific trainings for at least three (3)

underserved communities.

Complete

CLAS Standards

Met

1: Provides effective, equitable, understandable, and respectful quality care and services

that are responsive to diverse cultural health beliefs and practices, preferred languages,

health literacy, and other communication needs.

2:

Advances and sustains organizational governance and leadership that promotes CLAS

and health equity through policy, practices, and allocated resources.

3. Recruits, promotes, and supports a culturally and linguistically diverse governance,

leadership, and workforce that are responsive to the population in the service area.

4: Educates and trains workforce in culturally and linguistically appropriate policies and

practices on an ongoing basis.

7: Ensures the competence of individuals providing language assistance, recognizing that

the use of untrained individuals and/or minors as interpreters should be avoided.

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Table 8: LANGUAGE CAPACITY

Objective Building the Department capacity to address language needs by reducing language access

barriers and providing consumers and their family members with services and written

materials such as forms, brochures, and fliers, in their threshold language.

Strategies for

implementation

•

Review and update RUHS-BH translation policy and protocol Complete

for incoming translation requests and distribute to all program

managers

•

Recruit and select members to fill Translation

Complete

Committee vacancies

•

Select Chair of Translation Committee to serve 2-year term

Complete

•

Design a survey to evaluate the quality of interpretation In Progress

services (in-person and virtual), with input from

stakeholders

•

Secure ongoing ASL interpretation services for all CCRD Complete

committee and subcommittee meetings and community

events as needed

CLAS Standards

Met

1: Provides effective, equitable, understandable, and respectful quality care and services

that are responsive to diverse cultural health beliefs and practices, preferred languages,

health literacy, and other communication needs.

4: Educates and trains workforce in culturally and linguistically appropriate policies and

practices on an ongoing basis.

5: Offers language assistance to individuals who have limited English proficiency, at no cost

to them, to facilitate timely access to all healthcare and services.

6: Informs all individuals of the availability of language assistance services clearly and in

their preferred language, verbally.

7: Ensures the competence of individuals providing language assistance, recognizing that

the use of untrained individuals and/or minors as interpreters should be avoided.

8: Provides easy-to-understand print and multimedia materials and signage in the

languages commonly used by the populations in the service area.

13: Partners with the community to design, implement, and evaluate policies, practices,

and services to ensure cultural and linguistic appropriateness.

21 | Page

Goals for 2023-2024

In FY 2023-2024, the Cultural Competency program is working to:

• Continue to focus on health equity initiatives. The Cultural Community Liaisons' will work to

examine health equity for their targeted population to determine what is working and what is

needed in Riverside County. They will help to inform an outreach and engagement plan for targeting

the identified populations in conjunction with RUHS-BH.

• Increase community support by tailoring community outreach and resources. Expand the

collaboration with San Bernardino County Behavioral Health to increase capacity of community

organizations to bid on PEI contracts with APIDANH and LGBTQIA+ communities. Train and assist

community grassroots organizations with the process of applying for contracts with government

organizations.

• To increase the availability of culture-specific training programs and provide culturally informed

direct services to at least four underserved communities in Riverside County to reduce the stigma

associated with seeking mental health services within these communities. The issue of reducing

the stigma associated with seeking out mental health services is a critical concern that requires

attention from all stakeholders involved in the mental health care sector. Developing culturally

specific training programs in collaboration with PEI providers and the Workforce Education and

Training unit can significantly address this challenge. These trainings will enable them to provide

more effective and culturally appropriate care that meets the community's diverse needs. Such

training programs can also help to build trust and rapport between mental health providers and

their clients, which is essential for reducing barriers to seeking out mental health services. For

example, we are in the process of developing new training programs to address mental health issues

within the Asian American community. One of these programs is called "K-Drama and Mental

Health," which uses popular Korean drama series to help individuals experiencing mental health

challenges. Additionally, we are working on creating an integration of Interfaith and Spirituality

training for clinical therapists and a Clinical Skills in Spanish program for Hispanic/Latinx direct

service providers.

• To provide equitable access to services for individuals who are deaf or hard of hearing and those

with low or no vision, implementing innovative technologies and design strategies to create an

inclusive environment. The program continues to increase ASL interpretation access in all

department public meetings and for making closed captions, transcripts, and CART services available

for the community when needed. The WADE Alliance is collaborating with Blind Support Services

(BSS) to adapt RUHS-BH's products and services for people with low or no vision. Their first project is

building a BSS Emotional Wellness Hub, which includes high-contrast materials accessible to screen

readers.

RUHS-BH Evaluations 01.09.2023 1

Who We Serve

Consumer Population Profile

Fiscal Year 2022-2023

RUHS-BH Evaluations 01.09.2023 2

WWS-Fiscal Year 2022-2023

Executive Summary

Summary  In fiscal year 2022-2023, Riverside University Health Systems Behavioral Health (RUHS-BH) provided services

to 52,710 consumers through mental health and/or substance use services. In mental health, 44,028 consumers were served

through outpatient mental health, and inpatient psychiatric services. In substance use, 11,449 consumers were served through

detoxification, residential services, outpatient substance use treatment services, and intensive half day treatment programs (e.g.,

Drug Court, MOMs). An additional 8,879 consumers were served by RUHS-BH in detention facilities, with 2,539 of those

consumers also served by RUHS-BH outside of the detention facility. The grand total of RUHS-BH consumers served in FY22/23

was 61,817 including detention consumers. Statistics for RUHS-BH Detention consumers is provided separately beginning in this

report.

