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Home My WebLink About20120560.tiff WELD COUNTY Ci,.; 'SSIONERS Emit Childhood. �eado�ehip Commiaeion, 20!2 FEB 21 A 10: 10 RECEIVED February 16, 2012 Colorado Stakeholders: The Early Childhood Leadership Commission is excited to usher in 2012 with the release of the Colorado Early Childhood Needs Assessment and the Early Childhood Leadership Commission 2012 Annual Report. The Needs Assessment provides county-level data on the status of children and families.The report includes maps and charts on major indicators of early learning,family support, social emotional and mental health,and health domains,to assess the needs of the whole child. A User's Guide included in this report will help both local and state stakeholders use the indicator data for policy decisions and planning. The 2012 Early Childhood Leadership Commission Annual Report highlights the Commission's continued work to ensure that all Colorado children are valued, healthy and thriving. Highlights of the Commission's work include promoting a new early childhood state governance structure,to improve quality and provide children and families with more efficient, effective, and elegant services. The Commission strongly supports 5812-130 that would establish this new structure, an Office of Early Childhood in the Department of Human Services. Since the legislature passed SB 195 in 2010, it has been the mission of the Commission to promote the coordination of policies and procedures that affect the health and well-being of Colorado children. Entering its second year,the Commission will continue to partner on a comprehensive vision for Colorado children and supporting families as the first and best teachers. Sincerely, G 9° ki � Reggie Bicha Anna Jo Haynes Pat Hamill ECLC Co Chair ECLC Co Chair ECLC Co Chair The Early Childhood Leadership Commission 2012 Annual Report and the Colorado Early Childhood Needs Assessment can both be found electronically on www.earlychildhoodcolorado.org. For questions or more information please contact Colin Tackett in the Lt. Governor's Office: Colin.tackett@state.co.us or(303) 866-4528. Le rvvm.)6" i t_a)- CC k-15 D 2012-0560 s I _ .�-+�_• '• ! •1l P. _ � ` .ice .9 !` Viir Y I 4 _ bi 9, - V , IP i 1. y� C �P .1,..0, ••w ti A V IV/ IIiagait gj It C ILIC eadit Childhood, Seeadeuttic Cerruniaaifin, 2012 Annual Report Presented to : 11! Governor Hickenlooper Senate Education Committee, Senate Health and Human Services Committee, House Education Committee, House Health and Environment Committee IV -Fe : . . . s I ., , • ) 1. i ;i. , , C..... .. ; r- . ark - . ,_. . "'Ps + 4 Air dl, Greeting Children. 2011. Photograph. Clayton Early Learning Center, Denver. Colorado's future success and prosperity depends today on the foundation our communities build for every child to thrive. That's why this administration has identified early childhood as a top priority. We know that Colorado cannot prosper without strong support for its youngest citizens. Children who have a supportive family environment, a strong health foundation and quality early learning are more likely to succeed in school and, ultimately, the workplace. The Early Childhood Leadership Commission (ECLC) brings together early childhood stake- holders from across Colorado to improve outcomes for young children ages birth to eight. The Commission is committed to identifying opportunities for, and addressing barriers to, the coordination of early childhood policies and programs so that all Colorado children have a chance to be valued, healthy and thriving. This report reflects the Commission's accomplishments over the past year and provides a roadmap forward for Colorado's early childhood system. As a state, we will continue to pri- oritize early childhood development as the most important investment in Colorado's future. Joseph A. Garcia Anna-Jo Haynes Pat Hamill Reggie Bicha Lieutenant Co-Chair Co-Chair Co-Chair Governor ECLC ECLC ECLC Cover Image: Literacy Matters Tour School Assembly. 2011. Photograph. Martinez Elementary, Colorado Springs. Support for Early Childhood Is an Investment in the Future Did you know that only one of six U.S.children born into the bottom economic tier will move to the middle class and less than one in ten will move to the highest income levels?1 Some call this the lottery of birth.A recent study showed that U.S.children's edu- cational,social and economic futures are more tied to their parents'education when com- pared to some other countries.2 Less than half of U.S.parents now believe their children will grow up to experience a higher standard of living than their own.3 We know good policy can change our children's future.While gaps in ability and health across socioeconomic groups begin at very early ages,quality early childhood supports can mitigate these gaps. • Investment in early childhood education can help close achievement gaps,boost wage earnings,increase the likelihood of healthier lifestyles and reduce so- cial costs like crime.4 • Quality home visiting can decrease the incidence of low birth weight by almost half and cut rates of abuse and neglect by 80%.5 • Children with a medical home* have been shown to have 30% fewer emergency room visits as well as fewer hospitalizations and unmet health care needs.6 How Colorado Rates for Kids Changing the lottery of birth will be challenging. Currently, many Colorado children are born at-risk and stay at-risk: • DOUBLED.The number of Colorado children living in poverty in the last decade has doubled.? • LOW BIRTH WEIGHT. Colorado has one of the nation's highest rates of children born with low birth weight—a predictor for child development problems.8 • LESS THAN HALF. Only 48% of children ages 6 to 9 received the recommended number of medical well-child visits.9 • AVAILABILITY GAP. Colorado has an estimated 1.63 children for every 1 licensed childcare slot." • ONE QUARTER. 25%of Colorado students do not graduate high school. By and large,these are the same students who were not reading proficiently in the early grades.31 The Commission is committed to helping all children—especially those most at-risk—have the best chance to be valued, healthy and thriving.This report de- scribes the ways we're working to achieve this goal. *An approach promoting quality health care that is family-centered and coordinated across health care and community services. r CD X O L = C >, vi .6) 0 C O O ° V > b0 b0 O 0 O L L O M B a, L WOO > L — S; N O 'a FO U N-, N u N > b0 > .a LL, 'u FO 7 4.0 t ._:ff F - C '" O C 'O 'L O p 0 X u O et O i--, = L 'a u ti >, O ii C F. i b0 O 0 4_, i N .Z P1 O C 5.'E I." 'b y as N fti b N L '� CO •L a L ca t O ,-� p L C C 70 C) ca C - O U - 0.' L 2 E, NI p o zn O is U 4= ft O N V U. tC N U yV.) C `N o .--i N O 4,17.3 N U a r. L I—. E •vJ y A bD [ >,.a .O n° .Q `�' CD L1 aa)i O rat o E L to F c „ c " E 0 c e u y .,, u 'E N VI E c .a E s.. N t �' O .O L F Y V E O a) L �' o -Ti L C w O 0. 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E A $ ` Z'' E bC M y t� C ,.