ATTACHMENT C: FY PROPOSED BUDGET PROGRAM REQUESTS -- HIGHLIGHTS

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1 ATTACHMENT C: FY PROPOSED BUDGET PROGRAM REQUESTS -- HIGHLIGHTS The FY Proposed Budget continues implementation of strategies included in the FY Strategic Plan, as amended. The Commission approves the budget at the initiative level, and each initiative may include one or more programs. These highlights include a summary of budget requests at the program level. Although this year s budget is primarily a status quo budget, this attachment calls out programmatic investments that are high-profile, large, Commission priorities or involve significant changes. These highlights are organized according to the following investment areas. A. Place-Based Investments B. Countywide Strategies C. Countywide Initiatives D. Prior Strategic Plan Initiatives E. Research & Evaluation Further detail on each program budget request is provided in Attachment C. It is important to note that much of the information included in Attachment C is subject to change and may not be binding. Funding requests were generated using the latest information available at the time the budget was developed and may be updated to include recent expenditures. In addition, the output data related to Getting Better Data, as well as activities or funding estimates for contracts that have yet to be negotiated may be revised. A. PLACE-BASED INVESTMENTS Organizational Transition Team Alignment Building off the lessons learned from L3 and the Best Start inquiry, First 5 LA convened the OTT to develop concrete implementation plans that promote greater coordination of our placebased and countywide efforts. Staff identified three areas where there were opportunities available to achieve greater alignment around the core results of the BSFF. The goal of these alignment priority areas is to move the organization closer to a common agenda for the remainder of this Strategic Plan and improve overall effectiveness. The areas identified through this process include: (1) Organizational support to grantees and contractors; (2) Policy and advocacy; and (3) Parent education, information, resource and referral. Eighteen-month work plans recommending activities, resources and a timeline required to coordinate efforts across investments were created for each of these three areas. To implement the work plan during FY , the budget includes $26,500 to: (1) provide two webinars for contractors and grantees serving Best Start communities ($5,000 is included in the Best Start Community Funding initiative), (2) procure consulting services for a Parent Advisory Committee ($20,000 is in the Public Affairs Operating budget for Consultant Fees), and (3) reclassify a Program Officer II position to Government Affairs Officer II to serve as a liaison to Best Start communities, advocate for County home visiting efforts and work with County partners on Strengthening Families/preventive efforts (no fiscal impact). In addition to these OTT efforts, First 5 LA is working organization-wide to, as possible and appropriate, align programs with BSFF and our work in the 14 Best Start communities. 1

2 Best Start Family Strengthening Initiative The Family Strengthening strategy begins with engaging families through Welcome Baby, a home visitation program designed to serve as an outreach to families at strategic points in time during pregnancy, birth, and post-natally. Welcome Baby provides parenting education and health promotion information, and invites families into an array of services and supports in their community. In addition, families receive information and support during each visit on topics such as breastfeeding, health, safety, postpartum depression and other issues. All families delivering at participating hospitals, regardless of place of residence, will receive a Welcome Baby hospital visit at the time of their baby's birth. Families residing within a Best Start Community and identified as having a great risk for poor child outcomes will be eligible for referral to an intensive Select Home Visitation Program (Healthy Families America, Parents as Teachers or Triple-P). Although other, less intensive parent education and support services may be available, the goal is to develop a network of high quality, evidence-based models to serve as the primary resource for high risk pregnant women and new parents. Families residing within a Best Start Community are eligible for up to nine Welcome Baby engagements: three prenatal, at the hospital, and up to five postpartum engagements. Families living outside Best Start communities and facing serious challenges in caring for their newborn due to such factors as lack of social supports or limited knowledge on infant care will receive up to three Welcome Baby postpartum home visits, as needed. INITIATIVE/PROGRAM Revised Proposed FY Budget FY Budget Best Start Family Strengthening Welcome Baby Hospitals $ 12,075,533 60% $ 14,348,000 48% Select Home Visitation 5,510,271 27% 12,456,000 41% Family Strengthening Oversight Entity 2,483,619 12% 3,172,000 11% Family Strengthening Public Education - 0% 150,000 0% Total Best Start Family Strengthening $ 20,069, % $ 30,126, % Welcome Baby Hospitals ($14,348,000): Funding will support Welcome Baby provider hospitals. In FY , 13 provider hospitals completed their first year of implementation, including hiring, staff training and initial client enrollment. Four providers had contracts of seven months or less and will have 12 full months of fully-staffed levels in FY Two additional providers are expected to complete training and initiate enrollment in FY for a total of 15 Welcome Baby providers. As a result, FY costs are expected to increase by 19% over the current year. Primary goals for FY include the following: (Program Development) Enroll a minimum of 40% of participating hospitals births into the program; Achieve a 75% rate for program participants that will initiate any breastfeeding at time of hospital visit; Achieve an 80% rate for program participants receiving a 2-4 week postpartum visit who will be given options for ongoing emergency and other care; Achieve an 80% rate for program participants receiving a 3-4 month home visit who will receive an Ages and Stages Questionnaire (ASQ) screening at that visit; and 2