County Comparison  When RUHS-BH mental health consumer population was compared to 2023 Riverside County

population data, there were higher proportions of children, transitional age youth, and adult consumers in the RUHS-BH consumer

population compared to the general population. The proportion of older adult consumers was less than the general population of

Riverside County. The RUHS-BH substance use consumer population served a higher proportion of adults than is present in the

Riverside County population, but served a lower proportion of Children, transitional age youth, and Older Adults than are present

in the Riverside County general population.

Region  For both mental health and substance use, the Western region served the most consumers, followed by the Mid-

County region, with the Desert region serving the fewest.

Gender  Overall, within mental health, nearly an equal half of the consumers were male and female (51.2% to 48.8%,

respectively). Within substance use, the majority of consumers served were male at 58% of the population. There were some

variations by age. In mental health, there were more older adult females (57.1%) than males (42.9%) served; however, for

substance use there were more male older adult (64%) than female older adult (36%) consumers served.

Race/Ethnicity  Hispanic/Latinx made up the largest race/ethnic group served, while Caucasians made up the second

largest group served for both mental health and substance use. Combined these two groups represent 70% of all the consumers

served in mental health and 84.1% of all those served in substance use.

History & Diagnosis  Overall, in mental health, 32.9% of consumers had a history of drug/alcohol use and 74.9% of

mental health consumers had Medi-Cal. In substance use, 46.6% were reported to have a mental illness and 86.7% had DMC-

ODS Medi-Cal. In mental health, within each region the largest proportion of consumers served had been primarily diagnosed with

Mood, Anxiety or Adjustment disorder or Major Depression. This trend changed when looking specifically at primary diagnoses by

age groups. Children more often had a diagnosis in the AD/D grouping (which includes Oppositional Defiance, Conduct Disorders,

and Attention Deficit) and Mood, Anxiety, or Adjustment disorders. Adults and Older Adults were more often diagnosed with Major

Depression or Schizophrenia/Psychosis disorder. In substance use, overall 29% of consumers had an opiate diagnosis, while

25.7% of consumers had an Amphetamine diagnosis. Combined, these two diagnoses accounted for 54.7% of the treatment

population. In examining diagnosis by age, children had primarily a Marijuana diagnosis (40%). Almost a third of adults (30.4%)

had an Opiate diagnosis, followed by Amphetamines (29.1%). The majority of older adults (51.1%) had an Opiate diagnosis, with

Alcohol (24%) being the next highest diagnosis.

RUHS-BH Evaluations 01.09.2023 3

WWS-Fiscal Year 2022-2023

Region and Age Group

FY 21-22 % FY 22-23 % Change

From

Previous Yr

FY 21-22 % FY 22-23 % Change

From

Previous Yr

Children

(<18 Years)

13,501 31% 14,166 32% +1% 362 4% 1,014 9% +5%

Adults

(18-59 Years)

25,466 59% 25,419 58% -1% 8,312 89% 9,777 85.4% -3.6%

Older Adults

(60+ Years)

4,422 10% 4,443 10% 0% 647 7% 658 6% -1%

Total

43,389 44,028 1% 9,321 11,449 10.2%

Transition

Age Youth

9,194 21% 9,290 21% 0% 1,088 12% 1,483 13% +1%

Mental Health

Substance Use

In Mental Health, the Western

region served the highest

proportion, followed by the

Mid-County and Desert

regions.

In Substance Use, the

Western and Mid-County

regions provided similar

proportions of services, with

Desert region serving less

than the other two regions.

Regional Groups

Age Groups of Consumers Served

Overall, the total consumers served by mental health increased (1%) from FY21/22 to FY22/23. This increase was observed

across the children’s age group. The proportion served in each age group remained consistent. The largest age group served were

adults (58%). Substance use primarily served adults, with a slight decrease in older adults (0.5%) from FY 21/22. Moreover, ser-

vices for children increased by 5% and overall, the number of consumers served in substance use increased (+10.2%) from

FY21/22 to FY22/23.

*Rounding may provide numbers that are +/- 100% when summed.

Age Groups

RUHS-BH Evaluations 01.09.2023 4

WWS-Fiscal Year 2022-2023

Population Comparisons

FY 22-23

Served

% Riverside

County

Estimate

% % Population

Difference to

Estimate

FY 22-23

Served

% Riverside

County

Estimate

% % Population

Difference to

Estimate

Children

(<18 Years)

14,166 32% 563,269 23.16% +8.84% 1,014 9% 563,269 23.16% -14.16%

Adults

(18-59 Years)

25,419 58% 1,395,402 55.28% +2.72% 9,777 85.4% 1,395,402 55.28% +30.12%

Older Adults

(60+ Years)

4,443 10% 524,237 21.56% -11.56% 658 6% 524,237 21.56% -15.6%

Total

44,028

2,447,642

11,449

2,447,642

Transition

Age Youth

9,290 21% 366,675 15.07% +5.9% 1,483 13% 366,675 15.07% +2.07%

Mental Health Substance Use

The table above compares the mental health and substance use population with the general Riverside County population

estimates for 2023. In mental health, the older adult population served is less proportionate relative to the county general

population of older adults. This is also true in the substance use population where the proportion of older adults served is less

than their representation in the overall county population. In both mental health and substance use the proportion served is

greatest for adults. In mental health, the proportion of children served is more than their proportion represented in the overall

youth population; whereas, for substance use the children population served is much lower relative to their proportion in the

general population.

