Fraser Hammersly | First 5 LA Digital Content Specialist

May 25, 2023

First 5 LA’s Meeting of the Board of Commissioners convened in person on May 4. The agenda included presentations on First 5 LA’s Draft Proposed Fiscal Year 2023-24 Budget and updated Long-Term Fiscal Plan (LTFP) and the 2023 Strategic Plan Reset. Additionally, information was shared on several strategic partnerships and amendments, including the African American Infant and Maternal Mortality (AAIMM) initiative.

The May 4 Board of Commissioners meeting opened with remarks from First 5 LA Board Chair and L.A. County Supervisor Holly J. Mitchell, who offered an introduction and warm welcome to the new board member Summer McBride, who was appointed by Mitchell to represent the Second District.

“Thank you so much for agreeing to take on this task of leading L.A. County as we focus on our zero to five, our most important constituency group,” Mitchell said. “I appreciate you.”

McBride is a certified parenting instructor, full-spectrum doula and trained facilitator of Centering Pregnancy through the Charles Drew University Black Maternal Health Center of Excellence. She is also the CEO of The Village Legacy, a local nonprofit that offers affordable and culturally responsive parenting classes, and the co-chair of L.A. County’s African American Infant and Maternal Mortality (AAIMM) Community Action Team.

Following Mitchell’s remarks, Executive Director Karla Pleitéz Howell addressed the Board, calling attention to the primary focus of the meeting: the initial draft of First 5 LA’s proposed 2023-24 budget. She noted that the budget was developed by First 5 LA staff to incorporate the agency’s Long-Term Fiscal Plan, with an eye for both the current fiscal reality and the organization’s Strategic Plan reset.

“This budget reflects increases in strategic partnerships with our County, and we’re really excited about sharing some of that information with you,” Pleitéz Howell informed the Commission. “Most importantly, the work cannot and would not have been done without the whole First 5 LA team stepping up and saying: ‘Yes, we’re going to deal with this reality.’”

The consent agenda was unanimously approved. One notable agenda item consisted of a Board vote authorizing First 5 LA to submit an application to receive grant funding from the First 5 California Commission for the regional technical assistance for home visiting coordination and integration project. Contingent upon the final award, the grant is an anticipated amount of $1,454,689 and would go toward ongoing efforts to advance systems-building goals and strengthen existing infrastructure within L.A. County’s home visiting system. For more information, click here.

As highlighted by Pleitéz Howell, the spotlight of the May meeting was on First 5 LA’s draft proposed fiscal year 2023-24 budget. Chief Operating Officer JR Nino, Director of Finance Raoul Ortega, Financial Planning & Analysis Manager Daisy Lopez and Executive Vice President, Center for Child and Family Impact (CCFI) John Wagner joined the Board to provide an overview of the draft budget, including how First 5 LA’s fiscal reality in the context of Proposition 31 and the Strategic Plan reset impacted its development.

Developed in a similar process to previous years’ budgets, Nino explained that the draft budget was informed by what First 5 LA has done in the past and plans to do in the future, along with its multi-year contract obligations. What differed in this year’s budget, however, was the need to be proactive and responsive to declining revenues due to Proposition 31, which led teams to strive for a 5-10% reduction in spending below the established board spending limits.

Ortega pointed out how the draft budget focuses on First 5 LA’s long-term suitability goals with $8.3 million of non-Proposition 10 revenue. He also emphasized how the proposed budget resources are anchored to work priorities and fiscal realities: programmatic work that was slated to end or ramp down is continuing as planned, while new programmatic investments are on hold until the completion of the Strategic Plan reset. Additionally, some projects and activities were reorganized or consolidated to maximize efficiency. For more information, see slides 4-6 here.

Overall, the draft budget features a net decrease of 5.5% compared to last year’s budget, Lopez shared. Included in this decrease is a 5.2% reduction in programmatic spending and a 6.6% reduction in operating costs. Wagner spoke next regarding the programmatic decreases, providing context for CCFI’s strategic reductions in the Center’s budget, while Lopez gave an overview of budgets from the Office of Communications, Office of Data for Action, and Office of Government Affairs and Public Policy, as well as administrative and operational costs and reductions. For more information, see slides 8-12 here.

Lastly, Ortega provided an update on the LTFP, drawing a connection between how projected reductions in spending over time will support narrowing the gap between First 5 LA’s revenues and expenditures, particularly in the wake of Proposition 31.

“Currently, we are fiscally sound, but we do need to revisit and prioritize our future spending, including revisiting the established spending limits we established prior to Proposition 31. And as we move into the Strategic Plan reset process, we do need to make both difficult and strategic decisions to align to our new fiscal reality,” Ortega said.

As the Strategic Plan reset process continues, First 5 LA will return to the Board to provide updates on how these decisions impact First 5 LA’s long-term spending plans. The finalized 2023-24 budget and updated LTFP will be voted on at the June 8 Board of Commissioners meeting. For more information, see slides 14-24 here.

