Pr

2011-12 Annual Evaluation Report

October 24, 2012

2

OverviewOverall Well-Being of Children in Santa Cruz County A profile of Santa Cruz County’s youngest children

County trends in indicators of child and family well-being

Profile of First 5 Participants

Highlights of 2011-12 Results Healthy Children

Strong Families

Children Learning and Ready for School

Questions and Discussion

Overall Well-Being of Children in

Santa Cruz County

4

Profile of Santa Cruz County’s Youngest Children

Santa Cruz County has a growing and diverse population of young children.

57% Latino

37% Caucasian

4% Asian/Pacific Islander

1% Multi-Race

1% Other

21,517 children ages 0-5 55% English / 44% English Learners

5

Indicator: Unemployment Rate

Source: (Santa Cruz County, California, U.S.) U.S. Department of Labor, Bureau of Labor Statistics, 2012; (Aptos, Watsonville) State of California Employment Development Department, Labor Market Information Division, 2012.

* Unemployment rates for 2006-2011 reflect the average of all 12 months for each year. Unemployment rates for 2012 reflect the average of all months through August (the most current month available at the time of this report). Rates for previous years may have been updated to reflect revised inputs and reestimations.

Unemployment remains high and varies greatly across the county

6

Sources: (CalFresh data) California Department of Social Services, Food Stamp Program Participation and Benefit Issuance Report, 2012; (National School Lunch Program) California Department of Education, Educational Demographics Unit, 2011; (WIC) 2009 data=California Food Policy Advocates, 2010 County Nutrition and Food Insecurity Profiles; 2010-11 data=State of California Department of Health Services WIC Program, Certified Participants (Receiving F1s), Caseload, and Unissued Food Instrument Ratios for All Agencies by Month, 2010-11.

Notes: Based on the recommendation of the County of Santa Cruz Human Services Department, the methodology for calculating the CalFresh enrollment was changed to be consistent with their reporting procedures. Results are now based on a July-June fiscal year (e.g., 2006-07 data are reported in 2007), and reflect the average monthly total for each fiscal year. National School Lunch Program results are also based on a July-June fiscal year.

PROGRAM 2007 2008 2009 2010 2011 2012

CalFresh (Food Stamp Program)(Average monthly enrollment) 11,367 12,509 14,372 17,629 19,291 20,900

National School Lunch Program (Annual enrollment) 16,494 16,665 17,666 19,228 19,862 not yet

available

Women, Infants, & Children Program(Average monthly enrollment)

- - 9,310 9,571 9,540 not yet available

Enrollment in nutritional assistance programs has increased, particularly in CalFresh

Indicator: Enrollment in Nutritional Assistance Programs

8

Source: County of Santa Cruz, Public Health Department, Births, Santa Cruz County, Santa Cruz County, CA. July 2012.

Most women are receiving prenatal care in the 1st trimester (82%)

• Women <25 years old fall below Healthy People 2020 target of 78%

Source of payment makes a difference

Indicator: Prenatal Care in 1st Trimester

• Younger mothers (24 years old and younger)

% Received Prenatal Care50%

60%

70%

80%

90%

100%

93%

75%

Private

Medi-Cal

9

Source: (Santa Cruz County) County of Santa Cruz, Public Health Department, Births, Santa Cruz County, Santa Cruz County, CA. 2007-2011, State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2050. Sacramento, CA, 2011; (California) California Department of Public Health, Health Information and Strategic Planning, Vital Statistics Query System, Birth Records, retrieved 4/24/12 from http://www.apps.cdph.ca.gov, 2010. California data for 2011 are not yet available.

The rate of births to teen mothers (ages 15-19) is decreasing

Indicator: Teen Birth Rate (per 1,000)

10

Source: County of Santa Cruz, Public Health Department, Births, Santa Cruz County, Santa Cruz County, CA. 2010-2012.Note: These data were considered provisional.2009 N: Overall=3,290, ≤17=119, 18-19=200, 20-24=618, 25-34=1,709, 35+=644; 2010 N: Overall=3,170, ≤17=89, 18-19=169, 20-24=611, 25-

34=1,663, 35+=639; 2011 N: Overall=3,222, <=17=88, 18-19=168, 20-24=595, 25-34=1,684, 35+=687.