3 Achieve an 80% rate for babies receiving a 9-month visit who are up-to-date on immunizations. Family Strengthening Oversight Entity ($3,172,000): The Oversight Entity supports the implementation of the Family Strengthening strategies to ensure coordinated, high-quality services are offered across the system of participating providers. Standardization of the Welcome Baby program will ensure adherence to program fidelity by providers across the County. The Oversight Entity also provides programmatic technical assistance, training and support to the Welcome Baby and Select Home Visitation providers and supports efforts to develop referral pathways to best meet the needs of families. In FY , the Oversight Entity supported 13 Welcome Baby providers with ramp-up and training. FY represents the first year these 13 providers will be at full implementation with expected increases in enrollment, two additional providers beginning enrollment during the fiscal year. (Program Development) Select Home Visitation ($12,456,000): This program aims to: increase parent knowledge of early childhood development and improve parenting practices; cultivate and strengthen parentchild relationships; provide early detection of developmental delays and health issues; prevent child abuse and neglect; and increase children s school readiness and school success. This request represents an increase of 126% from FY when the 21 providers had contracts for seven months or less; FY will be a full 12 months with 50 additional new personnel. The main goals for the 21 Select Home Visitation providers in FY are as follows: (Program Development) Achieving an enrollment rate (based on receipt of the first home visit) of 70% of clients referred by Welcome Baby; Completing the first home visit within two weeks of the referral date from the Welcome Baby site 80% of the time; Ensuring enrolled clients receive at least 75% of the appropriate number of home visits based upon the individual level of service to which they are assigned; Tracking breastfeeding initiation, exclusivity and duration rates; Implementing Patient Health Questionnaire (PHQ) for Depression Screening at intake and once a month for 90% of the time for actively enrolled clients; Ensuring at least 80% of target children are linked to a medical/healthcare home. Family Strengthening Public Education ($150,000): Funding will provide marketing and communications support to the expanding Welcome Baby voluntary home visiting program throughout LA County. Strategies will include creative and editorial support, training, public relations, community outreach, advertising, social media, partnership building, in-kind fundraising and other efforts to support increased awareness of Family Strengthening and the Welcome Baby voluntary home visiting program. These resources will leverage the thousands of contacts between home visitors and new mothers to communicate specific First 5 LA key messages around family strengthening and the protective factors. Resources will also be used to explore marketing a proposed Welcome Baby Discount Card program and licensing/sponsorship of Welcome Baby program components. (Public Affairs) 3

4 Best Start Communities Initiative During the FY , the Best Start Communities BSFF will be in full implementation. The upcoming fiscal year will be a turning point as we: Enter into the action phase of the BSFF anchored by the Learning by Doing (LBD) process which includes seven program components (e.g., broad resident engagement, partnership capacity building, and results-focused actions); Restructure the role of Best Start staff to effectively and efficiently support First 5 LA s place-based investments; Introduce new elements, such as the Resident Leadership Academy and Best Start Advisory Council, that will support resident leadership and provide guidance and perspective as we continue to implement the BSFF; and Begin the transition to a Long-Term Business Model. As a result, the trajectory of these costs will increase in FY due to the need to build First 5 LA organizational capacity to support BSC Department staff and fully engage Community Partnerships in all aspects of the LBD process and other BSFF components. The explicit focus of the BSFF is on strengthening families capacity to nurture their children and help them thrive, while building human and community capital and improving the systems that will support parents in doing so. Anchored in the core results and initially approved in November 2013 as part of the BSFF Implementation Plan, the budget includes requests for the following cost components, described in further detail below: 1. Best Start LA Pilot Community 2. BSFF Alignment 3. Learning by Doing: Partnership Capacity Building and Planning 4. Learning by Doing: Resident Engagement 5. Learning by Doing: Results-Focused Actions 6. Learning by Doing: Assessing Progress 7. Learning by Doing: Community Convenings 8. Marketing and Communications INITIATIVE/PROGRAM Revised Proposed FY Budget FY Budget Best Start Community Funding Best Start LA Pilot Community $ 885,000 9% $ 885,000 7% BSFF Alignment 246,836 3% 153,000 1% LBD: Partnership Capacity Building & Planning 530,140 6% 1,438,000 11% LBD: Resident Engagement 661,610 7% 1,740,000 14% LBD: Results-Focused Actions 700,000 7% 2,865,000 22% LBD: Assessing Progress 1,298,686 14% 302,000 2% LBD: Community Convenings 2,886,986 31% 3,720,000 29% Marketing & Communications 2,161,249 23% 1,775,000 14% Total Best Start Community Funding $ 9,370, % $ 12,878, % Best Start Communities Department - Operating Costs $ 2,828,014 $ 3,476,613 4

