September 10, 2015 Commission Summary of Actions

September 10, 2015 Commission Summary of Actions

The Board of Commissioners meets on the second Thursday of each month at 1:30 p.m. unless otherwise indicated at the First 5 LA offices. All meetings are open to the public and agendas are posted on our website at least 72 hours in advance.

These Commission Summaries are intended to provide highlights of the Board of Commissioners’ actions and presentations to the Board, many of which involve legacy investments and key actions and investments related to our new 2015-2020 Strategic Plan. Please check our Commission Calendar for all updated meeting information and click here for Commission meeting packets, agendas, summaries and meeting notes.

At the September 10 Commission meeting, highlights include approval of an extension of the LA Care Healthy Kids Insurance Program, the Welcome Baby 36-month Pilot Evaluation, a presentation on Trauma Informed Care and approval of key contracts and agreements.

LA Care Healthy Kids Insurance Program Extension Approved

The Commission unanimously voted to waive Governance Guideline #7 and extend the Strategic Partnership with LA Care Health Plan for the Healthy Kids Insurance Program for nine months, through September 30, 2016, for up to $500,000.

As part of the expiring initiatives assessment process, the Board in April approve a 6-month expansion to December 31, 2015, for the Healthy Kids Insurance Program, which provides health insurance to 442 children in Los Angeles County who do not qualify for Medi-Cal. Since then, the 2015-16 state budget included Medi-Cal expansion to undocumented low-income youth to be implemented no sooner than May 1, 2016. 95 percent of Healthy Kids members are eligible.

The 9 month extension approved by the Board would ensure the continuity of care for these 442 children until the Medi-Cal expansion is in place. The decision also authorizes the Executive Director to extend the partnership for an additional three months should there be a delay in expanding Medi-Cal.

Welcome Baby 36-Month Pilot Evaluation: How are Children Doing at Age 3?

The Commission was presented with findings from the 36-month Child and Family Survey and 3-year longitudinal results from the Welcome Baby Home Visiting program in the pilot community of Metro LA. Through First 5 LA’s free, voluntary Welcome Baby program, pregnant women and new moms in the 14 Best Start Communities receive information, support and a trusted partner to help them through the journey of pregnancy and early parenthood.

The evaluation of Welcome Baby in the pilot community of Metro LA was conducted by the Urban Institute and its partner, the University of California, Los Angeles. To test for associations between program participation and child and family outcomes over time, the research team developed and administered a set of in-home surveys and observations at 12, 24 and 36 months postpartum.

Significant parental outcomes at 36 months associated with Welcome Baby include:

• Stronger maternal responsiveness
• Stranger maternal encouragement
• Stronger maternal affection
• Stronger maternal teaching
• Lower parenting stress

Significant child outcomes at 36 months associated with Welcome Baby include:

• Greater communication skills
• Greater social competence
• Greater engagement and attention
• Greater personal-social skills

At the same time, Welcome Baby participation was associated with having higher quality home environments at both 12 and 24 months, but by 36 months, this effect had faded.

A link to the full presentation on this evaluation can be found under Item 6 in the agenda packet here.

Strategic Plan Implementation: Trauma Informed Care Presentation

As part of First 5 LA’s 2015-2020 Strategic Plan, the Commission outlined trauma-informed care (TI-Care) as one of the specific areas of priority focus in the health-related systems outcome area. To better understand various examples of systems-change efforts happening at the state and local level around trauma-informed care, three panelists provided presentations to the Board: Cecilia Chen, Lisa Kohn and Mary Lou Fulton.

Chen, Associate Director of Policy at the Center for Youth Wellness, discussed the efforts of the Statewide Adverse Childhood Experiences (ACEs) Policy Working Group, of which First 5 LA is a participant. Convened in early 2015 to develop a statewide public-private partnership, this group has been meeting monthly to develop a common policy agenda, including problems, goals, objectives, strategies, principles and working agreements. Among the key points of Chen’s presentation:

• ACEs are a public health crisis
• In Los Angeles County, 60 percent of residents have experienced one or more ACEs
• ACEs can lead to toxic stress
• A person with four or more ACEs in their lifetime has a 1,220 percent greater chance of committing suicide
• Trauma-informed care has emerged as a key approach to dealing with ACEs

To better combat the impact of ACEs on public health, Chen said efforts are focusing on raising awareness (including through Assembly Concurrent Resolution 155), generating momentum for action (through an upcoming ACEs Summit), building a cross-sector coalition (including policy and communications groups) and launching a statewide communications campaign to highlight trauma-informed practices.

Kohn, Attorney-Advisor and Project Lead at the Office of the California Attorney General, discussed California’s Defending Childhood State Policy Initiative, of which First 5 LA will participate in as a thought partner. Launched in 2015, the goal of the Defending Childhood Initiative (DCI) is to help California state government agencies develop and implement a strategic plan for identifying, assessing and treating children who suffer from trauma, as well as identify federal, state, and local funding streams to heal and support these children and their families. Among the highlights of Kohn’s presentation:

• Through its support of the Children’s Data Network, First 5 LA has a key opportunity to partner with DCI to undertake further data and research analysis to examine the scope of the problem and identify gaps in L.A. County for identifying young children exposed to violence and trauma and reducing their exposure to it.
• The CA Defending Childhood team is expected to complete a draft state policy agenda by early 2016.

