the roots of change

Report to the Community Community Health Investment Fund Grants 2003-2006

L.A. Care Health Plan’s Community Health Investment Fund L.A. Care’s Board of Governors established the Co m m u n i t y H e a lt h

I n v e s t m e n t F u n d ( C H I F ) to support initiatives that strengthen the roots of community health. L.A. Care’s reinvestment strategies for CHIF are designed to fill gaps in health coverage in Los Angeles County and increase coverage for vulnerable populations.

L . A . C A R E h e a lt h P LAN (Local Initiative Health Authority of Los Angeles County) is a local public agency and health plan serving residents of Los Angeles County through a variety of programs including Medi-Cal, Healthy Families, and Healthy Kids. With nearly 800,000 enrolled members, L.A. Care is one of the largest health plans in California and is the nation’s largest public health plan. L.A. Care is a leader in developing new programs through innovative coalitions and partnerships designed to support public health, the safety net, and health insurance coverage for vulnerable populations.

board of governors James Lott, Chair

Thomas Kliztner, MD, p h D

Bryce YokomizO, Vice-chair

Honorable Don Knabe

Kimberly Wyard, Treasurer

Mario m. Ramos

dr. Peter Rivera, Secretary

Gloria Rodriguez, MPH

Bruce Chernof, MD

Robert e. Tranquada, MD

Catherine K. Douglas

Walter a. Zellman, p h D

Maria Guerrero

L . A . C a r e H e alt h P la n la u n ch e d t h e C o m m u n i t y H e alt h I n v e s t m e n t F u n d ( C H I F ) w i t h a s i m pl e g oal — strengthen the roots of the health care safety net in Los Angeles County to better nurture fundamental improvements in community health. When the roots of community health are strong, it becomes possible to mitigate disparities in health care that are brought on by chronic diseases. And when we keep chronic diseases under control, Los Angeles County will not only be one of the culturally richest places in America, but one of the healthiest.

L.A. Care has committed more than $50 million to improve community health.

In the past few years, L.A. Care has worked closely with the community to identify disparities in health, and we have partnered with more than 40 community-based organizations to bridge gaps in health care services. Through L.A. Care’s CHIF, we have committed nearly $50 million, over three years, to treat chronic diseases, expand health care coverage for kids, and improve health care access for those who cannot afford quality health care. In our endeavor to erase health disparities, we have learned that improving community health is a long road and one best traveled with community partners. We have enjoyed considerable success but we realize that there is still much to do. The health care challenges in Los Angeles County are immense and complex, but L.A. Care remains committed to tackling those challenges. Oral diseases remain a silent epidemic, and our Board plans to continue the effort to improve oral health in the county. Health care access remains a challenge for many, and we intend to provide funding to improve infrastructure, health care services, and health education for vulnerable populations such as seniors and people with disabilities. As the largest public health plan in America, L.A. Care serves nearly 800,000 lowincome individuals through health care, and we will work closely with stakeholders to ensure that L.A. Care continues to meet the health care needs of the community.

Howard A. Kahn

James Lott

Chief executive officer chair, board of governors

Children’s Health Initiative (CHI) of Greater Los Angeles Approximately 235,000 uninsured children reside in Los Angeles County. Many of them rely on hospital emergency rooms as their

L.A. Care then partnered with the Los Angeles County

only source of medical care. Their

Department of Health Services and The California

families live in a muted state of perpetual stress, knowing that a sudden illness could destroy them

Health Initiative of Greater Los Angeles,

financially or worse yet, force them out of their homes.

an ambitious effort to provide health coverage to

In July 2003, L.A. Care Health Plan partnered with

Endowment to co-convene the Children’s

all uninsured children in Los Angeles County.

