Chelsea Clinton talks child welfare, justice

Chelsea Clinton, left, and Amy Aparicio Clark, Aetna Foundation managing director of community impact and strategy, listen when San Diego County HHSA Director Nick Macchione makes a point during a roundtable discussion on child welfare and juvenile justice Thursday, Feb. 7, 2019/San Diego County News Service

The Strong Families, Thriving Communities Coalition, an ongoing partnership of the County of San Diego, the Clinton Foundation and the San Diego Foundation, hosted a roundtable discussion Thursday on improving child welfare and juvenile justice.

The Balboa Park event featured Chelsea Clinton, vice chair of the Clinton Foundation, and was designed to foster a community conversation about equity in the child welfare and juvenile justice systems in the San Diego region. It also aimed to highlight the importance of improving health outcomes.

“We all have a responsibility to make sure that every child has every opportunity for a safe, warm, supporting, loving healthy environment,” said Clinton. “There are so many structural and systemic barriers that prevent that.

“We’re hoping to empower (youth) to help us get to solutions more quickly.”

Clinton added: “We finally really do know what works,” Clinton said during the panel. “We really do know kind of what works, from how best to support young people, whether they’re in child welfare services, they’re in foster care, they’re going to be adopted or they’re on probation in the juvenile system.”

The question the group wants to answer, she said, was how best to coordinate resources to ensure there is community and individual support, mentoring and other types of assistance children need to ensure that they have every opportunity to have a safe, happy, healthy life.

County Supervisor Nathan Fletcher, District 4, gave opening remarks. He noted that a child living in La Jolla, which is part of his district, has a life expectancy 10 years longer than a child in City Heights, and it’s important to address that disparity.

Nick Macchione, director of the County’s Health and Human Services Agency, participated on the panel with Clinton.

“We have a grand vision we call Live Well San Diego, and it’s about getting every San Diegan to live to their fullest potential in life” said Nick Macchione, San Diego County Health and Human Services Agency director. “We can only live well when we all live well. That is why we all really need to come together.”

The County’s partnership with the Clinton Foundation and the San Diego Foundation began in 2017. Since then, the organizations have worked with over 100 community partners to examine challenges and identify solutions to make child welfare and juvenile justice systems more equitable for families and children.

For more information about the Strong Families, Thriving Communities initiative on the San Diego Foundation website.

Since the largely grant-funded collaboration between the Clinton Foundation, the county and other organizations was established in 2017, it has engaged hundreds of people and organizations in workshops and conversations to determine how to prioritize effects and leverage available resources, according to information provided by the group. It also created a “youth-trauma informed code of conduct” that organizations can adopt to improve performance.

A speaker at Thursday’s event, Jonathan Curiel, an 18-year-old former gang member who has been in juvenile custody and is now on probation, said the code of conduct is already being used in the county — and it has made a world of difference to him.

He said of his probation officer: “Me and her have a little partnership … . She sits down with me and actually helps me out and honestly I take that as a big role because I’ve never had that. I’ve been on probation since I was 12 and I’ve just had people telling me, ‘Don’t do this, don’t do that, you gotta do it this way.’

San Diego Foundation addresses the initiative

The San Diego Foundation believes all children deserve to be healthy, live well and thrive. Yet, in San Diego County thousands of children and families are suffering and pulled apart by poverty and substance abuse. Instead of living together, nurtured in the bonds of family, these children reside in the child welfare and juvenile justice systems without the support of parents and siblings.

African-American children are particularly affected. While they make up only 5 percent of San Diego’s child population, they represent 13 percent of children referred to the County’s Child Abuse Hotline, 13 percent of substantiated abuse allegations, and 16 percent of entries into foster care.

Recognizing this challenge, the County of San Diego invited The San Diego Foundation and Clinton Foundation to join forces to advance the quality of life of San Diego children and families resulting in the launch of the Strong Families, Thriving Communities initiative in March 2017.

Together with the Strong Families, Thriving Communities coalition, we have developed and are implementing a Blueprint for Action, including 29 Bold Action Steps, to align child welfare and juvenile justice policies, practices and resources to increase equity and effectiveness for communities, families and children.


  • Elevate the topic of disparities and inequities within the space of child welfare and juvenile justice, and facilitate a broader conversation on the current state of these systems;
  • Convene key decision makers, change agents, and stakeholders from across San Diego County to build consensus around a common agenda, objectives, and best path forward;
  • Present the outcomes of these findings, sharing a distillation of perspectives, data, and information related to the state of the child welfare and juvenile justice systems, and the factors that influence them; and,
  • Launch a strategic plan based on findings to implement solutions that will improve the health and well-being of children and families across San Diego


The 3-year partnership utilizes the Clinton Health Matters Initiative (CHMI) record of bringing together individuals, communities and organizations to make meaningful, collective contributions to improve the health of others.

Because of its expertise and track record working in community, the County of San Diego Health & Human Services Agency selected CHMI as a national partner to complement the substantial number of local partnerships it has through Live Well San Diego.

African American children in San Diego represent 13 percent of children referred to the County’s Child Abuse Hotline, 13 percent of substantiated abuse allegations, and 16 percent of entries into foster car./San Diego Foundation

CHMI uses a six-step theory of change process as the foundation for its work in improving community health. The six steps, and the timing and expected status of each step relative to this partnership, are:

  1. Build Support – In Progress
  2. Assess Capacity – In Progress
  3. Develop a Blueprint for Action – Summer 2017 – Early 2018
  4. Explore and Connect to Resources – Start Early 2018
  5. Implement Blueprint for Action – Launched March 2018
  6. Evaluate and Revise – Start Mid-2019

The CHMI Community Health Transformation Process is a road map to change that includes:

  • Synthesize information from stakeholder interviews and Environmental Scan
  • Convene key stakeholders across sectors for workshops to set local priorities know as Bold Action Steps, which form the basis of the Blueprint for action
  • Launch community Blueprint for Action and facilitate implementation of Bold Action Steps
  • Assist in developing solutions and connecting resource across sector sot accomplish Bold Action Steps
  • Monitor progress, document success, and address opportunities for recalibration

CHMI facilitates discussion and action amongst community leaders, creating systemic change in each of the four broad categories of social determinants of health included in the County Health Rankings Model:

  1. Health Behaviors – tobacco use, diet & exercise, alcohol & drug use, sexual activity
  2. Clinical Care – access to and quality of care
  3. Social & Economic Factors – education, employment, income, family & social support, community safety
  4. Physical Environment – air & water, housing & transit


By collaborating across industry sectors to address some of the most pressing challenges faced by children and families, The San Diego Foundation maximizes the impact of charitable giving in our region.

Together, in collaboration with donors, organizations and agencies, we’re creating a roadmap to improve systems that effect enduring change so all children and families in San Diego County are healthy, live well and thrive.

Support Strong Families, Thriving Communities


Story used by permission. Additional material from aggregated sources. Tom Christensen is a communications specialist with the County of San Diego Communications Office. Contact Tom Christensen

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