Live Webinar: How Wealth Managers Can Thrive Amidst Digital Disruption
THRIVE Indicators Review Webinar: 1/10/08 · THRIVE Indicators Review Webinar: 1/10/08 6 State...
Transcript of THRIVE Indicators Review Webinar: 1/10/08 · THRIVE Indicators Review Webinar: 1/10/08 6 State...
THRIVE Indicators Review Webinar: 1/10/08
1
THRIVE Indicator Review
Leslie L. Davidson, Nancy Bruning, Suzanne Theberge, Jane Knitzer,
Kay Johnson
www.nccp.org
Results Based Evaluation and Indicators
Outcome (Result desired/not desired)
– Can be an indicator
Indicators of risk, process, program
– measures the risk/resilience in the population
– measures the achievement towards an outcome
– measure the process/programs to achieve the outcome (Process measure)
www.nccp.org
THRIVE INDICATOR REVIEW
Designed to assist states in determining their unique indicator set
To facilitate the potential to compare to national, state, and local indicators
Set in a results-based evaluation framework
www.nccp.org
Indicator: (using Friedman Terminology)
Available (Data Power) and
Measurable (Data Power)
Meaningful (Communication Power)
Important (Proxy Power)
Can be tracked over time and in comparisons: Federal, State, Local
Can be developed (Data Development)
www.nccp.org
Choosing Indicators: Friedman WorksheetOutcome or Result__________________________________
Candidate Indicators CommunicationPower
ProxyPower
DataPower
H M L ?
HMeasure 1
Measure 2
Measure 3 HDataDevelopmentAgenda
Children ready to succeed in school
H M L ? H M L ?
H HH L
www.nccp.org
Methods used in Review
Reviewed possible national indicator sets
Created matrix based on the Friedman Indicator structure and state utilization
Entered all indicators from national sets and from State plans in their ECCS proposals (200+)
Consolidated and reviewed potential for indicators relevant to the ECCS programs
Suggesting 32 for fuller discussion with States
Gaps still exist
THRIVE Indicators Review Webinar: 1/10/08
2
www.nccp.org
National Indicator Sets
MCHB
Institute of Medicine
National School Readiness Initiative
Kids Count (ten indicators)
Federal Interagency Forum on Child and Family Statistics
Proposed additions from NCCP/THRIVE
www.nccp.org
MCHB Indicators
MCHB: indicators states are required to collect
18 national performance measures, 6 national outcome measures, and seven health systems capacity measures
Many outcomes are mortality measures
Few health care problems short of mortality
None re health care access, medical home, school readiness, parenting domain
Include children with special health care needshttps://perfdata.hrsa.gov/mchb/mchreports/Search/core/measureindicatemenu.asp
www.nccp.org
IOM
Very large number of indicators….not geared around what is available
Focused on national rather than state
Not geared at early childhood (birth to five)
Multimodal domains: environment, economic, nutrition, general health
Ongoing progress not measured
Institute of Medicine: Children’s Health: The Nation’s Wealth, 2004
www.nccp.org
National School Readiness Indicators (23 core)
17 states participated – focused at state level
Includes process and systems indicators
Includes relevant outcome measures
Some available by state, some need extensive data development
None cover ECCS parenting domain
Multilevel approach
Ongoing progress not monitoredGetting Ready: Findings from the National School Readiness Indicators
Initiative. Rhode Island Kids Count, Feb 2005
www.nccp.org
Kids Count (ten key indicators)
Include state data over time
Include measures of risk (poverty, single parent, low birthweight, teen birthrate)
Include mortality (infant, child, teen)
Includes distal outcome measures for early childhood
– School dropout, teens out of school without jobs
No proximal outcomes
2006 Kids Count Data Book, Annie E. Casey Foundation
www.nccp.org
Federal Interagency Forum on Child and Family Statistics
Include risk measures (single mothers, teen births)
Includes outcome measures
Focused on national, not state level
– Relies on repeated national survey data
• NHANES, NHIS etc.
