It was a year that challenged almost everything

Empty classrooms and full intensive care units created a year of unprecedented challenges for Los Angeles students, educators and healthcare providers.

A pandemic. An uprising. An education crisis. And an economic crash. The year 2020 was one of the most challenging years in our history — and an outsize share of those challenges were borne by the students, educators and healthcare workers we serve. 

“Our friends rallied around us, and we rallied around them during this crisis,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. “But the problems experienced in 2020 — healthcare and income disparity, racial injustice, distrust of our institutions and inadequate public health facilities — did not start in 2020 and will not disappear in 2021. We have so much work to do.” 

The L.A. Trust adapted quickly to the pandemic and school closures in mid-March, transferring in-person outreach to social media and face-to-face meetings to online platforms like Zoom. 

With schools on lockdown and many Wellness Centers closed, The L.A. Trust redoubled its efforts to address the primary, oral and mental health needs of Los Angeles Unified students: 

Held Wellness Center Learning Collaboratives online in May, October and December to discuss urgent issues related to the pandemic. The three online events were attended by a total of nearly 200 healthcare providers, researchers and L.A. Unified facilitators. 

Provided its stakeholders with information about the unfolding pandemic, interviewing experts like Barbara Ferrer, head of L.A. County Public Health, and Jim Mangia, president and CEO of St. John’s Well Child & Family Center, operator of Wellness Centers at Lincoln, Manual Arts and Washington Prep, which have remained open during COVID. 

June: Distributed more than 50,000 toothbrushes as part of Operation Tooth Fairy, garnering widespread media coverage about the importance of maintaining oral health. 

July/December: Conducted virtual convenings of The L.A. Trust’s Oral Health Advisory board to help providers pivot during COVID crisis. An in-person meeting was held in March, pre-COVID. 

July: Moved its nutrition programs online, reaching nearly 80,000 students and community members with Facebook workshops and professionally produced cooking videos. 

August: Trained student health advocates at our first-ever Summer Academy and supported Student Advisory Board members and their allies throughout the pandemic. 

August: The L.A. Trust launched our Student Mental Health Initiative, funded by a $100,000 grant by Cedars-Sinai and a $50,000 grant by Health Net. The initiative will train students as peer leaders through The L.A. Trust’s Student Advisory Boards, increasing awareness of symptoms like anxiety and depression, and building positive coping mechanisms and self-referrals to care. The initiative will include student-run social media campaigns and online trainings such as “Youth Mental Health First Aid” starting in the fall. 

September: Educated more than 40 state legislators and their staff on the need for school-based healthcare during a first-ever virtual Advocacy Day. 

September: Launched a new website for The L.A. Trust with expanded resources and a new rallying cry, “Putting the care in student healthcare.” 

October: Helped promote and conduct the online California School-Based Health Alliance Conference, attended by nearly 1,000 health advocates from across the state. 

October: Released a Data xChange Report on the impact of L.A. Unified Wellness Centers over the past five years. 

Fall: Partnered with L.A. Unified and KLCS-TV to broadcast The L.A.Trust-produced nutrition and oral health spots reaching an audience of up to 2.3 million students and family members. 

Fall: The L.A. Trust’s program managers, adult allies, director of programs and executive director completed the eight-hour Youth Mental Health First Aid (YMHFA) training and received certification as YMHFA providers. The L.A. Trust’s program manager in turn trained dozens of Student Advisory Board members in the How to H.E.L.P. A Friend curriculum. 

November: Worked with the office of Supervisor Mark Ridley-Thomas and the T.H.E. Clinic to distribute thousands of N95 protective masks to frontline healthcare workers at Los Angeles Unified Wellness Centers. 

December: Created a new Oral Health Toolkit to put resources at dental providers’ fingertips. 

“It has been a devastating year,” Puffer said, “and the effects are far from over. But last year witnessed unimaginable courage, resilience and resourcefulness. We are so proud of our students, educators, healthcare providers and partners in Los Angeles Unified and beyond.”

Oral Health Advisory Board focuses on prevention education

Dr. Jim Crall of UCLA More LA Smiles (and friend) discussed public oral health campaigns during the final Oral Health Advisory Board meeting of 2020.

Representatives of the L.A.’s student oral health community met online December 15 at the fourth and final 2020 meeting of The L.A. Trust’s Oral Health Advisory Board.  

More than three dozen oral health providers and stakeholders attended the event, which focused on public health campaigns and best practices for student oral healthcare in the midst of the coronavirus pandemic. 

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, discussed The L.A. Trust’s oral health education campaign on KLCS featuring Program Manager Esther Yepez and her kid-friendly puppet, Billy. The campaign has generated up to 1.5 million views to date.  