*Rounding may provide numbers that are +/- 100% when summed.

Population Comparisons

*Source: State of California, Department of Finance, Projections-P3 State and County Projection Database , Complete P-3 File Database-

Ready Format and Data Dictionary. Sacramento, California, December 2020. Retrieved from http://www.dof.ca.gov/Forecasting/Demographics/

Projections/

RUHS-BH Evaluations 01.09.2023 5

Mental Health Substance Use

WWS-Fiscal Year 2022-2023

Gender

West %

Mid-

County

% Desert % Total

Male 9,068 51.2% 7,414 48.4% 5,486 49.8% 22,060

Female 8,629 48.8% 7,893 51.6% 5,538 50.2% 21,968

Total 17,697 15,307 11,024 44,028

Mental Health Substance Use

West %

Mid-

County

% Desert

% Total

Male

2,859 64% 2,123 58% 2,067

63% 7,049

Female

1,614 36% 1,550 42% 1,236

37% 4,400

Total

4,473 3,673 3,303

11,449

Children

(<18)

% Adults

(18-59)

% Older

Adults

(60+)

% Total Transi-

tion Age

(16-25)

Male 6,978 49.2% 13,085 51.5% 1,905 42.9% 22,060 4,257

Female 7,188 50.8% 12,334 48.5% 2,538 57.1% 21,968 5,033

Total 14,166 25,419 4,443 44,028 9,290

Children

(<18)

% Adults

(18-59)

% Older

Adults

(60+)

% Total Transi-

tion Age

(16-25)

Male 571 65% 6,057 61% 421 64% 7,049 905

Female 443 35% 3,720 39% 237 36% 4,400 578

Total 1,014 9,777 658 11,449 1,483

The tables above illustrate gender distributions in the consumer population by region. In mental health, slightly more females were

served in the Mid-County and Desert regions than males, while the opposite was observed for West consumers. In mental health,

countywide, RUHS-BH serves roughly an equal proportion of females and males in mental health. In substance use, across all

regions, more males (63%) were served than females (37%) for FY22-23.

The tables above illustrate gender served by age group. In mental health, notably more older adults and slightly more transitional

age youth served were female. Slightly more adult males were served than adult females. Additionally, the proportion of male and

female children served were showed more males served. For all age groups across the regions, more males were served than

females by the County substance use providers.

*Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 6

WWS-Fiscal Year 2022-2023

Race/Ethnicity

Mental Health Substance Use

FY 22-23 % Riverside

County

Estimate

% % Population

Difference to

Estimate

FY 22-23 % Riverside

County

Estimate

% % Population

Difference to

Estimate

Caucasian 10,855 24.7% 788,052 32.4% -7.7% 5,039 44% 788,052 32.4% +11.6%

Black/African

American

5,185 11.8% 153,510 6.3% +5.5% 718 6.3% 153,510 6.3% 0%

Asian/PI 838 1.9% 180,179 7.4% -5.5% 81 0.7% 180,179 7.4% -6.7%

Hispanic/Latinx 19,988 45.4% 1,258,192 51.7% -6.3% 5,104 45% 1,258,192 51.7% -6.7%

Native

American

189 0.4% 7,620 0.3% 0.1% 71 0.6% 7,620 0.3% +0.3%

Other 6,973 15.8% 60,089 2.5% 13.3% 436 4.4% 60,089 2.5% +1.9%

Total 44,028

2,447,642

11,449

2,447,642

The table above provides a comparison of racial/ethnic groups served by County mental health and substance use providers in

comparison to population estimates for the County overall. In the 2022-2023 fiscal year, Hispanic/Latinx consumers made up the

largest proportion of the population served in mental health (45.4%). In substance use, Hispanic/Latinx consumers also made up

the largest proportion of the population served (45%), followed closely by consumers identifying as Caucasian (44%). Compared to

the Riverside County estimate for Hispanic/Latinx individuals, mental health served a proportion close to the reported population in

Riverside County (51.7%). In addition, substance use served a proportion similar to the Riverside County population estimate of

51.7% for consumers identifying as Hispanic/Latinx. Although Native American consumers accounted for the smallest proportion of

the consumer population in mental health and substance use, their representation in mental health is closely representative of the

County population estimate of Native Americans; however, this group is overly represented in substance use compared to the

County population estimate. In mental health, the proportion of Caucasian consumers served is less than their representation in the

County population estimate, while the proportion of Black/African American consumers served is greater than the County

population estimate. In both mental health and substance use, the proportion of Asian/PI consumers served is less than the County

population estimate for this group. Lastly, for mental health and substance use, the proportion of consumers who were served and

identified as Other (i.e., other race, multiracial, and unknown) was greater than the Riverside County population estimate.

*Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 7

WWS-Fiscal Year 2022-2023

Race/Ethnicity by Age Group – Children

Mental Health

Substance Use

West

Mid-

County

Desert Totals West

Mid-

County

Desert Totals

County Child

Population

2023

Asian/PI 61 68 27 156 Asian/PI 1 2 0 3 6%

Black/African

American

601 630 240 1,471

Black/African

American

8 7 5 20 5.7%

Caucasian 631 1,069 509 2,209 Caucasian 26 21 11 58 24.1%

Hispanic/

Latinx

2,894 2,663 2,285 7,842

Hispanic/

Latinx

139 61 176 376 59.8

Native

American

18 14 15 47

Native

American

1 0 0 1 0.3%

Other 1,138 863 440 2,441 Other 182 255 119 556

4%

Total 5,343 5,307 3,516 14,166 Total 357 346 311 1,014

For children, Hispanic/Latinx were served more than any other race/ethnicity group in mental health for all regions. In addition,

the proportion of Hispanic/Latinx children served in mental health was slightly lower than the proportion of Hispanic/Latinx

children present in the County child population. In substance use, the proportion of Hispanic/Latinx children served was more

than the general County child population. The proportion of Black / African American children served (10.4%) was higher than

the general population percentage for both mental health and substance use services.

RUHS-BH Evaluations 01.09.2023 8

WWS-Fiscal Year 2022-2023

Race/Ethnicity by Age Group – Adults

Mental Health Substance Use

West

Mid-

County

Desert Totals West

Mid-

County

Desert Totals

County Adult

Population

2023

Asian/PI 273 207 71 551 Asian/PI 30 26 18 74 7.5%

Black/African

American

1,615 999 573 3,187

Black/African

American

311 188 146 645 6.6%

Caucasian 2,466 2,472 1,701 6,639 Caucasian 1,211 1,271 1,017 3,499 27.5%

Hispanic/

Latinx

4,339 3,328 3,360 11,027

Hispanic/

Latinx

1,688 1,177 1,306 4,171 55.7%

Native

American

47 33 38 118

Native

American

26 9 28 63 0.3%

Other 1,906 1,335 656 3,897 Other 608 442 275 1,325

2.4%

Total 10,646 8,374 6,399 25,419 Total 3,874 3,113 2,790 9,777

Among adults, Hispanic/Latinx were served more than any other race/ethnic group in mental health across all regions. In

substance use, overall, Hispanic/Latinx were served slightly more than Caucasians with some regional differences. The proportion

of Hispanic/Latinx adult consumers served by mental health (43%) and by substance use (47%) was lower than the proportion of

Hispanic/Latinx adults present in the County Adult population (55.7%). Conversely, the proportion of Black / African Americans

served with mental health was higher than representation in the population.

RUHS-BH Evaluations 01.09.2023 9

WWS-Fiscal Year 2022-2023

Race/Ethnicity by Age Group – Older

Mental Health

Substance Use

West

Mid-

County

Desert Totals West

Mid-

County

Desert Totals

County OA

Population

2023

Asian/PI 76 41 14 131 Asian/PI 2 1 1 4 8.4%

Black/African

American

274 166 87 527

Black/African

American

19 18 16 53 6%

Caucasian 676 801 530 2,007 Caucasian 109 114 92 315 53%%

Hispanic/

Latinx

412 406 301 1,119

Hispanic/

Latinx

79 55 74 208 31.3%

Native

American

11 7 6 24

Native

American

2 3 2 7 0.3%

Other 259 205 171 635 Other 31 23 17 71

0.9%

Total 1,708 1,626 1,109 4,443 Total 242 214 202 658

Among older adults, Caucasian consumers were served more than any other race/ethnic group across both mental health and

substance use, and across nearly all regions. For both mental health and substance use,

Black / African Americans were served at higher rate than population percentages, whereas Asian / PI were served at a notably

lower rate.

RUHS-BH Evaluations 01.09.2023 10

WWS-Fiscal Year 2022-2023

History-Medi-Cal

Mental Health

West %

Mid-

County

% Desert % Total %

Medi-Cal 13,049 73.7% 11,397 74.4% 8,541 77.5% 32,987 74.9%

No

Medi-Cal

4,648 26.3% 3,910 25.6% 2,483 22.5% 11,041 25.1%

Total

17,697 15,307 11,024 44,028

Substance Use

West %

Mid-

County

% Desert % Total %

DMC-ODS

Medi-Cal

3,806 85% 3,148 85.7% 2,974 90% 9,928 86.7%

No DMC-

ODS

Medi-Cal

667 15% 525 14.3% 329 10% 1,521 13.3%

Total 4,473 3,673 3,303 11,449

The table above provides the Medi-Cal status for consumers served by mental health. Overall, 74.9% of the mental health

consumers served had Medi-Cal at some point in the 2022-2023 fiscal year. Regionally, there were some differences in mental

health with the Desert region showing a slightly higher proportion of Medi-Cal consumers served at 77.5%, while the West

region showed 73.7% and Mid-County region showed 74.4% enrolled in Medi-Cal.

The table above provides the Medi-Cal status for consumers served by substance use. Overall, about 86.7% of the substance

use consumers served had Medi-Cal at some point in the 2022-2023 fiscal year. In substance use, the Mid-County and Desert

regions showed the highest proportion of consumers served with Medi-Cal at 85.7% and 90%, respectively, while the Western

region had 85% of consumers who were enrolled into Medi-Cal.

