outline( building an early childhood system a...

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Geoffrey Nagle, PhD, LCSW, MPH Tulane University

Institute of Infant and Early Childhood Mental Health September 20, 2011

BUILDING AN EARLY CHILDHOOD SYSTEM:

A STATE EXAMPLE FROM LOUISIANA

Outline

§  Early Childhood Budget

§  QRIS – Focus on Social-Emotional Development

§  School Readiness Tax Credits

Early Childhood System Integration Budget

Basic Assumption (1)

§  The budget is the most significant POLICY DOCUMENT used in government planning.

§  “The budget process is the spinal column of public policymaking.”

Nathan, R. P. Handbook for Appointed Officials in America’s Governments. Chapter 5, Page 42. Available at www.rockinst.org/pdf/government_reform/2009-handbook_for_appointed_officials_in_america%27s_governments.pdf

Basic Assumption (2)

§  A cross-system plan without a cross-system budget is difficult to implement.


§  Looks at resources for children less than age 5 ú  Formatted by categories ú  Includes

  description   source of funds   population served   geographic areas served

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ECSIB

§  No right answers ú  Simply shows the resources and programs in

the priority areas

§  Context? ú  310,000 children under age 5 (7.2%) ú  30% of children under age 5 live in poverty

Typical Children’s Budget

DSS – Office of Family Support

State

General Fund

Federal Funds

Total

Funds

Child Care Assistance

$7,500,000 $109,804,670 $117,304,670

Head Start Collaboration

$35,000 $175,000 $210,000

Support Enforcement

2,349,694 $22,031,073 $24,380,767

Totals $9,884,694 $132,010,743 $141,895,437

EARLY CHILDHOOD SYTEM INTEGRATION BUDGET

FY 12 Appropriated SGF IAT Fees Stat.

Dedications Federal Total

Access to Medical Care

$240,017,765 $6,696,769 $1,453,550 $0 $616,902,589 $865,070,673

Early Care and Education

$22,871,312 $70,509,597 $1,832,631 $8,987,900 $180,378,210 $284,579,650

Family Support and Parenting Education

$35,977,551 $10,887,865 $5,654,080 $93,000 $188,488,360 $241,100,856

Mental Health and Social-Emotional Development

$1,031,606 $116,868 $0 $0 $6,382,944 $7,531,418

EARLY CHILDHOOD SYTEM INTEGRATION BUDGET TOTALS

$299,898,234 $88,211,099 $9,940,261 $9,080,900 $992,152,103 $1,398,282,597

Changes from FY 11 to FY 12 SGF IAT Fees Stat.

Dedications Federal Total


$45,350,842 ($2,317,543) $129,764 $0 ($12,956,575) $30,206,488


$1,020,161 $1,105,005 $182 ($4,510,251) $10,425,567 $8,040,664


$2,158,045 $2,087,849 ($47,493) $0 $5,762,732 $9,961,133


$195,635 ($89,342) $0 $0 $484,173 $590,466

EARLY CHILDHOOD SYTEM INTEGRATION BUDGET TOTALS

$48,724,684 $785,969 $82,453 (4,510,251) $3,715,897 $48,798,751




61.9%


20.4%

Family Support/Parenting Education

17.2%

Mental Health/Social-Emotional Development 0.5%

!"#$%&$#'(&)*+,-./0-

123"4-550-

!"#$%&'()*+&

SGF IAT Fees Stat. Dedications Federal Total


$240,017,765 $6,696,769 $1,453,550 $0 $616,902,589 $865,070,673


Medical 62%

Other 38%

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§  Overall increase of $30 million (3.7%) ú  $50 million SGF and -$12 million federal

  Due to increase in participation and FMAP change

ú  New initiative – Birth Outcomes Project ú  10 programs in this category

!"#$

!"#$%&'()*+&%&'$


Early Care and Education $22,871,312 $70,509,597 $1,832,631 $8,987,900 $180,378,210 $284,579,650


62% ECE 20% 80%



$35,977,551 $10,887,865 $5,654,080 $93,000 $188,488,360 $241,100,856


!"#$%&'()**+,-''./012'

3",45657'89):"6+5'

;0;2'

!"#$%&'()*+&

FS/PE 17%

83%



$35,977,551 $10,887,865 $5,654,080 $93,000 $188,488,360 $241,100,856


72.9%

4.4%

22.4%

Fam Support Parenting Ed Child Welfare



$1,031,606 $116,868 $0 $0 $6,382,944 $7,531,418


99.5% 0.5%

Mental Health and Social-‐Emotional Development

§  9 programs in this category ú  81% is in just one program

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2.28%

9.83%

5.60%

0%

2%

4%

6%

8%

10%

12%

of Total State Funds of Total Federal Funds of Total State Budget

ECSIB as a Percentage of Total State Budget (FY 12 Appropriated – Act 12)

0.63%

9.05%

3.29%

0%

2%

4%

6%

8%

10%

12%

of Total State Funds of Total Federal Funds of Total State Budget

ECSIB as a Percentage of Total State Budget (FY 12 as Appropriated) – Excluding Medicaid

www.brightstartla.org Quality Rating and Improvement System

Intentional Focus on Early Childhood Mental Health

Points to Earn Stars

Total Number of Points

Star Rating

3-‐5

6-‐9

10-‐11

Integrating Social-‐Emotional Development in the Rating System

§  Environment Rating Scales ú  Social-Emotional Subscale

§  Mental Health Consultation

§  Social-Emotional Screening

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Environment Rating Scales

Social-Emotional Subscale

Environment Rating Scales

Harms, T., Cryer, D., & Clifford, R. M. (2006).

