Vermont Accountability, Collaboration and Results 2004 Community Indicators Conference

1. Vermont Accountability, Collaboration and Results 2004 Community Indicators Conference March 13, 2004

2. Entrepreneurial Strategies Clear Mission & Goals Embrace Accountability Redesign Production Processes Adjust Administrative Systems Performance Consequences Change Organizational Culture

3. Clear Mission and Goals

4. Vermont State Team for Children, Families, and Individuals Mission To work in partnership with communities to improve the well-being of children families and individuals

5. Vermont Association of Regional Partnerships Vision Vermonters helping Vermonters thrive! Mission To work in partnership with local, state and national partners to improve the well-being of Vermont’s children, families, individuals and communities.

6. Vermont Association of Regional Partnerships Core Partnership Functions To Build Community Capacity • Focus on Outcomes • Support Local Decision Making • Build Trust • Facilitate Inclusive CommunityProcess • Monitor Local Data • Develop Strategies to Meet Local Strengths & Needs • Coordinate System Change • Evaluate Change in Community Conditions

7. Embrace Accountability

8. Outcome Based Planning Outcome 6 Youth Choose Healthy Behaviors State Partners and Local Communities Working Together to Improve the Well-Being of All Vermonters A report from the VT State Team for Children, Families, and Individuals February, 2004

9. Agency of Human Services Reorganization Vermont Agency of Human Services Reorganization 17 Focus groups were conducted between October 13 and November 12 and were held at various locations across the state selected by the partner groups • Victims • Parents of children with SED • Parents of more than one child each with different disabilities • Reach-up parents • Offenders – incarcerated (male) • Offenders – incarcerated (female) • Offenders - in the community • Homeless adults with children or dependents • People with co-occurring disorders • Parents of children in protective services • People with chronic health care needs • Parents of children with autism • Foster parents • Teen parents • Woodside Juvenile Detention Facility residents • Special Education Directors • Psychiatric Survivors • NAMI (families who have adult children or spouses with mental illness)

10. Redesign Production Processes

11. Easy enrollment! • Apply for services in convenient community locations • Provide application information only once • Access multiple programs offered by multiple departments and some nonprofit organizations. Vermont Agency of Human ServicesCommon Application

12. Family Friendly Family Advocacy Networks Family Members As Navigators Neighborhood Patch Sites Parent & Professional Trainings

13. Adjust Administrative Systems

14. AHS Sample Outcome Contract • Agency of Human Services Outcomes: • Check the AHS Outcomes this grant will address and delete the others: • Outcome 1: Families, Youth & Individuals are Engaged in Their Community’s Decisions and Activities • Outcome 2: Pregnant Women and Young Children Thrive • Outcome 3: Children are Ready for School • Outcome 4: Children Succeed in School • Outcome 5: Children Live in Stable, Supported Families • Outcome 6: Youth Choose Healthy Behavior • Outcome 7: Youth Successfully Transition to Adulthood • Outcome 8: Adults Lead Healthy and Productive Lives • Outcome 9: Elders & People w/ Disabilities Live with Dignity & Independence in Settings They Prefer • Outcome 10: Communities Provide Safety and Support for Families and Individuals

15. Vermont Agency of Human Services Home Office of Information and Network Systems This page was developed to enable AHS Community Partners to access the grants data entered by all AHS departments. If you have any questions regarding the data, or if you would like help using the system, please contact: brendahu@wpgate1.ahs.state.vt.us Report Menu

16. Vermont Agency of Human Services Home Office of Information and Network Systems AHS Grant Tracking Reporting Menu • Search Screens/Reports. • Report of Grants by specific deliverable • Report of Grants By Organization • Report of all Grants, ordered by department, with subtotals • Outcome report for all Districts • Grant Summary report- Total by Dept- with no details • List all Organizations Main Menu

17. Performance Consequences Vermont Uses Performance “Carrots”

18. Excerpts from a March 2003 letter from Charlie Smith, Secretary, VT Agency of Human Services… I’m committed to continuing, and strengthening, the Agency’s emphasis on using outcomes as the benchmarks of our success. With the publication of the latest Community Profiles, I want to take this opportunity to highlight some of the outstanding progress toward the outcomes your region is achieving, as well as some areas where further attention may be warranted. There are several trends to spotlight here: • Rates of child abuse and neglect are substantially lower than the state average, and declined by 38 percent between 1996-98 and 1999-01. • Rates of teen sexually-transmitted diseases are low. • Rates of poverty among elders (ages 65-plus) declined by 51 percent between 1989 and 1999. Of course, to sustain and improve progress on the indicators requires ongoing work—so, don’t let up! • The Year 2010 goal for 90 percent early prenatal care has not been achieved. • Rates of low birth weight are high, relative to the state average. • Lamoille County has a high rate, relative to the state average, of injuries resulting in hospitalization (ages 10-17, and 65-plus). • Lamoille County has high rates of out-of-home placements (ages 25-plus), relative to the state average.