RUHS-BH Evaluations 01.09.2023 11

WWS-Fiscal Year 2022-2023

History- Co-Occurring

Mental Health

History

Drg/Ach

West %

Mid-

County

% Desert % Total %

Yes 5,572 31.5% 4,819 31.5% 4,101 37% 14,492 32.9%

No 12,125 68.5% 10,488 68.5% 6,923 63% 29,536 67.1%

Total 17,697 15,307 11,024 44,028

Substance Use

History

MH

West %

Mid-

County

% Desert % Total %

Yes 2,133 47.7% 1,633 44.5% 1,571 47.6% 5,337 46.6%

No 2,340 52.3% 2,040 55.5% 1,732 52.4% 6,112 53.4%

Total 4,473 3,673 3,303 11,449

History Drug/Alcohol use

History Mental Health

Mental Health

History

Trauma

West %

Mid-

County

% Desert % Total %

Yes 8,860 50% 8,281 54% 6,276 56.9% 23,417 53.1%

No 8,837 50% 7,026 46% 4,748 43.1% 20,611 46.9%

Total 17,697 15,307 11,024 44,028

A history of drug or alcohol use

was reported for a nearly a third of the

mental health consumers served.

There was some regional variation

with the Desert region having the

highest proportion of consumers with

a drug or alcohol history; while, the

West and Mid-County region reported

a slightly lower proportion of

consumers.

A history of trauma was derived from

the mental health CSI Trauma

indicator reported on the diagnosis

data in the electronic health record.

Overall, 53% had a history of trauma

reported.

History Trauma

Data on mental illness is collected

and recorded for substance use

consumers from the California

Outcomes Measurement System

(Cal OHMS) data fields in the

electronic health record. About

46.6% of consumers reported

having a mental illness. Of those

recorded as having a mental

illness, 34.5% had a mental health

service recorded in the 2022-2023

fiscal year.

RUHS-BH Evaluations 01.09.2023 12

WWS-Fiscal Year 2022-2023

Diagnosis by Region

Mental Health

West % Mid-County % Desert % Total %

AD/D 1,214 6.9% 1,208 7.9% 834 7.6% 3,256 7.4%

Organic 69 0.4% 48 0.3% 19 0.2% 136 0.3%

Drug/Alcohol 206 1.2% 121 0.8% 86 0.8% 413 0.9%

Schiz/Psych

4,250 24% 2,567 16.8% 2,016 18.3% 8,833 20%

Mood/Anx/Adj

4,420 25% 4,543 29.7% 3,035 27.5% 11,998 27.3%

Major Depression

4,035 22.8% 3,389 22.1% 2,997 27.2% 10,421 23.7%

BiPolar

1,475 8.3% 1,468 9.6% 935 8.5% 3,876 8.8%

Other

2,028 11.5% 1,963 12.8% 1,102 10% 5,093 11.6%

Total

17,697

15,307 11,024

44,028

When analyzing countywide FY 2022-2023 mental health consumer primary diagnoses, a large proportion of consumers were

diagnosed with Mood, Anxiety, or Adjustment disorder (27.3%), Major Depression (23.7%), or Schizophrenia/Psychosis

disorders (20%). Consumers showed less Organic (0.3%) or Drug/Alcohol (0.9%) disorders compared to other diagnoses.

Within each region, these patterns were similarly prevalent. The Other diagnosis category comprised 11.6% of consumer

diagnoses. Other diagnosis includes eating disorders, sleep disorders, somatic, pervasive developmental disorders, encounter

for examination, Z-codes, and missing diagnosis.

*Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 13

WWS-Fiscal Year 2022-2023

Diagnosis by Age Group

Mental Health

A large proportion of consumers under the age of 18 were diagnosed with either a Mood, Anxiety, or Adjustment disorder

(36.9%) or Major Depression (21.4%) or AD/D (20.5%).AD/D includes oppositional defiance, attention deficit and conduct

disorders.

Among adult consumers, Schiz/Psych (28.8%), Mood, Anxiety, or Adjustment disorders (23.7%), and Major Depression

(24.2%) were more frequently diagnosed.

For older adults, Major Depression (27.9%) and Schiz/Psych (31.5%) were the most frequent diagnoses.

Variations in diagnosis were observed between age groups. For instance, the observed proportion of services for older

adults with Mood, Anxiety, or Adjustment Disorders was lower than that observed for adults. At the same time, the observed

proportion of older adults with a diagnosis of Major Depression or Schiz/Psych disorders was slightly higher than that

observed in adults. In a related observation, while a Schiz/Psych disorder diagnosis was not uncommon among the adults

and older adults served, the proportion observed for children was <1%. Similarly, the opposite occurrence was observed in the

high proportion of children receiving services with an AD/D diagnosis, which was observed at a much lower proportion for

adults (1.4%) and older adults (0.2%). Differences observed across age groups, particularly those occurring between

populations over or under the age of 18 can possibly be attributed to age of first onset, or the primacy of diagnosis.

*Rounding may provide numbers that are +/- 100% when summed.