5 BSFF Alignment ($153,000): First 5 LA s commitment to improve the core results requires a system of support within the communities and across First 5 LA. To this end, we will continue strengthening internal and external capacity to support implementation of BSFF. (Best Start Communities) Learning by Doing Partnership Capacity Building and Planning ($1,438,000): The Community Partnerships ability to lead a broadly supported community change agenda and process is dependent on the strength of their capacities. Training and technical assistance will be provided to strengthen their capacities to plan through the LBD approach. (Best Start Communities) Learning by Doing Resident Engagement ($1,740,000): Community change requires meaningful engagement by parents and residents to inform and lead a common vision and a results-focused agenda. Resources will be provided to expand neighborhood-level resident organizing to strengthen social connections and resident engagement. (Best Start Communities) Learning by Doing Results-Focused Actions ($2,865,000): LBD is grounded in the BSFF theory of change a change-making approach to strengthen families (i.e., the protective factors) by engaging with and influencing the systems that impact families and communities. Accordingly, the BSC Department will implement a systems change grant-making approach to support strategies identified by Community Partnerships to address the BSFF core results. In FY , the results-focused actions will be based on decisions made throughout the LBD process and funding will be provided for efforts in the following categories: 1. Civic Engagement: Build public awareness and influence public policy (at the municipal and/or BSC community level) to achieve BSFF core results. 2. Social Capital: Build relationships and partnerships among families, organizations, networks, and other community stakeholders. This also includes identifying, supporting and developing leaders within the local community. 3. Organizational Capacity Development: Strengthen informal and formal community groups, organizations and collaboratives to carry out effective programs and improve overall functioning. This funding is intended to create change that is sustainable beyond First 5 LA funding. 4. Community Resource Mobilization: Mobilize, leverage, and connect local and external resources. This can include, but is not limited to, approaches such as matching and challenge grants, and social enterprise investment. Consistent with the Board policy approved in September 2013, staff will implement a two-tiered funding approach: (1) base-level funding of $160,000 for each community, and (2) access to an additional performance fund of $560,000 for all communities based on demonstrated progress in achieving outcomes and performance. This approach ensures that communities not only have access to resources, but can also build on the momentum of their work. (Best Start Communities) Learning by Doing Assessing Progress ($302,000): LBD is based on the Results-based Accountability framework a disciplined way of making decisions based on demonstrated results and progress made towards those results. Therefore, LBD requires the identification and tracking of performance measures of strategies. Partnerships will regularly review performance data to assess, monitor and report progress in the targeted core result and make mid-course adjustments as necessary. Funding will be spent on data collection tools and methods (such as 5

6 surveys and focus groups), support for data systems to track and analyze performance measures, as well as reporting and dissemination of results. (Best Start Communities) Learning by Doing Community Convenings ($4,605,000): Foundational to Community Partnerships are the infrastructure supports necessary to bring the community together and foster meaningful exchange. Such convenings of parents, residents and community-based organization (CBOs) representatives are central to: (1) building relationships, trust and a collective vision toward improving outcomes for children and families; and (2) taking action to advance community-identified core BSFF results. General infrastructure support for Community Partnerships includes managing all logistical and facilitation needs for convenings and activities associated with the implementation of LBD activities. (Best Start Communities) 13 Best Start Communities: First 5 LA staff and contractors currently provide support to 13 Best Start communities. ($3,720,000) Best Start LA Pilot Community: Para Los Niños (PLN) serves as the lead agency for the Best Start Metro LA pilot community. ($885,000) Marketing & Communications ($1,775,000): The Public Affairs Department will provide communications and public education support for Partnership implementation of the BSFF, with a focus on community-specific