First 5 LA to address the high number of uninsured

CHI of Greater Los Angeles is a diverse coalition

children. With a generous grant from First 5 LA,

consisting of nearly 50 groups representing health

L.A. Care launched Healthy Kids for children

plans, foundations, government, community-

five years and younger. Healthy

based organizations, labor and business. Together,

Kids is a comprehensive health insurance program for children from families who live at or below 300% of the federal poverty level.

the CHI of Greater Los Angeles Coalition

expanded Healthy Kids coverage to include children through age 18. The coalition has raised

more than $100

million for Healthy Kids. CHI of Greater Los Angeles also has enrolled nearly 45,000 children in L.A. Care helped co-convene the Children’s

comprehensive health coverage that includes medical, dental, vision, and mental health coverage.

Health Initiative of Greater Los Angeles, and

we have contributed more than $40 million to Healthy Kids. 

Carlos and Patricia Aguirre legally immigrated to the United States six years ago from El Salvador with the dream of providing their two children, Renato and Carla, with a better life. Carlos and Patricia quickly found full-time work after they arrived, but like many in Los Angeles, they discovered that it is a challenge to afford health care. L.A. Care Health Plan has helped many families just like the Aguirres secure free and low-cost health care coverage for their children through Healthy Kids. “I am so grateful that my children have health

insurance,” says Carlos Aguirre. “It gives me peace of mind to know that my two children have health coverage if they get sick or injured.”



L.A. Care’s Oral Health Initiative

Mother Teresa once said, “We shall never know all the good that

a simple smile can do.” At L.A. Care Health Plan, we hope to find out.

“I thought I’d find some tiny

office with aging equipment because it’s a community clinic, but I was surprised to find new dental chairs and equipment. Although I am poor,

Since 2003, L.A. Care has invested $4.8 million through L.A.

Care’s Oral Health Initiative to provide low-income communities with free dental services. L.A. Care funded 23 clinics and community-based organizations throughout Los Angeles County to start

or expand dental services and oral health education to vulnerable populations.

they treat me with respect. It’s hard to

L.A. Care’s grants helped many clinics shorten the wait time for dental

keep your teeth when you are my age,

services and leverage additional funding sources. The 23 grantees

but the dentists have done such a great

formed a network of comprehensive dentistry that continues to serve

job here that I don’t need dentures.”

children, adults, the homeless and people with disabilities.

Larry Yen, dental patient at

To date, L.A. Care’s Oral Health Initiative has provided

Chinatown Service Center

free dental services to more than 110,000 people throughout Los Angeles County.



“I used to not smile because of my bad teeth. It was hard to find a job, and people treat you differently when your teeth are bad. Now many of my friends and family members are so surprised that my teeth look so great; they tell me I look better and am more confident.”

Reese Beecher, patient at Los Angeles Mission Clinic

“Lua was born with a developmental disability and she is nonverbal. She had a number of cavities that caused her a lot of pain and discomfort but she had no way of telling anyone. Through L.A. Care’s grant, she was provided a dentist who specializes in working with patients who have developmental disabilities. The dentist gave her the care she needed, and her quality of life has since improved substantially.” Juanita Purry, caretaker of Lua Mataitusi

“I couldn’t chew because of the pain, and I had to

swallow food whole. Most clinics wouldn’t provide me with treatment because I don’t have any form of I.D. I thought I’d lose all my teeth, but the dentist here helped me save my teeth.”

George Marxelly, homeless patient at Los Angeles Mission Clinic 

Improving Access to Health Care

L.A. Care provided $225,000 in funding

In 2002, Los Angeles County closed the Bell Gardens Community Health Center and Norwalk Regional

to help re-open Bell Gardens Community Health

Health Center due to budget cuts. The clinic closures in Bell Gardens and Norwalk impacted more than 15,000

Center and Norwalk Regional Health Center.

low-income residents. Difficult decisions are often made when there are great

demands on a system and

few resources. But for L.A. Care Health Plan, our decision to help reopen the clinics was an easy one.

Both clinics are located in communities that are underserved. When the clinics closed their doors due to county budget cuts, it left a void in health care services. Some patients tried to visit neighboring health centers, but they had to wait as long as a month for an appointment; others traveled an hour or more to get basic preventive care. Most, however, were forced to rely on emergency room services or simply forego care altogether. Through a $225,000 grant from L.A. Care, JWCH Institute was able to rebuild and reopen both clinics,

restoring free and low-cost health care services for thousands of residents in the communities of Bell Gardens and Norwalk. The Norwalk Regional Health Center rebuilt and ready to serve the community.