Next on the agenda was a presentation on First 5 LA’s Strategic Plan Reset. Chief Transformation Officer Antoinette Andrews Bush and Strategic Plan Senior Strategist Kaya Tith joined the Board to summarize feedback from the March Board meeting as well as the next steps in the Strategic Plan reset process.

Basic needs, child welfare, healthcare — both mental and physical — and education were public systems that Commissioners had called out as a potential focus for First 5 LA’s systems change impact, Andrews Bush summarized.

Additionally, advocate, partner/collaborator and architect/builder were highlighted as potential roles First 5 LA should play within the context of the Strategic Plan Reset. Commissioners also underscored the need to look at existing data and hear directly from families to gain a clearer picture of where First 5 LA can have the greatest impact.

“All of this leads directly to the Strategic Plan Reset itself,” Andrews Bush stated. “Staff heard clearly from Commissioners how important it is to have a clear, concise strategic plan with concrete goals and measures of success and that we engage the community throughout the process and continue our strong focus on equity.”

First 5 LA will return to the Board in June with an update on progress, following the onboarding of a Strategic Plan consultant. For more information, click here.

The final presentation on the agenda, given by Health Systems Program Officers Nicole Jones and Ellen Paddock and L.A. County Department of Public Health Director of Maternal, Child and Adolescent Health Dr. Melissa Franklin, focused on First 5 LA’s African American Infant and Maternal Mortality (AAIMM) initiative, with an emphasis on the AAIMM Community Action Teams (CATs).

Franklin shared an overview of AAIMM’s values, stating that the coalition — a partnership between First 5 LA, the L.A. County Department of Public Health, other County agencies and community-led organizations — is working together to end the unacceptably high rates of Black infant and maternal deaths in L.A. County by addressing the role racism and implicit bias plays as the root cause of the disparity.

In speaking about the four CATs — which are centralized in South LA/South Bay, Antelope Valley/Palmdale, San Gabriel/ Valley/Pasadena and Santa Clarita/San Fernando — Franklin explained how they were “the heart, and soul, and eyes and ears of our work, bringing on the ground community-centered specific strategies, as well as guiding the Department’s efforts.”

Critical milestones from the work were highlighted, including efforts to implement intervention practices at the clinical, institutional, community and data-gathering levels across eight hospitals within CAT regions, as well as an update on the AAIMM’s communications strategies which have involved celebrating “activating one’s village” of mentors, doulas, and other support systems that lead to joyous and healthy Black births.

According to Jones, an evaluation report by UCLA’s Center for Health Policy is underway. The report will include both qualitative and quantitative data that will measure the impact of the initiative’s efforts with an infrastructure, implementation success, and sustainability lens. The report is scheduled to be completed in June 2023.

Lastly, Jones shared overall learnings from AAIMM’s journey, which began in 2018 with a goal of ending the racial maternal mortality disparity within L.A. County in five years. A key learning has been that the five-year span is not enough time to uproot systemic racism, particularly in the wake of the COVID-19 pandemic that exacerbated the crisis.

“We need to shift our thinking from viewing AAIMM as a five-year initiative to a movement; a movement to disrupting racism through centering joy and safety for Black women and birthing people,” Jones said.

For more information, see the presentation here.

Additionally, an amendment to a strategic partnership that would continue supporting AAIMM’s community-driven strategies was provided as an information item, with a vote scheduled in June. For more information, click here.

When it came time for Commissioner discussion, Commissioner Carol Sigala shared her thoughts:

“To give women a voice in this area and to carry on this research is extremely important and, historically, never been done before. So, I thank you so much. As we look at systemic oppression — for all women of color and also women of poverty — hopefully, we can look at this data and create change not only in the Black community but in the other communities where it’s needed as well.”

Lastly, several items on the agenda were presented as written-only information and will be voted on at the June meeting. Notable items included:

  • Amend Strategic Partnership with 13 Welcome Baby Grantees in the Amount of $54,223,000 to Implement Welcome Baby Program: Representing First 5 LA’s continued investment in home visiting, this amendment is being recommended by First 5 LA to continue implementation of Welcome Baby in 13 hospitals in L.A. County over a two-year period. For more information, click here.
  • Amend a Strategic Partnership with the Los Angeles County Office of Education (LACOE) in the Amount of $11,000,000 to Manage the Implementation of Quality Start Los Angeles: Contingent upon final award from First 5 California’s IMPACT Legacy, First 5 LA is recommending that the Board approve an amendment to a strategic partnership with LACOE that will allow First 5 LA to continue building on its quality rating and improvement system with a new emphasis on providing quality improvement services within Family, Friend and Neighbor (FFN) care and home-based child care settings. For more information, click here.
  • Amend Strategic Partnership with Public Health Foundation Enterprises, Inc. in the Amount of $1,401,000 for the WIC Data Mining Project: First 5 LA is recommending that the Board approve an amendment that will continue PHFE WIC’s work of providing First 5 LA with critical data on low-income families that participate in WIC programs that will help First 5 LA understand the conditions of families in L.A. County. For more information, click here.

The next Board of Commissioners meeting is scheduled for June 8, 2023. For more information, visit 72 hours in advance of the date.

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