<18yrs % 18-59yrs % 60+ % Total %

AD/D 2,904 20.5% 344 1.4% 8 0.2% 3,256 7.4%

Organic 7 <1% 55 0.2% 74 1.7% 136 0.3%

Drug/Alcohol 22 0.2% 359 1.4% 32 0.7% 413 0.9%

Schiz/Psych 121 0.9% 7,314 28.8% 1,398 31.5% 8,833 20%

Mood/Anx/Adj 5,230 36.9% 6,025 23.7% 743 16.7% 11,998 27.2%

Major Depression 3,031 21.4% 6,150 24.2% 1,240 27.9% 10,421 23.7%

BiPolar 181 1.3% 3,078 12.1% 619 13.9% 3,878 8.8%

Other 2,670

18.7%

2,094

8.2%

329

7.4% 5,093 11.6%

Total 14,166

25,419

4,443

44,028

RUHS-BH Evaluations 01.09.2023 14

WWS-Fiscal Year 2022-2023

Diagnosis by Region

Substance Use

West % Mid-County % Desert % Total %

Alcohol 925

20.7%

697

19%

647

19.6%

2,269

19.8%

Marijuana 393

8.8%

313

8.5%

351

10.6%

1,057

9.2%

Hallucinogen 3

0.1%

7

0.2%

3

0.1%

13

0.1%

Sedative/Hypnotic 18

0.4%

14

0.5%

12

0.4%

47

0.4%

Inhalants 3

0.1%

0

0.01%

1

0.01%

5

0.1%

Opiates 1,146

25.6%

585

32.9%

967

29.3%

3,322

29%

Cocaine 46

1.0%

22

.9%

51

1.5%

131

1.1%

Amphetamines 1,285

28.7%

400

20.7%

901

27.3%

2,947

25.7%

Other substance 654

14.6%

634

17.2%

370

11.2%

1,658

0.7%

Total 4,473 1,583 1,539 11,449

The table above provides data on primary substance diagnosis by region. Data on diagnosis was analyzed from ICD-10

most recent primary diagnosis recorded in the electronic health record for consumers served in substance use. Reporting

does not differentiate between varying diagnostic categorization under the same substance, including differences between

use or dependent diagnoses.

Across all regions, nearly a third of substance use consumers (29%) had a primary diagnosis related to the usage of

opiates. Additionally, a third of consumers (25.7%) had a primary diagnosis for amphetamines. Combined, these two

diagnoses accounted for 54.7% of the treatment population. Among the total population served, a primary diagnosis

related to alcohol (19.8%) was more common than a primary diagnosis related to marijuana (9.2%).

Diagnoses related to opiate use and amphetamines were the highest compared to other diagnoses across all regions and

is reflective in each region individually where a primary diagnosis related to opiate use was the highest for its region.

*Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 15

WWS-Fiscal Year 2022-2023

Diagnosis by Age Group

Substance Use

<18yrs % 18-59yrs % 60+ % Total %

Alcohol 16 1.6% 2,095 21.4% 158 24% 2,269 23%

Marijuana 408 40.2% 635 6.5% 14 2.1% 1,057 9.2%

Hallucinogen 0 0% 13 0.1% 0 0% 13 0.1%

Sedative/Hypnotic 2 .2% 44 0.5% 1 0.2% 47 0.4%

Inhalants 1 0.1% 4 0.01% 0 0% 5 0.01%

Opiates 11 1.1% 2,975 30.4% 336 51.1% 3,322 29%

Cocaine 2 0.2% 119 1.2% 10 1.5% 131 1.1%

Amphetamines 7 .7% 2,844 29.1% 96 14.6% 2,947 25.7%

Other Substances 567 55.9% 1,048 10.71% 43 6.5% 1,658 14.7%

Total 1,014 9,777 296 11,449

The table above provides data on primary substance diagnosis by age group. Data on diagnosis was analyzed from the

ICD-10 most recent primary diagnosis recorded in the electronic health record for consumers served in substance use.

Reporting does not differentiate between varying diagnostic categorization under the same substance, including

differences between use or dependent diagnoses.

Overall, most substance use consumers (29%) had a primary diagnosis related to opiates usage. The second common

primary diagnosis was related to Amphetamines usage (25.7%).

Variations between primary substance and age group were observed. For consumers under the age of 18, a diagnosis

related to marijuana usage was the most common (40.2%). Less common for this age group were diagnoses related to

either opiate (1.1%) or cocaine (0.2%) usage. Moreover, consumers under the age 18 were less observed to have a

primary diagnosis related to alcohol usage (1.6%) than compared to the adult age group (21.4%) and older adult age group

(24%). Lastly, consumers under the age of 18 were observed to have a high proportion of other substance which includes

Z-codes.

Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 16

Who We Serve

Detention

Consumer Population Profile

Fiscal Year 2022-2023

RUHS-BH Evaluations 01.09.2023 17

WWS-Fiscal Year 2022-2023

Executive Summary-Behavioral Health Detention Services

Summary  In fiscal year 2022-2023, Riverside University Health Systems Behavioral Health (RUHS-BH) provided

Behavioral Health Detention Services to 8,879 consumers.

Region  The Western Region had the most consumers, followed by the Desert, and the Mid-County region, respectively.

Gender  Overall, more male than female consumers were served (80% to 20%, respectively). Across all county regions and

age groups, males consumers were served more than female consumers.

Race/Ethnicity  Hispanic/Latinx made up the largest race/ethnic group served, while Caucasians made up the second

largest group served. All regions served the Hispanic/Latinx consumers in greater proportions.

Diagnosis  Overall, the most frequent diagnoses were Mood/Anxiety/Adjustment disorders(30%), followed by Drug and

Alcohol use (27.5%), and Schizophrenia/Psychosis disorders (25.2%). Diagnoses varied by County region. Drug/Alcohol disorders

were frequent diagnosis across all regions, in the Desert region (28.3%), Mid-County region (30.7%) and West he region (24.6%).

Among adult consumers, Drug/Alcohol disorders (13.5%) were the most frequent diagnosis. For older adults Schizophrenia/

Psychosis (15.5%) disorders were the most frequent diagnosis. Older adults were more likely to be diagnoses with Major

Depression than were adult consumers.

