In California, Cautious Optimism About Better Collaboration on Kids Under Newsom

California advocates and policymakers are guardedly hopeful that the new governor will walk the walk when it comes to responding to child trauma and mental health challenges for children in the state.

That was the takeaway from the annual conference of Breaking Barriers, a collaborative built to foster dialogue about how government and community actors can form better partnerships in the interest of serving children and families.

State Senator Jim Beall (D) said the state is in “unsettled times,” especially when it comes to mental health. The four previous state governors have given little thought to the state’s mental health system, he said, but now the time is ripe for a renewed focus on the mental health system.

“We’ve got to get the governor engaged in mental health,” Beall said. “Every time there’s a new governor, there’s a new political dynamic.”

The Breaking Barriers conference was formed as a venue for often-isolated, child-serving systems — from education and mental health to child welfare — to talk about collaborative practices and policies to address persistent issues that stretch beyond just one agency or system. The group also helps support collaborative practices at the local level through resources like the new toolkit designed to address cross-system challenges like shared governance, data sharing and fiscal responsibility.

With the prospect of a more engaged administration, dozens of children’s advocates from across the state considered implications of new policies in the state and advanced county efforts to increase collaboration for the state’s most vulnerable children.

“That’s the whole point of this forum: to learn from one another who’s doing what, who’s getting where and to coordinate our care,” said Elizabeth Estes, an education lawyer and director of the annual conference.

State Sen. Richard Pan (D) said that as California takes on monumental challenges — like a new plan to roll out universal screening for childhood trauma — it must not shy away from a poor record of communication between child-serving fields. Currently, systems like education and health rarely make time to work in tandem when it comes to safety-net programs, he said.

“The two arms don’t work together and they don’t even talk to one another,” Pan said on a panel about addressing the impacts of child trauma.

In the state’s effort to tackle childhood trauma, there are still many questions about whether screening for adverse childhood experiences could have unintentional impacts on many systems, such as a potential flood of students into the special education system as a result of screening.

“We know we have a lot of challenges with child trauma, but the solution is not to say, ‘There’s a problem, and it’s probably pretty big but we don’t want to look at it,’” Pan said. “We can’t be afraid to find out the results … When we know the size of the problem, we can more effectively get resources on it.”

Just a year into his first term with a strong Democratic legislature, Gov. Gavin Newsom’s (D) initial investments in early childhood education and childhood trauma are part of an effort to live up to campaign promises to strengthen young children and their families. But there is still more work for the state to do to create a more effective, cohesive safety-net system for children in the state.

Beyond childhood trauma, another big-picture opportunity for California is a pending reform to its Medicaid program that would bolster its fragmented behavioral health system. Alex Briscoe, principal of the California Children’s Trust and previously the director of the Alameda County Health Care Services Agency used the conference to highlight a proposed plan from the state Department of Health Care Services that could have a big impact on children’s behavioral health. It would allow the state to draw down more Medicaid funding for services used by many child-serving systems, from school districts and public health departments to county mental health departments and regional centers in the state that coordinate disability services to children.

The “CalAim proposal” would alter the state’s regional rate system to increase the amount of federal dollars flowing into California for child behavioral health.

The number of children eligible for such services under the state’s Medicaid program has increased in recent years, Briscoe said, but the number of children receiving services has declined.

The CalAim proposal “could open up a whole new opportunity to dramatically expand access to care of children and offer huge opportunities for the field of behavioral health,” Briscoe said.

As the state considers big efforts at the state level, there are also collaborative approaches at the local level that can benefit vulnerable children and families. Chandra Ghosh Ippen, a psychologist and associate director of the child trauma research program at the University of California-San Francisco, said that relatively small efforts by police officers, teachers and other professions that interact with children can play an important part in lessening the impact of trauma.

For example, she said, when police officers make themselves less threatening in traumatic situations involving children and families, that effort can help down the line.

“To the degree you’re partnering in a trauma-informed system, you’re cutting down the amount of time I spend treating a family,” Ghosh Ippen said. “There are numerous ways we can cut down the mental health toll by partnering together because I know there aren’t enough of us, that’s why we need to build more, map services and seek partnership so that what I do goes faster.”

There are many different ways for counties to encourage specific collaboration. At the Breaking Barriers symposium, attendees broke up county groups, each made up of workers from several different systems. Each laid the groundwork for a unique plan attuned to the needs of that county.

The group from Ventura County is working to expand an effort to link services to an area of high need. According to Judy Webber, deputy director of the Ventura County Human Services, a recent geo-mapping effort found that a four mile by four mile area in Oxnard is the source of about half of all child welfare referrals in the county.

When Webber reached out to other county public agencies, Webber found that challenges existed beyond child welfare. On the public health side, the area lacks primary medical care resources and prenatal services for mothers, and in terms of education, the area has a high rate of students with special education needs, she said.

“All of that started to tell a story — this is a high-need community,” Webber said. “There are a lot of services but they aren’t organized in a true continuum and the access to those services is not very clear to the community.”

Through the county’s Neighbors Together Alliance, Webber and other leaders are trying to create a mechanism that can better organize services by recognizing the needs of the community and act as a conduit to share the situations on the ground with elected officials in Ventura County.

“I don’t think there are macro policies in place that really promote family healing,” Webber said. “We’re working very much in a siloed system, but we have to start somewhere, and I know I can’t do this alone.”

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