-. -12 ....L t ¢tj� gnu4 i q 21 caw ll 8 t "f: gin VI V c It- A L t i " A is 1$• t �, t �flt u � ,• p '5 li k4 Y t � � h SLAa i r a ort :15115:2tir 104111fAil Iiiii atatil'AVVCIFM21 II t = gi § 42412l52 -0 i a a = i - Cif=p! 41 g I g C C 5 C a Eii, L+ Y FLE C s g Es , QI t q �0 � C = � `s 7 � a jr1 I n = i iiTi _ ti 54 minim 8' ' Lai b- i p i E e rE ut EPEE td et a � �, R 6A1 � _ U U U U V V V }� U UO . t r Zp y t Q • • • ♦ • + • • • • • • • UYYB YY it lir 1 �� Y1 Z ‘Q 1 V152 � Z F V1W rww w4 ar 8 aL- W0 Early Childhood Leadership Commission Co-Chairs Charlie Forster-Collegiate Peaks Bank,President and CEO Reggie Bicha-Colorado Department of Human Services, Joel Jones-Durango Chamber of Commerce,Past President Executive Director of Fort Lewis College,Past School Board Member Durango Pat Hamill-Oakwood Homes,Chairman and CEO 9-R Anna Jo Haynes-Mile High Montessori,President Emeri- Representative Jim Kerr-Colorado State House of Repre- tus sentatives Cynthia Lindquist-Metro State College,Chair of Early Data,Needs Assessment&Insights Childhood Education,Special Education,Reading and Edu- Co mmittee Co-Chairs cational Technology Suzanne Helburn-University of Colorado,Denver,Profes- Jim Lynn-Governor's Office of Information Technology, sor Emeriti of Economics Agency Services Director Karen Trierweiler-Colorado Department of Public Health Fernando Martinez-San Luis Valley Community Mental and Environment,Director,Center for Health Families and Health Center,Executive Director Communities Senator Linda Newell-Colorado State Senate Fernando Pineda-Reyes-CREA Results,Founder and CEO Financing& Economic Development Kim Poast,PhD.-Colorado Department of Higher Educa- Cnnunittee Co-Chairs tion,Associate Deputy Director,Access&Student Services Brad Busse-RBC Daniels,Co-Head of Communication, Diane Price-Early Connections Learning Centers,Presi- Media&Entertainment,U.S. dent and CEO Elsa Holguin-Rose Community Foundation,Senior Pro- Sherry Price-Mesa Developmental Services,Director, gram Officer Children and Family Services Gina Robinson-Colorado Department of Health Care Pol- Program Quality.Coordination&Alignment Commit- icy and Financing,Program Administrator tee Co-Chairs Steve Romero-Morgan County Department of Human Anna Jo Haynes-Mile High Montessori,President Emeri- Services,Director tus Diana Sirko-Colorado Department of Education,Deputy Chris Watney-Colorado Children's Campaign,President Commissioner and CEO Representative Judy Solano-Colorado State House of Representatives Members Senator Nancy Spence-Colorado State Senate Gregory Anderson-University of Denver,Dean of Mor- David Suppes-Denver Public Schools,Chief Operating gridge School of Education Officer Greg Anton-Anton Collins Mitchell,Partner Faye Tate-Colorado Workforce Development Council, Charlotte Brantley-Clayton Early Learning,President and Member CEO Heather Tritten-Office of the Lieutenant Governor,Head Larry Curry-The Curry Center,Clinical Director and CEO Start State Collaboration Director Dave Ferrill-Governor's Office of Economic and Interna- Larry Walk,M.D.-The Rocky Mountain Youth Clinics, tional Trade,Field Representative,Global Business Devel- President and CEO opment oF,,, For Questions relating to the Annual Report ew•. e t please contact Colin Tackett: Cohn.tackett@state.co.us Updated February 2, 2012 • • • •• Colorado Early Childhood Needs Assessment • • • • • • , pF ' COO • • Pvto • Ar$ • caT ,•° f • • • v� O • • 65e • • l law •• SINE NUI� • • 1876 • • • • Conducted for the Early Childhood Leadership Commission • Office of Lt.Governor Joseph A.Garcia • • • • • • November 2011 • • • • • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Letter from the Early Childhood Leadership Commission • • The Early Childhood Leadership Commission (ECLC) is pleased to present Colorado's Early • Childhood Needs Assessment. The ECLC vision is for all Colorado's children to be valued, • healthy and thriving. Data about the needs of, and supports for, Colorado's children is an • important step in helping communities and the state ensure children are ready for school . and achieving to their full potential. • This document contains the following information: • • Information on counties' level of risk for poor child outcomes. • • County-level data that describes the state of the early childhood population across . the four Early Childhood Colorado Framework domains: early learning, family support and parent education, social, emotional,and mental health, and health. • Snapshots, by county, of available programs, supports and services for children and families. • In addition, to enable this to be a useful tool in community and state planning,we have also included a user's guide. We hope you take time to review the wealth of data in this document and use the information to aid in supporting young children and their families. . We look forward to the work and successes ahead. Sincerely, , Reggie Bicha Pat Hamill Anna Jo Haynes Co-Chair Co-Chair Co-Chair Letter from the Early Childhood Leadership Commission i 1 • • November, 2011 Colorado Early Childhood Needs Assessment • • Table of Contents • • • Introduction 1 • • Framing Early Childhood in Colorado 3 • • Identifying at-risk counties in Colorado Overview of Colorado 7 • Methodology 14 Results 17 • Strengths and Limitations of Analysis 17 • • Colorado Early Childhood Data Profiles • Overview 22 • Indicator Selection Methodology 22 • Indicator Results 23 • County Data Profiles 24 • Snapshots 25 Summary 26 Appendices • A. Early Childhood Resources 52 • B. Risk Assessment Maps (urban, rural, and frontier counties) 53 C. Indicator Descriptions 56 • D. County Data Profiles 61 • E. Indicator Maps 126 • F. Guidance Document for Early Childhood Professional 150 • 411 • • • Table of Contents ii • • • • November, 2011 Colorado Early Childhood Needs Assessment • List of Figures • • • • Figure 1 Early Childhood Colorado Framework 4 • Figure 2 Colorado topography, major roads, cities and 2000 population density 8 • • Figure 3 Colorado's Urban, Rural, and Frontier Counties, U.S. Census Bureau, 9 • 2009 • Figure 4 Percent of Colorado Population Ages 0 - 8 Years of Age, Colorado 10 • residents, 2010 • • Figure 5 Population estimates by race/ethnicity and age, Colorado residents, 11 • 2005 - 2009 • Figure 6 Changes in the Early Childhood Hispanic Population in Colorado 13 • (1990, 2000, 2010) • Figure 7 Quintiles of Risk 16 • • Figure 8 High, low, and moderate risk Colorado counties based on analysis 18 • from the Risk Assessment • Figure 9 Risk Assessment Data for Urban Colorado Counties (N=17) 19 • • Figure 10 Risk Assessment Data for Rural Colorado Counties (N=24) 20 • • Figure 11 Risk Assessment Data for Frontier Colorado Counties (N=23) 21 • Figure 12 High, Low,and Moderate Risk Colorado Urban Counties Based on 53 • Analysis from the Risk Assessment (N=17) • Figure 13 High, Low, and Moderate Risk Colorado Rural Counties Based on 54 Analysis from the Risk Assessment (N=24) • • Figure 14 High, Low, and Moderate Risk Colorado Frontier Counties Based on 55 • Analysis from the Risk Assessment (N=23) • • • • • List of Figures iii • • November, 2011 Colorado Early Childhood Needs Assessment • • List of Snapshots of Supports and Services • • • • Snapshot 1 Individuals in Poverty in Colorado, 2005 - 2009 27 • • Snapshot 2 Snapshot#2: Percent of Children 3 to 5 Years of Age Enrolled in the 28 Colorado Preschool Program, 2010 - 2011 • • Snapshot 3 Snapshot#3: Estimated number of children under age six in poverty, 29 • number of children under 6 years of age enrolled in Head Start, Early • Head Start or Migrant Head Start and number of slots for the Colorado Preschool Program by county, 2010 • • Snapshot 4 Results Matter Participation, 