LA County Board

15. Building Los Angeles County’s Prevention Infrastructure\nRecommendation as submitted by Supervisor Mitchell: Recognize the\nPrevention Services Task Force (Task Force) members and consultant teams\nfor their time and dedicated work in helping the County and the Board to outline\nthe vision for a prevention services infrastructure and take the following actions:\n1. Adopt the following vision, model, and guiding principles, as determined\nby the Task Force:\na. Vision: To deliver an equitable, community-driven, and holistic\nprevention and promotion model to enable a safer, stronger,\nthriving, and more connected community;\nb. Model: To include the following four concepts: Social Conditions,\nEquitable Decision-Making and Community Agency, Prevention,\nand Promotion; and\nc. Guiding Principles:\ni. Reduce racial disparities and increase equitable life\noutcomes for all races/ethnicities, as well as close\ndisparities in public investments to shape those\noutcomes;\nii. Authentically engage residents, organizations, and other\ncommunity stakeholders early to inform and determine\ninterventions (e.g., policy and program) and investments\nthat emphasize long-term prevention and promotion;\niii. Develop and implement strategies that identify, prioritize,\nand effectively support the most disadvantaged\ngeographies and populations;\niv. Collaborate to align funding investments and promote\nsystem changes to reduce barriers to achieve effective\nfamily-centered services;\nv. Use data and community-defined evidence to effectively\nassess and communicate equity needs and support\ntimely assessment of progress;\nvi. Work collaboratively and intentionally across\nDepartments, as well as across leadership levels and\ndecision-makers;\nvii. Seek to provide early and tailored support to improve\nlong-term outcomes, both intergenerationally (i.e., parent\nto child) and multi-generationally (i.e., grandparent to\ngrandchildren);\nviii. Act urgently, boldly, and innovatively to achieve tangible\nresults;\nix. Disaggregate and streamline data collection, as well as\nconduct analysis for different racial/ethnic and other\ndemographic subgroup categories; and\nx. Be transparent about our goals and our impact;\n2. Establish the Prevention and Promotion Systems Governing Committee\n(Committee) whose specific and immediate focus is to oversee the\ncoordination and collaboration of prevention and promotion services\nCountywide, and direct the Executive Officer of the Board, in\nconsultation with County Counsel, the Chief Executive Officer, and other\nCounty Department Heads/entities deemed appropriate and necessary,\nto provide sufficient staff to support the Committee, and hire an Executive\nDirector:\na. The Committee shall be comprised of eight County Department\nHeads or initiative Executive Directors representing relevant\nCounty Departments or Board priority initiatives, and one County\npartnering organization or regional entity, with the members and\nthe Chairperson of the Committee to serve on a rotating basis;\nb. The inaugural Committee shall be comprised of the following\nCounty Department Heads and Initiative Directors: Chief Executive\nOfficer, Public Social Services, Public Health, Children and Family\nServices, Racial Equity, Chief Executive Office-Homeless\nInitiative, Acting Chief Information Officer, Mental Health, and First\n5 Los Angeles, the inaugural Chairperson of the Committee shall\nbe the Director of Public Social Services; and\nc. Immediate tasks of the Committee shall include:\ni. In consultation with County Counsel, the Committee will\nadopt the bylaws and applicable rules, and authorities\nnecessary for the Committee to make recommendations\nto the Board for adoption of prevention and promotion\nprograms and services plans related to spending,\ncontracting and procurement coordination, human\nresources allocations and staffing, and data sharing\nperformance tracking, monitoring and evaluation, the\nbylaws should include determining the appropriate\nrotational structure and make-up of the membership and\nChairperson of the Committee following the Committee’s\nfirst rotation to ensure long-term continuity and\nengagement across all relevant County Departments and\ninitiatives;\nii. Establish the following three initial key focus areas to\nanchor foundational prevention and promotion services\ninfrastructure: child welfare and family wellbeing,\nhomelessness and housing, and behavioral health;\na. Within each of these three initial key focus areas,\nthe Committee will identify and address at least one\npopulation level outcome across the life course\nthrough multi-departmental collaboration and\ncoordination, when selecting and working on these\noutcomes, the Committee should focus on closing\nracial disproportionalities and disparities;\niii. Select