communications of decisions made and actions taken during the LBD process and other Partnership activities. Strategies will include documenting Partnership activities and bringing them to life for key stakeholders, including First 5 LA Commissioners. (Public Affairs) B. COUNTYWIDE STRATEGIES Data Systems Integration Getting Better Data ($375,000): First 5 LA is investing in an organization-wide data system hosted by an external contractor, Persimmony. This system will collect common data across programs, as well as client-level data for select direct service projects, on a semi-annual basis. In addition, the data system will enable First 5 LA to process electronic invoicing, thereby increasing our organizational efficiency. This investment will facilitate greater utilization of program data and help First 5 LA understand performance across all of the program initiatives. Funding reflects a discounted rate since we are partnering with three other Southern California First 5 Counties to share in the cost. (R&E) Health Access/Healthy Kids Healthy Kids Insurance Coverage ($1,253,000): Established in 2003, this initiative provides access to low- or no-cost health insurance for children ages 0-5 who are ineligible for Medi-Cal or other forms of insurance. First 5 LA partners with LA Care Health Plan to administer Healthy Kids insurance, a comprehensive benefits package that includes medical, mental health, dental and vision care. With unspent funds due to recent downward trends in enrollment, LA Care is working with First 5 LA on potential strategies to improve access to services. In addition, an amount was not included for this component in the FY budget because funds were advanced to the contractor in FY Funds are being included for FY to more accurately reflect programmatic expenditures against an annual budget as costs are incurred. (Grants Management) Health Access/Healthy Kids Healthy Kids Outreach, Enrollment, Retention and Utilization ($4,692,219): With a goal of universal coverage for children ages 0-5, this program funds a network of CBOs through LA County Department of Public Health (DPH) to identify 6

7 and assist potentially eligible families in applying for health insurance programs. In addition to Healthy Kids, DPH also enrolls children in Medi-Cal, Kaiser Permanente and others. In light of the changing environment (such as increased resources from the Affordable Care Act to support outreach, retention and assistance for health care coverage), DPH will identify opportunities to increase support of health care utilization and retention. (Grants Management) Policy Advocacy Fund Technical Assistance Provider ($113,000): First 5 LA has supported TA consultants to provide advice and guidance to 23 policy grantees on an as-needed basis in a number of key areas including: evaluation support, strategic planning, navigating complex policy systems and decisions, and reviewing data to develop recommendations. In addition, the TA consultant team will develop and execute a series of capacity building workshops focused on management, human resources, finance and communications to support improving the policy work of the agencies. The majority of the funding increase is related to this added TA component offered to policy grantees beginning in January This request is a 13% increase from the adjusted current year contract. (Policy) Policy Agenda/Advocacy ECE and Home Visitation Sustainability and Leveraging Support ($410,000): This strategy continues to advance First 5 LA s sustainability goals for ECE and home visitation using three approaches. (Policy) Support partners to advocate for the Local Control Funding Formula (LCFF): Funding allows partners to continue moving forward with Board-approved policy priorities related to the LCFF. Funding represents a 12% increase over the current year pro-rated allocation of $67,000 to encourage school districts to adopt early learning, advocate for relevant reforms at the state level, and engage parents and school districts. ($75,000) Provide focus to and increase advocacy efforts of home visiting sustainability: Building upon Board-approved policy priorities to sustain ECE and home visitation, these strategies are grounded in experience implementing the First 5 LA policy sustainability plan. Funding would support a contractor to aid coordination of statewide home visiting and ECE coalitions, policy and strategy development, policymaker education and stakeholder engagement. Content experts would also: explore different policy angles such as maternal mental health that could lead to public financing support; develop policy recommendations; produce policy briefs and distribute educational materials. In addition, funds would provide planning and management support to the LA County Home Visiting Consortium to improve outcomes which would ultimately assist with our advocacy efforts. ($185,000) Identify sustainability and leveraging opportunities: With declining revenues, First 5 LA will conduct an organization-wide review of existing and/or expiring grants and programs that may be eligible for public funding sources. ($150,000) Policy Agenda/Advocacy Opinion Research ($150,000): As First 5 LA advances its policy agenda, specifically around ECE and home visitation, a key advocacy and communications strategy is to understand the attitudes of voters in LA County and use data to encourage elected officials and candidates for public office to support early childhood policy priorities. Funds would initiate public opinion research data. Internally, data would also inform our policy agenda and shape our programmatic work. (Policy) Resource Mobilization Health Built Environments ($1,000,000): In support of the current Strategic Plan s Resource Mobilization strategy, First 5 LA will leverage resources to create a new children s play area at Grand Park in downtown L.A. This one-time investment of 7

