Ann Isbell | First 5 LA Health Systems Program Officer

October 27, 2022

This past September, the First 5 LA team and partners celebrated the final check-in of First Connections — an initiative that was part of our early identification and intervention strategy. While First Connections has come to an end, its learnings, partnerships, and successes continue to inform the efforts we are undertaking to make public systems work better for kids and families, particularly as we strengthen and lean into our role as a systems change agent.  

Beginning in January 2014 as Early Identification of and Referrals to Early Intervention Services for Autism and Other Developmental Delays — later to be named First Connections — was created out of a recognition that the earlier children receive intervention for a developmental delay, the better their outcomes. However, too many children are not identified as having a developmental delay until they enter school. In partnership with six community-based providers, First Connections implemented innovative approaches to embed developmental screening and strengthen referral processes within practices with the knowledge that too many children were not receiving screenings due to lack of access and difficulty in navigating a disparate network of services. 

Changing systems to work better for kids and families requires partnerships within and across public systems to align, integrate and prioritize supports that are responsive to families and communities — and the work of First Connections is a wonderful example of how this can be successfully done. While the “how” differed across the six grantees, each organization worked in parallel to successfully reach the goal to better identify children with or at risk of developmental delays and connect them and their families to culturally and linguistically appropriate early intervention services and supports as early as possible.  

Approaches that First Connections grantees implemented included standardizing processes that led to screening thousands of children (over 60,000 screenings!), connecting families to services (e.g., Regional Centers, Early Head Start/Head Start, mental health), building community partnerships and increasing awareness of the importance of early identification and intervention among staff and the larger community. With nimbleness and flexibility, First Connection partners were able to shift outreach strategies to better engage families of diverse backgrounds and develop approaches to bridge service gaps as found in a 2019-20 evaluation report.

As First Connections evolved across various settings — federally qualified health centers, family-serving agencies and a regional center — we harnessed the many learnings, promising practices, and accomplishments achieved by our First Connections partners to inform other key systems delivering early identification and intervention, including Help Me Grow LA (HMG LA). There are learnings that we are still grappling with, such as data sharing and capacity for care coordination. There are also learnings such as how thoughtful workflows lead to scalable and sustained screening and referral practices resulting in meaningful practice change.  

Furthermore, these learnings continue to help advance our systems change work with the development and release of the Early Screening, Better Outcomes toolkits for pediatric clinics, family-serving agencies and family resource centers to support implementing or refining high-quality developmental, screening and linkage programs across early childhood agencies. These toolkits have been shared at the local, state and national levels to encourage wide-ranging practice change. For instance, we are excited that L.A. Care Health Plan, as part of our HMG LA partnership, is adapting parts of the pediatric clinic toolkit as they integrate screening and referral protocols into practice workflows with participating practices.  

This past May, First 5 LA — in partnership with the Los Angeles County Department of Public Health — launched the HMG LA’s website and call center — a community-driven initiative that helps L.A. County families navigate developmental services so that their child can receive supports as early as possible. First Connections was critical in informing planning and implementation of the HMG LA model, and our grantees will continue to play a part in ensuring that L.A. County kids have the developmental supports and services they need as a part of the HMG network. 

A tremendous thank you to our First Connections partners: Allies for Every Child, AltaMed Health Services Corporation, Eisner Pediatric Health, Foothill Family, Northeast Valley Health Corporation and South Central Los Angeles Regional Center as well as training and technical assistance provider Children’s Hospital Los Angeles for being leaders and partners in this collective effort to support every child’s healthy development. It has been a pleasure working with you!