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CalHHS Annual Letter: A Year of Hope and Action.

Dear CalHHS Partners,

As I sit down to write this letter, I am reflecting on this past year and I am reminded of the power of family, friendship, and community. This year brought hope.  We administered over 64 million doses of the COVID-19 vaccines.  It also brought heartache. We grieved the loss of over 75,500 Californians to COVID-19.

It is the very relationships with our family, friends, and community that allowed us to navigate this year, giving us inner strength and emotional security. These relationships are the foundation of who we are as people, and Californians.

I write this letter to you, our partners, because without you we could not have achieved as much as we did this past year. You pushed us to do better, to be better. Together we furthered our vision of a Healthy California for All, where all health and human services are person centered, equity focused, and data driven.

Despite the challenges brought on by this year, and despite the uncertainty we face now with the presence of a new COVID-19 variant, I look forward to 2022 with optimism.

This next year will allow us to further our recovery from the pandemic, giving us the opportunity to not only build back better, but build back more equitably, fundamentally re-architecting the foundations and structures that support our health and human services programs. From this re-architecting, we create the opportunity to lift all boats, but especially those which need to be lifted higher, to achieve the California dream for ALL.

To our team at CalHHS, our recovery from the pandemic means more than getting back to normal, it means redefining normal.

We cannot go back to a normal where an individual’s zip code decides their life trajectory, where children sleep in cars, and where families struggle to eat. “Normal” in California should and will mean that all Californians can thrive and be part of communities that are healthy, equitable, supportive, and engaging. Normal in California is where everyone has access to health and behavioral health services, housing, food, and nurturing communities.

This year we began putting together the foundation for our recovery. A series of independently important efforts that puzzle together to demonstrate our holistic approach to meeting the needs of our beneficiaries, clients, consumers, and all we serve.

Marshaling Resources to Deliver Change

We developed a set of guiding principles and strategic priorities to anchor our work and guide our collective efforts in the coming year to produce meaningful outcomes for the Californians we serve.

We also launched an internal Justice, Equity, Diversity, and Inclusion Workgroup to accelerate our work on equity and diversity in a more meaningful way both in terms of our organization, but also the programs and services we deliver.

The 2021 Budget Act furthered our guiding principles and strategic priorities by providing unprecedented investments, an additional $30 billion in total funds when compared to the prior year, to improve the lives of all Californians, with a particular focus on the most vulnerable in our communities.

This includes $4.4 billion for the Children and Youth Behavioral Health Initiative, which we launched this year, and roughly $2.2 billion for the construction, acquisition, and rehabilitation of infrastructure to expand the community continuum of behavioral health treatment resources.

We also expanded and strengthened our Home and Community-Based Services with an additional $4.6 billion in investments. These efforts independently provide historic one-time investments to build capacity and transform critical safety net programs to support and empower Californians.

Taken together, these investments advance the health and well-being of our entire state, promoting economic mobility and overall social stability.

Leveraging Data to Improve Outcomes

We are thinking differently about how our programs deliver outcomes that improve the lives of the most vulnerable among us. To do this, we are utilizing both our people and our information to improve government’s role and function. We have made considerable progress toward this vision by enlisting our teams not only to think about how we do business more efficiently, but by reconnecting with the individuals we serve, our clients.

We launched the Center for Data Insights and Innovation to leverage data to improve outcomes. In many cases, our clients’ varied needs, such as food insecurity or lack of access to affordable health care, do not happen in isolation of one another so we built the CalHHS Program Dashboard to help us better understand those needs.

We also know that Californians are entering multiple doors to access various programs and services. For example, two-thirds of CalWORKs clients receive benefits from three health and human services programs; another quarter receive services from four programs. With this in mind, we have created data products like the dashboard and the CalHHS Data Playbook to help our staff and partners better understand the multifaceted nature of service provision in a dynamic, intuitive format.

Focusing on data enables us to prioritize our work on what matters the most to the people we serve.

Supporting Older and Disabled Californians with Purpose

We issued California’s first Master Plan for Aging along with a Local Playbook and a Data Dashboard for Aging. This whole-of-society roadmap was accompanied by the launch of over 100 initiatives designed to further our vision of the Master Plan’s five bold goals for 2030. More importantly, communities across California are taking action to build age, disability, and dementia friendly policies, programs, and environments.

We also marked the 30th anniversary of the Americans with Disabilities Act, the landmark civil rights legislation that established a foundation of justice and equal opportunity for individuals with disabilities as well as the 100th anniversary of the establishment of vocational rehabilitation services.

Although much progress has been made over the past few decades, individuals with disabilities continue to be employed at a rate far below those without disabilities and are largely underrepresented in our workforce.

As a result, we doubled down on our efforts to ensure that individuals with disabilities—both visible and invisible— have equal employment opportunities. Every person is entitled to an accessible workplace, a level playing field, and the same privileges, pursuits, and opportunities as family, friends, and neighbors without disabilities.

