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The County of San Mateo’s innovative efforts to make housing accessible to residents at all price points and treat those with severe substance abuse issues through a unique multi-disciplinary approach have earned two prestigious Challenge Awards from the California State Association of Counties (CSAC). 

CSAC’s annual statewide program honors innovation and best practices in county government. The County of San Mateo’s two winners were chosen from a vast pool of 284 entries.

The County was honored for Home for All, which builds community support for all types of housing through education, innovative tools like its one-stop online Second Unit Center and bringing people together to talk about housing. Home for All and the task force that preceded it, are credited for helping close the jobs/housing gap from 24:1 in 2014 to approximately 12:1 presently.

The County was also honored for the Integrated Medication Assisted Treatment (IMAT) Team which is embedded in San Mateo Medical Center’s Emergency Department and not only links those with opiate and alcohol dependencies with services but also stays with them during their recovery journey. In each year of operations, IMAT has consistently and dramatically dropped inpatient hospital, emergency room and psychiatric emergency services visits.

“Both County programs are outstanding, and we are pleased that CSAC is recognizing the amazing work of our County employees and partners who have made these programs so successful.  Our County is dedicated to helping the people we serve.  Home for All and IMAT are two excellent examples of how our County works together to solve problems,” said Supervisor Carole Groom, president of the Board of Supervisors.

Both award-winning programs are rooted in the realization that not one individual or agency could solve two large-scale concerns on their own. In 2015, Supervisors Don Horsley and Warren Slocum convened and co-chaired a “Closing the Jobs/Housing Gap Task Force” which brought together 54 individuals representing all community sectors with the goal of educating the community about housing options, increasing funding for affordable housing, promoting creative land use and expanding community participation in housing decisions. The task force evolved into Home for All, a staff initiative managed out of the County’s Office of Sustainability, which continues this work. As a result, between 2014 and 2018, a total of 23,531 housing units were completed, under construction, permitted or in the pipeline. The County also hosts a website (www.secondunitcenterSMC.org) which helps homeowners navigate the process of adding an accessory dwelling unit.

“Our County is innovative – and both our Home for All and Integrated Medication Assisted Treatment teams exemplify this through their projects.  Home for All is particularly close to my heart because it grew from the momentous work of our Closing the Jobs/Housing Gap Task Force,” Slocum said. “It is a shining example of how the County can bring together multiple partners with multiple perspectives and find common ground on potential solutions to our local housing crisis. This Challenge Award is as much a win for them as it is for the County.”

Like Home for All, IMAT builds on collaboration and culture change. Health leaders recognized that individuals with severe substance use often arrived in the emergency department which was equipped to stabilize them medically but could not link patients to services that could prevent re-occurrence. In 2013, Behavioral Health and Recovery Services (BHRS) conducted a successful pilot with 20 complex clients that paired medication assisted treatment and case management.

“We are fortunate that the leadership of San Mateo County has been willing to confront the stigma of addiction by embracing new research showing that medications in conjunction with other services saves lives,” said BHRS Director Scott Gilman.

In 2015, the IMAT team permanently formed as a unique partnership between Heath Plan of San Mateo (HPSM), BHRS, San Mateo Medical Center Emergency Department, primary care clients, correctional Health and contracted substance use providers. One year later, HPSM and BHRS also helped open a primary care clinic solely focused on addiction medicine.

“I am beyond proud of the work this team has done, as we are reminded on a daily basis of the lives we are changing and those we are losing to this horrific epidemic. It can take years to make small system changes, to advance philosophies, and behaviors. Through this team’s dedication, integrity, and compassion, we are managing to save individual lives and transform our system of care at the same time,” said IMAT Supervisor Mary Taylor Fullerton.

One changed life is that of a 37-year-old IMAT client. She shared that “not too long ago, I found myself in the emergency room due to addiction problems. When I met an IMAT case manager there, he made every last effort to help me. There was no judgment, just an unconditional offer to help, which I needed. With their help, I was able to get connected to a clinic and mental health counseling and have been sober for seven months. I am forever grateful for the time they spent getting me from a homeless addict back into a life that is full and good again.”

The County has previously earned CSAC awards for its agile workforce initiative, STEP foster youth mentorship program and plan to end homelessness. CSAC will present the County with its 2019 awards at future Board of Supervisors meeting.