8 $500,000 (matched 1:1 by the First Supervisorial District) will be managed by the LA County Chief Executive Office to oversee the design and construction, as well as the ongoing operation, maintenance and safety of the children s play area in perpetuity. This partnership also provides branding and communications opportunities for First 5 LA. This budget also includes $500,000 to create a 1:1 Matching Tot Parks and Trails enhancement opportunity to support safety improvements that will further upgrade the parks. This need emerged during the community resident design meetings for the Tot Parks and Trails with project contractors, and allows the project to be responsive to community input. The match structure represents First 5 LA s changing fiscal context and the need for community partners to share in the cost of identified park improvements. (Community Investments) Resource Mobilization Organizational Capacity Building ($700,000): Consistent with the current Strategic Plan, Organizational Capacity Building will continue to be a key piece to the Resource Mobilization countywide strategy. In FY , two types of capacity building opportunities will be offered to increase organizations ability to leverage funds and sustain programming in service of the Commission s Governance Guidelines. (Community Investments) 1. Leveraging Capital will be dedicated to strengthening organizations within LA County that provide safety net services (e.g. food, shelter, health, employment and childcare) in low-income, high-need areas, including Best Start communities. First 5 LA funds will be matched at a minimum of 1:1 and support approximately 15 organizations. One-year funding will be used to provide financial literacy and health workshops, strategic advisory support and development of a pool of working capital, allowing organizations to move beyond day-to-day demands of running a business and begin building long-term stability and strength. ($200,000) 2. Restructuring and Shared Services will assist nonprofit organizations serving young children and their families to understand opportunities to reduce costs. This strategy will improve administrative and programmatic efficiencies through restructuring of organizations to better integrate services and share administrative burdens. All First 5 LA funds will be matched at a minimum of 1:1, engaging approximately 80 organizations. One-year funding will be used to host intensive orientations for executive directors and board members, readiness assessments, training and technical assistance. ($500,000) Resource Mobilization Project Development Strengthening Families ($100,000): Consistent with the current Strategic Plan s countywide approach to support systems improvement, First 5 LA will develop strategies to engage County systems in cross-agency collaboration, reinforcing and creating linkages to community resources, and promoting practice change utilizing the Protective Factors Framework. The specific activities will be informed by First 5 LA s Strengthening Families Scan, the Parent Engagement, Education, and Empowerment (P3E) Scan, and from other external inputs such as recommendations from LA County Blue Ribbon Commission on Child Protection, and model programs like Project DULCE at Boston Medical Center. (Community Investments) C. COUNTYWIDE INITIATIVES At-Risk Fathers Investment ($300,000): In November 2013, the Commission approved a motion establishing a two-year investment of $600,000 to engage and support at-risk fathers of children ages 0-5. Although the initiative is still in the early stages of development, based on the Harder+Company study recommendation to leverage existing resources to better support 8

9 fathers, a preliminary scan identified several First 5 LA programs that could be enhanced. Staff will also explore options to use Black Infant Health (BIH) as a platform for engaging fathers. Finally, a Request for Information (RFI) will be released in July 2014 to better understand the landscape of fatherhood activities in LA County. In November 2014, a multi-stakeholder planning group will be convened to identify leveraging opportunities, articulate outcomes and key implementation considerations. (Grants Management) Black Infant Health Black Infant Health Program ($1,452,000): BIH is a California Department of Public Health program to address high infant mortality rates among African Americans by improving infant and maternal health and reducing health disparities through social support and empowerment, thereby mitigating the impact of chronic stress. First 5 LA funds draw down Title XIX (Medi-Cal) matching/reimbursement funds for activities that assist eligible clients in applying for or accessing Medi-Cal services. First 5 LA started supporting BIH in 2009 when State support was cut. In November 2013, the Commission approved to extend and expand BIH at 25% of its FY funding level for five years. This augmentation will help BIH programs enhance services such as mental health to better support clients. During FY , funds will support three BIH programs: LA County DPH, City of Pasadena, and City of Long Beach. (Grants Management) Black Infant Health Birth Outcomes and Disparities Policy and Systems Change ($500,000): Approved by the Commission in