The process requires managers and staff to participate fully as a team in discussions of what the program's picture of CPM should be. In this case, a committee and staff already existed for the purpose of reviewing severely mentally ill clients who were candidates for these antipsychotic drugs. The MEIC, which includes the committee and staff, has been able to create measures and modify the existing data system to collect the measures. This MEIC is well on the way to completion of its measurement process, though the process is expected to be fine-tuned over time. As CPM enters its third year of development, approximately 40 percent of the county is using the process.
Training is available for both staff and facilitators to assist MEICs in their work.
Santa Clara's next steps are gathering information to determine the degree of implementation and the need for support by its agencies, as well as revising its countywide mission and service priorities. With plans to tie performance measures to the budget by 1999, the county considers CPM an ongoing system of management in which services can be based on measurable results. The CWI has 30 outcome indicators divided into 8 categories, with the indicators generally consistent with or identical to Healthy People 2000 indicators. State officials have used the outcome indicators to generate composite rankings for each county and plan to disseminate broadly this local health status information to public health officials, the media, and the public. Level II is the core of the accountability system, with 32 process and outcome measures that address how well the community is responding to local health needs.