Maria Martinez was born and raised in Bell Gardens. Now, a mother of three, Maria devotes her life to her children. She noticed that her youngest son, Jonathan, was having difficulties learning and developing speech. Maria had her son examined by a few doctors, but none could solve the mystery of what was wrong. “Mother’s intuition told me that something was

wrong with my son. The doctors at Bell Gardens Health Center helped me solve the riddle—my son is autistic. I was happy and sad all at the same time to finally find out.”

Maria Martinez and her son Jonathan, a patient at Bell Gardens Health Center



L.A. Care’s Asthma Management Pilot Program Nearly one

million people in Los Angeles County have asthma. More than 200,000 of those who suffer from asthma are children. Asthma is a chronic disease that accounts for more than 14

million lost days of school and 60,000 emergency room visits per year. Asthma can be life-threatening, but it is manageable with proper education and medication. “Since I speak their language, share their culture and live

in the neighborhood, families trust me and even invite me into their

In 2004, L.A. Care launched L.A.

Care’s Asthma Management Pilot Program, a $600,000 countywide pilot program to help those who suffer from asthma better control their chronic condition.

homes to help them understand how to better manage their child’s asthma.”

The pilot focused on asthma education and outreach, teaching children

Maria Garcia, promotora

and families how to mitigate asthma triggers in the home and how to properly use asthma medication to keep asthma at bay.

LBACA promotoras (below, from left to right): Delores Simms, Herendira Razcon, Phaktra Huch, Maria Garcia, and Irene Mineses.

The Los Angeles County Department of Health Services reports that

poor asthma management is the most common reason for asthma-related hospitalization. Cultural and language barriers play a part in the improper management of asthma. In Long Beach, where asthma is a key health concern for residents, L.A. Care partnered with the Long Beach Alliance for Children with Asthma (LBACA) to face the challenge head-on. LBACA tapped into the strength of existing community resources to deliver vital asthma education services. By providing home visits and asthma education through five promotoras, health educators from within local ethnic communities in Long Beach, LBACA has been able to effectively educate a number of individuals and groups about asthma symptoms, proper use of medication, and environmental factors that trigger asthma attacks.



Elisia Valencia has changed the way she sees asthma with help from the Long Beach Alliance for Children with Asthma. She didn’t understand how to use the asthma medication, and she was always afraid to ask. Elisia is the mother of two children who suffer from asthma. “What I feared most is not knowing how to protect my children from an asthma

attack. Doctors prescribed medicine for my children’s asthma, but they didn’t explain what provokes asthma or how I can prevent my children from having an asthma attack,” said Elisia. “Thanks to the program run by the Long Beach Alliance for Children with Asthma, I now understand asthma much more.”

Elisia Valencia with her two children, Alan and Sharon 

L.A. Care’s Safety Net Initiative

For many who are uninsured, the health care safety net is

the last line of defense against disease and illness. L.A. Care’s Safety Net Initiative is a $3 million effort to strengthen the health care safety net in Los Angeles County. We believe that a strong health care safety net is essential to improving community health and access to health care. L.A. Care has worked with 18 community partners to improve infrastructure, expand health care access, develop innovative health education programs, and address unmet needs in health care.

C h i n ato w n S e r v i c e C e n t e r Located in an old shopping mall, Chinatown Service Center is a hidden gem. It provides free and low-cost

L i t t l e C o m pa n y o f Ma r y

health care to a community that is predominantly Asian

With the largest population of Samoans outside the Pacific Islands, the South

American, low-income, elderly and monolingual Chinese.