2010 - 2011 32 • Snapshot 5 Estimated Ratio of Children to Childcare Slots, 2010 36 • • Snapshot 6 Social and Emotional Programs Available in Colorado, 2010 39 • • Snapshot 7 Medical Home, 2010 44 • Snapshot 8 Early Childhood Population Eligible but Not Enrolled in CHP+ or 45 • Medicaid, 2008 - 2009 • • Snapshot 9 Location of Mental Health, Oral Health, and School Based Health 48 • Centers, (School Year 2010 - 2011) • Snapshot 10 Early Childhood Developmental Supports for Providers, 2010 49 • • Snapshot 11 Statewide Early Childhood Home Visitor Programs in Colorado, 2010 50 • • • • • • • • • • • List of Snapshots of Supports and Services iv • • • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Acknowledgements • • • The Colorado Early Childhood Needs Assessment was conducted as part of the Early • Childhood Leadership Commission grant from the United States Department of Health and • Human Services,Administration for Children and Families (number 90SC0006). The Early Childhood Leadership Commission would like to thank the following individuals and • organizations for their contribution of time and expertise. • • Principal Investigator: Indira Gujral, MS, PhD, Epidemiologist, Epidemiology, Planning, & . Evaluation Branch, Prevention Services Division, Colorado Department of Public Health and Environment • . Editors (in alphabetical order): • Barbara Gabella, MSPH, Epidemiology Unit Director, Epidemiology, Planning, & Evaluation Branch, Prevention Services Division, Colorado Department of Public Health and • Environment . Jennifer Stedron, PhD, Executive Director, Early Childhood Leadership Commission, Office of Lt. Governor Joseph A. Garcia, State of Colorado Karen Trierweiler, MS, CNM, Director, Programs &Services, Prevention Services Division, • Colorado Department of Public Health and Environment. Map Creation: Mario Rivera, MS, Program Evaluator, Epidemiology, Planning, and Evaluation Branch, Prevention Services Division, Colorado Department of Public Health and Environment ID Advisory Work Group (in alphabetical order) Charlotte Brantley, MA, President and CEO, Clayton Early Learning Heather Dubiel, MS, RN, Early Childhood Director, Prevention Services Division, Colorado Department of Public Health and Environment Meg Franko, MS, Senior Consultant, Evaluation, Early Childhood Councils Initiative, Colorado Department of Education Jodi Hardin, MPH, Director, Early Childhood Systems Initiatives, Office of Lt. Governor Joseph A. Garcia, State of Colorado Lisa Piscopo, PhD, Vice President of Research, Colorado Children's Campaign Angela Rothermel, MEd, Director, Early Childhood Partnership of Adams County Acknowledgements v • • November, 2011 Colorado Early Childhood Needs Assessment • • Ken Seeley, EdD, President,The Partnership for Families and Children • Ayelet Talmi, PhD,Associate Director, Irving Harris Program in Child Development& Infant • Mental Health,Assistant Professor, Departments of Psychiatry and Pediatrics, University of • Colorado Denver • Special thanks to the following contributors for data, information, advisement, and technical assistance: • • Matthew Barry, Director of Data and Information Initiatives,The Piton Foundation • Orla M. Bolger, Senior Consultant, Exceptional Student Leadership Unit, Colorado • Department of Education • • Stacy Buchanan,Vice President of Information Strategy, Qualistar Colorado • Elizabeth Garner, State Demographer, Colorado Demography Section, Colorado • Department of Local Affairs • • Ashley Juhl, MSPH, Epidemiologist, Epidemiology, Planning, &Evaluation Branch, Prevention Services Division, Colorado Department of Public Health and Environment • Gabriel Kaplan, PhD, MPA, Director, Epidemiology, Planning& Evaluation Branch • Prevention Services Division, Colorado Department of Public Health and Environment • Stephanie Kuhn, MSPH, Epidemiologist, Epidemiology, Planning, & Evaluation Branch, • Prevention Services Division, Colorado Department of Public Health and Environment • • Nick Ortiz, Data Consultant, Colorado Preschool Program, Colorado Department of Education • Sue Ricketts, PhD, Demographer, Epidemiology, Planning, & Evaluation Branch, • Prevention Services Division, Colorado Department of Public Health and Environment • Colin Tackett, Meetings and Communications Coordinator, Early Childhood, Office of Lt. S Governor Joseph A. Garcia, State of Colorado • Rickey Tolliver, MPH, Director, Maternal and Child Health Surveillance Unit Health Statistics Section, Colorado Department of Public Health and Environment • Sara Wargo, Program Assistant, Maternal &Child Health/Women's Health, Prevention • Services Division, Colorado Department of Public Health and Environment . • • • Acknowledgements vi • • November, 2011 Colorado Early Childhood Needs Assessment • Executive Summary • • • Early childhood is a stage in human development when children experience life holistically. • Social, emotional, cognitive, language, and physical lessons are not learned and experienced • separately but rather have collective effects on children over time. Families and care providers of young children play important roles in shaping childhood experience. • • The goal of the Colorado Early Childhood Needs Assessment is to describe the current • condition of the early childhood population, ages 0 through 8 years, at the state and county level across the four domains outlined in the Early Childhood Colorado Framework (early • learning; family support; social, emotional,and mental health; and, health). To accomplish this goal,three objectives were developed: • • Objective 1: Identify counties with high levels ofsocio-demographic risk and high rates of • poor maternal, infant, and child outcomes • Objective 2: Provide county-level data estimates and supports and services for the four • system domains impacting early childhood outcomes: early learning;family support and • parent education;social, emotional, and mental health; and health • Objective 3: Provide state and local agencies with guidance on how to use the data • provided in the needs assessment to assess assets and resources in their community. The comprehensive nature of this needs assessment allows state and local early childhood IP professionals to identify gaps, prioritize efforts and make data-driven decisions to set goals • and develop recommendations to improve or sustain supports, services, and policies. By • promoting health, mental health, education, and strong families, Colorado can work to • ensure that all children are valued, healthy, and thriving. The needs assessment will be widely distributed, reaching professionals in early childhood councils, early literacy initiatives, local public health agencies, foundations, and non-profit . and state agencies. You are invited to review this report, share its resources with other early childhood advocates, and work with us to improve the lives of all children. Summary of Results • Objective 1:Identify counties with high levels of socio-demographic risk and high rates of poor maternal, infant, and child outcomes. Thirteen indicators were used for the early childhood risk analysis. Six indicators were • used to identify counties with high levels of socio-demographic risk and seven indicators . were used to identify high rates of poor maternal, infant, and child outcomes. Using this data, each Colorado County was identified as either high, moderate, or