THE STATE OF FLORIDA’S CHILD Update 2011 pdf

The State of Florida’s Child – Update 2011 recognizes that: The Florida Cabinet for Children and Youth adopted The State of Florida’s Child report in March 2009, and spent significant

THE STATE

OF FLORIDA’S CHILD

Facts and analysis about the well being of our state’s families and children by The Policy Group for Florida’s Families and Children Inc

The State of Florida’s Child

U P D A T E 2 0 1 1

PREFACE

Formed in 2000, The Policy Group for Florida’s Families and Children Inc is an independent, analytical group

of statewide leaders that develops and supports public policies focusing on the well being of families and children and grounded in evidence-based research Fellows of the Policy Group are nominated and selected through a process that considers the nominee’s historical contribution to the general welfare of children and families The Policy Group promotes efforts that bring together diverse groups of stakeholders to research and develop policy; that inform key audiences such as professionals, state agency heads, legislators and funders; and that expand alliances and networks of voices who share the same vision

The Policy Group conducts policy analyses in domains where outcome measures reflect poor performance, and where measurable changes in context indicate need for review of current policy We provide analyses so that Florida’s leaders know what policies, programs and practices make a difference, and we center our efforts on building upon and using the strengths, assets and resources that already exist in communities Policy Group Fellows believe that an integrated system of services with a prevention focus is the best way to produce positive child and youth outcomes

This report, The State of Florida’s Child – Update 2011, focuses on child and youth outcomes in four key results areas The report updates The State of Florida’s Child1and is predicated on shared results accountability for

outcomes The State of Florida’s Child – Update 2011 recognizes that:

The Florida Cabinet for Children and Youth adopted The State of Florida’s Child report in March

2009, and spent significant time between then and December 2010 developing a process for shared efforts and results accountability Likewise, statewide stakeholders have engaged in results

accountability and united around shared indicators for their work These seminal efforts must continue and adapt as data further reveals and measures their progress

It is more important than ever for stakeholders, families and communities to coalesce around shared goals for their children and consider their contribution – programmatic and otherwise - to these shared goals This is more than just lip service; it’s willingness to be involved and accountable for work done

by actively measuring and evaluating outcomes

The long-term view of what is best for the state’s children must not be subsumed by short-term politics, funding crises, individual interests or self-protection Inherently, we all want a great state in which to live, work and rear children To flourish, positive social policies require sustained attention and

dedication to shared values that are meaningful and enduring It is the intention of The Policy Group

to continue providing leadership that is genuine, concentrates on shared values and principles, and

These concepts should guide the consideration of this update and those to follow:

It is imperative that the best information and data inform practice and policy

Many different state agencies may impact outcomes, and no single agency is solely responsible for a specific outcome Likewise, no single program on the local or county level can significantly impact a specific outcome

Adequate and stable funding is essential to coordinating work toward shared outcomes

Creating more flexibility within existing funding categories is an important component of success Early investments yield tremendous financial and social benefits

Family members must be involved to achieve optimal child well being outcomes

Outcomes and performance measures must be developed and implemented in a logical, reasonable manner so that they can be easily interpreted and used

Evaluation and data-driven decision-making are ongoing processes The Policy Group intends to provide this type of results accountability update at least every two years.2

The State of Florida’s Child3 report presented indicators of child well being grouped in four goal (results) areas:

Every Florida child will be healthy

Every Florida child will be ready to learn and succeed

Every Florida child will live in a stable and nurturing family

Every Florida child will live in a safe and supportive neighborhood

These goal areas provide a framework for understanding what children need to thrive and to contribute to Florida’s future No single indicator fully measures progress; together, they speak volumes about our state’s children and about our investment of time and resources The initial report provided baseline data as a starting point for understanding where the state stands, and that is generally at the bottom of the heap when

it comes to our children, families, and our future economic prosperity This report provides trend line data for the indicators This allows further review and analysis of patterns of progress and decline, and identification

of areas that need increased attention

Overall, the data show positive change in a few indicators, but no change or negative change in many others The lack of progress or negative change is pervasive throughout the trend line data in this report Troubling as this is, the data become even more ominous when the recent economic downturn is considered A fuller

discussion of this context occurs in the Analysis section on page 30, following the presentation of data

HOW FLORIDA RANKS WITH OTHER STATES ON SELECTED INDICATORS

The Annie E Casey Foundation ranks Florida 35th in the country overall based on several measures of child well-being – low birth weight babies; infant mortality rate; child death rate; teen death rate; teen birth rate; teens not in school and not working; children in families where no parent has full-time, year-round

employment; children in poverty; and single parent families.4 The ranking is based on changes in indicators over a 5-year period for some measures or data from the current year on other measures (Data for the Percent Low Birth weight Babies, Infant Mortality Rate, Child Death Rate, Teen Death Rate and Teen Birth Rate lag one year behind the other measures.)