Over half the births in the County were paid for by Medi-Cal

Indicator: Births Paid for by Medi-Cal

~ 80%

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Summary of County Trends

Overall Well-Being of Children in the County Santa Cruz County has a growing and diverse population of young children

Unemployment remains high and still varies greatly across the county

Families are still feeling the effects of the recession

Not enough young mothers and mothers with Medi-Cal insurance are receiving prenatal care in the 1st trimester

Profile of First 5 Participants

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Profile: Children Served (Ages 0-5)

Sources: Population figures are for calendar years, taken from State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, 2000–2050. Sacramento, CA, July 2007-2012. Client counts are for fiscal years, taken from SUN database/CCD data, July 1, 2006 – June 30, 2012.

First 5-supported programs are wide-reaching

First 5 served 8,382 unique children in FY 2011-12.

That’s 39% of all children ages 0-5 in Santa Cruz County

and 54% of all Latino children ages 0-5.

71% of children

served by First 5

reside in South

County,

65% live in Spanish-speaking

households

16

Sources: (Income) SUN database/CCD data for July 1, 2011 – June 30, 2012. N=477. (Federal Poverty Level) U.S. Department of Health and Human Services, 2012 HHS Federal Poverty Guidelines. (California Self-Sufficiency Standard) Insight Center for Community Economic Development, The Self-Sufficiency Standard for Santa Cruz County, CA, 2011.

Note: While not all programs collect income data from families, these results are considered to be representative of the First 5 client population. Poverty and self-sufficiency thresholds are for a family of five. The annual self-sufficiency wage for a family of five was calculated using the median wage of all families of five containing two adults and three children, where at least one child was five years old or younger.

First 5 is reaching an increasingly low-income population 2012 Federal Poverty Level (family of 5): $27,010 2011 Santa Cruz County Self-Sufficiency Standard (family of 5): $107,142

Profile: Income Level

17

Source: (Levels of Vulnerability) Applied Survey Research, Geo-Mapping Children’s Vulnerability in Santa Cruz County, Presentation to First 5 Santa Cruz County, 2005. (2011-12 Distribution of Children) SUN database/CCD data for July 1, 2011 – June 30, 2012.

Note. First 5 programs served 8,382 children. The 2011-12 chart displays data for the 7,841 children with known ZIP codes.

Levels of Children’s Vulnerability in Santa Cruz County (2005), by ZIP code

Profile: Risk Indicators vs Areas Served

Distribution of Children Who Received Services (2011-12), by ZIP Code

First 5 serves children in the highest risk zones of the county

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Summary of First 5 Participants

First 5 is serving the most vulnerable children First 5-supported programs are wide-reaching

First 5’s funded partners consistently reach children who are Latino, live in Spanish-speaking households and live in South County

First 5 is reaching an increasingly low income population

First 5 is serving children in the highest risk zones of the county

Healthy Children

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Healthy Children: Insurance Coverage

Source: Health Care Outreach Coalition, County Benefits Tracking Report, 2012; Health Care Outreach Coalition, Newborn Enrollment Statistics, 2012.Note: These numbers are from Certified Application Assisters who expand enrollment and retention efforts in the County. Many families are enrolled in

other ways. For example, the County Human Services Department processes Medi-Cal applications which are not included here, and families can self-enroll in Healthy Families.

Note: The number of children in this analysis may be slightly different than related enrollment results from HCOC due to differences in the timing of the collection of data. and since families may come to HCOC for enrollment assistance more than once in the fiscal year.

Children are getting enrolled in public health insurance programs

Children 0-5 newly enrolled in public health insurance since

2004:

9,439

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Healthy Children: Insurance Coverage

Source: Health Care Outreach Coalition, Newborn Enrollment Statistics, 2012.1 The total number of completed newborn Medi-Cal applications includes ALL applications completed, which included Santa Cruz County enrollments as well as

enrollments from other Counties. Newborn Medi-Cal application data represent the status of children’s applications as of 9/13/12.