No person should face unnecessary barriers to success, and no person with a disability should be limited in their desire to work. We launched a campaign highlighting Californians that have been provided services in the community. Meet Danny Burke a veteran who struggled to manage his mental health while experiencing chronic homelessness, but with supports from the Department of Rehabilitation he was able to not only find employment, but find a career that he is passionate about. Also, meet Samuel Olanrewaju who was diagnosed with glaucoma and become legally blind, with the necessary supports, Samuel was able to navigate his new world and earn not only a salary, but a college degree.

Danny and Samuel give me hope, they also demonstrate what is possible when we lift up those who need to be lifted higher.

Lifting Migrant and Immigrant Communities

We also found hope and inspiration as we served migrants coming into California fleeing war, violence, and persecution. Together we put on display our country’s motto—E Pluribus Unum—which translates into “out of many, one”.

In partnership with local and non-profit partners, we have served migrants at the Southern Border ensuring that those who are released from federal custody are not left vulnerable in border communities without COVID-19 mitigations and supportive services. This is the right thing to do not only to protect those who are arriving in California, but to protect our border communities.

We have worked across sectors to ensure that Afghan refugees coming into California are resettled and integrate into California communities with respect and dignity. We owe a debt of gratitude to the non-profit resettlement agencies across California who have stepped up at an unprecedented time to welcome these families with open arms and full hearts.

We continue to support and lift immigrant communities within California. Our state is proud to be home to the nation’s largest immigrant population and we are committed to building a California that is inclusive of all our neighbors.

We released an updated, more consumer-friendly public charge guide (English, Spanish) to serve as a resource for individuals and families with questions about the current federal public charge policy. We also submitted formal comments to the federal government about future changes to the federal public charge policy.

Transforming our Health Care Delivery System

Medi-Cal – a cornerstone of California’s health care system – is undergoing a bold transformation that puts people’s needs at the center of care, setting the pace for transformation of the entire health care sector. Medi-Cal’s broad reach presents a unique opportunity to improve health and advance health equity. The California Advancing and Innovating Medi-Cal (CalAIM) Initiative is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated​, and person-centered approach to maximizing their health and life trajectory.​​​​

CalAIM is moving Medi-Cal towards a population health approach that prioritizes prevention and whole person care. Our goal is to extend supports and services beyond hospitals and health care settings directly into California communities.

​Our vision is to meet people where they are in life, address social drivers of health, and break down the often ineffective silos of health care. CalAIM will offer Medi-Cal enrollees coordinated and equitable access to services that address their ​physical, behavioral, developmental, dental, and long-term care needs, throughout their lives, from birth to a dignified end of life.  Its specific focus on some traditionally overlooked populations – justice involved, those experiencing homelessness, those with serious behavioral health conditions – will help California support those who often fall through the cracks.

Focusing on Whole Child

Building on our commitment to support the state’s young children and their families, we furthered the work outlined in the Master Plan for Early Learning and Care: California for All Kids, which has provided us with a roadmap for building a comprehensive and equitable early learning and care system over the next decade. The great news is that Califrnia is already making strides to implement recommendations within the plan. Federal and state-level investments through the last budget cycle will build upon this plan’s foundation to advance equity by providing each child a great start in life that prepares them for success in school and life and unlocks their full potential.

Our work this year centered around the needs of the whole child and whole family. This builds on our Surgeon General’s Roadmap for Resilience in the context of adverse childhood experiences and toxic stress.

A whole child approach recognizes the interconnection of the multiple domains of child development, especially during the first eight years of life. These include physical well-being/motor development, social emotional development, language and literacy development, and cognition. A whole child approach recognizes that a child cannot fully learn and develop without addressing and understanding the context in which the child lives, grows, and develops. Health and well-being are critical to successful academic learning; trauma and adverse experiences negatively impact a child’s ability to learn.

Connecting Health and Human Services

There is so much more to highlight, including the work of the Department of Developmental Services to reform how we pay for services for individuals with developmental and intellectual disability with a focus on quality and value; the work of the Department of Community Services and Development to develop a new program that is focused on providing financial assistance for California energy utility customers to help reduce past due energy bill balances that increased during the COVID-19 pandemic; the work of the Department of Child Support Services to improve the user experience with a focus on the needs of the children served; and the work of the Department of Health Care Access and Information, formerly known as the Office of Statewide Health Planning and Development, to grow California’s health workforce and provide wider access to health care.

Closing

Despite our progress this year, we have much more ahead of us in 2022. We will have to test the bounds of our current partnerships and look to forge new, innovative partnerships that will deliver on our vision of a Healthy California for All. I am hopeful and optimistic for our future and our work in the coming year.

On behalf of all of us at CalHHS, thank you for your partnership. We wish you, your families, and your communities all the best for a happy and healthy new year.

In partnership,

Mark Ghaly, MD, MPH

Secretary