Bay is a fitting location to host a diabetes prevention program known as

Chinatown Service Center found that while they were

Soifua Maloloino, or “healthy living” in Samoan. This ethnic group

able to treat their patients, it was difficult to make sure

tends to have a high prevalence of diabetes, making outreach, screening

that patients properly filled their prescriptions. Barriers in

and education of this at-risk population that much more important.

language, age, and income all played a role in preventing

L.A. Care Health Plan understands the value of serving

patients from getting their prescriptions filled.

ethnic

communities in their native languages. In 2003, L.A. Care

In 2003, L.A. Care Health Plan awarded Chinatown

awarded a $315,000 grant to Little Company of Mary to start the unique diabetes

Service Center a grant of more than $135,000 to

program. Soifua Maloloino continues

start an onsite pharmacy. The onsite pharmacy provided patients free and low-cost prescription medicine. It helped increase the

operating today, and it has expanded to serve other ethnic communities in the South Bay.

likelihood that patients filled their prescriptions, and more importantly, that patients understand in their native

10

language how to properly use the medication.

“My husband and I worked in a

sweatshop for 15 years. When we got too old we were let go. We were unemployed and my medication cost $4 per pill. The pharmacy at the Chinatown Service Center made the difference. There is no way I could afford this on my own.”

Xiu Chan Yang, patient at Chinatown Service Center, with her husband Lai Ying Wong

L.A. Care’s Chif Grants, 2003-2006 C H I L D R E N ’ S H E A LT H I N I T I AT I V E O F G R E AT E R LO S A N G E L E S , $4 0 m i ll i o n

• Mission Community Hospital: Provided oral health education and screenings for more than 1,400 children in Panorama City and San Fernando.

L.A. Care provided $40 million in grant funding to the Children’s Health Initiative of Greater Los Angeles to support children’s health insurance. L.A. Care is also a co-convener of the Children’s Health Initiative, the coalition that launched Healthy Kids in Los Angeles County.

• Partners in Care Foundation/Antelope Valley Partners in Health: Mobile dental unit provided dental services and oral health education for more than 3,000 children and parents at school sites.

O R A L H E A L T H I N I T I A T I V E , $4. 8 m i ll i o n More than 110,000 adults and children in Los Angeles County have received dental services through L.A. Care’s Oral Health Initiative. • AltaMed Health Services Corporation: Built dental clinic in East Los Angeles and provided free and low-cost dental services to more than 650 patients. • Children’s Dental Center: Expanded oral health education program to reach more than 1,000 children and adults. • Children’s Dental Health Clinic: Used mobile dental clinic to provide dental services to children in Long Beach and surrounding communities. • Chinatown Service Center: Doubled capacity to provide free and low-cost dental services. • City of Long Beach: Provided dental screenings, sealant applications, and oral health education to more than 4,000 elementary school students. • Clinica Monseñor Oscar Romero: Established new dental clinic and provided pediatric dental services and oral health education. • COACH for Kids and Their Families: Mobile dental clinic provided oral health education to children in South Los Angeles, Skid Row, Pico Union, and Inglewood. Trained health care providers on how to conduct an oral health diagnostic.

• Providence Holy Cross Medical Center: Oral health education and oral hygiene kits for more than 2,000 elementary school children. • South Central Los Angeles Regional Center: Provided specialized dental services for people with disabilities at little or no cost. • St. John’s Well Child and Family Center: Provided dental services, including oral surgery, for approximately 2,300 patients in South Los Angeles. • United Family Dental Group: Developed oral health education program based on storytelling. Provided dental screenings for approximately 1,200 children and comprehensive dental treatment for more than 400 children. • University of Southern California, School of Dentistry: Provided dental exams, sealant and fluoride services, and oral health education to more than 1,200 children in South Los Angeles and Boyle Heights. • Valley Community Clinic: Expanded dental services at a new dental facility in San Fernando.

• Eisner Pediatric & Family Medical Center: Funded periodontal services for low-income adults with diabetes who have periodontal disease.

• Venice Family Clinic: Provided free and low-cost dental services to low-income individuals in Los Angeles.

• L.A. Free Clinic: Increased capacity to provide dental services and oral health education to children and adults.

