Mr. Mark noted that there were three factors that started the reorganization: 1) The implementation of the Chanda Smith Consent Decree; 2) Pressure from parents regarding the reorganization of the District and Division; 3) The reaction of bringing in parents. Mr. Mark reviewed the Division of Special Education Interim Organization Chart.

Mr. Mark discussed the major functions of the division:

€ Compliance
€ I.D.E.A. (Individuals with Disabilities Education Act)
€ Due Process
€ Low Incidence/Budget
€ Nonpublic Schools
Waivers
€ Legislation
Communications
Required Corrective Action for California Department of Education
Complaints
€ Program Development
Behavior
Optimal Learning Environment (OLE)
Special Day Class (SDC)
Resource Specialist Program (RSP)
Least Restrictive Environment (LRE)
Consortium of Institutions of Higher Education (IHE)
€ Chanda Smith Consent Decree
Plan Analysis

Mr. Mark responded to the Committee Members questions.

UPDATE ON NEWLY EVOLVING HEALTH INITIATIVES FOR CHILDREN

Health Mapping and Strategic Planning Grant

Mr. Kelly Jones, Project Coordinator, Student Medical Services reported on the Health Care Mapping and Strategic Planning Project that was designed to support the educational process and reduce barriers to learning through the assessment, analysis and mapping of health care needs, resources and gaps within school complexes and communities. The project is funded by a grant through the California Endowment. Information will be analyzed, mapped and integrated into a written strategic plan containing recommendations for distribution of District resources, accessing existing services and creating community-based partnerships that adequately meet the needs of children and families. This is done in collaboration with the Los Angeles County Health Services, Department of Mental Health, the Children's Planning Council, United Way, and other public and private entities.

The Project will result in the elaboration of profiles reflecting the health care needs of students and families in geographic cluster or complex-based units. These profiles will be formulated and verified through a community validation process involving a central planning committee as well as semi structured focus groups with school-related staff, families, community based organizations, and other agencies involved in health planning. The profiles are to serve as a consistent bench mark for monitoring the health status, unmet health needs and effectiveness of the multitude of programs and services provided for children and families. The desire of project staff is that mechanisms be explored to institutionalize the profiling process so that critical information can be reproduced and tracked over time.

Mr. Jones responded to the Committee Members concerns regarding the collection of data on mental health. Mr. Kiriyama suggested looking into the mental health programs Los Angeles County provides. He referred to the Asian Pacific American Mental Health program in Gardena which might be able to provide information on finances. The children being served are predominantly Vietnamese and Hmong children - many who do not speak English.

Medi-Cal Outreach and Enrollment and Healthy Families Insurance Program

Dr. DuPlessis discussed some of the issues that are affecting children. She spoke about the changes that have occurred recently in children's health programs and some of the controversies. She spoke about a specific activity the District will be engaging in dealing with the children's health reforms. Dr. DuPlessis distributed two documents: An outline used for her presentation on the Medi-Cal Enhancement and "Healthy Families" Program; and a "draft" on Children's Health Access and Medi Cal Project (CHAMP).

Dr. DuPlessis noted that there has been substantial program enhancements to Medi-Cal. The changes are monumental because there has not been any significant expansion in health services for children over 30 years. In 1967, the Early and Periodic Screening Diagnosis and Treatment (EPSDT) legislation was passed, but it took California another 6 years before issuing regulations establishing Child Health and Disability Prevention Program (CHDP). The state is moving quicker this time and has submitted a plan to the Federal Government in order to take advantage of the state Child Health Insurance Program funds that will establish Healthy Families as well as some of the Medi-Cal Enhancements.

Dr. DuPlessis used the following outline for her discussion:

Medi-Cal Program Enhancements

• Increased threshold for "full-scope" Medi-Cal from 85% to 100% Federal Poverty Limit (FPL) for youth aged 13-18 years
  
• Waived requirement for certain asset tests for children
  
• Established one month transitional Medi-Cal coverage for Healthy Families applicants
  
• Encouraged simplified application process

• Subsidized insurance program for children aged 1-18 years in families with incomes up to 200% FPL administered by the Managed Risk Medical Insurance Board (MRMIB)
  
• Increased coverage equivalent to the Public Employees' Retirement System (PERS) with dental and vision (managed care model)
  
• Provided 12 months continuous eligibility
  
• Provided transitional payment for 30 days for pending applications (CHDP/Medi-Cal)
  
• Provided for mail-in application (combined HF/Medi-Cal application)
  
• Required coordination with other programs (County Mental Health, CCS, CHDP) and encouraged coordination with others (e.g., Regional Centers, Alcohol & Drug programs, Local Educational Agency (LEA)
  
• Designated lower cost "Community Provider Plan" (CPP) in each region
  
• Provided purchasing credit option for employer-covered dependent care

• Provided twenty-one million dollars to secure outreach contract with private entities (40% traditional; 60% community based)
  
• Establish five rural demonstration projects

• "Public Charge" issue
  
• Fifty dollar application assistance fee permissible
  
• Defining traditional and safety net provider (and CPP designation)
  
• Affordability of premiums and co-pays
  
• Mental health coverage
  
• Coverage for the undocumented and for families not eligible for these programs.

Dr. DuPlessis discussed the Children's Health Access and Medi-Cal Project (CHAMP). LAUSD
has been working with Healthcare Association of Southern California (HASC), Los Angeles County Office of Education (LACOE), National Health Foundation (NHF), Los Angeles County
Departments of Public Social Services (DPSS) and Health Services (DHS) are seeking funds to support CHAMP through which low-income school children will gain access to various health programs. The project focuses not only on Medi-Cal but on Healthy Families, KP Cares for Kids, CHDP, California Kids, and other health programs for children.

There was a lengthy discussion and a suggestion was made to take advantage of the timing. Everything is in place, the funding is there, everyone is in agreement on the issue, and the Healthy Families program is coordinated with Medi-Cal to move forward on getting more kids into Medi-Cal. This program is not just for LAUSD. Funding will depend on its first effort. If it is done effectively by a responsible organization and is working, there is no reason for the state not to provide funding.

The January meeting of Student Health and Human Services is canceled. The next meeting will be February 5, 1998.