Baby Gateway is connecting Santa Cruz County’s newborns to medical care

PROGRAM COMPONENT

WATSONVILLE

COMMUNITY HOSPITAL

DOMINICAN HOSPITAL

SUTTER MATERNITY &

SURGERY CENTER OF

SANTA CRUZ

NUMBERPERCENT OF ALL COUNTY

BIRTHS

Total Number of All Births in Santa Cruz County 1,443 944 938 3,325 -

Total Number of Newborn Visits (regardless of insurance status) 1,278 763 751 2,792 84.0%

Number of Kits for New Parents Distributed 818 611 633 2,062 62.0%

NUMBERPERCENT OF

ALL MEDI-CAL BIRTHS

Total Number of Medi-Cal Births 1,211 405 247 1,863 -

Number of Completed Newborn Medi-Cal Applications1 1,036 297 163 1,496 80.3%

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Healthy Children: Medical & Dental Homes

(Access to Primary Care Practitioner) Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators. There are no HEDIS data regarding access to primary care practitioners for children under age one. For children age one, there were not enough children in the HEDIS sample to draw any inferences. N: 2006=227, 2007=221, 2008=227, 2009=208, 2010=164, 2011=134.

(Well-Child Visit) Source: Central Coast Alliance for Health, Health Care Quality Measurement annual report, using HEDIS Indicators. N: 2006=210, 2007=207, 2008=211, 2009-191, 2010=152, 2011=117.

Children enrolled in Healthy Kids have medical and dental homes

94% of children ages 2-6 had access to a Primary Care Practitioner

87% of children ages 3-6 had well-child check-ups

89% of children ages 4-6 had a dental visit in the past year

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Healthy Children: Preventative Care

Source: Health Improvement Partnership of Santa Cruz County, Healthy Kids Biannual Evaluation, July 2011 – June 2012..* Percent change in infant ED visits since the launch of Baby Gateway at this hospital, as of Quarter 1 of both years. ED visits peak during the first two

quarters of each year. Consequently, it is important to evaluate the same quarter when making comparisons between years.

Fewer infants are being seen in the Emergency Department

Baby GatewayLaunched at

Watsonville Community Hospital

31% decrease in infant

ED visits*

Baby GatewayLaunched at Dominican and

Sutter Hospitals

2009 2010 2011 2012

26% decrease in infant

ED visits*

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Healthy Children: Developmental Milestones

The Dominican Child Development Program (DCDP) is providing coordinated, comprehensive care to meet the developmental and social/emotional needs of young children in foster care. Mental health assessment Developmental & behavioral testing Clinical consultations Case management & coordination

15.1%

20.8%

11.3%18.9%

15.1%

15.1%3.8%

< 1 year old

1 year old

2 years old

3 years old

4 years old

5 years old

6+ years old

Source: Dominican Child Development Program, Annual Progress Report, 2012. N = 53

53 children served• 55% Female / 45% Male• 83% English / 17% Spanish• 59% Latino / 38% Caucasian

26

Healthy Children: Developmental Milestones

Young children in foster care are receiving early intervention, increasing the likelihood they will meet developmental milestones.

Source: Dominican Child Development Program, Annual Progress Report, 2012. N = 53

0%

10%

20%

30%

40%

50%

35.8%

7.5%

1.9%

9.4% 9.4%

1.9% 1.9%0%

10%

20%

30%

40%

50%

22.6%

11.3%7.5%

3.8% 3.8%1.9%

Percentage of Children With These Developmental Levels & Services at Intake

Percentage of Children With These Referrals, After Assessments

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Summary of Healthy Children Strategic Results

First 5 Santa Cruz County insures children Children are getting enrolled in public health insurance plans

Children are renewing and using their health insurance

Santa Cruz County’s newborns are getting connected to medical care

Children have medical and dental homes Children have access to a primary care practitioner

First 5 increases the use of preventative health care Children are getting well-child check-ups and dental visits

Fewer children are using the emergency department

First 5 helps children meet developmental milestones Young foster children are receiving coordinated, comprehensive care to meet their

developmental and social/emotional needs

Strong Families

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Strong Families: Child Abuse & Neglect

Source: SUN database, Structured Decision Making: Family Prevention Services Screening Tool (SDM:FPSST) data, 2008-2012. * Although very few families had a “low risk” score at baseline, these families were omitted from these analyses so that only those who could demonstrate

reduced risk on the tool remained in the analysis. Note: Due to inaccuracies in data entry in 2006-07, clients with baseline assessments before 7/1/07 were omitted from this analysis. Results for the 3 rd

reassessment were not reported due to the low number of clients.

