Standardize and integrate justice system data elements for care coordination and system planning

Lead agency: To be reviewed, along with a collaborative review of priority actions in this area

Population of focus (if applicable): N/A

Summary of planned action: 

Pursue screening and needs assessment at key justice system intercepts, standardize data elements, advance data sharing between systems to improve care coordination for justice populations, and allow for systematic planning for alternatives to incarceration based on data. 

Actions taken:

  • Health and justice partners involved in implementing the CalAIM Justice-Involved Reentry Initiative requirements are focused on implementing specific information sharing between the Sheriff, HHSA, and Managed Care Plans. Information sharing prior to jail release will facilitate care coordination and connections to Medi-Cal benefits and services for eligible individuals with physical and/or behavioral healthcare needs during reentry.   

  • On May 10, 2022 (3), the Board of Supervisors approved supporting care coordination for justice-involved individuals by providing funding and directing the establishment of a new Integrated Data Infrastructure project. The Chief Administrative Officer directed HHSA to lead this project. In July 2023, HHSA led the County resource assessment, which assessed what resources existed or would be needed to advance data sharing, and it was completed in 2024. At the same time, the County’s Chief Data Officer (CDO) started to chair a Cross-County Data Governance Team. The Cross-County Data Governance Team was composed of staff across the enterprise to work on improving data sharing to support care coordination of justice-involved individuals. The data governance group developed a list of assessments justice-involved or at-risk individuals commonly receive in the health and justice systems and shared it with the ATI team.  

  • CDO, HHSA and Public Safety Executive Office reviewed the work conducted in 2023 and 2024 for findings about specific actions or resources to improve streamlined assessments and data sharing for coordination. Use cases looking at client reentry into specific services, which were reviewed in 2024, showed either that care coordination was largely successful between the justice system and a contracted community service provider, or that gaps were easily addressed once identified. Likewise, the inventory of assessments reviewed by ATI partners showed that assessments generally contain specific elements or definitions required by the system or program assessing the client, and that “shared data systems” or “common definitions” would not provide a universal or common solution for all clients at each point where care should be coordinated. Therefore, they determined, the original goal should be revisited and potentially updated to emphasize specific, identified gaps in care coordination and particular actions the County can take, or systems it can connect, to improve care co-ordination. 

Next steps: 

  • Data sharing and care coordination as part of  the CalAIM Justice-Involved Reentry Initiative implementation remain a major emphasis.

  • HHSA and PS will work with the ATI Advisory Group and the community in 2026 to better understand any specific transition points between health and justice systems and community-based services where shared assessments or data should be improved to support care coordination.