20. “Outcomes Progress-Index” The “Outcomes Progress-Index” is an attempt to address these concerns, through a multi-faceted approach. Each indicator’s data for the most recent year (as long as there are three or more years’ data) is scored three ways: Direction Is the indicator going in the “right” direction? (e.g., is percent low birthweight going down? Is median household income going up?) Turning the curve Does the most recent direction move the trend in a direction opposite from the previous year’s, or turn it more steeply in the same direction? Beating the background trend Is the most recent “local” trend significantly at-odds with the “background” (state, national) trend?

21. Change Organizational Culture

22. What Works “What Works” Series Promoting Youth Justice Through Restorative Alternatives Helping Youth Stay in School in Your Community Preventing Child Abuse and Neglect in Your Community Promoting Positive Youth Development in Your Community Preventing Teen Pregnancy in Your Community Preventing Youth Disruptive or Violent Behavior in Your Community Preventing Youth Substance Abuse in Your Community

23. Youth choose healthy behaviors. Youth successfully transition to adulthood. Adults lead healthy and productive lives. Elders and people with disabilities live with dignity and independence in settings they prefer. Communities provide safety and support to families and individuals. N/A Families, youth, and individuals are engaged in their community's decisions and activities. Pregnant women and newborns thrive. Children are ready for school. Children succeed in school. Children live in stable, supported families. Spending on Outcomes by AHS through Grants to Organizations

24. Platforms of Accountability External Authorization Internal Inclusion Results Management Managing for Results

25. External Authorization

26. TITLE 3: Executive, Chapter 53: Human Services 3 V.S.A. § 3026 Partnerships for children, families and individuals. (a)  Establish a Research Partnership to study and make recommendations for improving the effectiveness of state and local health, human services, and education programs. Critical program outcomes relating to the well-being of Vermonters should be addressed… 10 outcomes embedded (b)Regional Partnerships shall develop and implement local strategies for improving the social well-being of Vermonters, and shall advise AHS and DOE … (c)  The State Team for Children, Families and Individuals shall support the activities of the regional partnerships, and participate in the development and implementation of state policies and programs designed to improve the well-being of Vermonters.  Added 2001, No. 63, § 97; amended 2001, No. 142 (Adj. Sess.), § 119.

27. 2003 Act 45: AHS Reorganization “The overall success of the reorganization project should be based on measurable indicators, on trends and ultimately on realization of the statutory outcomes itemized in 3 V.S.A. §3026(a).”

28. InternalInclusion

29. State Team For Children, Families and Individuals Managers of state agencies State coordinators of interagency teams Directors of service and family advocacy Partners in higher educations institutions Parents Regional Partnership coordinators

30. VT Association of Regional Partnerships Regional Partnerships are working closely with the State Team for Children, Families and Individuals to support new ways of improving the well-being of Vermonters. Community and state partners are mobilizing and coordinating the capacity of both the informal and formal support systems that we depend on. These partnerships work in the following areas: • Focusing on outcomes that improve the well-being of Vermonters. • Engaging diverse community members as partners. • Mobilizing resources to enhance local support services and systems.

31. Results Management

32. Vermont’s Outcomes FAMILIES, YOUTH AND INDIVIDUALS ARE ENGAGED IN AND CONTRIBUTE TO THEIR COMMUNITY'S DECISIONS AND ACTIVITIES  PREGNANT WOMEN AND YOUNG CHILDREN THRIVE CHILDREN ARE READY FOR SCHOOL CHILDREN SUCCEED IN SCHOOL CHILDREN LIVE IN STABLE, SUPPORTED FAMILIES YOUTH CHOOSE HEALTHY BEHAVIORS   YOUTH SUCCESSFULLY TRANSITION TO ADULTHOOD ADULTS LEAD HEALTHY AND PRODUCTIVE LIVES   ELDERS AND PEOPLE WITH DISABILITIES LIVE WITH DIGNITY AND INDEPENDENCE IN SETTINGS THEY PREFER COMMUNITIES PROVIDE SAFETY AND SUPPORT FOR FAMILIES AND INDIVIDUALS

33. Indicator Reports Community Profiles http://www.ahs.state.vt.us/03compro/03ComProExpl.cfm Social Well Being of Vermonters http://www.ahs.state.vt.us/pdfFiles/03SWB.pdf Healthy Vermonters 2010 http://www.healthyvermonters.info/admin/pubs/hv2010/pdf/hv2010.pdf Youth Risk Behavior Survey http://www.state.vt.us/adap/yrbs2003.pdf Outcomes Based Planning Report http://www.ahs.state.vt.us/PDFFiles/OutcomeBasedPlanning03.pdf

34. Managing For Results

35. 2003 Community Profile For the Community Served by: Lamoille North Supervisory Union Prepared By: Vermont Agency of Human Services Planning Division www.ahs.state.vt.us