Multi-domain approach (family, economy, environment, education and health)
Focused more on youth and children as a whole rather than on early childhood
Ongoing tracking present
America’s Children: Key National Indicators of Well Being 2007. Federal Interagency Forum on Child Health and Family Statistics
THRIVE Indicators Review Webinar: 1/10/08
3
www.nccp.org
School Readiness Domains
Physical Wellbeing and Motor Development
Social and Emotional Development
Approaches to Learning
Language Development
Cognition and General Knowledge
www.nccp.org
System,Program,
andProcess
IndicatorsChild care
quality rating
Child care subsidies Medical homeHealth coverage
Annual dental visitsbeginning at early age
Early Head Start BreastfeedingImmunization
High BMI forchildren 2-5 in WIC
Accredited child care centersand family child care homes
Elevated blood lead level
EPSDT screening (comprehensive well-child exam) in a year
Substantiated cases of child abuse and neglect
Maternal depressionscreening
Infants & toddlers abusedand neglected referred toPart C Early Intervention
Enrollment in Part BPreschool Special Education
No more than two out-of-home placements in a
24-month period
Children with special health care needs(CSHCN) receive coordinated, ongoing,
comprehensive care within a medical home
Expulsion from early care and education due tobehavioral problems
Teachers with bachelor's degreeand training in early childhood
Hospitalizationfor asthma
Prepared by Project THRIVE at NCCP January 2008
Result: Children healthy and ready to succeed in the early school years.
Percent of children beginning school with undetected developmental
delays or chronic health problems
Percent of children demon- strating school readiness in all five domains of development
Percent of children reading proficiently
in grade 3 or 4
Using Indicators in a Results-based Accountability Framework for State Early Childhood Comprehensive Systems
Overall Outcomes
Poverty and extreme poverty
Birth to a teen motherages 15-17Low birthweight
Population risk
factorsBirth to a mother receiving
late or no prenatal careNon-white
race/ethnicity
Developmental andmental health screening
3-4 year olds in pre-K,Head Start, etc.
Health / mental health consultation in child care
www.nccp.org www.nccp.org
Overarching outcome measures
YesReadiness all five areas
YesCommonwealthUndiagnosed delays or health problems at kindergarten
YesYesSchool ReadinessReading proficiency at 4th grade
50 State data
exist
ECCS in one or more state
Recommended byIndicator
www.nccp.org www.nccp.org
Population Based Risk Factors
YesYesMCHB, ReadinessBirths under 2500 grams (5.5 pounds)
YesMCHB, ReadinessBirths to mothers with late or no prenatal care
YesYesMCHBBirths to teens
YesYesIOM, NCCP, ReadinessPoverty below federal poverty level
YesIOM, NCCPExtreme Poverty (below 50% of federal poverty level)
YesYesNCCPChildren non white
YesYesNCCP/THRIVEMultiple risk factors
50 State data
available
ECCS: one or more state
Recommended
by
Indicator
THRIVE Indicators Review Webinar: 1/10/08
4
www.nccp.org www.nccp.org
Health and Medical Home
YesYesMCHBBMI equal or over the 85th
percentile (those on WIC)
YesYesIOMDental Care in previous year
YesYesMCHBCompleted Immunization Schedule (19-36 mos)
YesYesMCHB, NCCPToddlers with at least one EPSDT Periodic Screen
IOMMedical Homes
YesYesMCHB, NCCP, Readiness,
No health insurance
50 State data
available
ECCS: one or more state
Recommended
ByIndicator
www.nccp.org
More Health Indicators
YesMCHBBreast feeding at 6 months
YesDevelopment and behavioral screenings (under 6 years)
YesYesReadinessBlood lead at or above 10 micrograms/deciliter
YesYesMCHBHospitalizations for asthma in (under 5 years)
50 State data
available
ECCS: one or more state
Recommended
by
Indicator
www.nccp.org
Special Needs Measures
?YesMCHBMedical Home for children with special needs (0-6 years)
YesYesNCCPEnrollment in early childhood Part B special education programs (3-5 years)
?YesIOM, NCCPSubstantiated cases abuse & neglect referred to Part C (birth to three years)
YesYesNCCPPart C Early Intervention Services (birth to three years)
50 State data
available
ECCS: one or more state
Recommended
by
Indicator
www.nccp.org
Social-emotional development and Mental Health Indicators
YesMothers screened (1) and (2) referred for depression
YesExpelled from child or preschools due to behavior problems (0-5)
YesYesReadinessOver two out-of-home placements in 24 months (0-6)
YesYesIOM, ReadinessSubstantiated cases child abuse and neglect (0-6)
50 State data
available