low risk. . Executive Summary vii November, 2011 Colorado Early Childhood Needs Assessment • • 15 "high risk" counties identified • Adams,Alamosa, Baca, Clear Creek, Costilla, Crowley, Denver, Gilpin, Huerfano, Lake, Mesa, Morgan, Otero, Pueblo, and Saguache • • 27 "moderate risk" counties identified • Arapahoe,Archuleta, Bent, Chafee, Custer, Delta, El Paso, Fremont, Garfield, Gunnison, • Jackson, Jefferson, Kit Carson, Las Animas, Lincoln, Logan, Montezuma, Montrose, Phillips, Prowers, Rio Grande, San Juan, Summit,Teller,Washington,Weld, and Yuma • 22 "low risk" counties identified • Boulder, Broomfield, Cheyenne, Conejos, Dolores, Douglas, Eagle, Elbert, Grand, • Hinsdale, Kiowa, La Plata, Larimer, Mineral, Moffat, Ouray, Park, Pitkin, Rio Blanco, • Routt, San Miguel, and Sedgwick • • Objective 2:Provide county-level data estimates and supports and services for the four • system domains impacting early childhood outcomes: early learning;family support and parent education;social, emotional, and mental health; and health. S • County data profiles were developed for each of Colorado's 64 counties to show what is • happening with children and families at the community level. • • 24 early childhood population-based indicators were created using the Early Childhood Colorado Framework as a conceptual model. 5 • 11 snapshots of supports and services were developed to identify and locate the early • childhood resources available throughout the state of Colorado. • • Objective 3:Provide state and local agencies with guidance on how to use the data • provided in the needs assessment to assess assets and resources in their community. • Using the guidance, local and state advocates can review the data presented to identify • gaps and make data-driven decisions to set goals and prioritize efforts. • • Early childhood advocates and professionals can collectively review and use the data by referring to the guidance document in Appendix F to help with o Local Early Childhood Systems Assessments and Strategic Planning • o Assisting with Early Childhood Grant Opportunities . o Communicating with grant funders conducting routine needs assessments • o Planning community-based Early Childhood Literacy Initiatives o Local Health Integration Planning • o Communication with policymakers and state agencies • • • Executive Summary viii • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Introduction • • In 2010, Governor Ritter established Colorado's Early Childhood Leadership Commission • (ECLC) by Executive Order. The purpose of the Commission is to improve outcomes for • young children birth to eight years of age and their families by advancing the alignment, coordination, and efficiency of programs and services. In 2010, the ECLC received funding • for its operation from the U.S. Department of Health and Human Services. This federal grant requires the ECLC to conduct a needs assessment of children and their families in • Colorado. The ECLC contracted with the Colorado Department of Public Health and . Environment to conduct the needs assessment. • The goal of the Colorado Early Childhood Needs Assessment is to inform state and local • early childhood professionals, policy makers, and service providers of the issues affecting • families and children zero through eight years of age. This needs assessment provides data that allows each community to identify gaps and opportunities and to make data-driven decisions to prioritize areas and develop recommendations to improve or sustain supports, services, and policies. To achieve this goal,three objectives were established for the needs . assessment process. • Objective 1:Identify counties with high levels of socio-demographic risk and high rates of poor maternal, infant, and child outcomes. . A significant body of research has shown that a number of economic, demographic, and social risks can harm a child's development and contribute to behavior problems, failure at . school, and poor health.' These socio-demographic risks often co-occur, meaning, that children who live in a place where they experience one stressful factor are likely to experience other stressors as well. 2 As part of this needs assessment,a statewide risk . assessment was developed to identify counties with high rates of co-occurring socio- . demographic risks and poor maternal, infant, and child outcomes. Objective 2:Provide county-level data estimates and supports and services for the four system domains impacting early childhood outcomes: early learning;family support and parent education;social, emotional, and mental health;and, health. . A risk assessment helps to identify which communities in the state are experiencing a disproportionate amount of general socio-demographic risk, but it does not describe, more • specifically,what is happening across the early childhood domain for families and young children at the county level. Therefore, county-level data profiles are provided to describe . the early childhood population in each county related to four system domains: early . learning; family support and parent education; social, emotional, and mental health; and, health. These four system domains are encompassed in the Early Childhood Colorado Cole, M.,and S.R.Cole. 1993. The Development of Children,2n°Edition. New York:Scientific American. . 2 Moore, K.A.,Vandivere,S., & Ehrle,J. (2000).Sociodemographic Risk and Child Well-Being,Assessing the New Federalism (No. B-18):The Urban Institute. . Introduction 1 • • November, 2011 Colorado Early Childhood Needs Assessment • • Framework(as described in Framing Early Childhood in Colorado). In addition, eleven snapshots are provided to locate and understand current family and early childhood • supports and services. Objective 3:Provide state and local agencies with guidance on how to use the data • provided in the needs assessment to assess assets and resources in their community. • A needs assessment is conducted as part of a planning process to determine and address needs, or "gaps" between current and desired conditions.This needs assessment provides • an unbiased look at current conditions affecting the early childhood population. This needs • assessment does not replace local decision-making about what needs can be addressed and should be priorities of local efforts. Therefore, a guidance document was developed to guide early childhood professionals in reviewing the data, further assisting them with the • identification of local assets, programs, and resources that impact early childhood • outcomes. Using the guidance as is, or adapting it,will help early childhood professionals to • make data-driven decisions at that state and local levels. • Summary This needs assessment is a county-by-county snapshot of the early childhood population in • Colorado. This document provides policy makers and early childhood professionals with a • broader understanding of the environment (both the risks and supports) where families • and communities support children to be valued, healthy, and thriving. The addition of guidance documents for both local and state early childhood professionals • will enable data driven decision-making at the state and local levels. Local early childhood • professionals are encouraged to convene an interdisciplinary group of community experts to review the data included in this assessment along with other relevant