Transforming Together: Implementation Guide
The process of expanding the AB 2083 required MOU took time—nearly five years from the initial drafting to full implementation. “It has taken years to have all the agreements in place and to finalize our operational manual,” Ramirez said. “Now we’re in the early implementation phase of our agreements.” The MOU is held together by a shared vision, clearly defined agreements about interagency functions, and a strong commitment to collective accountability. County departments, including behavioral health, social services, probation, public health, First 5, the office of education and the San Andreas Regional Center all played key roles in its development. They were joined by parents and youth whose lived experience helped shape the work. “We even pay parents and are now working to bring in youth voice through paid internships,” Ramirez shared. However, sustaining alignment is not without its ongoing challenges. “There’s this constant creative tension,” Ramirez explained. “If we don’t hold tightly to the vision, people fall back into their silos—especially when new policies or budget pressures emerge.” To help address these tensions, the team revisits its shared logic model, holds regular retreats, and starts each agenda with a reminder of the shared goals. Looking ahead, Santa Clara’s ecosystem continues to evolve their MOU as new partners come to the table, including managed care plans. “At first, they weren’t part of the work,” Ramirez said. “Now they are, and they’re sharing data and identifying how we can help connect families to the services they offer.”
For other counties considering a similar path, her advice is simple but powerful: “Start with trust. Build relationships. Define your vision and your terms—even if it takes six months just to agree on what ‘prevention’ means for example. And take the time to build your blueprint. Don’t try to build the plane while it’s flying.”
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