Puffer thanked QueensCare for funding upcoming student oral healthcare education by The L.A. Trust at nine LAUSD sites and introduced The L.A. Trust’s new Oral Health Toolkit, providing useful resources for student and community dental care providers.  

Dr. Maritza Cabezas, dental director for L.A. County Department of Public Health, and Dr. Abrey Daniel, walked attendees through the development of a County oral health education campaign. She outlined the campaign development process, including: determining the need; selecting the audience; developing the message; and crafting the final creative with the help of focus groups. The County’s campaign’s goals are to increase awareness among caregivers of children under 5, demonstrating the importance and ease of at-home oral health habits.  

“People don’t understand the disease process when it comes to cavities – it’s insidious,” said Dr. Jim Crall, project director of UCLA More LA Smiles. He said “there are a lot of disconnects in oral health treatment” for children. Simple changes in student behavior can make a big difference and education is key. He previewed a series of TV spots featuring Sesame Street characters, which will be shown on KLCS remote learning channels through February. The L.A. Trust helped facilitate the broadcast of the Sesame Street spots.  

Doors still open 

Gloria Velasquez, organization facilitator for LAUSD Health and Human Services, said  seven Wellness Centers and school-based health clinics were still providing partial or full oral health services for students and community members: El Sereno Middle School (Western Dental); Hart Street Elementary School (Dr. Samoha); Jefferson Wellness Center (South Central Family Health Center); Maclay and Sun Valley Middle Schools (NEVHC); Monroe (Valley Community Health, appointment only); and Washington Prep Wellness Center (St. John’s Family and Wellness Center). 

Crall noted that the Medi-Cal Dental Transformation Initiative would continue but local DTI pilot programs would not. UCLA’s More LA Smiles LADRRS program (Los Angeles Dental Registry & Referral System) would be sustained for now and potentially integrated into the Department of Health Care Services.

The L.A. Trust and its allies tackle student oral health

Beyond the Bell employees helped The L.A. Trust distribute more than 50,000 toothbrushes during Operation Tooth Fairy in June.

Oral health leaders from government, academia, nonprofits and the healthcare industry met online at The L.A. Trust’s Oral Health Advisory Board quarterly convening June 2. Representatives from more than a dozen organizations discussed ways to help students and their families access oral health services during the COVID-19 crisis.

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, presented an update on how the COVID-19 crisis was impacting dental care for students and communities. She outlined steps The L.A. Trust is taking during the current school closures, including the development of virtual education with upcoming videos, new referral cards for LAUSD local districts, and Operation Tooth Fairy, which raised oral health awareness and distributed more than 50,000 toothbrushes at 16 Grab and Go Food Centers in June.

Gloria E. Velasquez, organization facilitator for Los Angeles Unified’s Student Health and Human Services, outlined steps for re-opening LAUSD campuses under several models released by the Los Angeles County of Education. The models include face-to-face, distance and hybrid learning, depending on health conditions.

Budget cuts and telehealth

COVID-19 has had a major impact on state funding. Fatima Clark, senior policy and outreach associate for Children Now, noted there would be a staggering $54.3 billion budget deficit over the next two years. Among the budget changes: Delayed implementation of the CalAIM initiative; $300 million in cuts to Community Schools Grants; shift of $1.2 billion in Prop. 56 funds to support Medi-Cal; reduction of Adult Dental Benefit; and transitioning all Medi-Cal dental services to the fee-for-delivery system, eliminating voluntary dental managed care in L.A. County.

Dental care providers statewide are getting support from Sacramento as they grapple with COVID-19, according to a presentation by Stephanie Thornton, a fellow with the California Children’s Partnership. California has eased restrictions on telehealth, she noted, but the “digital divide” needs to be closed before these options can be accessed by everyone who needs them.

Ambitious agendas

Lisa Nguyen, associate director, community-based clinical education at the UCLA School of Dentistry, outlined what her institution is doing to advance school-based oral health, including updates on their assessment, education and outreach programs. Nguyen also provided an update on More LA Smiles and discussed the impact of COVID-19.

The meeting ended with a recap of a proposed 2020 policy agenda for The L.A. Trust’s Oral Health Advisory Board. The agenda includes achieving 100% compliance with the Kindergarten Oral Health Assessment Mandate throughout L.A. Unified; ensuring the highest standards of care and case management; integrating teledentistry and alternative practice providers; supporting robust funding for school-based oral health; creating a centralized resource repository; and promoting the use of fluoridated water by Los Angeles Unified families.