ARROWS SHOW DECLINE OR IMPROVEMENT IN FLORIDA’S RANK SINCE THE 2009 STATE OF FLORIDA’S CHILD REPORT

BACKGROUND FOR THIS UPDATE

The State of Florida’s Child report was presented to and adopted by The Florida Cabinet for Children and

Youth on March 17, 2009 In adopting the report, the Cabinet also adopted a recommendation to engage in

a results accountability process as the best way to focus collaborative efforts on achieving the goals for children and families The Cabinet spent nearly 1½ years in thoughtful, guided discussion and decision-making leading to the selection of 13 “headline” indicators on which to focus efforts In mid to late 2010, the Cabinet further defined four indicators, one from each goal area, that they believed were most important to be addressed first Cross-agency state work groups were formed to provide more information and data on the four indicators: homeless children, abuse and neglect, kindergarten readiness scores and health insurance Statewide, others also began exploring results accountability in their communities Mark Friedman, well-known Results-Based Accountability (RBA) expert, was a frequent visitor to Florida, leading numerous workshops and training sessions on implementing RBA Notable successes on the local level include The Broward Children’s Services Council, which has integrated RBA into its funding and accountability process; The Children’s Trust (Miami-Dade), which restructured its strategic plan using results accountability principles; and The Children’s Board of Hillsborough County, which is using RBA to frame both population level and performance level results, with a focus on turning the curve The Children’s Board also has gone to a shorter term strategic plan with more leading indicators to focus work on achieve these results by knowing how well they are doing in advance of the headline indicators

Throughout the state, there is a growing recognition that by defining the outcomes we collectively want for our children and families, we can better measure our individual efforts and the strategies that contribute to the desired outcomes And we can more accurately determine the impact of one outcome upon another, and who

or what is accountable for results

To that end, there are some changes between this update and the initial report:

• The 2009 report included 74 indicators in four goal areas Since that time, the Florida Children and Youth Cabinet and others engaged in results accountability work have found that outcomes can be better measured and analyzed using a more streamlined and meaningful set of indicators This report contains that set of indicators The indicators in this report promote the ability to compare across communities within Florida and across states

• The initial report contained data at a point in time This report provides trend line data for the

indicators, so that the state and stakeholders can directly address these critical, results accountability questions:5

o Is the trend line okay?

o What are the causes/forces behind the trend line?

o What would it take to change the trend line in a positive direction?

o Who are the partners in this effort?

o What works to change the trend line?

o What is the multi-year action plan and budget to make this happen?

• This report includes a brief summary of the research that answers the question, “why is this important?” for each indicator By providing information on an indicator-specific basis, readers will be better able

to understand relationships and make connections between and among individual indicators and goal areas

• It is important to know “what works” to improve trend lines This information is available in the initial

State of Florida’s Child, which is online at www.policygroup.org.

TREND LINES

Every Florida child is healthy

Healthy children are the building blocks of a solid and productive society.6 All children

need basic health care Many health problems that might otherwise threaten a child’s

overall well-being and school achievement can be prevented or treated Approximately

15% of all children nationwide have a chronic condition, and approximately a third of

these are considered moderate to severe.7 Eighty percent of all non-traumatic health care

spending is attributable to chronic illness, a figure applicable to just 20% of all children.8

The remaining majority of children have minimal, relatively low intensity/cost needs All

health care for children and youth should be prevention-based, family-focused and

developmentally-oriented.9

Indicator definition: Percent of

live births with prenatal care beginning in the first trimester

Source: Florida Department of

Health, Florida Charts

Note: Florida is among reporting

areas that adopted the 2003 revision of the U.S Standard Certificate of Live Birth in 2004 and

2005 According to Betty Serow, MPH, Ph.D., Senior Health Policy Analyst for the Florida Department

of Health, this change meant that the baseline for this data

effectively “started over” in 2005

Indicator definition: Live births

weighing more than 5.5 pounds

Source: www.floridacharts.com or

through the NCHS Vital Stats system,

www.cdc.gov/nchs/VitalStats.htm

W HY IS THIS IMPORTANT ? Children who were born with low birth weight and fewer parental resources have

poorer health, are less likely to work and have lower earnings as adults.11 The risk of low birth weight babies for African-American women is greater in segregated neighborhoods than in less segregated areas And, mothers of low birth weight babies are 27% less likely to be married than mothers of normal weight babies.12

Indicator definition: Deaths

occurring to infants under 1 year of age per 1,000 live births The data are reported by the place of residence, not the place of death