ECCS: one or more state
Recommended
by
Indicator
www.nccp.org
Early Care and Education Indicators (1)
Centers with access to ongoing health & mental health consultation
YesYesNCCP, ReadinessReceipt of child care subsidies
(0-6 years)
YesYesReadinessAttendance center based early child care % education
(3-4 years)
YesReadiness combined indicators
Attendance early care & education (high quality)
50 State data
available
ECCS: one or more state
Recommended
byIndicator
THRIVE Indicators Review Webinar: 1/10/08
5
www.nccp.org
Early Care and Education Indicators (2)
YesYesReadinessFamily Care Homes accredited by NAFCC (National Assoc. for Family and Child Care
YesYesReadinessCenters accredited by NAECY (National Assoc. For the Education of Young Children)
YesReadinessTeachers with Bachelors and specialization in Early Childhood
YesReadinessEnrollment Early Head Start for children in poverty (0-3)
50 State data
available
ECCS: one or more state
Recommended
by
Indicator
www.nccp.org
ECCS Domains and Indicators
Access to health care and medical homes
– Insurance, indicators of lack of care
Social Emotional Development and Mental Health
– Maternal depression
– Child protection and foster care
Early Care and Education
– Enrollment in Quality Child Care
Parenting Education
– ?
Family Support Services
– ?
Risk– LBW, single parent, poverty, extreme poverty, language, race/ethnicity
www.nccp.org
Key indicator challenges for states and federal government
Medical Home
Mental health and behavior domains
Parenting and family support domains
www.nccp.org
Using an indicator
Population Risk Indicators
– Modify understanding of level of outcome indicators
– May predict difficulty in accomplishing goals
– May guide states in strategies on programming
www.nccp.org
Asthma hospitalization rates
This may have meaning for states at many levels
– Environmental Exposure: diesel fumes, pesticides,
– Access to health care:
• Availability of health insurance
• Presence of a medical home
– Failure to integrate child care with health access (consultation)
– Contributing to failure to achieve readiness domains
www.nccp.org
Data development: Ready in 5 domains
Not all states have readily available, high quality data
Some states (or portions of states) require kindergarten/school entry assessments
– If standardized assessment and comparable data, state is ready to use indicator
– If not, data development is key step
• Pilot data collection efforts
• Voluntary data collection efforts
• Mandatory data collection efforts
• Statewide???
THRIVE Indicators Review Webinar: 1/10/08
6
www.nccp.org
State indicator development
Ensure appropriate aggregation or disaggregation by age, race/ethnicity, geography
Work with what is there and track it
Consider modest data development projects – prioritize proximal outcomes
Use the risk measure in interpreting the process measures
www.nccp.org
System,Program,
andProcess
IndicatorsChild care
quality rating
Child care subsidies Medical homeHealth coverage
Annual dental visitsbeginning at early age
Early Head Start BreastfeedingImmunization
High BMI forchildren 2-5 in WIC
Accredited child care centersand family child care homes
Elevated blood lead level
EPSDT screening (comprehensive well-child exam) in a year
Substantiated cases of child abuse and neglect
Maternal depressionscreening
Infants & toddlers abusedand neglected referred toPart C Early Intervention
Enrollment in Part BPreschool Special Education
No more than two out-of-home placements in a
24-month period
Children with special health care needs(CSHCN) receive coordinated, ongoing,
comprehensive care within a medical home
Expulsion from early care and education due tobehavioral problems
Teachers with bachelor's degreeand training in early childhood
Hospitalizationfor asthma
Prepared by Project THRIVE at NCCP January 2008
Result: Children healthy and ready to succeed in the early school years.
Percent of children beginning school with undetected developmental
delays or chronic health problems
Percent of children demon- strating school readiness in all five domains of development
Percent of children reading proficiently
in grade 3 or 4
Using Indicators in a Results-based Accountability Framework for State Early Childhood Comprehensive Systems
Overall Outcomes
Poverty and extreme poverty
Birth to a teen motherages 15-17Low birthweight
Population risk
factorsBirth to a mother receiving
late or no prenatal careNon-white
race/ethnicity
Developmental andmental health screening
3-4 year olds in pre-K,Head Start, etc.
