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The Office of Diversion and Reentry (ODR) in Los Angeles County operates jail-based clinical diversion programs designed to help individuals with serious mental health diagnoses. The largest of these programs is the ODR Housing Program, which has diverted more than 3,000 individuals since its inception in 2016. Given the community's interest in providing alternatives to incarceration, eliminating racial disparities in incarcerated and jailed mental health populations, and addressing the overwhelming rates of homelessness in Los Angeles County, continuing to expand and refine this model will be important in supporting the county's "care first, jails last" vision. The authors of this report describe the program's implementation, including how participants are identified and enrolled, what services are provided, and what resources are needed to operate the program; identify program facilitators and challenges, as expressed by program administrators and key service providers; and obtain participant perspectives on the ODR Housing Program. The insights provided in this report should help program staff expand and refine efforts associated with the program. This research into how the ODR Housing Program operates might also serve as a roadmap for other jurisdictions looking to implement similar initiatives; provide context for interpreting past and future evaluations of the program's effectiveness; and, through an examination of provider and client viewpoints on the program, provide a perspective often missing from evaluations that focus primarily on outcomes.

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Many states separate, or "carve out," Medicaid financing of behavioral health services from financing for other types of health care, but there has been a recent trend in some states toward "carve-ins," whereby financing for behavioral health services is combined with the larger pool of Medicaid-covered services. This trend has been driven by evidence that strategies to enhance clinical integration of behavioral and physical health care can improve physical health care outcomes for individuals with serious mental illnesses. California's Medi-Cal system uses a carve-out approach to finance specialty behavioral health services for enrollees with serious mental illnesses and/or substance use disorders, but the state has planned to pilot carve-in contracts as part of a broad reform of Medicaid delivery and payment. To inform the policy discussion, the authors of this report examined other states' experiences with carve-ins, the evidence on the impacts of this approach, and the implications for California.

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Service members experience a variety of harmful behaviors, such as sexual assault, sexual harassment, domestic abuse, and suicide, that can affect their overall health and quality of life and be detrimental to force readiness. While response and treatment are vital services to address these harms, a robust prevention system is also needed. The Department of Defense (DoD) asked RAND Corporation researchers to develop a prevention capabilities assessment process for use across the active and reserve forces and to pilot the process during visits at 20 installations that were at higher risk for, or had a greater number of protective factors to mitigate, these harmful behaviors. This report describes how the prevention capabilities assessment process was developed, pilot tested, and assessed for validity. The metrics assessed prevention capabilities in nine areas covering the extent to which military installations prioritized, were prepared to promote, or are currently promoting integrated primary prevention and efforts to create healthy and protective environments and are engaging with service members around these efforts. In pilot tests, Office of the Secretary of Defense (OSD) leaders, researchers, and some installation staff found the metrics beneficial in terms of capturing and providing useful and nuanced information about prevention practices and areas for growth, and the analyses generally supported the validity of the metrics. Moving forward, DoD should continue to validate and refine these metrics as prevention efforts evolve and grow. These metrics, as part of an integrated process of risk identification and assessment, will help DoD track its prevention capability.