Families Together participants are reducing their level of risk for child abuse and neglect

Baseline* (N=388) 1st Reassessment (N=304) 2nd Reassessment (N=130)0%

10%

20%

30%

40%

50%

60%

70%

32.7%

50.3% 51.5%48.7%

22.0%

13.1%18.6%

3.0% 4.6%

24.7%

30.8%

Low Risk Moderate Risk

High Risk Very High Risk

Change in Families Together Participants’ Risk Levels Over Time (2007-12)

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Strong Families: Child Abuse & Neglect

Source: Applied Survey Research, Triple P – Santa Cruz County: Special Study to Assess Child Welfare Outcomes: Summary of Findings, 2012.N: 97 Triple P participants and 137 comparison group participants.

Triple P improves outcomes for families involved in the child welfare system

Triple P Participants Comparison Group Triple P Participants Comparison Group0%

5%

10%

15%

20%

5.2%

12.4%

4.1%

10.2%

Substantiated Allegations of Child Maltreatment

(12 months after program entry)

Foster Care Placements(12 months after program entry)

31

Strong Families: Parenting Practices

Families throughout Santa Cruz County are using the Triple P – Positive Parenting Program to strengthen parent-child relationships

In-depth Services: 641 parents

Brief/Targeted Services: 457 parents

Seminars & Workshops: 1,631 parents*

Social Marketing: Entire community

* May include duplicate counts, as parents may attend multiple Seminars & Workshops

32

Strong Families: Parenting Styles

Source: Triple P data from the Parenting Scale, analyzed by Applied Survey Research, Jan. 2010 - June 2012.Note: The Parenting Scale measures parenting styles in 3 scales, and overall. Scores for each scale are calculated by averaging the participants’ responses for

each of the items. Higher scores indicate a greater degree of ineffective parenting styles. In 2012, modifications were made to the Parenting Scale to accommodate the launching of the “Teen” variant of the Triple P program, so comparisons to previous years’ results should be made with caution. Due to these changes, there is no Clinical Cut Off for the overall assessment score. ‑

** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Triple P participants are developing more positive parenting styles

1

2

3

4

5

6

7

3.2 3.83.1

3.23.4

2.9 3.4 3.0 3.12.63.0

2.7 2.6 2.82.5

2.92.5 2.7

Pre Post

Functional Parenting

Dysfunctional Parenting

Parenting Scale (2010-12)

33

Strong Families: Child Behaviors

Source: Triple P data from the Eyberg Child Behavior Inventory, analyzed by Applied Survey Research, Jan. 2010 - June 2012.Note: The Eyberg Child Behavior Inventory measures the frequency with which certain child behaviors occur (Intensity subscale), and the extent to which

parents view those behaviors to be a problem (Problem subscale). Intensity scores could range from 36 (Never occurs) to 252 (Always occurs), and Problem scores ranged from 0 (No) to 36 (Yes), with higher scores indicating greater frequencies of problem behaviors and greater likelihood that these behaviors were a problem to the parent.

** Results marked with two asterisks had PRE/POST differences that were statistically significant at p<.05, with a moderate to large magnitude of change (≥ 0.5).

Triple P participants experience improvements in their children’s behaviors

0

6

12

18

24

30

36

14.8

22.9

10.916.2

16.5

12.2

17.2

12.610.6

7.5

11.7

5.58.3 8.5

6.5

9.45.9 6.7

Pre Post

All behaviors were a problem

No behaviors were a problem

Clinical Cut-off:

>=15

Eyberg Child Behavior Inventory – Number of Problems (2010-12)

34

Summary of Strong Families Strategic ResultsFirst 5 Santa Cruz County is helping families reduce their risk for child abuse and neglect Families are reducing their risk of child abuse and neglect

Triple P improves outcomes for families involved in the child welfare system

First 5 Santa Cruz County helps strengthen parent-child relationships Implementation of Triple P makes evidence-based parenting support available to all

families

Parenting skills and knowledge are improving along several domains

Triple P participants who had more serious parenting issues made the most meaningful changes in their family lives

Children Learning and Ready for

School

36

Children Learning and Ready for School: 3rd Grade Reading Scores

Source: California Department of Education, STAR Test Results, 2007-2012.