and recommend Countywide prevention and\npromotion outcomes and metrics to guide prevention and\npromotion programing, address racial disproportionality\nand disparities and guide Countywide funding\ninvestments in accordance with the Life Course Theory\nacross major age groups, to include populations such as\ninfants and toddlers, children, youth, young adults,\nmiddle-aged adults, and older adults;\na. The metrics should be created in partnership with the\nActing Chief Information Officer and Director of\nPublic Health, to maximize the efficacy of data\ncollection, systems integration, and evaluation, the\nDirector of Public Health will serve as the lead for\nprevention and promotion program evaluation\nCountywide;\niv. Develop a Countywide prevention and promotion\nprograms and services plan that identifies operational\ninputs and outputs to achieve the specified outcomes\nand identify how each Department will contribute to and\nbe responsible for meeting the outcomes;\nv. Work in collaboration with the Chief Executive Officer\nand the Director of Personnel, to identity relevant\npositions that can be leveraged to focus on prevention\nand promotion programs and services, develop a\npermanent cross-departmental staffing plan to support\nthe alignment of prevention and promotion services, and\nserve as staff to the Committee, the plan must be\nsubmitted to the Board for consideration and should\nspecifically:\na. Be comprised of existing staffing positions that can\nbe leveraged to advance prevention and promotion\nservices administration across the County;\nb. Include a matrix of roles and responsibilities which\nidentifies who will be responsible for achieving\nprevention and promotion outcomes; and\nc. The Committee may request the Chief Executive\nOfficer to re-evaluate the long-term staffing plan of\nthe Committee’s permanent staff beginning in Fiscal\nYear 2025-26;\nvi. In collaboration with the Chief Executive Officer, develop\na comprehensive prevention and promotion programs\nand services annual spending plan, the Chief Executive\nOfficer will present the Prevention and Promotion\nServices spending plan to the Board for consideration in\nthe fiscal year immediately following the commencement\nof the Committee’s work, as part of the County’s regular\nbudget process, and annually thereafter, the spending\nplan should include the following:\na. Recommendations for coordinating local, State, and\nFederal funding sources (e.g., managed care,\nCalifornia Advancing and Innovating Medi-Cal\n(CalAIM), Family First Prevention Services Act ,\netc.), as permitted by and in compliance with all laws,\nin order to maximize the application of funding\nsources for use in the delivery of prevention and\npromotion services;\nb. Recommendations and an actionable plan for\nleveraging and braiding Countywide funding streams;\nc. Identify and develop a comprehensive\ncross-departmental prevention and promotion\nprograms and services gap analysis for\nconsideration in the spending plan; and\nd. Yearly spending comparisons of Countywide\nprevention programming investments;\nvii. In partnership with the Anti-Racism, Diversity, and\nInclusion (ARDI) Initiative and Chief Executive Office,\nthrough the Legislative Affairs and Intergovernmental\nRelations Branch, coordinate and consolidate a\nCountywide prevention and promotion annual policy\nagenda at Federal, State, and local levels to advance\nprevention and promotion outcomes;\nviii. In partnership with the ARDI Initiative, develop a robust\ncommunity engagement and outreach plan that involves\na diverse geographic representation of people with lived\nexperience, service providers, clients, and other\nstakeholders to advance prevention and promotion\noutcomes;\nix. Within 180 days, develop the operational management\nplans and agreements by identifying Departmental roles,\ncommitments, timelines, metrics, and milestones needed\nto achieve selected prevention and promotion outcomes;\na. Semi-annually, the Committee Chairperson shall\nprovide the Board with an update on Countywide\nperformance based on the established prevention\nand promotion outcomes and metrics as well as\nDepartmental performance; and\nb. The Committee will have full authority to obtain all\nnecessary data and information from County\nDepartments and the entities as permitted by law, to\ncomplete its work;\n3. Direct the Chief Executive Officer, through the Executive Director of\nRacial Equity, as the Chair of the Task Force, to take the necessary\nsteps within 90 days, to disband the Task Force and transition any\noutstanding relevant work to the Committee;\n4. Instruct the Executive Director of Racial Equity, in collaboration with the\nCommittee Chair, to establish and oversee the Prevention and Promotion\nCoordination and Implementation Team (PPCIT) and, in consultation