Harms, T., Clifford, R.M., Cryer, D. (2005).

Infant/Toddler Environment Rating Scale - Revised (ITERS-R) – birth through 2½ years

Early Childhood Environment Rating Scale - Revised (ECERS-R) – 2½ years to 5 years

Harms, T., Cryer, D., & Clifford, R. M. (2006) Harms, T., Clifford, R. M., Cryer, D. (2005)

Each ERS Scale Assesses

§  Space and Furnishings

§  Personal Care Routines

§  Activities

§  Listening & Talking/Language-Reasoning Skills

§  Interaction

§  Program Structure

Social-‐Emotional Subscale

§  ITERS-R ú  Listening and

Talking ú  Interaction ú  Program Structure

§  ECERS-R ú  Language-

Reasoning ú  Interaction ú  Program Structure

Points Criteria

1 An average of 3.75 on the social-‐emotional subscale, with no one classroom lower than 3 on the subscale

2 An average of 4 on the social-‐emotional subscale, with no one classroom lower than 3 on the subscale

3 An average of 4.25 on the social-‐emotional subscale, with no one classroom lower than 3.25 on the subscale

4

An average of 4.5 on the social-‐emotional subscale, with no one classroom lower than 3.5 on the overall ERS

5 An average of 5 on the overall ERS, with no one classroom lower than 4 on the overall ERS

Program Standards -‐ Scores on the ERS (ITERS/ECERS)

Mental Health Consultation

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Mental Health Consultants

§  12 full time equivalent consultants across state

§  All have master’s degree in a mental health field and hold a license

§  Primarily LCSW or LPC

§  12 total visits ú  One day every other week (day = 5-6 hours) ú  Centers with 8 or more classrooms receive weekly

visits with up to 24 total visits

§  All centers participating in the QRIS program are eligible

§  Centers serving children enrolled in CCAP, or in foster care, receive priority



§  Designed to support ALL children, teachers, and families involved in child care.

§  A combination model ú  Program ú  Child focused

A Combination Model of MHC

§  3 types of MHC ú  Program Centered

  designed to improve experience of all individuals involved with center

ú  Child Centered   designed to assess and make recommendations

about particular children

ú  Combination Model   uses aspects of both models to assist center and

individuals within center

Program Centered Components § Focus on relationships

§ Observes in classrooms

§ Meets with director

§ Meets individually with staff members

§ Provides 6 clock hours of training

§ Parent meetings/workshops are available

Child Centered Components

§  MHC available to complete a child-centered consultation when requested ú  Parent permission necessary ú  MHC can:

  Observe child in classroom   Interview parents/teachers/director   Make referrals when needed   Assist in designing behavior management

program for class and assist teacher in implementing

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Consultant Training

§  Pre-Service Training ú  Full training on all aspects of MHC

model 6 interactive didactic trainings (most based on CSEFEL)  2 community trainings

ú  Shadow consultants in field ú  Infant Mental Health training  60 hours of class time in person or via

videoconferencing

Consultant Supervision §  Consultants participate in

ú  Individual reflective supervision two times per month

ú  Group reflective supervision one time per month

§  Focus of supervision ú  Relationships with center staff ú  Avoiding the “expert stance”

Evaluation -‐ Teacher Self Report

§  Teacher Self-Efficacy ú  Ability to make a difference in children’s lives ú  Increase at end of intervention •  Increase maintained after 6 months

§  Teacher Competence ú  Knowledge of, and ability to, support child

development ú  Increase at end of intervention •  Continued to increase after 6 months

•  Greater impact on younger and less experienced teachers

Evaluation -‐ CLASS Observations

§  After 6 months §  Significant improvement in all 7 areas

Emo$onal Support

Posi$ve Climate Nega$ve Climate

Teacher Sensi$vity Regard for Student

Perspec$ve

Classroom Organiza$on

Behavior Management

Produc$vity Instruc$onal Learning

Social-‐Emotional Screening

Program Standards: Social-‐Emotional Development Screening

Points Criteria

4 Complete screening for social-‐emotional development with instrument from recommended list for all children (0-‐5 yrs.) within 45 calendar days of enrollment and annually thereafter.