November 2013, the intent of the motion is to support policy and systems change efforts that help to address the disparity in birth outcomes for African Americans. The Harder report (referenced earlier within the At-Risk Fathers Investment) found that the issue of health disparities is complex, with multiple factors contributing to poor birth outcomes including lack of quality care, access to care, poverty, lack of social support and racial discrimination. Future efforts will focus beyond direct services and address the systemic issues that contribute to preterm and low birth weight for African Americans. To advance meaningful change, policy and systems strategies must be regional in nature. First 5 LA will partner with organizations in the two regions with the highest preterm and low weight births in the County, South Los Angeles and the Antelope Valley. Staff will return to the Commission with recommendations informed by input from local stakeholders and other key resources. (Policy) Children s Vision Care ($1,342,000): This services program aims to improve the vision and school readiness of preschool children. Services include vision screening and eye examinations, as well as free prescription eyeglasses if needed. The program was initiated in FY with UCLA as the sole contractor, and expanded in FY to include Junior Blind of America and Vision to Learn. Relatedly, the Policy and Grants Management Departments are developing advocacy/policy strategies focused on system change efforts around vision care coverage and utilization by children. (Grants Management) Data Partnership with Funders Children s Data Network ($1,000,000): This project with the Children s Data Network (CDN) is a critical element to making data more accessible and useful to First 5 LA, LA County families, service providers, stakeholders and others. CDN is a data and research collaborative housed at USC s School of Social Work to inform children s policies and programs through the linkage and analysis of administrative data (data sharing agreements, applications for access to data). A concrete example of how using linked administrative data can help shape program practices is a project that will involve CDN developing risk models and data products that can assist our programs in identifying the type of 9

10 clients most likely to have contact with the Department of Children and Families Services. It is anticipated that CDN will also receive $800,000 from the Hilton Foundation. (R&E) Little by Little/One Step Ahead ($3,647,000): Little by Little (LBL) is an early literacy program developed by Public Health Foundation Enterprises-Women, Infants and Children Program (PHFE-WIC) and funded by First 5 LA from in the amount of $4.7 million, serving approximately 117,000 children. The program offers anticipatory guidance to parents regarding early literacy and safety awareness. Funding provides individual counseling and developmentally appropriate books, safety items and materials regarding child development, early literacy and safety at each WIC client visit. In January 2011, the Commission approved an allocation of $30 million to expand LBL under the Little by Little/One Step Ahead (LBL/OSA) initiative. In May 2013, the Commission approved a six-year Strategic Partnership with PHFE-WIC to lead the LBL/OSA expansion to other WIC sites. By September 2014, the program will ramp up to ten WIC sites across LA County. Of these, five are located within Best Start communities and three are adjacent to Best Start communities. Funding will support lead agency (PHFE WIC) expenses, including costs related to program/fiscal oversight of six WIC agency subcontracts, securing fund development and consultants to develop a multi-year sustainability plan, and providing training and technical support to on-site WIC staff. (Program Development) Peer Support Groups for Parents ($1,418,000): Through peer support groups for parents within the five Supervisorial Districts, this program aims to foster social connections, reduce isolation, and encourage sharing knowledge among parents of children ages 0-5. Lead agency, Children s Institute, Inc. (CII), in partnership with five CBOs, will organize and facilitate a total of 100 groups countywide. CII is also the Technical Assistance Provider that will train parent facilitators and conduct outreach to parent group participants. Recruitment and outreach for the participants and parent facilitators will occur countywide, as well as in Best Start communities (each CBO serves at least one community) and in Welcome Baby Hospitals. The program began in FY with an initial 6-month planning period and only 3 months of implementation. The program will be in full implementation in FY (Program Development) Reducing Childhood Obesity ($16,510,000): The LA County DPH implements and manages this program in partnership with the Child Care Resource Center, ChangeLab Solutions, and 20 CBOs. In July 2011, the Commission approved an allocation in the amount of $41,197,400 to support this four-year project. The increase from FY is primarily due to significant delays faced by the grantee in hiring project personnel and in the subcontracting process, resulting in many performance objectives and costs being carried over to FY The three major interventions are below: (Program Development) 1. Choose Health LA Kids (CHLA Kids), an intensive public education and skills-building effort to promote healthy eating and active living in targeted community clinics, restaurants, grocery stores, and neighborhoods; 2. Los Angeles Reducing Childhood Obesity in Child Care Settings (LA ROCCS), a program focused on improving nutrition and physical activity in child care settings; and 10

