First 5 Los Angeles


First 5 Los Angeles is a nonprofit child-advocacy organization that is part of the First 5 California Children and Families Act.

History

First 5 California was created in November 1998 when California voters passed Proposition 10 to invest tobacco tax revenues in programs that would help improve the lives of children in California. Spearheaded by Hollywood producer and political activist Rob Reiner, who acted as the commission's first chairman in 1999 under former Governor Gray Davis, First 5 California was created to use tobacco tax revenues to fund health, safety and early education programs for children age prenatal to 5 years old in California. In the 12 years subsequent to its creation, First 5 LA had invested more than one billion dollars from tobacco tax revenues into grants and programs that benefit the children of Los Angeles County.

Mission

First 5 LA aims to create programs and services for children age prenatal to five. The mission is to increase the number of Los Angeles County children ages 0 to 5 who are physically and emotionally healthy, ready to learn, and safe from harm.

Programs

Programs are centered around child, parent/caretaker, and teacher to improve early childhood outcomes in the areas of health and nutrition, early literacy and language development, quality child care, and smoking cessation.

Funding

established a 50 cent-per-pack tax on tobacco products towards the healthy development of California's children from prenatal to age five. Declining birth and smoking rates is causing First 5 LA's revenue stream to decrease. First 5 faces decreasing funding due to declining sales of tobacco products and increased administrative fees assessed by the State Board of Equalization for the collection of tobacco taxes. Additional funding declines are fore coming due to state cutbacks. Eighty percent of the commission's resources is divided among California's 58 counties, to be spent according to local needs and priorities.

Grants and contracts

Since 1998, First 5 LA has contributed $800 million in grants and programs to benefit the children of LA County. First 5 LA manages funding for proposals or projects through a transparent Request for Proposal/Request for Qualification process. Proposals or projects can fall under the following categories:
First 5 LA's funding decisions are guided by the following principles:
First 5 LA has faced controversy due to the 2011 Harvey M. Rose audit that prompted concerns over its financial management.
It discovered that while the program was overstaffed, it underspent on programs, resulting in a surplus of $800 million unused funds. Auditors also noted a lack of transparency within the organization. Staff within First 5 LA failed to report over $200 million in contracts and grant awards in one fiscal year, despite the policy that contracts exceeding $25,000 were to be approved by commissioners. The lack of commission oversight made it impossible for auditors to determine whether or not agreements were made for appropriate purposes or qualified vendors and determine whether or not malfeasance had occurred.
In response to the audit, First Five LA's former executive director, Evelyn V. Martinez, resigned. Los Angeles County Board of Supervisors voted 4-1 to make moves towards to transform First 5 LA from a separate legal entity to a county agency.
In response to these challenges, the commission developed an accelerated plan to utilize nearly $400 million in program and services for county children. The plan, which began in 2012, is estimated to serve up to 200,000 children. Some of the initiatives provide services such as expanded health intervention programs, housing for homeless families, expansion of dental care for children age 5 and younger, and partnerships with UCLA to bring dental and vision care to preschoolers.

Public health implications

First 5 LA's four goal statements carry several public health implications.
Babies are born healthy.
Children maintain a healthy weight.
Children are safe from abuse and neglect.
Children are ready for kindergarten.

Outcomes

Evaluation of the Black Infant Health program has suggested that BIH clients have lower amounts of birth defects, infant mortality, and higher amounts of breast-feeding when compared to other African American mothers in LA County and the U.S. Evaluation of the Healthy Birth Initiative showed more intermediary results. Rates of gestational age, pre-term birth weight, and infant mortality were higher in HBI clients when compared to LA County statistics. Although comparisons of infant mortality and pre-term birth rates between HBI clients and the outside community were not statistically significant, the proportion of Cesarean births and formula feeding was found to be significantly lower.
First 5 LA's Early Developmental Screening Initiative has shown increased collaboration between clinicians, community groups, and patients. Physician practices that participated within EDSI's Physician Collaborative increased developmental screening rates from 20% to over 85%. Furthermore, rates of maternal depression screening also increased from 7% to 54%, and the percentage of participating practices which used comprehensive care prompting systems increased from 7% to 77%. Collaboration with Women, Infants, and Children programs has shown modest gains in visit preparation; 18% of the 500,000 participants reported that the programs affected the way they approach doctors visits.
The Family Literacy Initiative also showed moderately positive outcomes; in fact, greater family participation in the Family Literacy program was associated with greater increases in parent reading skills, library use, and school involvement. Although child participation in early childhood education classes was not correlated to an increase in pre-literacy or math skills, parent participation was correlated with higher child ability to name numbers, understand stories, and learn English. The School Readiness Initiative showed small but statistically significant improvements in child communication and social-emotional school readiness skills. SRI children also had higher scores in English proficiency, and slightly higher scores on mathematical assessments.

Sponsorships