local data that is • not included in this assessment.At the state level, the Early Child Leadership Commission • can use the guidance to identify gaps, prioritize efforts, and develop a sustainable plan for • growing and supporting early childhood systems in Colorado. • a • • • • • Introduction 2 . • • • November, 2011 Colorado Early Childhood Needs Assessment • • Framing Early Childhood in Colorado • • • The Early Childhood Colorado Framework(referred to as the Framework), serves as the • conceptual framework for the needs assessment process.3 The Framework functions as the • unifying guide for developing a comprehensive, coordinated service delivery system for Colorado's youngest children and serves as the foundation for the work of the ECLC. The Framework was developed in 2008 to guide comprehensive early childhood systems work in . Colorado. Since its release, state and local early childhood stakeholders have used the • Framework as a resource to help identify needs, guide planning and decision making, and build . partnerships. • The Early Childhood Colorado Framework: • • Recognizes the needs of the whole child and family by including outcomes that cut • across the early learning, family support and parent education, mental health, and health sectors. • • Communicates the vision for comprehensive early childhood work by helping early childhood partners see how their work, individually and collectively, contributes to the . greater picture of all children in Colorado being valued, healthy, and thriving. . • Ties "comprehensive systems building" language to specific strategies for action and measurable outcomes for children, families,and early childhood professionals. • Provides a framework to guide and focus the actions of public and private stakeholders who work with or on behalf of young children. • Promotes an outcomes-based approach to early childhood systems efforts. As seen in Figure 1, the Early Childhood Colorado Framework recognizes four areas or systems domains: early learning, family support and parent education, social, emotional and mental health, and health. Each of these domains encompasses three levels: the child, . parents and service providers (i.e. teachers, caregivers), and resources that support the . child.This needs assessment focuses on the needs of the child, their family, and the service providers for whom this framework exists. . 3 The Colorado Early Childhood needs assessment builds upon work that has been previously completed by early childhood professionals in Colorado. Past efforts include the development of the Early Childhood Colorado Framework in 2008 and the Framework in Action State Plan 2010-2012. Other resources and documents that informed this needs assessment include, but are not limited to,the Colorado School Readiness Indicators project (2004), Smart Start Outcomes and Evaluation Task Force(2008),and the Councils by the Numbers(2010).A complete list of resources is found in Appendix A. 1 Framing Early Childhood in Colorado 3 1 1 • . 1 O W VS n ad V 4 a >, �' = a� E o p O 7 or • 4 a in v H W _ . R �; 4-1 o 3 03 �+ Q .4 v a o m an o a, o f °� c R c • • H I•• , O L aJ - C Y G Rs •D u O w) W •> E C o f W V C CD N O C } � E v u o N - Z c a (A- a o • O R s c 4 I- Lit� c3 -1 ea a 4.6 it cc •Q - C CU CCt- o 4 •J p :. N -0 u v c N Y V V •C _ o E •� co v C _ - •T• G W : N L C Q o O N O C C CC Z N �' ^ 4- v n, i a V o of O <p • ' E C (C C C N L. 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W C 2 _ cn U Q _co a L ^p Z o o E °• Ea a) - ca Q ° Z U"iii U C cU ° a 0- .° 00 ca } u) O L O a) - d > ¢ U CO L .C U) CD aj CL I �' ° U oa W TL -oo ° a) r L) o ( o 0 UUC 7:3 ° cn c 0 J E p CLJ a) ca r a) U @ 'C Ch C O E • L o o cn D ° U CO ca ° o a) `�° f° o co E a m 03 Ti a) L .2 a) c a) o v ^ - E a cA o C� CO ID aE03s —� cn Y g � CD UIL m c`a c`o _ cam c ` cacv � n� ca E w U o 0 ` M c � � c c a) > U coU O ca O L O t. O co a) -O -p I C p co r > E 'er a d ._ UVUWUUW2 cWY � 1- Q L ` Q c W - T O O O O L O A as a a�i 'j L (a Q O a I. E c a U Q W CD (A O • • • • • • • • II c-1 ca E V �- O U cr coc ov • • • • Q ._ .� ✓ ✓ CU CU tit tID Q qi ..1, II Izi III • • November, 2011 Colorado Early Childhood Needs Assessment • • The vision described in the Early Childhood Colorado Framework is that "all children are valued, healthy, and thriving." To meet this vision, Colorado early childhood partners • recognize that efforts must be taken to better coordinate, align, and integrate services, • supports and resources. No one entity, organization, department, or collaborative • partnership can realize the vision independently. • The Early Childhood Colorado Framework Vision in Action • The Early Childhood Colorado Framework is a well recognized and unifying conceptual • framework among early childhood professionals in Colorado. To assess its reach, an • evaluation was conducted among 351 early childhood professionals.4 Approximately four • out of five respondents reported that they were either very aware or aware of the Framework, suggesting that the Framework is far reaching among early childhood • professionals in Colorado.When asked to rank the most important content characteristics • of the framework,the top three content areas ranked were: 1) recognizes the need of the • whole child and family; 2) communicates the vision for comprehensive early childhood • work; and, 3) emphasizes multi-agency/organization ownership and leadership. • The Framework is far reaching and has been used by individual organizations and agencies • to align efforts, identify and enhance partnerships, frame and motivate grant submissions, • and monitor progress toward collective goals. The incorporation of the Framework in this needs assessment will further support state and community systems-building work. • • • • • • • • • • • • • • • • • • • • 4 Survey results will be published in the fall of 2011. • Framing Early Childhood in Colorado 6 • • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Identifying at-risk Counties in Colorado • • This needs assessment begins with the identification of at-risk counties in Colorado. This • work builds on prior work directed by the Patient Protection and Affordable Care Act of • 2010 (Affordable Care Act) (P.L. 111-148),which is designed to make quality,affordable health care available to all Americans. A provision in the Act created the Maternal, Infant, • and Early Childhood Home Visiting grant program. Intended to help states respond to the • needs of children ages zero to five and families in communities at-risk, the program aims to • improve health and developmental outcomes for the early childhood population through the implementation of evidence-based home visitation programs. To be eligible for Early • Childhood Home Visiting grant funds, each state was required to conduct a statewide needs • assessment.As part of this needs assessment, each state was directed to identify and • provide comprehensive services to improve outcomes for families who reside in at-risk • communities.5 At-risk communities, as defined by the Affordable Care Act legislation,were • "Communities with concentrations of: premature birth, low-birth-weight infants, and infant mortality, including infant death due to neglect, or other indicators of at-risk • prenatal, maternal, newborn, or child health; poverty; crime; domestic violence; high rates • of high-school