11 3. Los Angeles Managing Obesity in Moms (LA MOMs), a program designed to reduce obesity among postpartum women. Tot Parks and Trails ($2,139,000): This main objective of this program is to expand the number of play spaces for all young children, including those with special needs and families residing in park-deficient communities. (Program Development) Universal Assessment of Newborns Welcome Baby Hospitals ($8,558,000): A five-year, $54,100,000 investment, this program aims to identify families at greatest risk/need and link them to supportive services. Supporting the development of a countywide universal assessment program for all new parents at the birth of their child, it will provide up to three home visits. Integrated with the Best Start Welcome Baby implementation, the target population is the estimated 112,000 annual LA County births outside of First 5 LA s 14 Best Start communities. Funding provides a Welcome Baby hospital visit with risk screening to a minimum of 60% of hospital births, as well as up to three additional postpartum engagement contacts for 80% of eligible high-risk clients. Universal assessment services are delivered by the same hospital providers taking part in the Welcome Baby program. (Program Development) Workforce Development ECE Career Development Policy ($1,151,000): This six-year $5.7 million project was created to garner support from policymakers, business and civic leaders, and the academic and nonprofit communities on policies related to the retention, compensation or workplace conditions for the ECE workforce. Scheduled to expire in April 2015, funds will be spent to support advocacy and education efforts on ECE workforce issues. This request is a 21% increase from the previous year. (Policy) Workforce Development ECE Workforce Consortium ($13,090,000): The five-year $37 million project aims at increasing the quality of early learning programs for young children and supporting the recruitment, education, preparation and retention of a diverse ECE workforce. A multi-faceted collaboration among stakeholders, the Consortium provides training and professional development to the current and potential ECE workforce. As the lead agency, LAUP will ensure continuation of collaborative efforts and promote recruitment and retention. (Program Development) D. PRIOR STRATEGIC PLAN INITIATIVES Los Angeles Universal Preschool ($54,245,000): LAUP provides access to quality early childhood education programs for children in LA County by: creating preschool spaces, making it more affordable, providing families with preschool programs options, and connecting programs to communities. A model for a statewide rating system, the 5-Star Quality Rating and Improvement System also ensures quality services. FY funding will support preschool services for 10,760 children to participate in 1/2 day of quality programming throughout the school year, coaching for preschool providers, and evaluation to measure and report on outcomes that promote children s readiness and success in school. In previous years, only the Operating Funds portion of the LAUP contract was included in the budget. However, for FY , $3.5 million is included for the District Demonstration Projects to more accurately reflect anticipated expenditures for the fiscal year. Thus, while the LAUP Operating Funds will decrease slightly in FY from FY , the total budget will show as a minor (4%) increase. 11

12 In addition, since outcome targets are expected to stay constant for the two remaining years of the LAUP contract, First 5 LA and LAUP staff worked collaboratively to develop exhibits (Performance Matrix; Budget and Reporting Framework) through FY for a two-year contract budget. This has no impact on the First 5 LA annual budget. (Program Development) Neighborhood Action Councils ($1,902,000): Since 2002, First 5 LA has had a Strategic Partnership with South Bay Center for Community Development (SBCC) to develop and support Neighborhood Action Councils (NACs). Funding supports building and strengthening resident relationships (with one another, as well as other community partners) and garnering resident leadership to pursue neighborhood-level change activities that support the wellbeing of families with young children. Given the clarity and movement associated with the adoption of the BSFF in 2013, staff is identifying opportunities and linkages to leverage the work of the NACs. The NACs are positioned to mobilize an existing network of residents that can act quickly and collectively with the Community Partnerships to: (1) connect the voices and priorities of parents to Best Start Partnership activities, (2) address emerging needs related to the BSFF core results, and (3) communicate key messages regarding the protective factors. In FY , these types of linkages will be more intentional and strategic with the 68 NACs operating within the Best Start communities. In addition, First 5 LA will continue to fund the 29 NACs outside of the Best Start communities which can be leveraged as the Public Affairs Department begins implementation of a broader, countywide public awareness campaign on the protective factors. The NACs can also mobilize around the First 5 LA policy agenda related to strengthening families. (Best Start Communities) Oral Health and Nutrition Dental Home ($3,600,000): This program seeks to increase access to dental care for children ages 0-5 and perinatal women by establishing dental homes in 12 