5 Same

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Staff Qualifications: Social Emotional Screening Training

Points Criteria

3 Directors and lead teachers complete training in social-‐emotional screening of children.

4 Same

5 Same

Introduction to Social Emotional Screening Community Training

§  Rationale for universal screening ú  Importance of early detection ú  Identifying risk and protective factors ú  Outcomes for early treatment vs. later

treatment

§  Screening results are not a diagnostic indicator

Selection of Screening Instrument

§  Approved screening instruments

§  Age ranges

§  Cost of implementation

§  Psychometric properties

Select Screens

§  Ages and Stages: Social Emotional (ASQ:SE)

§  Brief Infant Toddler Social Emotional Assessment (BITSEA)

§  Early Childhood Screening Assessment (ECSA)

§  Preschool Kindergarten Behavior Scale (PKBS)

§  Temperament and Atypical Behavior Scale (TABS)

Select Screens

6 – 11 months

12 – 17 months

18-‐35 months

36 – 60 months

ASQ: SE u u u u

BITSEA u u

ECSA u u

PKBS u

TABS u u

Select Screens

Time to Administer

Format

Time to Score

ASQ: SE 10-‐15 minutes 3 point rating scale

1-‐3

minutes

BITSEA 7-‐10 minutes

3 point rating scale Some reverse scoring

ECSA 5-‐10 minutes 3 point rating scale

1-‐2

minutes

PKBS 8-‐12 minutes 4 point rating scale

TABS 10 minutes Yes/No 5 minutes

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Select Screens Costs

ASQ: SE Approximately $200

BITSEA Approximately $100 +

ECSA Free

PKBS Approximately $100 +

TABS Approximately $85

Warm Line

§  Statewide 800 number

§  Leave a message

ú  Child care providers

ú  Parents

§  Will receive call back by the end of the next day

Evaluation Findings

§  Significant increase in positive attitudes towards mental health screening

§  Significant increase in perceived knowledge

School Readiness Tax Credits

Long Term and Sustainable Funding

School Readiness Tax Credits

§  Package of 4 Tax Credits ú Credits to Providers

ú Credits to Directors and Teachers

ú Credits to Business for Supporting Child Care

ú Credits to Parents/Consumers

TAX CREDITS TO CHILD CARE PROVIDERS

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Tax Credits to Providers

§  Providers receive a tax credit based on the number of children they serve in the Child Care Assistance Program (or in foster care)

§  Refundable credit

§  Both for-profit and non-profit centers are eligible


Star Rating Tax Credit

(per child in CCAP/foster care)

$1,500

$1,250

$1,000

$750

1 Star (or not participating) No credit


§  If you serve 10 CCAP children and you are a 2 star center, then you receive a $7,500 refundable tax credit! ú  10 children x $ 750 (2 star center) = $7,500

ú  10 children x $1,000 (3 star center) = $10,000



TAX CREDITS TO TEACHERS AND DIRECTORS

Tax Credits to Directors and Teachers

§  Refundable credits

§  Based on the level of education ú  Must be working at a center participating in

the rating system ú  Must work there at least 6 months ú  The star rating of the center does not

impact this credit

Tax Credits to Directors and Teachers

Child Care Director and Teacher Qualification Tax Credit

Level 4 $3,000

Level 3 $2,500

Level 2 $2,000

Level 1 $1,500

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TAX CREDITS TO EMPLOYERS/BUSINESSES

Tax Credits to Business

§  Employers receive a credit for “eligible child care expenses” based on the quality rating of the center

§  Refundable credits


Star Rating Tax Credit

20% of eligible expenses

15%

10%

5%

1 Star (or not participating)

No credit


§  Eligible Expenses Employers may claim a tax credit for up to $5,000 in grants to child care resource and referral agencies. ú  This credit is dollar for dollar. ú Maximum is $5,000

TAX CREDITS TO PARENTS/CONSUMER

Tax Credits to Parents

§  Builds on the existing state child care tax credit.

§  Families are eligible for an increased tax credit based upon the quality rating of the center.

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Star Rating Increase to Existing State Tax Credit

200%

150%

100%

50%

1 Star (or not participating) No Change

SRTC IMPACT

3 Years 2008-2010


4710

7075

9489

2008 2009 2010

Column1


$949,970

$1,316,299

$1,618,936

2008 2009 2010

Column1


121

249

387

2008 2009 2010

Column1


$1,618,129

$3,189,635 $3,363,992

2008 2009 2010

Column1

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Tax Credits to Teachers

869

1696

2147

2008 2009 2010

Column1

Tax Credits to Teachers

$1,496,402

$3,205,500

$4,148,250

2008 2009 2010

Column1

Tax Credits to Businesses

$144,014

$609,668

$357,041

2008 2009 2010

Column1

Total Impact

5867

9393

12,266

2008 2009 2010

Column1

Total Impact

$4,208,515

$8,321,102

$9,488,219

2008 2009 2010

Column1

Citations §  Heller, S. S., Boothe, A., Keyes, A., Nagle, G., Sidell, M., &

Rice, J. (2011). Implementation of a mental health consultation model and its impact on early childhood teachers’ efficacy and competence. Infant Mental Health Journal, 32(2), 143-‐164.

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THANK YOU Contact Information: Geoffrey Nagle, PhD [email protected]

(504) 988-8241

www.brightstartla.org

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