drop-outs; substance abuse; unemployment; or child maltreatment" • The statewide needs assessment for the Maternal, Infant, and Early Childhood Home • Visiting grant identified 15 Colorado at-risk counties (see Appendix A for more information • on the Maternal, Infant, and Early Childhood Home Visitor program Statewide Needs • Assessment). The purpose of this analysis is to expand upon this existing risk analysis to • identify and categorize the remaining 49 Colorado counties into low and moderate risk categories. To better understand the methodology and results of the risk analysis, an • overview of Colorado's geography and population distribution is provided. Subsequent • sections detail the methodology and highlight the results of the at-risk analysis. • • Overview of Colorado • • Geography and Demography The demography or distribution of the population is influenced by the geography of the • state. Bisected into eastern and western slopes by the Rocky Mountain range, Colorado has the eighth largest area of land mass in the U.S., and its borders form an almost perfect • rectangle, measuring 387 miles by 276 miles.The eastern half of the state consists of grassy • plains and rolling prairies,which is in stark contrast to the mountains that gradually, rise westward and give Colorado the highest mean elevation of any state.6 The metropolitan • Front Range (where the plains meet the mountains), extends north to south along the • • 5 Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program Supplemental Information • Request for the Submission of the Statewide needs assessment, Health Resources and Services Administration. 5 Colorado Department of Personnel Administration.Colorado State Archives Geography Page(2009),website: • http://www.colorado.Rov/dpa/dolt/archives/Qeographv.htm • Identifying at-risk Counties in Colorado 7 • • I November, 2011 Colorado Early Childhood Needs Assessment I 1 foothills, and includes the capital of Denver, with an elevation of 5,280 ft. which gives the , city its nickname of "Mile High City." 1 I Colorado's vast area of land mass and 2009 estimated population of 5,024,748 give it a 4 ratio of 41.5 persons per square mile, compared to the U.S. at 79.6. Eighty-six (86) percent ' of the state's population live in 16 urban counties along the Front Range, and one urban 4 county on the Western Slope. The other 18 percent of residents are scattered throughout Colorado's 47 rural and frontier counties.? Front Range population centers include the 4 cities of Denver, Aurora, Boulder, Ft. Collins, Greeley, Colorado Springs, and Pueblo. The 4 city of Grand Junction, located in Mesa County, is the major metropolitan area on the Western Slope (Figure 2).8 a Figure 2. Colorado topography, major roads, cities and 2000 population density 4 4 Detail area: , Front Range Urban Corridor earful r�`:,,i;: r Fart , oCraig " Collins 0 :ai o' wr g 1 LorKin. if De nye Boulder ' Glenwood �...n<o° o_.� 5t fi w i , �..�be ,.. nr.lnsref �AV2r a a :- -a orana o Aurora ' Lu►e„bod Cnk•r:,,l,. 'a Cheyenne , Cspri n ii•. "Its 4 __. \,. ,. _C21AC't fm., o gr,• ,.,. I Colorado , - Springs Dow , Animas ' Creek O. S� f 6� I v7. ,� -.-y ''.� :vac it +, � ee ingti ld :) �Y' �'.y},� �l'�Sb _ a .1 6' '" Canon x<. • City AntOnl<Oac ei0T' F'tlf;.IbG .-... ' nili; .r I N o 2s 50 100 Mies Population pet square mile 0 10 20 40 Mmes AI 1 1 r l ► i l l f.)'%c ' - F I Source: U.S. Census Bureau Census 2000 population by block group t 'P t^. sr 0,,, s re to e I Colorado has unique features, similar to many western states: few urban centers with vast ' rural areas, the topography of the Rocky Mountains, and the snowy winters. These features, ' while attractive to residents, create service challenges. Of Colorado's 64 counties, 17 are I Colorado Department of Local Affairs (www.dola.state.co.us/dlg/demog/pop colo forecasts.html) I 8 "Colorado Quick Facts," U.S Census Bureau, website: www.quickfacts.census.eov/qfd/states/08000.html 4 Identifying at-risk Counties in Colorado 8 I I • • November, 2011 Colorado Early Childhood Needs Assessment S urban, 24 are rural and 23 frontier (defined as less than six persons per square mile). Eleven (11) of Colorado's 23 frontier counties have two or fewer persons per square mile • (Figure 3). 9 Colorado has more than one thousand peaks over 10,000 feet high, and many • western slope counties find themselves geographically isolated by winter weather and • mountain passes. Figure 3. Colorado's Urban, Rural, and Frontier Counties, U.S. Census Bureau, 2009 • 1G:in* Oi-iii Coifs ` 30318 Pants RO sdm 606 • j003it12-J,D01=a%1Z5+-?S �co•naMeol�e+p ! �� Jackson 111.01111rdgwick • i hillips Moffat I_ Routt W• - IGrand Boulder Sroemma Rio Blanco �i- --` — Irt• Garfield ek Denver • --- Eagle Arapahoe — 0 ` v44 Dmigtas Kit Carson • Pil#liin ftake Elbert Parh Delta Cheyenne • Gunnison lc Lincoln _____ — • -- 1 /- Fremont Mows Montrose _ Crawley _Oturayl ' • San Miguel ' 1 insdala Saguache Custer Bent Prawn %` ` � 1 M Inert, _ lI • Dolores Alumna ' Huerfano Rlo Grande • Montezuma _e —� Las Animas Baca ; Castilla 5 La Plata Archuleta -\� Conajos 1 Rural, Frontier, and Urban Counties • Please note that oorurbies are tethnicMy designated as rna+IropoMten or non+reetropoliten; here, "ethos!' and "near serve Urban - 17 counties es proxies for these designations. Frooerer courses are a subset of rural counties_ Rural - 24 counties . j Frontier - 23 counties • Colorado Early Childhood Population • The distribution of the early childhood population varies in urban, rural, and frontier • counties. The majority (approximately 82 percent) of the early childhood population lives in one of 10 urban counties: Denver, El Paso, Arapahoe, Adams, Jefferson, Douglas, Weld, II Larimer, Boulder, and Pueblo. Population distribution varies significantly within each of • these counties. For example, the early childhood population comprises 15 percent of the • total population in Denver and Adams counties, but only 10 percent of the total population • in Jefferson County. Understanding these population variations is important for identifying • 9 Colorado Rural Health Center, July 2009. Website: www.searchcolorado.org/Rural Urban Frontier Map.pdf • Identifying at-risk Counties in Colorado 9 I November, 2011 Colorado Early Childhood Needs Assessment I II I future early childhood resources and services. Figure 4 highlights the percent of the early childhood population for each of the 64 Colorado counties. I Figure 4. Percent of Colorado Population Ages 0 — 8 Years of Age, Colorado residents, 2010 I I- , 9.6% ' SE.DGWICK 10.7% ' 7.9% 10-�� LCOAr! ' JACKSON LARIMER 10.2% • ROUTT ' i 10% I 10.7% ' GRAND !BOULDER'_ II : longs Percent # of Counties • - GILPIN - 6.5% 9£t°r6 WASHINGTON L -16.1 % - 8.3% 7 1 CLEJC3% . REEI•. . �..;1. . ERS' -- I L 8.4% - 9.8% 14 ;- 8.9% 10.2% 9.9% - 11 % 17 . 9.3% ELBERT KIT CARSON 1 PITKIN 9.2% I I - 11 .1% - 13.2% 13 PARK 9.3% - -- -- - 1 10.6% _ 91% J LINCOLN 101% 13.3% - 15.4% 13 DELTA % >, 8.1% TELLS CHEYENNE 10.7 I ,, GUNNISON • HAFFEE i_____ --- State Average 13.0% 8.1% - 10% I . • FREMONT I A_. 7% • 8.9% 1 v ROWLEY ' - ' 10.9% OURAY t - 7.2% CUSTER SAN MIGUEL ,.-.�4 9.5% BENT • 9.6% JUPNH3ISDAL E 8.3% ' 16.1% HUERFANO ' MINERAL ii S �, 8.8% I .MtA ' 10.2% - 9.7% 10.5% BATA LAPLATA 101% COSTILLA LPSWUIMPS 4 .ARCHLILE TA t _ i I Source: Population estimates provided by the Colorado Demography Section, Colorado Department of Local Affairs 4 (2010). Estimates collected on July 29, 2011. 