Supervisor Kuehl also serves as the Chair of the Board of Commissioners of First 5 LA, an innovative funder, leader and advocate on early childhood issues working collaboratively across LA County. Created in 1998 to invest L.A. County’s allocation of funds from California’s Proposition 10 tobacco tax, First 5 LA has invested more than $1.2 billion in efforts aimed at providing the best start for children from prenatal to age 5 and their families.

Here’s the Supervisor’s recap of this month’s First 5 meeting:


At this month’s Board of Commissioners meeting, First 5 LA staff provided updates on Home Visiting System Building and Sustainability Strategies, to place our work in LA County within the broader context of state and national trends. First 5 LA has been identifying opportunities to advance the vision for home visiting, its most significant and long-standing direct services investment. First 5 LA is currently the largest funder for home visitation in LA County.

The substantive analysis was presented by Dr. Deborah Daro, Senior Research Fellow at Chapin Hall at the University of Chicago, who is considered one of the nation’s leading experts in the area of child abuse prevention policy and early home visiting research. Her current work focuses on the unique and pivotal role early intervention programs can play in strengthening parental capacity across diverse populations, enhancing child development and keeping children safe.

Home visiting is a powerful strategy to improve parental capacity and a young child’s life trajectory and is the most common strategy used to prevent child maltreatment and enhance parental capacity. Early home visiting is utilized to varying degrees in all 50 states, however, an additional 18 million pregnant women and families (23 million children) could greatly benefit from home visiting but have not yet been reached. LA County faces a similar challenge – a network of strong home visiting programs that reach many families but still leave many more unserved. Expanding and sustaining a sufficient level of support for all families within the current fiscal climate requires thinking beyond simply replicating models to building systems that reach new parents in a non-stigmatizing, supportive manner, meeting families where they live.

First 5 LA is working on expanding quality, access, sustainability, and availability of home visiting services with an intentional focus on maternal mental health. They’ve been testing new models and platforms to engage mothers earlier in supportive services, expanding and developing partnerships to connect with current services and strengthen referral networks, and exploring partnerships and strategies to leverage the existing health delivery system.

Our partners in home visitation already include the LA County Departments of Public Health, Health Services, Mental Health, Public Social Services, Probation, and Children & Family Services, as well as County Libraries, the Office of Education, and the Office of Child Protection.

The meeting also included a fascinating panel discussion: Lessons Learned related to Oral Health Policy, Systems Change and Sustainability. The presentation was a look-back on lessons learned from one of First Five LA’s early investments, the Children’s Dental Care Program (CDCP). We heard from our CDCP partners (USC, UCLA and Western University of Health Sciences) on what they had learned about leveraging investments in order to change whole key systems. CDCP was an opportunity to expand and build upon current infrastructure to serve an additional 95,000 children through preventative and treatment-oriented dental services; and more fully integrate oral health with other physical health services. The Universities exceeded that number and served over 125,000 children.

The panel included a representative from each of CDCP’s University partners. Dr. Roseann Mulligan from USC, Dr. James Crall, from UCLA, and Dr. Jenny Tjahjono from Western University.

Key strategies of the different investments included delivery system reform and improvement, direct services (prevention and treatment), workforce training, and policy and advocacy. Each University identified unique approaches to achieving outcomes based on differing needs and service gaps, partnerships, and infrastructure within their service region. For example, USC focused on training health care providers about the importance of oral health in young children and assisting children’s caregivers to find a dental home. UCLA prioritized building capacity at ten community clinics to serve as a quality dental home for 0 to 5-year-olds and pregnant women, as well as on building out service learning opportunities for pediatric dentistry in underserved communities. Western University’s efforts exposed dental students to pediatric populations to expand the number of dentists committed to serving young children. All three of these partners will be able to sustain and build upon the infrastructure established as a result of CDCP to keep this important work moving forward.

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