First 5 Sacramento Adopts Systems Sustainability Plan

First 5 Sacramento has approved a Systems Sustainability Plan. The plan is the first of its kind for Sacramento, and focuses on 3 areas: public awareness and action, policy change and financial resources. The plan offers a roadmap for investing in and creating systems sustainability while looking forward to matching their expenditures to revenue by 2024. Like First 5 Humboldt, they will face up a 30% decrease in expenditures during this process. Unlike First 5 Humboldt, they will expend their reserves completely by 2024.

The plan describes investment in the three systems change areas and lays out plans in each strategic goal area. I feel like First 5 Humboldt could use many of these concepts to further refine our own strategic roadmap. I’m interested in what our Commissioners and staff think of Sacramento’s plan. You can access it here: First 5 Sacramento Systems Sustainability Plan.

Prop 56 Cigarette Taxes Raise Money for Early Childhood Oral Health

From the First 5 Association:

“CDPH has released the county allocation amounts for the new Local Oral Health Program funded by Proposition 56.  This new program is intended to support implementation of the state’s Oral Health Plan, which includes a heavy emphasis on children 0-5. As described in the June letter, Local Health Jurisdictions are expressly urged to coordinate with their First 5 commissions.

For most counties this will be a significant increase in local resources for oral health education targeting pregnant mothers and young children. ”

Many First 5 counties are significantly funding county early childhood oral health efforts (until our significant cut last year, we were in the top 5 counties in percentage of our revenue dedicated for oral health). The Association is urging counties to reach out and partner with their county public health folks. Locally, the Pediatric Oral Health Initiative Leadership Team (POHILT) is doing great work to increase access to pediatric oral health education and services. Last year, Redwood Community Action Agency greatly increased their work in early childhood oral health education, funded through a SAMSHA grant. First 5 Humboldt reduced its investment in early childhood oral health for this current fiscal year.

Home Visiting Day of Action Tomorrow, July 12

The Home Visiting Coalition is asking you to join with their forces in a Day of Action to turn up the heat on Congress to reauthorize the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program before it expires in September.

Key Components of Day of Action on Wednesday, July 12th

  • Webinar:  Advocates participated in a Webinar on July 10 at 2p ET to preview the Day of Action activities.
  • Release of MIECHV Sign-on Letter:  Over 800 organizations have signed onto a letter to Congressional leaders urging them to reauthorize and expand MIECHV.  Many others have signed state delegation letters.  The First 5 Association has already signed on. See the full list of state and national organizations on the letter here.
  • Full Page Ad in Politico:  On Wednesday, July 12th  a full page ad will appear in Politico, a Washington, DC publication read by members of Congress, Hill staffers and other thought leaders and influencers, to urge members of Congress to act on MIECHV.  See the ad here.

July 12th  Activities:

Call & E-Mail Members of Congress: Invite your friends, family members and neighbors to call, e-mail, write, tweet your member of Congress to make sure they know that MIECHV is too important to not reauthorize and expand the program.

  • Engage in Twitterstorm from 2-3p ET:  Let Congress hear from you on social media.
  • Toolkit:  Use this Toolkit to Engage Congress. Please keep up the action through July and August when members of Congress are back home for the congressional recess.

Other Important Information:

The National Home Visiting Resource Center, ,recently launched the 2017 Home Visiting Yearbook which presents a portrait of early childhood home visiting across America, expanding our understanding of who receives, administers, and funds home visiting. Highlights include—

  • More than a quarter of a million families including more than 300,000 children received evidence-based home visiting services in 2015 over the course of more than 2 million home visits.
  • About 18 million pregnant women and families (including more than 23 million children) could benefit from home visiting but are not being reached.
  • States have long supported home visiting, pooling limited resources to serve as many families as they can in a way that makes sense on a local level.

Preventing Early Childhood Adversity Before It Starts: Maximizing Medicaid Opportunities

In Humboldt County, Adverse Childhood Experiences (ACES) are of special concern. There are many thoughts in the community about how this should best be addressed. Some advocate for resilience promotion, some for reducing parental and prenatal substance use, others for housing families. All of these goals are important. For years, First 5 Humboldt’s approach has been through family strengthening and promotion of the 5 Protective Factors, which are associated with reductions in child abuse and neglect. This resilience promotion approach is something that can co-exist with specific public health and social service approaches and is something that can benefit all families that participate in our programs.