4 In 2009, the estimate of the total population of Colorado children 0 to 8 years of age was 644,351. As seen in Figure 5, the number and distribution of the early childhood population 4 by race/ethnicity is similar across the three early childhood age groups. Among all ages, 4 just under two-thirds (63 percent) of children were white non-Hispanic, with over one- ' quarter (27 percent) identified as white Hispanic (Figure 5). Of the remaining 10 percent, approximately five percent of children were black/African American and three percent were Asian American/Pacific Islander. The smallest racial ethnic group was the American 4 Indian/Native Alaskan, which represented only two percent of the population. a 4 I 4 I I I I Identifying at-risk Counties in Colorado 10 4 a I •• November, 2011 Colorado Early Childhood Needs Assessment • • Figure 5. Population estimates by race/ethnicity and age, Colorado residents, 2005—2009 • • Age Groups • Race/Ethnicity Total 0-2 years 3-5 years 6-8 years • N (%) N (%) N (%) N (%) • White Non- 134,198 (63%) 137,873 (64%) 131,482 (62%) 403,553 (63%) • Hispanic White Hispanic 57,131 (27%) 56,903 (26%) 58,726 (27%) 172,760 (27%) • Black/African 11,453 (5%) 11,087 (5%) 12,127 (6%) 34,667 (5%) • American • Asian American/ 6,635 (3%) 6,692 (3%) 7,464 (3%) 20,791 (3%) • Pacific Islander • American 4,381 (2%) 4,316 (2%) 3,883 (2%) 12,580 (2%) Indian/Native • Alaskan • • Total 213,798 (100%) 216,871 (100%) 213,682 (100%) 644,351 (100%) • Source:5-year population estimates(2005—2009)from American Community Survey, United States Census Bureau. • • Hispanic Population:Fastest Growing Minority Population in Colorado • The Hispanic population under age eight has grown faster than the total population under eight. Between 1990 and 2000 the Hispanic population under eight increased 70 percent • from 82,000 to 140,000, slightly slower than the total Hispanic population (73 percent). • From 2000 to 2010 the under eight Hispanic population increased from 140,000 to • 200,000 or 42 percent, faster than the total Hispanic population at 41 percent. The • Hispanic population under eight as a share of the total population under eight has increased from 20 percent in 1990 to 35 percent in 2010.As seen in Figure 6,the Hispanic • population under age eight has grown faster in some areas of the state as compared to • other areas. • Across several measures of education and health, Hispanic children and youth lag behind • other groups. Since 2003,the percent of Hispanic children scoring proficient or above on al the Colorado State Assessment Program for reading,writing, and science is the lowest of all • racial/ethnic groups in Colorado.t" In terms of health, the percentage of Hispanic children • ages 2 - 14 years of age that are overweight or obese is higher (35.9 percent) than among white non-Hispanic children (22.7 percent), and a higher percentage of Hispanic children • rely on low cost foods (49.0 percent versus 20.4 percent)." The percent of Hispanic ill parents who reported behavioral or mental health problems among their children 1 - 14 • years of age was 31.2 percent compared to 26.2 percent among white non-Hispanics.l2 5 1°Colorado Children's Campaign. 2011 Kids Count in Colorado! Pages 51-53(2011). Si' Data source: Child Health Survey, Health Statistics Section,Colorado Department of Public Health and Environment, 2003-2007. • 12 Ibid. 10 • Identifying at-risk Counties in Colorado 11 • • November, 2011 Colorado Early Childhood Needs Assessment • Since the Colorado Hispanic population is relatively young (64 percent of the total Hispanic • population is under 35 years of age compared to 43 percent of the white non-Hispanic population),the identified disparities in child health and educational attainment could • develop into long-term consequences as children move into adulthood.The reliance on low • cost foods and the propensity of economically disadvantaged groups to supplement with • calorically dense foods such as soda and processed foods can disproportionately increase the burden of obesity among children as they age and grow. The complications from • obesity and poor nutrition range from hypertension and cardiovascular disease to diabetes • and cancer. Low educational attainment can compound these problems by widening the • income disparities that already exist as significant proportions of disadvantaged children become low-skilled and under-employed adults. • • According to the United States Census Bureau,the median household income among • Colorado Hispanic adults was $20,000 lower than the median income of white non- • Hispanic adults ($38,166 and $58,497, respectively).13 Over 35 percent of Colorado Hispanics 25 years of age and older had less than a high school diploma in 2009, in stark contrast to 5 percent of white non-Hispanics.14 Improving health and educational attainment among the early childhood population of Hispanics will place these children on • a trajectory to reduce existing educational and health disparities and improve the health, • education, and economic well-being of Hispanics residing in Colorado. • • • 13 American Community Survey, United States Census(2005—2009) • 14 American Community Survey, United States Census(2009) . Identifying at-risk Counties in Colorado 12 • • • November, 2011 Colorado Early Childhood Needs Assessment • • Figure 6. Changes in the Early Childhood Hispanic Population in Colorado* (1990, 2000, 2010) • • - 1990 Ii • • •• L. • ` i .. .l 't,)t t Y ; • i - -- - 0 2000 • r � r S • __ � . _ f... . , • 4 �' a :` Percent <� l _ l Ti / 0% - 6 .1 % • k Le r `. -. J I 6.2% - 11 1 % a t t - 11 .2% - 18.4% may. . : 18.5% - 38.1 % Ill G ...N,i - 38.2% - 87.1 % Y • u i i 2010 • i • a -.4,` ` 1 y 1, - - Ill II k-- May • . *Broomfield County was not established until 2001 and is excluded from analysis 5 Data Source: State Demographer's Office, Colorado Department of Local Affairs (1990, 2000, 2010) • Identifying at-risk Counties in Colorado 13 • • November, 2011 Colorado Early Childhood Needs Assessment • Methodology • • This needs assessment expands the risk assessment analysis conducted as part of the 2010 • Maternal, Infant, and Early Childhood Home Visiting (Home Visitor) grant program • mandated in the Affordable Care Act. • Overview of the Maternal, Infant, and Early Childhood Home Visiting grant program • The result of the Home Visitor risk assessment analysis of the Colorado early childhood • population was the identification of 15 at-risk Colorado counties. The identification of these at-risk counties stemmed from legislation requiring states to identify at-risk • communities using 13 population-based indicators reflecting maternal and child health • outcomes and socio-demographic factors.15 The addition of the socio-demographic factors • such as poverty, crime, unemployment, and educational attainment is critical: a significant • body of research indicates how a child's development is influenced by a number of economic, demographic, and social risks, all of which contribute to behavior problems, • failure at school, and poor mental health outcomes.16 These socio-demographic factors, • known in the public health field as social determinants, are often co-occurring, meaning, • that children who live in a place where they experience