Highlights from the Sept. 13 Commission meeting include an update on funding and research of African American birth mortality disparities in Los Angeles County, a follow up to the July interactive “gallery walk” for Board members on First 5 LA’s Impact Framework progress and process, the welcoming of a new Board member and a presentation of the final report on Strengthening Home Visiting in L.A. County.

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First 5 LA’s focus on creating systems change through innovation and leveraging of funds was highlighted during an update on its research approach to help reduce African American birth disparities in L.A. County during the September 13 Commission meeting.

During the presentation by Family Supports Director Barbara Andrade DuBransky and Senior Strategic Advisor Lindsey Angelats, a number of sobering statistics were shared: African American infants die at more than three times the rate observed for White and Asian infants. Additionally, exposure to racism and racialized stress throughout the lifespan can negatively impact birth outcomes.

Released in July, L.A. County’s Center for Health Equity Action Plan includes a central goal to reduce the gap in infant mortality rates between White and African American babies by 30 percent in L.A. County. In an effort aligned with this plan, First 5 LA is partnering with the L.A. County Department of Public Health (DPH) to ensure more African American women have access to support during pregnancy and post-partum, reducing stress.

As part of this effort, First 5 LA has been conducting focus groups with African American mothers, grandmothers and women of childbearing age to better understand their perspectives on pregnancy and birth, prenatal services, the role of race and racism in birth outcomes and social, economic and structural factors associated with birth outcomes.

Early findings include an opportunity to increase health sector trust and engagement, as well as African American women’s knowledge of their increased risk of preterm birth. These findings support a call to explore the development of a public communications campaign, to transform the health care delivery system to meet the needs of African American women, and to route women to more effective clinical care. The final report will be released this fall.

“I think that this is groundbreaking work that would help set the direction for other First 5’s.” — Commissioner Dr. Barbara Ferrer

Additionally, First 5 LA has collaborated with the State Department of Health Care Services (DHCS) on a pioneering effort to profile the health care utilization of Medi-Cal enrollees of childbearing age, by race. It is anticipated that this data will be available in early 2019.

In a new leveraging of funds, First 5 LA was awarded $150,000 from the National Pritzker Children’s Initiative to further critical stakeholder communications work with the African American community. Pending commissioners’ approval of this grant at the September 27 Program and Planning Committee meeting, this amount will be matched by First 5 LA for an amount not to exceed $310,000 through Aug. 31, 2020 to support the work of a proposed Pritzker Fellow with expertise in stakeholder communications.

“I don’t think a lot of other First 5’s are doing this,” said Commissioner Dr. Barbara Ferrer, who serves as director of DPH. “I think that this is groundbreaking work that would help set the direction for other First 5’s.”

In a follow up to the July Board retreat “gallery walk” sessions, Vice President of Programs Christina Altmayer and Vice President of Integration and Learning Daniela Pineda shared key themes that emerged from Commissioners’ feedback on the development of the Impact Framework, which will help First 5 LA update its approach to measuring progress and propose future refinement of its strategic plan in 2019.

The key themes from Commissioner feedback included 1) Content Integration; 2) Communicating the First 5 LA Story; 3) Measurement Considerations; and 4) Questions about Strategy. Further details can be found here.

Commission Vice Chair Judy Abdo praised the July gallery walk and the progress reflected in the follow up presentation. “This whole process was not done and put on a shelf,” she said. “This was done to detail our work moving forward.”

Development of the Impact Framework will continue this fall. A list of county-level outcomes and monitoring measures for Board consideration are expected to be presented at the October Commission meeting, followed by a request for the Board to approve these in November. Pending approval, measurement and reporting plans would be developed during spring and summer 2019.

Additionally, staff will introduce a proposed process for refining the strategic plan at the September 27 Special Meeting of the Board/Program and Planning Committee meeting. This will include a description of the process, a set of key steps and a timeline.

In another presentation, DPH Maternal, Child and Adolescent Health Programs Director Linda Aragon was joined by DuBransky to unveil the county’s plan, Strengthening Home Visiting in Los Angeles County: A Plan to Improve Child, Family and Community Well-Being.

The plan, authored by DPH and presented to the County Board of Supervisors in July, is intended to serve as a core framework on which to develop and layer more detailed implementation of a coordinated system of home visiting for families of children 0-5 in L.A. County. As an innovator in and largest funder of home visiting in the county, First 5 LA was one of the key partners and contributors to the creation of the plan, which was developed in response to a December 2016 motion by the Board of Supervisors to expand and enhance the system of home visiting supports in the county.

Key components of the plan include expansion efforts and commitments made by participating organizations to:

  • build a coordinated system of referrals into home visiting;
  • strengthen the connections of home visiting participants to an array of community services;
  • increase utilization of state and federal dollars to support home visiting expansion;
  • integrate with related county priorities; and
  • enhance the ability for agencies to effectively reach, engage and assist in achieving outcomes for diverse populations within the county.

In their presentation, DuBransky and Aragon also outlined early implementation wins, highlights in progress and next steps. The full report, which is available to read here, was welcomed by First 5 LA Commissioners.

Another warm welcome was extended to Dr. Astrid Heppenstall Heger, a new Board member replacing outgoing Commissioner Jane Boeckmann. This was her first meeting as a Commissioner.

“She touches nearly everything that First 5 LA is about,” Abdo said of Heger, who serves as executive director of the Violence Intervention Program (VIP), located at the Los Angeles County-USC Medical Center, where she is also a professor of clinical pediatrics. In 1984, she founded the Center for the Vulnerable Child (CVC) for the evaluation of child abuse.

The next Board of Commissioners meeting is scheduled for Thursday, October 11.

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