R. Brandon Summary of Linkage Track, 3-11-05 Linkages: Across ECE programs [Breakout 1]

1. R. Brandon Summary of Linkage Track, 3-11-05 • Linkages: • Across ECE programs [Breakout 1] • ECE to social, health (physical, mental) services [Breakout 2] • ECE financing to quality [Breakouts 10, 11] Sessions reported: Innovative state actions, recent research findings, some burning issues

2. Linkages Across ECE Programs: Ohio example = “Agility” • [Schilder, Gottesman, Brandon] • Close collaboration of human service and ed depts • Evolving ECE-Head Start partnerships => • Early Learning Initiative • Common standards for process quality => • common input standards => Common: • assessment tools and methods • reimbursement rates • eligibility policies

3. Burning issues for linking across programs: • Assuring adequate funds for all services • Compensation and work conditions nec to recruit, retain qualified staff – full vs. part time work. • Balancing flexibility with accountability for funds while meeting needs of children • Moving from concepts and policies to operational linkages • Cultural competence within and across programs • Understand how low income families move among subsidy programs; view from perspectives of families and providers.

4. Linkages to social, health services: Knitzer: High priority for mental health linkages: - high prevalence - children’s emotional as well as cognitive development - problems more with provider than child - avoid “rush to the clinical” - links to Parts B, C of IDEA - Research similar interventions in health, MH

5. MH Linkages: CT: EC Consultation Partnership [Mary Ann Dayton-Fitzgerald] Relationships among all significant adults for child Community-based programs for CWD Team approach for families, providers,, staff; multiple entry points Assessment pre, post: statewide data base. Utilized with legislators and other policy makes Beginning randomized intervention outcomes study.

6. VT: Children’s UPstream Services “CUPS” [Brenda Bean] • Focused on linking emotionally disturbed kids to ECE and reducing SED placement; strengthen behavioral health of families • Regional plans; Medicaid funds used to sustain • ECE vs. MH: different language, training, expectations • Consultation model to build MH expertise within ECE, cross- training => increased requests for help • Different models in KS, RI, MA

7. Burning issues [MH]: • Lack of trained child MH specialists; train-the-trainers. • Reliable assessment at early ages; physical-mental co- occurrence • Methods to serve but not ‘blame’ young children • Expand GS/GS to include social, emotional development • Emphasize communication between MH specialist, family; families more concerned with concrete survival issues; consider family stress, empowerment, substance use/depression, resources • Depression among ECE staff • Cultural relevance

8. Burning issues [MH] - 2: • Funding linked to diagnosis, not to more important risk factors; study long-term cost-effectiveness • Need cost analyses for MH programs for young children and families. • Need many more linkages: ed, CPS JJ, TNAF, employers, judicial, adult substance abuse and MY, special • Engage business and faith communities. • Need cross-discipline clearinghouse, cross-agency indicators.

9. ECEfinancing to quality – QRS/Tiers, Data Systems [Carolyn Drugge, Facilitator] Examined 3 state QRS/Tier systems KY [Kim Townley]: voluntary [participation = 25% centers, 10% FCH]] TN [Deborah Neill], OK [Judy Collins]: mandatory [full participation] Seeing drop in ratings: real or tougher enforcement? QRS Requires entire support system: assessment, professional development, regulation, parent ed. Continual nurture. Research based rating criteria; evaluation of impact to learn, sustain support. Impact of publishing results, centers protect reputation

10. QRS/Tiers - 2 • Costs: TN = 13% total CCDF $$; use all of quality and MOE. NB: OK has reduced costs. How? • Payments as bonuses, avoid raising rates – resistance to higher parent payments – some increased demand, rates. • Scholarships for staff improvement. • Varying degrees of automation, professional judgment in ratings. • Need cost studies, eg cost-effectiveness of different approaches to assessment, more/less frequent assessments.

11. Linking State Data Systems • [Rod Southwick, Facilitator] • SC [W. David Patterson]: • Agencies maintain full control of data, contribute $ • Children = track since 1995, unique identifiers • Providers: developing integrated system • WISC: [Alan Sweet]. • Capacity grant. Multi agency: licensing, accreditation, CACFP, MRS, staff registry, linking to NACCRAware • Developing public access work site for rating system; • Negotiate common identifier with agencies.

12. Challenge of linking different technologies • Privacy concerns • Chapin Hall [Maired Ready]: • Linking admin data for 30 years Studied ECE subsidy and employment issues • Collaboration with Census Bureau: re ILL, MD, TX - linking admin data with individual census data to analyze eligibility, participation, employment. • Data matching complicated. Never full reliability or compatibility; probabilistic record matching. Confidentiality always an issue; cooperative relationships essential