Source: www.floridacharts.com

W HY IS THIS IMPORTANT ? The cost of intensive neonatal and basic health care for infants born with severe and

life-threatening problems far exceeds the cost of prenatal care and other supports that can prevent these problems While infants in every socio-economic category have better odds for survival than in past years, babies in households at or near poverty face greater risks than infants born to more affluent families.13

Indicator definition: Deaths

occurring to infants under 1 year of age per 1,000 live births, by race The data are reported by the place

of residence, not the place of death

Source: www.floridacharts.com

W HY IS THIS IMPORTANT ? Non-white infants die before age 1 at more than double the rate of white infants

Indicator definition: Percentage

of 2-year-old children fully immunized

Source: www.floridacharts.com

W HY IS THIS IMPORTANT ? Progress toward immunization of all young children has stalled since 2004

Immunizations prevent a wide range of diseases, and are a good indicator of child health status There is no

Indicator definition: Children 17

and under who were covered by health insurance at any point

during the year

Source: www.kidscount.org, from

The Urban Studies Institute at the University of Louisville, analysis of

data from the U.S Census Bureau

W HY IS THIS IMPORTANT ? Children with health insurance have a better chance of receiving routine health care,

thus avoiding preventable health care costs15

learning Hispanic children are much less likely than other children to have health insurance There is little difference in the percentages of children of other races with insurance.16

Indicator definition: Percentage

of children 0 through 4 who are

covered by Medikids and Medicaid

Source: www.floridacharts.com

W HY IS THIS IMPORTANT ? The data show that the number of children served by KidCare (primarily low-income

children) in Florida increased slightly in 2008, but decreased in 2009, which may mean more children are uninsured However, in mid-September 2010, Florida reported that enrollment in KidCare has increased statewide by 15% in the 15 months since then Governor Crist signed a law making it easier for low-income families to get health insurance for their children Maintaining eligibility, however, is difficult for many parents who cannot pay required fees

Children with health insurance

FLORIDA CHILDREN’S CABINET HEADLINE INDICATOR

Indicator definition: Percentage

of children 0-17 who received health care in the past 12 months that meets the American Academy

of Pediatrics (AAP) definition of medical home, defined as primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and

culturally effective

Source: www.nschdata.org

W HY IS THIS IMPORTANT ? Children with accessible, coordinated primary health care have a medical “home”

where all developmental needs can be identified and addressed

Indicator definition:Percentage

of children who saw a doctor, nurse, or other health care provider for preventive medical care such as a physical exam or well-child check-up, during the past 12 months

Source: www.nschdata.org

W HY IS THIS IMPORTANT ? Preventive medical care means problems can be identified and adressed early,

when they are less costly and there is more opportunity for successful outcomes

Children receiving a preventive medical

visit in the past year

FLORIDA CHILDREN’S CABINET HEADLINE INDICATOR

Indicator definition: Percentage

of children who saw a dentist for preventive dental care, such as check-ups and dental cleanings, during the past 12 months

Source: www.nschdata.org

`W HY IS THIS IMPORTANT ? Children from low-income families are less likely to receive dental care and more

likely to have unmet dental needs.17

Indicator definition: Percentage

of children who received any treatment or counseling from a mental health professional (psychiatrist, psychologist, psychiatric nurses and/or clinical social worker)

Source: www.nschdata.org

W HY IS THIS IMPORTANT ? Studies have shown a 4 to 10% prevalency rate of clinically significant emotional

and behavioral difficulties among young children, with significantly higher estimates for low-income children.18 Of non-instituionalized children 5 to 15 with special needs, 5.5% have a mental disability, by far the largest percentage among types of disability.19 These data show that many children are not receiving the mental health counseling they need Many issues, if left unaddressed, can lead to other poor outcomes such as drug use and teen pregnancy

Children receiving a preventive dental visit

in the past year

Children 2-17 with mental health problems

requiring counseling who received mental

health care

H e l p f u l l i n k s

Kids Count Indicator Brief – Preventing Low Birthweight

www.aecf.org/~/media/Pubs/Initiatives/KIDS%20COUNT/K/KIDSCOUNTIndicatorBriefPreventingLowBirthWeig/PreventingLowBirthweight.pdf

Kids Count Indicator Brief – Reducing Infant Mortality

www.aecf.org/~/media/Pubs/Initiatives/KIDS%20COUNT/K/KIDSCOUNTIndicatorBriefReducingInfantMortalit/ReducingInfantMortality.pdf

Child Trends Data Bank – Health Care Coverage

TREND LINES

Every Florida child is ready to learn and succeed

The quality of child care and early education and, in particular, the quality of the daily transactions between providers and the children for whom they are responsible, carry the weight of the influence of child care/early education on children’s development The positive relationship between child care/early education quality and virtually every facet

of children’s development that has been studied is one of the most consistent findings of developmental science.20 Staff qualifications are the strongest predictor of program quality and child outcomes.21