with\nthe Board, identify and select a Project Manager and team;\n5. Direct relevant Departments to provide high level-decision making staffing\nsupport with subject matter expertise to serve on the PPCIT and to inform\nrecommended policies, procedures, and practices relating, but not\nlimited to, budgeting and spending planning, human resources, program\ndesign and administration, legal analysis, equitable contracting, program\nmonitoring, data sharing and evaluation, and other issues related to\ncoordination and completion of tasks within their Departments, as well as\ncollaboration across Countywide prevention and promotion entities;\na. The PPCIT shall accomplish the following:\ni. Complete user journey mapping of customer and client\nexperiences navigating County programs and systems to\nidentify opportunities to address issues relating to\nresource navigation, data sharing, the time-tax,\nno-wrong-door approaches, racial disproportionality and\ndisparities in user access, and their impact on\nprevention and promotion outcomes;\na. In consultation with County Counsel, create and\nmonitor on an ongoing basis, a comprehensive legal,\npolicy, and regulatory analysis, including efforts to\naddress barriers to leverage and braid funding, and\ncoordinate procurement and data sharing for\ncross-departmental programming, with the analysis to\ninclude any relevant draft policy change\nrecommendations that must be adopted or authorities\nthat must be expressly granted by the Board;\nii. To aid in facilitating the production of relevant\ncross-department data, collaborate with the Acting Chief\nInformation Officer and County Counsel, to develop and\nrecommend to the Board a Countywide prevention and\npromotion services delivery data plan and program to\ncoordinate cross-departmental collaboration and services\nand produce the necessary cross-departmental data\nsharing reports (e.g., dashboards), develop a universal\ndata sharing customer and client authorization, to be used\nby all relevant County Departments and build upon\nprevious and ongoing County efforts regarding client\nconsent (e.g., Whole Person Care, CalAIM, Enterprise\nLinkages Program, etc.), and formalize a Countywide\nframework to facilitate referrals and a “no-wrong door”\napproach to service delivery, with guidelines, rules, and\nshared agreements relating to this coordinated approach,\nas well as privacy and data consent;\niii. Work with the Director of Internal Services and the\nEquity in County Contracting unit to incorporate a\ncomprehensive prevention and promotion programs and\nservices contracting plan for consideration by the\nBoard, the contracting plan should include the following:\na. A timeline for coordinating programming and the\nassociated procurement plan;\nb. A programming prioritization plan, by key focus\nareas, with principal considerations given to data on\nracial disproportionalities and disparities, an\ninventory of existing programming, community\ninterest and priorities, and County priorities; and\nc. Utilization of a centralized contracting mechanism to\neffectuate a comprehensive community-based\nprevention services delivery system;\n6. Instruct all County Departments and Board-created workgroups and\ncouncils working on prevention and promotion to work collaboratively\nand transparently with the PPCIT and Committee, and timely share\ninformation with, and respond to requests, and the Board should be\nimmediately notified, in writing, of any barriers or challenges\nassociated with receipt of any requested information;\n7. Instruct all County Departments, Board-created workgroups, initiatives,\nand councils, who are not serving as members of the Committee and\nwho are administering prevention and promotion programs and services\nto collaborate with the PPCIT and Committee to coordinate their\nprograms in alignment with the prevention and promotion plan;\n8. Direct Chief Executive Officer to establish a Countywide Management\nAppraisal and Performance Plan goal for all Departments who are\nparticipating in the prevention and promotion plan;\n9. Delegate authority to the Chief Executive Officer and the Executive\nOfficer of the Board, to execute any agreements necessary to support\nthe foregoing efforts, provided that any such agreements are in form\napproved by County Counsel; and\n10. Approve a Fiscal Year 2023 -24 appropriation adjustment to transfer\n$4,000,000 from the Provisional Financing Uses budget unit designated\nfor Children and Families/Board Priorities to the Chief Executive Office ,\nOperating Budget to provide funding to the ARDI Initiative’s support for\nthe Committee and PPCIT in continuation of the County's work to build\na prevention services infrastructure. (23-2649)\nAttachments: Motion by Supervisor Mitchell\nChief Executive Office Report\nPublic Comment/Correspondence