36. Outcome Based Planning Outcome 6 Youth Choose Healthy Behaviors State Partners and Local Communities Working Together to Improve the Well-Being of All Vermonters A report from the VT State Team for Children, Families, and Individuals February, 2004

37. State Team Outcome # 6 State Team Outcome # 6 Youth Choose Healthy Behaviors Troublesome Indicators Youth Choose Healthy Behaviors Heartening Indicators Increasingly, we know that we cannot define positive youth development as simply the absence of risk behaviors; we must also identify those strengths in the lives of young people that contribute positively to their well-being. Recent analysis of Vermont Youth Risk Behavior Survey data shows the cumulative effect that just six “assets” have on the likelihood that teens will engage in either risk behaviors or healthy behaviors. The six are: getting good grades in school, talking with parents frequently about school, feeling that students help decide what goes on in school, participating in after-school programs, volunteering in the community, and feeling that “I matter” in the community. The more of these six assets students report having, the less likely they are to venture into risky behavior, and the more likely they are to adopt health-promoting practices. There are a growing number of youth who are at increased risk for diabetes, cardiovascular disease and hypertension because of obesity. Many factors are related to the increasing number of children who are overweight or at risk for being overweight: increased consumption of fast food (high in calories and fat) in large quantities, less than optimal levels of physical activity, increased hours of TV and video watching. School based interventions focusing on nutrition education, physical education classes, informal opportunities for activity and cafeteria nutrition will only be successful if linked to community based and family opportunities for fitness and healthy eating. Communication with parents on school-related topics may be seen as a measure of a young person’s closeness to his or her parent, as well as an indicator of parental involvement in this important arena. “Connectedness” to parents, and parental involvement in schooling, have been linked with greater likelihood of academic success, emotional health, and avoidance of harmful behaviors ("Murphey, Lamonda, Carney, and Duncan, unpublished). The good news is that Vermont's rates declined From '99 to '01. The bad news is that marijuana use in Vermont is significantly higher than use rates nationwide. 30% of 9-12th grade youth in Vermont used marijuana compared to 24% nationally. Marijuana continues to be an issue because community norms are favorable to use, it’s easy to obtain and is often a gateway drug to other substances. New Directions coalitions are successful in reducing alcohol, cigarette and marijuana use among youth in their communities by implementing multiple, integrated strategies focused on reducing substance use. From 1997 to 2001, New Directions, reductions in tobacco and marijuana use, as compared with the rest of the state, were statistically significant. In 2000, the VT Tobacco Control Program was funded to carry out a comprehensive strategy of curricula, no smoking policies, media campaigns, community coalitions, smoking cessation programs, and youth empowerment anti-tobacco programs such as VT Kids Against Tobacco and Our Voices Xposed. From 1997 to 2003 the percentage of Vermont students who had smoked fell from 36% in 1997 to 20% in 2003. There has been an increase of over 160% in the number of people seeking treatment for heroin use between fiscal 1999 and 2002. A dis-proportionately large portion of this increase is driven by 18 to 24 year old clients. Since not all heroin users seek treatment, the population in need of treatment is expected to be much larger. Youth don’t just wake up one day and start using heroin. According to the 2001 Youth Risk Behavior Survey alcohol is the most commonly used drug among youth. While using marijuana and alcohol do not necessarily cause young people to use heroin, using these substances set up patterns of behavior to take the next step. Comprehensive prevention efforts work.

38. A Decade Of Turning The Curve From 1990 (or date indicated) to most recent data available % Change People With Health Insurance +1% Children With Health Insurance +3% Smoking During Pregnancy -7% Homicide Rate -9% Deaths From Motor Vehicle Crashes -14% Violent Crime Rate -17% Child Abuse & Neglect – Substantiated -17% Elderly In Nursing Homes (1992-2002) -18%

39. Teen Drinking (1993-2003) -19% Deaths From Cardiovascular Disease -19% Repeat Births To Teens -21% Youth Unemployment -26% Suicide -27% 2 Year Olds Immunized (1989-2002) +28% Teen Birth Rate -31% Child Deaths -32% Infant Mortality -35% Teen Smoking (1993-2003) -35%

40. Rate of Property Crime -43% Alcohol Related Teen Motor Deaths -47% Late Or No Prenatal Care -50% Young Teen Pregnancy Rate -50% Alcohol Related Motor Vehicle Deaths -52% Elevated Lead Levels (children 0-5) (1994-2000) -59% Institutionalization For Mental Illness -60% Parentage Established (1991-2002) +63% Child Support Cases With Collections +98% Families Receiving New Baby Visits (1994-2002) +223% School Meals +368%

41. The Bottom Line Good Results Have Avoided Costs Of Approximately $247,000,000 Toward An Economics Of Prevention – Nov 2000 http://www.financeproject.org/vermont.htm