• Worksite Wellness: Oral health education and referrals for low-cost dental services to more than 700 adults at small manufacturing businesses.

• LAUSD GREAT & HOPE Collaborative: Dental examinations and oral health education for 4,000 elementary and middle school students and their parents. • Los Angeles Mission Community Clinic: Provided free dental services to homeless patients on Skid Row. • Los Angeles Oral Health Foundation: Trained dentists in pediatric dentistry. Provided more 12 than 900 children with free and low-cost dental services.

S afet y N et I nitiative , $ 3 m i ll i o n L.A. Care’s Safety Net Initiative is intended to strengthen the health care safety net in Los Angeles County. • Asian Pacific Healthcare Venture: Developed culturally and linguistically competent perinatal program for Thai and Cambodian community. • Cedars-Sinai COACH for Kids: Provided mobile health care and case management services to uninsured and medically underserved children and families at elementary schools. • Children’s Dental Health Clinic: Provided dental services to children from low-income families. L.A. Care’s grant doubled the capacity of the clinic to provide dental services. • Chinatown Service Center: Started an onsite pharmacy that provides free and low-cost pharmaceuticals to low-income patients. • Compton Unified School District: Increased primary care services at school-based clinics throughout Compton Unified School District. • East Valley Community Health Center: Helped fund the purchase and installation of four modular units so the clinic could continue to offer health care services at the site while undergoing renovation. • Eisner Pediatric & Family Center: Funded the purchase of all 10 dental operatories at Eisner Pediatric & Family Center. • Little Company of Mary: Funding to start Soifua Maloloino, a Samoan diabetes program. • Northeast Valley Health Corporation: Established a marketing department to increase enrollment of qualified individuals and families in Medi-Cal and Healthy Families. • San Gabriel Unified School District: Established the only school-based health clinic in the entire school district. • South Bay Family Health Center: Provided dental services for low-income individuals and families in the South Bay. • South Central Family Health Center: Provided preventive care services to low-income families. Conducted community education campaign on the importance of preventive care. • Tarzana Treatment Center: Implemented electronic health record system to improve patient care and increase clinic efficiency. • The Center for Partially Sighted: Provided low vision devices and rehabilitation services to the partially sighted. Also conducted outreach and education on the risks of vision-loss and how to slow vision-loss caused by diabetes. • Venice Family Clinic: Funding to support renovation of the clinic to increase patient capacity. The grant also paid for primary care services for clinic patients. • Westside Neighborhood Clinic: Increased comprehensive medical services to low-income and indigent individuals in Long Beach. • White Memorial Medical Center: Provided diabetes treatment and management services for low-income and uninsured residents in East Los Angeles.

A sth m a Manage m ent P ilot P rogra m , $6 00,000 In 2004, L.A. Care started a $600,000 asthma management pilot program to gauge the best approach to helping asthma sufferers control their chronic condition. • Asthma & Allergy Foundation of America, Southern California Chapter: Worked with the Healthy African American Families and Coalition for Community Health to provide in-home asthma education to families with asthmatic patients. • LAUSD Student Health & Human Services Division: Trained nurses and attendance counselors to identify students who suffer from asthma, and provided information and resources on asthma management. • Long Beach Alliance for Children with Asthma: Developed community-based outreach and education program relying on promotoras or community health educators. • Long Beach Unified School District: Developed asthma intervention program that relies on school nurses to evaluate and monitor the effectiveness of students’ asthma management plans, and provided in-home asthma education to children and adults. • Northeast Valley Health Corporation: Worked with promotoras or community health educators to provide asthma case management and intervention to low-income children and families. • Venice Family Clinic: Provided asthma education to nearly 200 children, and assisted with the evaluation of asthma triggers in the home.

To learn more about L.A. Care’s CHIF, please contact Johanna Goldberg, Direc tor of Communit y Benefits, at 213-694-1250.

555 West Fifth Street Los Angeles, CA 90013-3036 213-694-1250 www.lacare.org LA0145 06/06