RUHS-BH Evaluations 01.09.2023 18

WWS-Fiscal Year 2022-2023

Detention Services - Region and Age

FY 21-22 % FY 22-23 % Change

From

Previous Yr

Adults

(18-59 Years)

9,221 95.7% 8,447 95.1% -0.6%

Older Adults

(60+ Years)

415 4.3% 432 4.9% +0.6%

Total

9,636 8,879

Transition Age

Youth

1,278 13.3% 1,018 11.5% -1.8%

Behavioral Health Detention Services

More adults and older adults from the

Western region received Behavioral

Health services in Detention facilities.

Regional Groups

Age Groups of Consumers Served

Overall, the total consumers served by behavioral health in detention decreased (4%) from FY21/22 to FY22/23. This decrease

was observed for adults while older adults did not increase significantly. The largest age group served were adults (95.1%). At

least 11.5% of the adults were transition age youth (TAY) age 18-25. Overall, the number of consumers was fairly consistent

across fiscal years.

*Rounding may provide numbers that are +/- 100% when summed.

Age Groups

RUHS-BH Evaluations 01.09.2023 19

Behavioral Health Detention Services

WWS-Fiscal Year 2022-2023

Gender

West %

Mid-

County

% Desert % Total

Female 710 20% 494 18.7% 540 20% 1,744

Male 2,824 80% 2,152 81.3% 2,159 80% 7,135

Total 3,534 2,646 2,699 *8,879

Behavioral Health Detention Services

Adults

(18-59)

% Older Adults

(60+)

% Total Transition Age

(16-25)

Female 1,673 19.8% 71 16.4% 1,744 200

Male 6,774 80.2% 361 83.6% 7,135 818

Total 8,447 432 *8,879 1,018

The table above illustrate gender distributions for consumers served by behavioral health detention services by region.

Countywide and among regions, RUHS-BH served a higher proportion of males than females (80.4%; 7,135/8,879).

The table above illustrate gender served by age group. More males than females were served in each age group.

*Eight unknown gender statuses across consumers.

**Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 20

WWS-Fiscal Year 2022-2023

Race/Ethnicity

The table above provides a comparison of racial/ethnic groups served by Behavioral Health Detention Services. Hispanic/Latinx

consumers were served the most (45%), followed by Caucasian consumers (31.7%) and Black/African American consumers

(20%). The Other category includes other race, multiracial and unknown. Percentages may not sum to 100% due to rounding.

Behavioral Health Detention Services

West Mid-County Desert Totals

Asian/PI 44 27 25 96

Black/African

American

829 535 418 1,782

Caucasian 975 952 888 2,815

Hispanic/

Latinx

1,618 1,063 1,316 3,997

Native

American

6 17 17 40

Other 62 52 35 149

Total 3,534 2,646 2,699 8,879

RUHS-BH Evaluations 01.09.2023 21

West % Mid-County % Desert % Total %

AD/D

5 0.1% 5 0.1% 9 0.1% 19 0.2%

Drug/Alcohol

422 4.8% 368 4.1% 377 4.2% 1,167 13.1%

Schiz/Psych

514 5.8% 273 3.1% 299 3.4% 1,086 12.2%

Mood/Anx/Adj

459 5.2% 349 3.9% 371 4.2% 1,179 13.3%

Major Depression

179 2.0% 132 1.5% 172 1.9% 483 5.4%

BiPolar

131 1.5% 54 0.6% 75 0.8% 260 2.9%

Other

1,824 20.5% 1,465 16.5% 1,396 15.7% 4,685 52.8%

Total

3,534 2,646 2,699 8,879

Behavioral Health Detention Services

WWS-Fiscal Year 2022-2023

Diagnosis by Region

When analyzing FY 2022-2023 countywide consumer primary diagnoses, a large proportion of consumers were diagnosed

with Mood/Anxiety/Adjustment disorders (30%), Drug/Alcohol disorder (27.5%), or Schizophrenia/Psychosis disorders

(25.2%). Consumers showed few AD/D (0.6%) disorders compared to other diagnoses. Diagnoses varied by region. In the

Western region, Schizophrenia/Psychosis disorders were the most frequent diagnosis (29.7%), Drug/Alcohol disorders were

the most frequent diagnosis in the Mid-County (30.7%) and the Desert (28.3%) regions. The Other diagnosis category

comprised 1.7% of consumer diagnoses. Other diagnosis includes eating disorders, sleep disorders, somatic, pervasive

developmental disorders, encounter for examination, impulse and missing diagnosis. Missing diagnosis was relatively high

(51.9%)

*Rounding may provide numbers that are +/- 100% when summed.

RUHS-BH Evaluations 01.09.2023 22

WWS-Fiscal Year 2022-2023

Diagnosis by Age Group

Among adult consumers, Drug/Alcohol disorders (13.5%), Mood, Anxiety, or Adjustment disorders (13.3%), and

Schizophrenia/Psychosis disorders (12.1%) were more frequently diagnosed. For older adults, Schizophrenia/Psychosis

disorders (15.5%), Mood, Anxiety, or Adjustment disorders (12%) Drug/Alcohol disorders (8.6%), were the most frequent

diagnoses. Older adults were more likely to be diagnoses with Major Depression than were adult consumers.

