Highlights from the June 14 Commission meeting include approval of First 5 LA’s 2018-19 fiscal year budget, policy and systems change learnings from an Oral Health Case Study, an update on Home Visiting system building and sustainability strategies and approval of a key amendment to enhance early care and education.
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“When it comes to systems change, we need to keep time, partnership and trust front and center” -Tara Ficek
Staying the course with key program investments and a strategy that advances advocacy, policies and systems that benefit young children and their families, First 5 LA’s Board of Commissioners unanimously approved a $139,992,688 budget for fiscal year 2018-19.
The new budget — a mere 0.1 percent increase over the previous year’s spending — recognizes First 5 LA’s declining tobacco tax revenues and the advancement of the 2015-2020 Strategic Plan, which is entering its fourth year and emphasizes partnership, systems change and public policy in furtherance of population-level outcomes.
Key highlights from the 2018-19 budget include:
- The Program Division’s $88.7 million budget is a 26 percent increase from the previous fiscal year, representing an ongoing shift away from Legacy Investments to further the priorities in the four strategic plan outcome areas: Family Supports ($40.9 million), Communities ($21.0 million), Early Care and Education ($23.3 million) and Health-Related Systems ($3.7 million). This includes support for anchor investments in Home Visiting ($38.3 million for Welcome Baby and Select Home Visiting) and Best Start Communities ($18.8 million). Other key investments include $15.4 million to advance a countywide Quality Rating and Improvement System (QRIS) for early care and education and $2.6 million for Help Me Grow-LA and First Connections for early identification of and intervention with young children at risk of developmental delays.
- Within the Programs Division, the budget also calls for continued investment and development of First 5 LA’s work to promote family engagement ($2.3 million for Abriendo Puertas and Project Dulce) and to advance trauma-informed care and systems change ($827,000).
- With First 5 LA’s focus on advocacy to advance policy and systems change, investment in the Policy and Strategy Division remains strong, with a 7.8 percent increase over the previous fiscal year to $10.7 million. The Integration and Learning Division budget increased slightly (1.9 percent) to $5.9 million.
- The agency’s total operating budget, including administrative costs, increased by 5.7 percent to $22.8 million, representing 16.3 percent of the agency’s overall budget.
Further details on the 2018-19 budget can be read here.
In other action, the Board also approved a key amendment to a strategic partnership with Child Care Alliance of Los Angeles (CCALA) in the amount of $898,000 for a total project amount not to exceed $2,648,000 over four years. CCALA is the fiscal agent for Partnerships for Education, Articulation and Coordination through Higher Education (PEACH), which furthers First 5 LA’s efforts to enhance early care and education, specifically professional development with colleges and universities. More details can be found here.
The Board also received an update on home visiting system building and sustainability strategies from First 5 LA Vice President of Programs Christina Altmayer and Dr. Deborah Daro, senior research fellow at Chapin Hall at the University of Chicago. Click on these links to read Altmayer’s and Daro’s presentations, which will be part of an in-depth article on First 5 LA’s home visiting efforts in the July ECM newsletter.
Finally, Health Systems Department Director Tara Ficek moderated a panel on the policy, systems change and sustainability learnings from First 5 LA’s Children’s Dental Care Program (CDCP). Launched countywide in 2013, the $38 million, five-year investment involved three key partners: USC, UCLA and Western University of Health Sciences. During that time, 125,000 children were served by the program — 30,000 more than the original estimate.
“When it comes to systems change, we need to keep time, partnership and trust front and center,” Ficek said as she introduced the panel, which included Dr. Roseann Mulligan of USC, Dr. James Crall of UCLA and Dr. Jenny Tjahjono of the Western University of Health Sciences.
“This project allowed us to develop an infrastructure and rub elbows with people in the community who were not provided care, didn’t know how to find care and helped them navigate what to them is a very complicated system,” Mulligan said. “Over 55 percent of the children at the WIC (Women, Infants and Children) centers had no dental home.”
Because 60 percent of families approached ask to speak to a social work intern, Mulligan said her school is expanding the practice of integrating social work students into pediatric dental care, a practice begun through the CDCP. The impact of this effort will be presented at the American Association of Public Health meeting in San Diego, she added.
“The community at large still has a disconnect between oral health and overall health” -Dr. Jenny Tjahjono
Another need was for anesthesiologists in treating the 0-5 population for oral health, a practice that worried many parents. Through First 5 LA’s support, an information video about the sedation experience was created to educate parents on the practice. The video was later shared with the American Academy of Pediatrics, which is using the content to help craft new sedation and general anesthesia guidelines. Additionally, Mulligan said, the video has been shown to state lawmakers who are currently considering three bills related to anesthesia with children.
On the question of sustainability, Mulligan touted the construction of the Pediatric Dental Clinic at the LAC-USC Medical Center in 2016 with First 5 LA funding. Recently, the Los Angeles County Board of Supervisors approved running the cost of this clinic, she noted.
“We feel this is the prime example of something that was built with First 5 LA funding that not only allowed us to build the infrastructure, but also the operational strategies that allowed us to demonstrate that we could in fact be cost effective as well as serve the community,” she said.
Asked what lessons learned in the CDCP effort can guide First 5 LA’s systems change efforts going forward, Crall stressed the importance of sharing and coordinating data between medical and dental centers.
For her part, Tjahjono said communication with the community is key, noting how her college has done extensive messaging on the value of oral health.
Even with the evidence that oral health has a direct impact on a student’s performance in school, she said, “the community at large still has a disconnect between oral health and overall health.”
