2011-12 Annual Evaluation Report October 24, 2012

1. 2011-12 • Annual Evaluation Report • October 24, 2012 • Pr

2. Overview Overall 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

3. 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. • 21,517 children ages 0-5 • 55% English / 44% English Learners 1% Multi-Race 37% Caucasian 1% Other 4% Asian/ Pacific Islander 57% Latino

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. Indicator: Enrollment in Nutritional Assistance Programs • Enrollment in nutritional assistance programs has increased, particularly in CalFresh 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.

7. Indicator: Prenatal Care in 1st Trimester • Younger mothers (24 years old and younger) 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

8. Indicator: Teen Birth Rate (per 1,000) The rate of births to teen mothers (ages 15-19) is decreasing 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.

9. Indicator: Births Paid for by Medi-Cal ~ 80% 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

10. 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

11. Profile of First 5 Participants

12. Profile: Children Served (Ages 0-5) 71% of children served by First 5 reside in South County, That’s 39% of all children ages 0-5 in Santa Cruz County and 54% of all Latino children ages 0-5. 65% live in Spanish-speaking households • First 5 served 8,382 unique children in FY 2011-12. 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

13. Profile: Income Level 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 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.

14. Profile: Risk Indicators vs Areas Served First 5 serves children in the highest risk zones of the county 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 Distribution of Children Who Received Services (2011-12), by ZIP Code

15. 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

16. Healthy Children

17. Healthy Children: Insurance Coverage Children 0-5 newly enrolled in public health insurance since 2004: 9,439 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

18. 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

19. 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

20. Baby Gateway Launched at Watsonville Community Hospital Healthy Children: Preventative Care 31% decrease in infant ED visits* 26% decrease in infant ED visits* Baby Gateway Launched at Dominican and Sutter Hospitals 2009 2010 2011 2012 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

21. Healthy Children: Developmental Milestones • 53 children served • 55% Female / 45% Male • 83% English / 17% Spanish • 59% Latino / 38% Caucasian 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. Source: Dominican Child Development Program, Annual Progress Report, 2012. N = 53

22. Healthy Children: Developmental Milestones Percentage of Children With These Developmental Levels & Services at Intake Percentage of Children With These Referrals, After Assessments 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

23. 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

24. Strong Families

25. Strong Families: Child Abuse & Neglect Change in Families Together Participants’ Risk Levels Over Time (2007-12) 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 3rd 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

26. Strong Families: Child Abuse & Neglect • Substantiated Allegations of Child Maltreatment • (12 months after program entry) • Foster Care Placements • (12 months after program entry) 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

27. Strong Families: Parenting Practices • Families throughout Santa Cruz County are using the Triple P – Positive Parenting Program to strengthen parent-child relationships Social Marketing: Entire community Seminars & Workshops: 1,631 parents* Brief/Targeted Services: 457 parents In-depth Services: 641 parents * May include duplicate counts, as parents may attend multiple Seminars & Workshops

28. Strong Families: Parenting Styles Parenting Scale (2010-12) Dysfunctional Parenting Functional Parenting 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

29. Strong Families: Child Behaviors Eyberg Child Behavior Inventory – Number of Problems (2010-12) All behaviors were a problem Clinical Cut-off:>=15 No behaviors were a problem 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

30. Summary of Strong Families Strategic Results • First 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

31. Children Learning and Ready for School

32. 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 scores Freedom Elementary has made tremendous improvements

33. Children Learning and Ready for School: Quality Early Child Care Practices SEEDS-trained teachers and coaches are creating language- and literacy-rich environments

34. Children Learning and Ready for School: SEEDS-Trained Educators State and Federally-Subsidized Classrooms Licensed Family Child Care Homes and Private/ Non-Profit Centers Unduplicated total,* Spring 2007 – June 2012 388 222 169 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

35. 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

36. Children Learning and Ready for School:Pre-Literacy Skills Percentage of Children “At” or “Above” Target Levels 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

37. Children Learning and Ready for School: Pre-Literacy Skills & SEEDS Plus Percentage of Children Meeting Targets for Later Reading Success Primarily English-Speaking Children 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

38. 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

39. 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 • In 2011-12, 4,135 children and their families participated in Raising A Reader’s weekly rotating book bag program • Children are learning letter sounds • 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 • Teachers and parents at 47 preschools completed individual Child Snapshot forms for 942 children • Parents are receiving kindergarten transition information • 251 parents participated in Transition to School Workshops

40. Questions?