Fulton, Senior Program Manager at The California Endowment, presented the local context around trauma-informed care, with examples from work from various counties throughout the state. Key points from her presentation included:

• It’s not just about trauma. It’s about the power of owning your story about what happened to you.
• Counties are the hub of the wheel in regards to trauma-informed care. For example, San Diego County provided training for all 6,000 health and human services agency employees, San Diego Unified became a “restorative” district, County Supervisors adopted a “Live Well San Diego” initiative; San Francisco City/County provided training for 9,000 employees toward common framework and language; and Sonoma County First 5 leadership took on role of convener, trainer and partner; focused on child abuse and parent education through Triple P (Positive Parenting Program) and will be part of national Mobilizing Action for Resilient Communities.
• School discipline reform has offered key opening for trauma-informed approaches, including training/professional development and Cognitive Behavioral Intervention for Trauma in Schools (Los Angeles Unified School District).

Best Start Panorama City & Neighbors Project Among Key Contracts and Renewals Approved

The Commission unanimously approved the following two new agreements and three renewals for a total of $4,016,181.

The two new agreements include:

• $491,604 for a one year, five month contract with Friends of the Family, which will implement the strategy and activities selected by the Best Start Panorama City & Neighbors (BSPCN) Community through the Learning by Doing process. Five activities will focus on building positive social networks to support parents of children prenatal to age five within the BSPCN boundaries, including hosting Parent Cafes, training community residents to become Parent Support Liaisons and engaging partner agencies to provide supportive and coordinated services.
• $298,500 for Diversified Printers, Inc. to print the family guide, booklets and posters for two years and nine months.

The three renewals include:

• $2,445,942 for Public Health Foundation Enterprises, Inc. to continue to coordinate, oversee and implement the Little by Little (LBL) program at 10 selected Women, Infants and Children (WIC) locations. This includes early literacy counseling, handouts and safety and literacy items to WIC participants. This is the third year of a six year project.
• $622,980 for the final year of the Peer Support Groups for Parents program, which aims to foster social connections, reduce isolation and encourage sharing of knowledge and skills among parents of children prenatal to age 5 by establishing peer support groups for parents within each of the Supervisorial Districts.
• $157,155 to Children’s Institute, Inc. for training and technical assistance for the Peer Support Groups for Parents program.

Executive Director’s Report

Executive Director Kim Belshé began by introducing new Commission Alternate Dayton Gilleland, the chief academic officer at the Los Angeles County Office of Education.

Summing up a busy summer, Belshé noted how the past couple of months were full of creating new partnerships and ways of working, strengthening First 5 LA, and notable transitions.

First, Belshé said, First 5 LA’s new Strategic Plan recognizes that the agency needs to approach its work in different ways to achieve our goals for young children in L.A. County. Central to our success will be participating in partnerships that advance our work, Belshé said. Towards that end, First 5 LA is partnering with existing contractors in new ways and building new partnerships. These include:

• Working with existing partner LA Care, the nation’s largest publicly operated health plan, in new ways to focus on access and utilization issues for developmental screening and oral health to nearly 40 percent of young children in L.A. County.
• Playing a convening role to the Early Childhood Education QRIS (Quality Rating and Improvement System). With the support of VIVA consulting, we have convened an early education alliance, informally known as the “QRIS Architects”. First 5 LA has convened this group for a number of reasons, including First 5 CA’s latest funding initiative, IMPACT, which is intended to “support a network of local quality improvement systems”. This group is working together to develop an approach to the IMPACT application that aligns and builds upon existing QRIS efforts in L.A. County.
• New efforts to support the Office of Child Protection in the development of a prevention plan for L.A. County. Relatedly, First 5 LA is exploring alignment of interests related to the development of common core indicators to measure prevention.

Second, Belshé said, First 5 LA staff continues to focus on improving our organizational effectiveness and operational efficiency, working across multiple work streams associated with effective execution of the new Strategic Plan. This includes staff development, business process improvements and organizational alignment. Across all domains, staff is working together in new ways that will enhance First 5 LA’s effectiveness and maximize our impact. These include identifying the interdependencies of our work and the alignment, development and capacity building of staff in order to execute the new Strategic Plan.

Third, Belshé noted two important transitions within the agency:

• The departure of Jessica Kaczmarek, director of First 5 LA’s Office of Strategic Planning Implementation (OSPI), who will be assuming a new senior role at the James Irvine Foundation, where she will focus on improving opportunity in the San Bern/Riverside and CV regions. Belshé thanked Kaczmarek for her 8+ years of services to First 5 LA and her many contributions to advancing our organization’s mission, particularly in her OSPI leadership role over the past 18 months.
• Former Policy Manager Stacy Lee has assumed leadership of the OSPI team. Stacy brings a terrific set of skills, experiences, and abilities to this role. Working with her OSPI colleagues, Belshé said, Lee will be able to ensure OSPI continues to play its important organizational-wide leadership role to support F5LA’s effective execution of the new Strategic Plan.

Finally, Belshé called out a number of Commission items:

• Philip Browning was recently honored with the Chauncey Alexander Lifetime Achievement award. This award was established in 1989 and is given to social work leaders whose innovation and action have contributed to lasting and positive social change.
• Marvin Southard announced that he will be retiring as the director of Los Angeles County Department of Mental Health in November. Southard is a founding member of the F5LA Commission and has served in numerous leadership roles throughout his tenure.
• A dozen First 5 LA staffers were delighted to join Commissioner Dennis Duane’s at a July event to celebrate 17 years of success as Executive Director of Pathways LA.