Federally Qualified Health Centers (FQHCs) countywide. Intended to be a comprehensive sustainable model, it uses integrated service delivery to link local healthcare providers, childcare providers and families. Under the oversight of UCLA, the clinic sites will implement systems and capacity building/infrastructure improvements, as well as practice changes to establish the dental home model. Additionally, the project will train childcare providers to promote oral health among young children and their families. Although no funding was included in the FY budget because funds for this program were advanced to the contractor in FY , funds are being included for FY to more accurately reflect programmatic expenditures against an annual budget. (Program Development) E. RESEARCH & EVALUATION Program Evaluation Best Start Evaluation ($1,233,000): The Best Start Evaluation will consist of an ongoing developmental evaluation and preparation for a formative evaluation anticipated to begin in FY The funding level requested represents a four-fold increase from FY because this will be the first full year of implementation in the communities and each community will have its own lead developmental evaluator. 1. The Best Start Developmental Evaluation will describe the evolution and ongoing development of Best Start as the Learning by Doing process is rolled out. Deliverables will include: evaluation plan for FY , data collection protocols, learning briefs for 12

13 the 14 communities and First 5 LA, interview and focus group findings, presentations, learning materials and a final report. 2. The Formative Evaluation RFP is anticipated to be released to the end of FY An expert panel on Place-Based Evaluation will provide input on the evaluation design and external reviewers will review the RFP. Program Evaluation Home Visiting Evaluation ($1,300,000): The evaluation of our home visiting investments in FY will include multiple projects designed to inform the larger policy and sustainability discussions. Below is a brief description of projects to be implemented: 1. Welcome Baby Pilot Study: This ongoing longitudinal study assesses the effects of Welcome Baby on a sample of initial participants in the pilot community at 36-months postpartum. 2. Welcome Baby Implementation and Outcome Study: This new study, to be designed and launched in FY , aims to examine implementation, costs and outcomes from the Welcome Baby expansion in the Best Start communities. 3. Welcome Baby Impact Study: This new study, to be designed in FY , aims to determine if outcomes experienced by Welcome Baby clients are due to the Welcome Baby program. 4. Universal Screening Psychometric Study: This new study will evaluate the psychometric properties of the modified bridges screening tool. 5. Cost-Benefit Exploratory Study: This new exploratory study will determine the costs and monetized benefits of expected outcomes for Welcome Baby. 6. Welcome Baby Medi-Cal Data Match: Contingent upon State approval of the request for Medi-Cal data and the success of merging Medi-Cal and Welcome Baby client data, this ongoing study aims to examine Welcome Baby client enrollment in and utilization of Medi-Cal in addition to the feasibility of merging client records going forward. Program Evaluation LAUP Universal Preschool Child Outcomes Study (UPCOS) ($1,602,000): Funding for Phase 8 of UPCOS will provide support for the following projects: 1. The Child Outcomes Study: This study involves the direct assessment of development in multiple domains among children in LAUP preschools in fall and spring. This work supports efforts to assess LAUP performance targets. 2. The Data Match Project: The goal of this study, which began in FY , is to compare academic performance in elementary school between children who attended LAUP preschools and children who did not by matching LAUP preschool records with school district records ( data matching ). The study also uses information districts have about the characteristics of LAUP children and their school experiences to identify an appropriate comparison sample of non-laup children ( analytical matching ) in order to compare scores on California s standardized tests. 3. The English Language Learner Sub-study: This sub-study is still in development and is intended to focus on English and Spanish language development among English Language Learners and how to support the unique needs of this population. 4. Quality Rating and Improvement System Sub-study: This sub-study is still in development and is intended to focus on better understanding how quality (as defined by quality rating scales) relates to child outcomes. 13

14 Program Evaluation Professional Development Evaluation ($2,350,000): This study is a longitudinal, quasi-experimental evaluation of the effectiveness of the six professional development programs in First 5 LA s ECE Workforce Development Portfolio. Evaluation activities will include: interviews with more than 2,000 early educators in fall 2014 and over 1,700 early educators in spring 2015; classroom observations with more than 500 early educators in spring 2015; and interviews and surveys with program administrators. Part of the $52 million ECE workforce investment, the six programs included in the evaluation are: 1. Child Development and Education Workforce Initiative (CDWFI) 2. A Stipend Program for Early Educators (ASPIRE, aka CARES Plus) 3. Family Child Care Higher Education Academy (aka Project Vistas) 4. Gateways for Early Educators 5. ECE Professional Learning Communities 6. Steps to Excellence Program (STEP) 14