EARLYLEARNING COUNCIL

The Future of Public Health And Oregons Early Learning SystemMay 12, 2014PRESENTED BYTeri ThalhoferDana Hargunani

1Oregon Community Foundation P-3Agenda

Evidence for earlyHub overviewpublic health and early learningCollective impactdiscussion2Oregon Community Foundation P-3Evidence for EarlyCritical aspects of brain architecture are established before and soon after birthExperiences during sensitive periods of development play an exceptionally important role in shaping the capacities of the brain and other vital organsDifficult for new/different experiences to alter.

Early InvestmentsThe evidence is quite clear: early health and early childhood development from birth to age 5 is a form of preventive health and economic investment that drives achievement and economic returns.

Gabriella Conti and James J. Heckman Investing in What Works for Americas Communities

Early Learning Council GoalsThe goalsChildren ready for success in kindergarten when they arrive. Children raised in stable and attached families. Services that are integrated and aligned into one early learning system focused on results.

5Oregon Community Foundation P-345,000 children born each year315,000 ages 0-640% at risk (n=~120,000)$380+ million per year focused on prevention$1.7 billion per biennia on young children/familiesServing 25-33% of at-risk children

Oregon Snapshot

6Oregon Community Foundation P-3Oregons Kindergarten AssessmentEarly Literacy (direct assessment)Letter namesLetter sounds

Early Math (direct assessment)Numbers and operations

Approaches to Learning (observational assessment)Child Behavior Rating Scale

Our results 1/3 of entering kindergartners could name 5 or fewer letters 1 in 7 children couldnt name any letters

Over 1/3 couldnt identify a single letter sound

One quarter of entering kindergartners did not regularly demonstrate skills like completing tasks and following directions. Early Literacy (direct assessment)English letter namesEnglish letter soundsSpanish syllable sounds* *only for Spanish Speaking English Language Learners

Early Math (direct assessment)Numbers and Operations

Approaches to Learning (observational assessment)Child Behavior Rating Scale

Other results:On-time high school graduation rates: 69% in OR (2nd to last)Health outcomes: similar results

Oregon Community Foundation P-38What is an Early learning hub?A self-organized community-based coordinating body created to provide a system approach to early childhood education that works to improve efficiency and outcomes for our youngest children. Early Learning Hubs9Oregon Community Foundation P-3Early Learning HubsEarly learning hub WillBuild on existing community resources and assets Ask tough questions about what could be done differently to get better results, especially for at risk childrenCommunities can define their own strategies and service areas to achieve the outcomesBring public schools, early learning providers, health care, social services and the private sector together around shared outcomes, for the first time in Oregons history.

10Oregon Community Foundation P-3Early Learning Hubs

Early Learning HubsOur Hubs are self-organized community collaboratives. By July 1 of 2014 we will have up to 16 of these regional collaboratives coordinating services for the state. Responsible for coordinating services across sectors moving away from the isolated impact of a programs approach and toward the collective impact of a systems approach. Weve taken a loose-tight approach to these hubs.

There are a set of responsibilities they all share including finding the children who need help the most, working with families, coordinating services across traditional boundaries/silos, and accounting for outcomes collectively.

State Board of Education11

Health SystemKindergarten readinessStable/attached families Early Learning System

Coordinated systemsPublic Health Strategies132Better healthLower costs132Better careKindergarten Assessment: The Look Forward and Look BackAchieving Cross-system Goals13Health Role in Early LearningMonitoring developmental progressionPhysical, language, social, emotional developmentAssuring safe and nurturing environmentsIdentification of risk to health/developmentReferral and coordination of careTrusted information resource e.g. child care, educationHealth of the familyPhysical, behavioral, mental, dentalPublic Health StrategiesData: Assessment and SurveillanceConceptual framework and research basisFamily planning: One Key QuestionMCH home visiting programsCare coordination/Case managementHealth and nutrition standards in early learning programsConnecting pregnant women and children to health coverageFood security and nutrition: WIC programWater fluoridation and dental careImmunizations

Conceptual framework and research basisLifecourse theoryDevelopmental Origin of Health and Development (DOHaD)Adverse Childhood Experiences (ACEs)

Oregon Community Foundation P-315Early Head Start~1,120 served mostly fed; 68 StateHealthy Families Oregon~3,181 served (90-95% GF; MAC, local match)Nurse Family Partnership

~623 servedFFS/TCM/GF/MIECHVBabies First!~6,000 servedTCM/GF/MCH block grantMaternity Case Management2,660 servedFFS/MCH block grantChildrens Relief Nursery~2,685 served50/50 GF, local fund- raising

Health SystemEducation System(ODE/Early Learning/Federal)Early Intervention

~3,000 served(20% fed, 80% GF) Cacoon

~1,800 servedTCM/GF/MCH block grantFamily Support (DHS)OR Home Visiting SystemMIECHVMigrant/Seasonal Early Head Start~ 698 (fed), 18 (state) servedAI/ANEarly Head Start~ 72 (fed) and 2 (state) servedCollective impactCollective Impact: the commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem. Five Conditions of Collective SuccessCommon AgendaShared Measurement SystemsMutually Reinforcing Activities Continuous CommunicationBackbone Support Organization

John Kania & Mark Kramer, Collective Impact, Stanford Social Innovation Review, Winter 2011

Joint Early Learning and Health PolicyChartered by the Early Learning Council and the Oregon Health Policy Board

Kindergarten readiness as a common agendaEstablish shared incentivesImplement a shared measurement strategyDevelop opportunities for cross-system learning and information exchangeAdopt and implement statewide system of screeningFocus on coordination of services At state level: breakdown barriers to working together, achieving outcomeSupporting collective work at community level through technical assistance, learning collaborativers, alignment in metrics, etc.

State Board of Education5/8/201418Collective Impact StrategiesShared developmental screening effortsConnecting to appropriate services; coordination of care

Implement screening in prenatal settingsMental/behavioral/social health screening tools, connection to resources

Expand early literacy programs in community settings

Support a coordinated system of home visitingInnovative use of TCM dollars in CCO global budget

Care coordinationPublic health/CCO/Medical Home/Early Learning Hubs

Developmental origins of health and disease (DOHaD)Role of nutrition and stress in preconception/prenatal period

State LevelData help measure progress over timeData help target resources to Early Learning Hubs and schoolsEarly Learning HubsData help measure progress over timeData help target local supports, strategies and interventionsCommunity LevelSchools: Data inform classroom instruction Pre-K and Early Learning: Data inform program and system design Kindergarten Assessment: The Look Forward and Look Back20Early Learning HubsPublic Health and Hubs Work together to collectively impact shared goalsIdentify the children/families that need help the mostWork with families to identify their unique and specific needsLink families with services and providers who can best address their needsAccount for outcomes collectively and cost effectively

Oregon Community Foundation P-321Questions and DiscussionHow does the future of public health align/integrate with early learning?Teri Thalhofer, RN, BSNDirector, North Central Public Health DistrictWasco-Sherman-Gilliam Countiesterit@co.wasco.or.us

Dana Hargunani, MD, MPHChild Health DirectorOregon Health Authoritydana.hargunani@state.or.us

www.OregonEarlyLearning.comContact Information

23Oregon Community Foundation P-3