Santa Cruz County human services chief Cecilia Espinola to retire

Nov. 29--SANTA CRUZ -- Cecilia Espinola, Santa Cruz County's human services director, is set to retire Dec. 30, capping 30 years with the county, with 19 of those at the helm of the department.

Espinola, 62, a Santa Cruz native who got her master's degree in social welfare at UC Berkeley, leads a department with a $91 million budget and 550 employees. Last year her staff served 91,000 people, one third of the county's population, most with limited financial resources, intervening when children or elders are abused or neglected, checking eligibility for food stamps, serving veterans, overseeing in-home supportive services and job training.

While Covered California, the state health exchange, got a lot of headlines and enrolled 14,530 people in Santa Cruz County for 2016, Espinola's human services staff enrolled 69,933 people into Medi-Cal, the state program of free health care that expanded dramatically after the federal Affordable Care Act took effect.

"It's our largest program," said Espinola. "Obviously a strong need."

County residents with Medi-Cal are covered through the Central California Alliance for Health, a nonprofit with networks of health-care providers in three counties, as well as safety net clinics in Santa Cruz County.

The cost of providing health insurance is a challenge for small businesses, which predominate in Santa Cruz County, because unlike larger employers, they have no leverage to negotiate better rates.

Espinola said Medi-Cal cases are up 83 percent and county staff is up 45 percent.

"The way we've been able to do that is through technology ... ways to do the work more efficiently," she said.

One example is the smartboards installed three years ago that enable county staff to join discussions without spending time on the road driving to a meeting site.

"We all know the traffic woes," Espinola said.

Another example is technology from ContractPal that allows an application for CalFresh food stamps to be completed with a signature over the phone, speeding up the process.

Espinola expects the biggest challenge for her successor will be implementing a new approach to foster care Jan. 1, as envisioned in AB 1997, proposed by Assemblyman Mark Stone, D-Scotts Valley, and signed into law in September.

This will mean turning long-term group homes into places where youths removed from parental custody get short-term therapy for up to six months, then come home to be cared for by relatives or foster parents needing support to deal with the child's nightmares, acting out and depression resulting from what they have experienced.

"They've suffered trauma," Espinola observed.

Santa Cruz County has about 20 youths living in group homes, fewer than other counties, which Espinola said is due to a county emphasis on placing children with relatives or foster parents.

The county began recruiting Espinola's successor in September. The job pays $176,405 to $236,330, depending on experience.

"It's a rewarding position," said Espinola, the county's most senior department chief. "It's never been dull. It's always challenging."

She has two daughters, Alexandra, 26, a second-year medical student at Tulane University, and Madeline, 24, working in public relations in San Francisco. She is married to Will Lightbourne, director of the California Department of Social Services since April 2011, who spends the week in Sacramento.

"He comes home on weekends," Espinola said.

As for her post-retirement plans, she expect to get outside more, hike and play tennis "and enjoy this beautiful area."

Medi-Cal Enrollment

Santa Cruz County enrollment in the state Medi-Cal program jumped when the Affordable Care Act declared those with incomes of up to 138 percent of the federal poverty level eligible for free health care. This year, that is $16,395 for an individual, $22,108 for two people, and $33,534 for a family of four. People 65 or older, those who are blind or disabled or in a skilled nursing or intermediate care home, those under 21, or pregnant also are eligible.

In Santa Cruz County, the Central California Alliance for Health is responsible to connecting the newly enrolled with primary care providers in its network. Here are the county's Medi-Cal enrollment figures.

Dec. 2010: 34,932

Dec. 2011: 35,023

Dec. 2012: 34,225

Dec. 2013: 41,159

Dec. 2014: 61,019

Dec. 2015: 70,325

Sept. 2016: 69,494

Source: California Department of Health Care Services

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