This article from the Center for Health Care Strategies offers a good discussion on how existing Medicaid provides opportunities to address ACES. All of the key strategies identified in the article have already been spearheaded by our own 0 to 8 Mental Health Collaborative and First 5 at the county level: integrating some cross-sector data and working to do expand where we can, using data to target interventions to infants, families and neighborhoods–through playgroups but also through the 0 to 8 MHC’s grant-funded pilot project focusing on ACES and children 0-3 in Fortuna, Eureka and McKinleyville, identifying assessment tools and shared metrics, such as our use of Humboldt’s Kindergarten Screening Tool results in our data analysis, and building strong cross-agency partnerships through the 0 to 8 Mental Health Collaborative, our recent convening of an early childhood/Mental Health Services Act workgroup, the Infant Regional Mental Health workgroup, and the ACES Stakeholder Group convened by the North Coast Grantmaking Partnership and First 5. Last but not least, depending on approval of Humboldt County’s Budget next week, we are about to launch a partnership with Humboldt’s Department of Health and Human Services to work on ACES prevention, thanks to the Humboldt County Board of Supervisors’ foresight and commitment to address ACES in our county.

In all, I think First 5 Humboldt is doing some innovative and powerful work. My hat is off to our current Commission, staff, our partners and community advocates, former Commissioners, and former ED Wendy Rowan for creating such a strong and forward-looking Humboldt County Children and Families Commission.

Click on the infographic below to open the full image.

Medicaid plays a critical role in the first 1000 days of a child's life in addressing ACES and preventing negative lifelong outcomes

California Legislature Sends Budget Bill to Governor

The Legislature has sent their Budget bill to the Governor Jerry Brown for his signature. The bill includes key provisions for young children, in the areas of child care and health.

Here’s the summary from the First 5 Association:

Fulfilled Promises of the 2016 child care promises: 

  • $7.9 million for the addition of nearly 3,000 full day state preschool slots administered by local education agencies (LEAs). If LEAs cannot spend the allotted money, non-LEAs can apply for the funding.

Reimbursement Rate Increases:

  • $42.2 million increase to Regional Market Rate for voucher-based child care providers by using the 75th percentile of 2016 SMI, beginning 2018
  • $67.6 million increase to the Standard Reimbursement Rate and an additional 6% increase ($92.7 million) above what was promised in the 2016 budget deal for CSPP and other direct-contracted providers

Additional Child Care Investments & Activity: 

  • $25 million for updated family eligibility 12 month continuous child care, and graduated exit eligibility (to essentially implement AB 60)  — Note, this increased from $20late last week 
  • $15 million to fund emergency child care for foster children beginning January 1, 2018. An additional $31 million in ongoing funding to establish a voluntary county program to provide emergency child care vouchers.
  • Title 22 and ratios for school-run preschool programs remain in tact, and LAO will convene a stakeholder group to examine health and safety requirements under Title 22 and issue a report with recommendations by March 15, 2018.

Proposition 56 ($2 tobacco tax) Funds: 

In January, the Governor proposed that the estimated $1.3 billion from new tobacco tax revenues, passed under Prop 56 in Nov 2016, be dedicated to existing Medi-Cal services. The health care field and the legislature pushed back, citing the intent of the proposition was to in part increase provider payments for medical professionals serving Medi-Cal patients. The following compromise was struck:

  • Increased payments for medical professionals in 2017-18: $546 million (of the projected $1.3 billion in Prop 56 revenues) would go to Medi-Cal providers as “supplemental payments” to five provider groups: up to $325 million for physicians; up to $140 million for dentists; up to $50 million for women’s health providers; up to $27 million for providers serving people with developmental disabilities; and up to $4 million for providers caring for people with HIV/AIDS. The rules for allocating “supplemental payments” will be determined by the Department of Health Care Services by July 31, 2017.
  • Additional Funding for Medi-Cal: The remaining Prop 56 funds will pay for ordinary spending growth with the Medi-Cal program, which could total up to $711 million in 2017-18.
  • Contingency Plan: Supplemental payments will be disbursed only if: 1) California receives “all necessary federal approvals” to receive Medicaid matching funds (the proposed $546 million supplemental payment would receive a $613 million federal Medicaid match); and 2) The federal government does not cut funding for Medi-Cal from current projected levels.This will be monitored by the Department of Finance.
  • Beyond 2017-18: The compromise sets an expectation that supplemental payments could receive up to $800 million in 2018-19. However, these funding levels will be subject to next year’s budget negotiations.