Meaningful early learning experiences are not entirely relegated to early education and care settings A family environment that values learning and creates opportunities for rich interactions and relationships helps encourage early learning and later educational success For all children, not just those in early care and education programs, parents are the most influential adults in their lives

High-quality early childhood settings offer economic benefits, as well The economic development impacts of quality early childhood settings include effects on regional economies (in terms of jobs, income and purchase of commodities in other economic sectors), effects on parents (supporting workers and their employers), and effects on children (building human capital).22

Early childhood education costs in Florida amount to $5,750 to $7,584 or more a year for one child.23 For low-income families, assistance is essential in order for them to be able to work and remain self-sufficient Mothers who receive child care assistance are 40% more likely to remain employed after two years than those who do not receive assistance.24 Former welfare recipients with young children are 82% more likely to be employed after two years if they receive child care assistance.25 Unfortunately,

assistance often is not available and not provided in quality programs.26

Studies show that families who lose child care assistance are often forced to quit their jobs, change work hours, spend their savings, go into debt, turn to welfare, or choose lower quality, less stable child care.27

Indicator definition: Percent of

births to mothers with no high school diploma or GED

Source: www.floridacharts.com

W HY IS THIS IMPORTANT ? There are positive correlations between a mother’s education and a child’s academic

performance, particularly in cognitive development and academic outcomes.28

FAIR scores, first year ECHOS scores shown in yellow

Indicator definition: The Florida

Kindergarten Readiness Screener has two measures: the Early Childhood Observation System (ECHOS) and the Florida Assessments for Instruction in Reading – K (FAIR-K) The ECHOS measures benchmarks in seven domains; the FAIR-K measures growth and development of early literacy skills Prior to 2009, the DIBELS was used instead of the FAIR

Children whose kindergarten entry scores

show they are ready for school

ECHOS

FLORIDA CHILDREN’S CABINET HEADLINE INDICATOR

Indicator definition: Percentage

of early childhood staff with a bachelor’s degree

(Based on data collected by the 65% of facilities that report this data to DCF; this does not include staff credentials from counties who conduct their own child care licensing independent of the state

As well, the calculation does not include those staff who work with mixed age groups or staff who work with children 5+ years of age)

Source: Florida Department of

Children and Families

outcomes.30 Yet most of Florida’s young children are taught by staff without bachelor’s degrees These numbers have not changed significantly over the past five years

Indicator definition: Percentage

of licensed facilities with accreditation by the National Association for the Education of Young Children (NAEYC)

Source: The Florida Children’s

Forum

with social skills and academic achievement and leading to higher graduation rates and less crime and delinquency,31 especially for poor children who otherwise arrive at kindergarten already way behind their higher income peers Accreditation by the National Association for the Education of Young Children is considered to be one indicator of program quality, yet few programs achieve this accreditation

Indicator definition: Percentage

of family child care homes accredited by the National Association for Family and Child Care (NAFCC)

Source: The Florida Children’s

Forum

with social skills and academic achievement and leading to higher graduation rates and less crime and delinquency,32 especially for poor children who arrive at kindergarten already way behind their higher income peers Accreditation by the National Association for Family and Child Care is considered to be one indicator of family child care home program quality, yet few programs achieve this accreditation

Indicator definition: Percentage

of children 0-5 whose families read

to them every day

Children whose families read to them daily

FLORIDA CHILDREN’S CABINET HEADLINE INDICATOR

Indicator definition: Percentage

of children 0-5 whose families sing

or tell them stories every day

Source: www.nschdata.org

Note: This data was not collected

for the 2003 National Survey of

Child Health (NSCH)

with children Singing and story telling are two easy ways to do this

Indicator definition: Percentage

of total students in grade 3 who scored at or above achievement level 3 in FCAT reading*

* Level 5: Successful with the most challenging grade-level content

Level 4: Mostly successful with challenging grade-level content

Level 3: Partly successful with grade-level content – performance is on grade level

Level 2: Limited success with grade-level content

Level 1: Minimal success with grade-level content

Children scoring on or above achievement

level 3 in FCAT reading

Indicator definition: Percentage

of total students in grade 3 who scored at or above achievement level 3 in FCAT math*

* Level 5: Successful with the most challenging grade-level content

Level 4: Mostly successful with challenging grade-level content

Level 3: Partly successful with grade-level content – performance is on grade level

Level 2: Limited success with grade-level content

Level 1: Minimal success with grade-level content

Source: www.www.fldoe.org, Data

Report: Florida Public High School Graduation Rates 2008-2009, Series 2010-09D, November 2009

W ? Failure to graduate from high school means lower lifetime earnings and fewer

opportunities for economic success Quality early learning experiences can help improve a child’s success in

Children scoring on or above achievement

level 3 in FCAT math