Behavioral Health Detention Services

18-59yrs % 60+ % Total %

AD/D 19 0.002% 0 0.0% 19 0.6%

Drug/Alcohol 1,132 13.4% 35 8.1% 1,167 27.5%

Schiz/Psych 1,019 12% 67 15.5% 1,086 25.2%

Mood/Anx/Adj 1,127 13.3% 52 12.0% 1,179 30%

Major Depression 444 5.2% 39 9.0% 483 11.8%

BiPolar 246 2.9% 14 3.2% 260 6.8%

Other 4,460 52.7% 225 52.0% 4,685 51.9%

Total 8,447 432 8,879

MHSA Prevention and Early Intervention

Who We Serve

FY 2022-2023

1

Prevention and Early Intervention

Who We Serve - Summary

Mental Health Awareness

and Stigma Reduction

• Community Mental Health

Promoter Program

• Stand Against Stigma

• Integrated Outreach and

Screening

Parent Education and

Family Support

• Mobile PEI

• Triple P & Teen Triple P

• Strengthening Families Program

Early Intervention for

Families in Schools

Transition Age Youth

Project

• TAY Peer to Peer

• Stress and Your Mood

• CAST

• Teen Suicide Awareness

Prevention Program

First Onset for Older Adults

• CBT for Late Life Depressions,

• Care Pathways,

• Healthy IDEAS,

• Office on Aging

• PEARLS

Trauma-Exposed Services

for All Ages

• CBITS for children

• Seeking Safety for TAY and adults

Underserved Cultural

Populations

• BRAAF

• Mamás y Bebés,

• Keeping Intergenerational Ties in

Ethnic Families (KITE)

• Celebrating Families AI

• Asian/PI Mental Health Resource

Center

Riverside County Residents were engaged by Prevention

and Early Intervention Outreach and Service Programs

Prevention and Early Intervention

Who We Serve—Demographic Overview

Prevention and Early Intervention Services Demographic Overview

A total of 2,636 individuals and families participated in Prevention or Early Intervention (PEI) services in FY2022-2023. An additional

4,267 middle school and high school age youth and 693 school staff, parents and community members participated in suicide prevention

training on school sites. This resulted in a total of 7,596 served and does not include outreach. The following details the demographics of

the 2,636 participants for which demographic data is collected.

Hispanic/Latinx (50%) comprised the

largest proportion of the PEI participants

served. Hispanic/Latinx, American Indian

and Asian/PI, Black/African American

participation reflects the underserved

priority populations intended to be

reached by the PEI programs and is also

representative of the county population.

The majority of PEI participants were adults

(44%), many of whom were participating in

parenting programs. The second largest age

group served by PEI programs were children

(34%). Older adults represented 20% of the

population served by PEI programs. PEI also

focuses on Transition Age Youth (TAY), and

22% of the 2,636 participants were aged 16

to 25 years (not shown in the graph).

More than half (70%) of PEI participants

were female, 23% were male,0.6%, were

transgender, and 0.7% were gender fluid

or non-binary. Gender was unknown for

6%.

Race/Ethnicity

PEI

Participants

(n=2,636)

County Census

(n=2,447,642)

Caucasian

15% 32.4%

Hispanic/

Latinx

50% 51.7%

Black/African

American

9%

6.3

Asian/Pacific

Islander

6% 7.4%

American Indian

1.4% .03%

Other/Unkn/

Multi-Racial

20% 2.5%

34%

44%

20%

2%

Age (n=2,636)

Children (0-17) Adults (18-59)

Older Adults (60+) Unknown Age

70%

23%

0.6%

0.7%

6%

Gender (n=2,636)

Female Male

Transgender Gender Fluid/Non-Binary

Prevention and Early Intervention

Who We Serve—Demographic Overview

Prevention and Early Intervention Outreach Demographic Overview

In total 104,255 individuals were reached by PEI from a variety of Outreach activities including, Depression screening at Community

Health Centers, specific outreach to TAY youth and Older Adults and outreach activities provided under Mental Health Stigma and

Awareness presentations, and Suicide Prevention trainings.

The largest group of those reached by

PEI Outreach were Hispanic/Latinx

(62%). Race/ethnicity was unknown for

some Outreach participants because the

programs did not have the opportunity

to collect demographic information at

outreach events.

The largest age group reached were adults

18-59 (60%), 12% were children 0-17. TAY

were also outreached to and accounted for

15% of the people in outreach efforts. Peer

to Peer Speaker’s Bureau mostly targets TAY

and that is reflected in the ages in the graph

above. The unknown amount is due to

programs not having the opportunity to

collect demographic information at

outreach events.

Females made up the largest group of those

reached in PEI Outreach efforts (53%), 33%

were male, and 14% were of unknown

gender. The unknown amount is largely due

to the programs not having the opportunity to

collect demographic information at outreach

events.

Race/Ethnicity

PEI

Participants

(n=104,255)

County

Census

(n=2,447,642)

Caucasian

15%

32.4.%

Hispanic/

Latinx

62%

51.7%

Black/African

American

8%

6.3

Asian/Pacific

Islander

4%

7.4%

Native American

1%

.03%

Other/

Unkn

/Multi-

Racial

12%

2.5%

12%

60%

16%

10%

Age (n=104,255)

Children (0-17) Adults (18-59)

Older Adults (60+) Unknown Age

53%

33%

0.2% 14%

Gender (n=104,255)

Female Male Transgender Unknown