Santa Cruz County’s 3rd grade reading scores remain lower than statewide scoresFreedom Elementary has made tremendous improvements

2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 2011-20120%

10%

20%

30%

40%

50%

60%

37% 38%

44% 44% 46% 48%

34% 34%

40%37%

40% 39%

21% 20%25% 24%

28%25%

12% 12%16%

24%28%

24%

California

Santa Cruz County

PVUSD

Freedom Elementary

37

Children Learning and Ready for School: Quality Early Child Care Practices

SEEDS-trained teachers and coaches are creating language- and literacy-rich environments

38

Children Learning and Ready for School: SEEDS-Trained Educators

Source: Early Literacy Foundations Initiative, Client and Assessment Data Entry Template, 2007-2012.Note: Early childhood educators and coaches may have participated in more than one SEEDS class, but are only counted once in these analyses. For these clients, their language and

education data are as of their earliest class, in order to assess the status of these educators at the beginning of their participation in the SEEDS program. Family, Friend or Neighbor (FFN) informal child care providers are not included in these analyses.

Language N=387; Education N=354.* In some cases, early childhood educators have moved into different types of classroom settings, and therefore may appear in both state-subsidized and private classroom totals.

First 5 has trained nearly 400 Early Childhood Educators in SEEDS

Educational attainment Primary language

State and Federally-Subsidized Classrooms

Licensed Family Child Care Homes and Private/

Non-Profit Centers

Unduplicated total,*Spring 2007 – June 2012

222 169 388

26.6%

48.1%

22.2%

3.1%

English Only

Spanish Only

Bilingual English/Spanish

Other

8.2%9.0%

20.9%

27.4%

5.9%

11.6%

8.5%

4.0% 4.2%No Formal SchoolingLess Than High School Diploma/GEDHigh School Diploma/GEDSome CollegeAA in non-ECE/CDAA in ECE/CDBA in non-ECE/CDBA in ECE/CDSome Graduate School or Postgraduate Degree

39

Children Learning and Ready for School: Quality in Classrooms

Source: Early Literacy Foundations Initiative, Early Language and Literacy Classroom Observation (ELLCO) & ELLCO Pre-K, 2007 – 2012.Note: Clients may be included more than once if they participated in multiple SEEDS classes during these years. Low-quality support = means less than or equal

to 2.5; Basic support = means between 2.51 and 3.5; High-quality support = means between 3.51 and 5. Percentages less than 3% are not labeled. This analysis includes data from SEEDS coaches, early childhood educators who attended SEEDS of Early Literacy courses, and SEEDS Plus participants.

* The analysis of these questions marked with an asterisk began in 2007-08, so results reflect the combined data for 2008-2012.Child Choice and Initiative N=173, Book Reading N=254, Children's Writing N=260, Approaches to Curriculum N=173.

The quality of support for language and literacy increases when early childhood educators are trained in SEEDS

Pre Post Pre Post Pre Post Pre Post0%

20%

40%

60%

80%

100%

9.2% 16.1% 20.4% 22.5%

37.6%

5.8%

50.0%

10.6%

48.8%

11.2%

38.7%

11.6%

53.2%

94.2%

33.9%

88.2%

30.8%

88.5%

38.7%

87.9%

Low-Quality Support Basic Support High-Quality Support

Opportunities for Child Choice and Ini-

tiative*

Approaches to Book Reading

Support for Chil-dren's Writing

Approaches to Cur-riculum*

40

Children Learning and Ready for School:Pre-Literacy Skills

Source: Early Literacy Foundations Initiative, Individual Growth and Development Indicators (IGDI’s) Assessment Tool, 2011-2012. English Speakers: English N= Fall: Picture Naming (109); Rhyming (103); Alliteration (97). N= Winter: Picture Naming (140); Rhyming (136); Alliteration (129). N=

Spring: Picture Naming (94); Rhyming (89); Alliteration (78). Spanish Speakers: Spanish N= Fall: Picture Naming (302); Rhyming (281); Alliteration (274). N= Winter: Picture Naming (307); Rhyming (289); Alliteration (282). N= Spring: Picture Naming (262); Rhyming (248); Alliteration (251). Spanish Speakers: English N= Fall: Picture Naming (323); Rhyming (305); Alliteration (303). N= Winter: Picture Naming (334); Rhyming (315); Alliteration (315). N= Spring: Picture Naming (275); Rhyming (256); Alliteration (259).