What was NOT funded: 

  • The CalWORKs Baby Wellness and Family Support Home Visiting program was not funded. Thank you to all the commissions who worked tirelessly on this proposal. Legislators and advocates alike were very appreciative of First 5’s engagement around this effort.
  • CalWORKs ancillary diaper services for CalWORKs families also did not receive funding.
  • The Legislative Women’s Caucus requested additional funding for most child care slots. No slots were added above the 2016 child care promised.

Blue Ribbon Commission on Early Childhood Education

The Assembly Speaker, Anthony Rendon, has convened the first meeting of the Blue Ribbon Commission on Early Childhood.
Here’s the summary from the First 5 Association:

Blue Ribbon Commission’s First Hearing
The Speaker-appointed Blue Ribbon Commission on Early Childhood Education held their first hearing in Sacramento yesterday. The first hearing provided a platform for the commissioners, both Assemblymembers and child care experts, to introduce themselves and offer what they hoped to discuss and tackle as a commission.
Notably, many commissioners discussed the importance of studying issues facing infant-toddler-, preschool-, and school-aged students, along with workforce concerns. Additionally, many acknowledged that the system is widely under-resourced. As such, the commission is also tasked with discussing funding sources to support recommended changes.
Three speakers helped set the stage and provide a historical overview of child care systems in California and the many state and federal funding streams. Speakers included:  Erin Gabel, Deputy Director External Affairs, First 5 California  Donna Sneeringer, Policy Director, Child Care Alliance of Los Angeles  Rowena Kamo, Research Director, CA Child Care Resource & Referral Network

First Blue Ribbon Commission hearing held in Sacramento on March 6th
All three speakers discussed how child care funding remains 20 percent below pre-recession levels, which has impacted all providers. Rowena Kamo highlighted the dramatic impact of budget cuts have had on family child care providers. Erin Gabel discussed the school-side of child care and relayed that the system, while complex, was designed to address the diversity of parent’s needs and meet the dual workforce and child development goals. Donna Sneeringer focused on the voucher-side of child care and discussed how Alternative Payment Programs provide the needed flexibility to meet the needs of families with non-traditional and unpredictable work schedules. She also discussed the complex reimbursement structure through the Standard Reimbursement Rate (SRR) and Regional Market Rate (RMR) and encouraged commissioners to address the discrepancies between these two structures.
Handouts from the presentation are available here. The hearing’s full agenda is available here. The next meeting has not been announced, but the Association is monitoring the hearings and will be meeting with many of members of the commission.

Advocacy Committee Votes to Support Legislation
The Advocacy Committee met on February 22nd to take positions on bills.
Please remember that it is still early in the legislative process and the Advocacy Committee will be voting on additional bills in the coming months. If you would like to recommend that the Association take a position on a specific bill, please contact Margot.
Most notably, the Association the voted to support AB 60 (Santiago/ Gonzalez Fletcher), legislation that will update the State’s Median Incomes (SMI) level to current date and provide continuous 12 month child care eligibility for families. This legislation is the same as last year’s AB 2150 and is a top priority in the child care field. The Association submitted a support letter and we encourage other commissions to do the same. The bill will be heard in the Assembly Human Services Committee today.

Reflective Practice Training

Meg Walkley and Beth Heavilin will present a Reflective Practice workshop for IMPACT participants on March 18. They will be offering workshops on this valuable approach each year of the IMPACT program. Reflective Practice promotes a thoughtful, client/family/child-responsive approach to interactions, supervision and support services. It is an approach used by multiple human service fields, including nursing and teaching. It is also content that is required for California Infant-Family Early Childhood Mental Health (IFECMH) endorsement. The IMPACT program will prepare participants for when we have an in-county endorsement process.