Health / mental health consultation in child care
www.nccp.org
Resources & Upcoming Events
THRIVE Indicators Discussion Forum
– www.nccp.org/forum
February Conference Call: States’ Experiences Developing Indicator Sets
– Joan Blough (MI), Bob Costantino (VT), & Deborah Nelson (NC)
– February 7th, 2008, 2:30-4:00 EST
AMCHP Presentation: The State of Play at the State Level: Findings of the Project THRIVE Indicator Review
– March 3rd, 2008, 10:45am
ECCS Annual Meeting: Indicators are key conference theme
– March 12-13th
www.nccp.org
Questions?
www.nccp.org
System,Program,
andProcess
IndicatorsChild care
quality rating
Child care subsidies Medical homeHealth coverage
Annual dental visitsbeginning at early age
Early Head Start BreastfeedingImmunization
High BMI forchildren 2-5 in WIC
Accredited child care centersand family child care homes
Elevated blood lead level
EPSDT screening (comprehensive well-child exam) in a year
Substantiated cases of child abuse and neglect
Maternal depressionscreening
Infants & toddlers abusedand neglected referred toPart C Early Intervention
Enrollment in Part BPreschool Special Education
No more than two out-of-home placements in a
24-month period
Children with special health care needs(CSHCN) receive coordinated, ongoing,
comprehensive care within a medical home
Expulsion from early care and education due tobehavioral problems
Teachers with bachelor's degreeand training in early childhood
Hospitalizationfor asthma
Prepared by Project THRIVE at NCCP January 2008
Result: Children healthy and ready to succeed in the early school years.
Percent of children beginning school with undetected developmental
delays or chronic health problems
Percent of children demon- strating school readiness in all five domains of development
Percent of children reading proficiently
in grade 3 or 4
Using Indicators in a Results-based Accountability Framework for State Early Childhood Comprehensive Systems
Overall Outcomes
Poverty and extreme poverty
Birth to a teen motherages 15-17Low birthweight
Population risk
factorsBirth to a mother receiving
late or no prenatal careNon-white
race/ethnicity
Developmental andmental health screening
3-4 year olds in pre-K,Head Start, etc.
Health / mental health consultation in child care
For more information or questions, contact us at Project THRIVE
Jane Knitzer, EdD Director, National Center for Children in Poverty
Kay Johnson, MPH, EdM Project Director
Leslie Davidson, MD, MPH Senior Health Advisor [email protected] or 1-212-342-0247
Suzanne Theberge, MPH Research Analyst
System,Program,
andProcess
Indicators
Child carequality rating
Child care subsidies Medical homeHealth coverage
Annual dental visitsbeginning at early age
Early Head Start BreastfeedingImmunization
High BMI forchildren 2-5 in WIC
Accredited child care centersand family child care homes
Elevated blood lead level
EPSDT screening (comprehensive well-child exam) in a year
Substantiated cases of child abuse and neglect
Maternal depressionscreening
Infants & toddlers abusedand neglected referred toPart C Early Intervention
Enrollment in Part BPreschool Special Education
No more than two out-of-home placements in a
24-month period
Children with special health care needs(CSHCN) receive coordinated, ongoing,
comprehensive care within a medical home
Expulsion from early care and education due tobehavioral problems
Teachers with bachelor's degreeand training in early childhood
Hospitalizationfor asthma
Prepared by Project THRIVE at NCCP January 2008
Result: Children healthy and ready to succeed in the early school years.
Percent of children beginning school with undetected developmental
delays or chronic health problems
Percent of children demon- strating school readiness in all five domains of development
Percent of children reading proficiently
in grade 3 or 4
Using Indicators in a Results-based Accountability Framework for State Early Childhood Comprehensive Systems
Overall Outcomes
Poverty and extreme poverty
Birth to a teen motherages 15-17
Low birthweight
Population risk
factorsBirth to a mother receiving
late or no prenatal careNon-white
race/ethnicity
Developmental andmental health screening
3-4 year olds in pre-K,Head Start, etc.
Health / mental health consultation in child care
Exposure to multiple(3+) risk factors