Children in SEEDS-trained classrooms increase their skills on all three key predictors of later reading success

Picture Naming

Rhyming Alliteration Picture Naming

Rhyming Alliteration Picture Naming

Rhyming Alliteration0%

20%

40%

60%

80%

100%

30.3%35.0% 39.2%

5.6% 3.2%9.5% 6.2% 3.0% 6.9%

41.4%47.8% 50.4%

17.3%

31.5%

57.1%

15.9%24.4%

43.8%51.1%

57.3% 59.0%

45.0%

58.1%70.5%

36.4%

52.0%

66.4%

Fall Winter Spring

Primarily English-Speaking Chil-dren

Primarily Spanish-Speaking ChildrenSpanish Assessment English Assessment

Percentage of Children “At” or “Above” Target Levels

41

Children Learning and Ready for School: Pre-Literacy Skills & SEEDS Plus

Source: First 5 Santa Cruz County, SEEDS Plus Individual Growth and Development Indicators (IGDI’s) Assessment Tool, 2011-2012. English Speakers: English N: Picture Naming (65); Rhyming (65); Alliteration (63); Letter Naming (64); Letter Sounds (64). Spanish Speakers: Spanish N: Picture

Naming (43); Rhyming (40); Alliteration (37); Letter Naming (36); Letter Sounds (34). Spanish Speakers: English N: Picture Naming (25); Rhyming (22); Alliteration (22); Letter Naming (24); Letter Sounds (17).

Children in SEEDS Plus classrooms improve their pre-literacy skills when they receive tailored support

Picture Naming

Rhyming

Alliteration

Letter Naming

Letter Sounds

Picture Naming

Rhyming

Alliteration

Letter Naming

Letter Sounds

Picture Naming

Rhyming

Alliteration

Letter Naming

Letter Sounds

0%

20%

40%

60%

80%

100%

16.9% 20.0%25.4%

35.9%43.8%

4.7% 5.0%13.5%

2.8% 5.9% 4.0% 4.5%9.1% 12.5%

5.9%

35.4%

55.4%61.9%

71.9% 71.9%

25.6%

32.5%

51.4%47.2%

61.8%

8.0%

22.7%

36.4%41.7%

47.1%

First Benchmark (Oct.) Final Benchmark (Feb.)

Primarily Spanish-Speaking ChildrenSpanish Assessment English Assessment

Percentage of Children Meeting Targets for Later Reading Success

Primarily English-Speaking Children

42

Summary of Children Learning & Ready for School Strategic Results

First 5 Santa Cruz County builds early literacy foundations by training early childhood educators to enhance language rich practices in the classroom Early childhood educators are getting trained in literacy activities

The SEEDS curriculum is being used throughout Santa Cruz County child care programs and preschools

Classrooms and home-based settings of SEEDS-trained early educators are being transformed into literacy-rich environments

Children in SEEDS Plus classrooms improve their pre-literacy skills when they receive tailored support

43

Summary of Children Learning & Ready for SchoolStrategic Results

First 5 Santa Cruz County helps children build the foundation for later reading success Parents are getting involved in their children’s reading

o In 2011-12, 4,135 children and their families participated in Raising A Reader’s weekly rotating book bag program

Children are learning letter soundso 87% of children in the Migrant Education - Summer Pre-K program (who attended at least 14 sessions)

increased their letter sound recognition by at least five letter sounds

First 5 Santa Cruz County helps children successfully transition to kindergarten

First 5 Santa Cruz County is working with parents and early childhood educators to create an information “bridge” for children as they transition to kindergarten

o Teachers and parents at 47 preschools completed individual Child Snapshot forms for 942 children

Parents are receiving kindergarten transition informationo 251 parents participated in Transition to School Workshops

Questions?