‘We are in a moment’ — policy experts discuss converging student health crises

The L.A. Trust Student Health Policy Roundtable met for the first time last month to address healthcare issues affecting L.A. County students and their families.

An invited group of leaders in children’s health and student wellness assembled at the kickoff meeting of The L.A. Trust Student Health Policy Roundtable, online December 8, 2021. They discussed the urgent need to work together to find new solutions to the converging crises affecting student and community health. 

The purpose of the roundtable, funded by Cedars-Sinai, is to “establish a forum where cross-sector leaders can advance a shared policy agenda for school-based healthcare and student wellness in Los Angeles County,” said Gabrielle Tilley, senior policy manager for The L.A. Trust. 

Participants came from the public and private sectors, including the Children’s Partnership, the Community Clinic Association of Los Angeles County (CCALAC), Helpline Youth Counseling, Kaiser Permanente, L.A. County Departments of Public Health and Mental Health and Office of Education, Planned Parenthood Los Angeles (PPLA), L.A. Care and UCLA. Ana Perales and Toyomi Igus were present from The L.A. Trust board of directors. 

New opportunities

Maryjane Puffer, executive director of The L.A. Trust, said, “We are in a moment of great need.” She cited ongoing harm from the once-again surging coronavirus, numerous, interconnected health crises, and long-standing discrimination and racial disparities. 

Along with the challenges, Puffer noted major opportunities, including increased public awareness and political will, federal recovery funds, California’s budget surplus and new spending on youth, education and mental health, especially the $4 billion California Youth and Behavioral Health Initiative. 

Puffer said it was time to follow in the footsteps of The L.A. Trust’s original policy roundtable, which helped create a school healthcare model designed to integrate primary, behavioral and oral healthcare at L.A. Unified Wellness Centers. “There were five LAUSD Wellness Centers at the time (2008), but their efforts were not always uniform.” 

Puffer said The L.A. Trust Data xChange is a key component to finding policy solutions that will take a holistic approach to student and community health concerns and “make our schools a center of well-being.” 

Foundations

Tilley noted that 32 partners representing 21 organizations were interviewed prior to the inaugural meeting. Representatives included the Advancement Project, the Children’s Defense Fund, Children’s Law Center of California, CSHA, Children Now, the Community Coalition, CCLAC, Children’s Partnership, Essential Access Health, Inner City Struggle, PPLA, and L.A. Unified and the L.A. County Board of Education, Board of Supervisors, Office of Education and Department of Public Health.  

Common challenges cited included lack of collaboration and integration, labor shortages, school leadership turnover, student and parental consent for services, cultural competency, funding, referral and billing processes, punitive disciplinary policies and a need to focus on the “whole child.” 

Interviewees cited major opportunities for improvement, including major investments in schools and mental health, school-based health centers (SBHCs), community schools, peer advocacy, student and community engagement, reinvestment of policing dollars, universal free school meals, and early intervention with the 0-5 population. 

Participants listened as Taaliyah Tucker, a former member of The L.A. Trust Student Advisory Board at Washington Prep, discussed the challenges faced by her fellow students, including COVID, quarantine and mental health.  

“Mental health is really important right now,” she said. “Kids say they’re fine, but they’re not fine. You have to read the signs.” 

Discovering shared values 

Participants broke into eight groups to identify shared values. Issues raised included the importance of Black health, removing barriers to student healthcare and increasing power sharing and transparency. 

“We must make health education culturally competent,” one participant said. Another emphasized the importance of “adventure counseling,” noting that most prevention education is negative or punitive. “It has to be youth-centered or it doesn’t work.” 

A representative of the Los Angeles County Office of Education noted their focus on access for immigrant families, who have been hit especially hard by COVID. 

Puffer said improving the student healthcare referral systems and working with L.A. Unified’s Community of Schools Initiative launched in 2020 should be considered as top priorities. 

Next steps 

Tilley announced that the group will meet again on January 14, 2022. “We will work from the heart, listen actively and assume good intentions.” The main purpose of the body will be to build an agenda that focuses on two or three major policy goals. 

“Much like children’s health needs — the interests of this group are diverse and complex. Identifying two or three shared goals among us is no easy task, but after one meeting it’s clear this collaboration can be a powerful force for policy change,” Tilley said. “This is just the beginning.”