Highlights from the Past… Planning for the Future…

1. Highlights from the Past… Planning for the Future… December 3, 2005 Sheraton Hotel Burlington, VT

2. The first things we need to do…are • Organize our thinking and move beyond the traditional outcome domains and silos around which we have traditionally organized our work. • Establish outcomes and indicators that cut across these traditional domains. • And construct a prevention oriented outcomes approach.

3. Traditional Outcome Domains • Health • Education • Employment Security • Safety • Sport • Culture • Etc.

4. The traditional outcome domains are the way that governments, all over the world, organize their work But, that is not the way that people organize their lives

5. For example…Following is a Prevention Driven Outcomes Model That is closer to how people organize their lives

6. ALL • Pregnant Women & Young Children Thrive. • Children are Ready for School. • Children Succeed in School. • Children Live in Stable, Supported Families. • Youth Choose Healthy Behaviors. • Youth Become Successful Adults. • Families & Individuals Live in Safe & Supportive Communities. • Elders and People with Disabilities Are Resources in their Communities & Live with Dignity & Independence in Places They Prefer.

7. And…here are two examples of how… We can measure these cross cutting outcomes

8. An Outcomes & Indicator Sampler • Pregnant Women & Young Children Thrive • Low Birthweight Babies • Pregnant Women Smoking Rates • % Births w/ Adequate prenatal Care • % Women w/ prenatal Care in 1st Trimester • Infant Mortality Rate • Toddler Immunization Rate • % of Young Children w/ Health Insurance • Rate of Injury Resulting in Hospitalization • Young Children Poverty Rate

9. An Outcomes & Indicator Sampler • Children Are Ready for School • Child Abuse/Neglect Rates 0-6 • Incidence of Childhood Lead Poisoning • Incidence of Childhood Asthma • Incidence of Hunger/Malnutrition • Preschool Participation • % Kindergartners Fully Immunized • % Children Ready for Kindergarten

10. Powerful Outcomes & Their Indicators…are • Clear & Declarative • Bigger than You • Connect Emotionally • Positive • Measurable • Comparable • Presented Over Time

11. Powerful Outcomes & Their Indicators…are • Extended Beyond Political Cycles • National, Statewide, Local • Interactive • Accumulative Over Time

12. Secondly… We created a data array for the outcome we wanted to work on over time, by looking back as far as we could.

13. And… • They didn’t get hung up on trying to do everything at the same time… • Because…

14. Anywhere Leads to Everywhere • Infant Mortality- connected to • Pregnant Mom Smoking Rates - connected to • Higher Education Levels - connected to • Dropouts - connected to • Teen Pregnancy Rates - connected to • Child Abuse Rates - connected to…………...

15. And… • We adopted some important statewide strategies, which, over time, helped bring more strong results.

16. Instead of Thinking Services …Think Strategy • Common purpose • Communities & families • Citizen participation • Service collaboration • Human relationships • Public health style communications

17. A Community Based Strategy: All Families Receive ‘New Baby’ Visits Improved • % Children (0 - 5) with elevated lead levels • Child abuse & neglect victims • Late or no prenatal care • 2 year olds fully immunized • Teen sexually transmitted diseases • Infant mortality • Child deaths • Children with health insurance • Parentage established • Child support cases with collections

18. Next… We created data sets for our communities to use to help decide which outcomes and indicators were the most important to change for the community.

20. Next…using the community profiles • We held data mirrors up to some of our communities so they could see for the first time real information about what was happening in their community. • And, many communities, with help from the State of Vermont decided to do something about what they saw.

21. We also worked hard… To communicate our changing indicators

22. The Results Over time

23. 10% to 30% Improvement b • Children with health insurance 11.8% 1984-2001 • Births to Women Receiving 1st Trimester Care 13.9% 1980-2002 • 12th graders using alcohol (last 30 days) 18.9% 1993-2003 • Elders in nursing homes 20.0% 1992-2002 • Adults who are ‘binge drinkers’ 21.4% 1990-2002 • Repeat births to teens 22.1% 1986-2002 • People with disabilities employed 23.3% 1990-2000 • Deaths from heart disease 25.0% 1990-2002 • Two year olds fully immunized 27.9% 1989-2002 • Adults that smoke 29.7% 1982-2002

24. 30% to 50% Improvement b • 12th graders smoking (over last 30 days) 35.3% 1993-2003 • Violent crimes (per 100M) 40.1% 1980-2002 • Births to women receiving late or no prenatal care 40.7% 1980-2002 • High school graduates to higher education 41.7% 1978-2001 • Youth (16-19) not attending school or working 45.5% 1986-2000 • Teen birth rate (age 15 – 19) 46.7% 1974-2002 • Alcohol related teen motor vehicle deaths 47.1% 1990 -2002 • Deaths from motor vehicle crashes 48.9% 1980-2002 • Property crime (per 100M) 49.6% 1980-2002

25. Greater than 50% Improvement b • Young teen pregnancy rate (age 15-17) 51.7% 1974-2002 • Infant mortality 61.4% 1980-2002 • Alcohol related motor vehicle crashes 63.9% 1988-2002 • Institutionalized for mental illness 81.7% 1980-2001 • Institutionalized for developmental 100% 1998-2002 • Knowing who the father is 126% 1988-2001 • Child support cases with collections 175% 1985-2002 • Families receiving ‘new baby’ visits 223% 1994-2002 • Schools participating in school meals 537% 1989-2002

26. National implications…of the Vermont outcomes and indicator work • Vermont, over the last 15 years, has proven that the work can contribute to significant and measurable results • The work can bring agencies and communities together around common purpose • The work is low cost and high value • Outcomes and indicators can bring a higher purpose to the everyday work of our employees and contractors