one stressful factor are likely to • experience other stressors as well.17 For example, many researchers believe that poverty itself may not directly cause negative outcomes in children, but rather poverty is highly • associated with many stressors such as low educational attainment and family breakup, all • of which contribute to poor maternal and child outcomes.18 • Indicators Selected • The federal guidance stipulated the use of 15 required indicators along with the associated • metrics to be used for the needs assessment. If data on a particular indicator wasn't • available, states were instructed to use an alternative indicator or document the lack of • data. Colorado data were not available for domestic violence19 and the juvenile crime arrest rate indicator had to be modified.2° To meet the legislative definition of an at-risk • community ("a community for which indicators, in comparison to statewide indicators, • demonstrate that the community is at greater risk than is the State as a whole"), the • indicators selected for analysis needed to be meaningful and accurate, and the results • needed to vary enough from the state average to represent significant differences. • 15 The 2010 Home Visitor grant program legislation in the Affordable Care Act instructed states to"Identify • communities with concentrations of: premature birth, low-birth-weight infants, and infant mortality,including infant death due to neglect,or other indicators of at-risk prenatal, maternal, newborn, or child health; poverty; • crime;domestic violence; high rates of high-school drop-outs;substance abuse;unemployment;or child • maltreatment." • 16 Cole, M.,and S.R. Cole. 1993. The Development of Children,2n°Edition. New York:Scientific American. "Moore, K.A.,Vandivere, S., & Ehrle,J.(2000).Sociodemographic Risk and Child Well-Being,Assessing the New • Federalism(No. B-18):The Urban Institute. • 19 Garmezy, N. (1993). "Children in Poverty: Resiliency despite Risk." Psychiatry 56: 127-36. 19 Note: Data for the domestic violence indicator was unavailable;there is currently no population-based data • collected regarding domestic violence in Colorado;therefore this indicator was omitted. 30 Note:The federal guidance asks for a juvenile crime arrest rate for juveniles age 0-19 years, but the publicly- • available data from the Colorado Bureau of Investigations was for juveniles was limited to 10—17 years of age. • Identifying at-risk Counties in Colorado 14 • • • •• November, 2011 Colorado Early Childhood Needs Assessment • • Therefore, indicators not meeting these assumptions were excluded from the analysis, • including: child maltreatment by type2t and four substance abuse indicators 22 • • In addition to the required indicators,the federal guidance allowed states to include other • indicators relevant to maternal, infant, and child health. Four additional indicators were included in the original analysis: 1) infant death rate (per 100,000) due to neglect and • abuse as reviewed by the Colorado Child Fatality Committee; 2) percent of children born to a high risk mother as identified by three risk factors (unmarried, under 25 years of age and • without a high school diploma); 3) child death rate (per 100,000) for children ages 1 - 14; • and, 4) percent of children (under age 18) living in poverty.23 • The 13 total indicators that were included in the analysis to determine communities at risk included: • • Percentage of premature birth • • Percentage of low birth weight infants • Infant mortality rate • Infant death rate due to neglect and abuse • . Percentage of women with three risk factors as defined above • • Overall child maltreatment rate • • Child death rate •S . Percentage of children in poverty • Juvenile crime arrest rate • Percentage of high school dropouts Reported overall crime rate • • Percentage of unemployment • • Percentage of individuals below the federal poverty level. • As indicated above, all indicators were defined using rates or percentages,which are • appropriate for comparison; however, there are some limitations. First, small numbers of • events and/or a small population size can be misleading by making a problem seem more • acute than it actually is.24 Secondly, using rates and proportions does not assess the 21 Note: Child maltreatment by type is a data subset of the overall maltreatment rate,which is a more meaningful • and accurate indicator,given small numbers of events and the small population sizes of some counties.Therefore, • overall maltreatment rates were used for the analysis that defined at-risk communities;however subtypes were collected and recorded in Appendix A. • 22 Note: Four substance abuse indicators(binge drinking, marijuana use,nonmedical use of prescription drugs,and use of illicit drugs excluding marijuana)were excluded because data provided by the Sub-state Treatment Planning reports combined county data into large regions,and the variance between the seven regional estimates and • compared with the state estimate was too small to identify any true differences. 23 Note:The main data sources used were vital records(birth and death certificates);the indictor regarding • children living in poverty was from the United States Census Bureau. • 24 Note: An example of this would be if a smaller county experienced two events in one year(i.e.,child death)and • four events in the next,their rate of the event just doubled,which could be alarming in a larger community, but may not mean anything in a small one(i.e., if the smaller county's number of events varies from zero to five each • year, both one and four events fall into what would be expected). • Identifying at-risk Counties in Colorado 15 November, 2011 Colorado Early Childhood Needs Assessment , burden of the problem in terms of the total number of individuals affected.25 Therefore, to portray a more accurate picture, indicators for similar counties (based on population size) were compared to each other, rather than compared to all counties. Counties were divided into urban, rural, and frontier categories as defined by the metropolitan statistical areas of the U.S. Office of Management and Budget (OMB). Of Colorado's 64 counties, 17 (26%) are urban, 24 (38%) are rural, and 23 (36%) are frontier. Identifying At-risk Counties In the 2010 Home Visitor analysis, a definition was developed to describe the magnitude of , variance from the state mean in order for an indicator to be considered "at-risk." In this analysis, all indicators are measured in the same direction, meaning, that a higher percentage or rate indicates a worsening problem. The top and bottom quintiles (20 percent) of every indicator measured high and low risk, respectively. Figure 7 illustrates this principal. 1 Figure 7. Quintiles of Risk Bottom 20% of indicators Top 20% of indicators 1 County indicator is lower County indicator is higher , than the Colorado mean Colorado's Mean = 50% than Colorado mean , < 1 For this needs ' `` assessment, the same methodology used in the 2010 Home Visitor risk assessment was employed to provide a risk category for the remaining 49 Colorado Counties. A spreadsheet was developed listing all counties, Colorado's 13 indicators, and the appropriate metrics. , Counties were categorized by urban, rural, and frontier status as defined by the U.S. Office of Management and Budget. Within each category of counties (urban, rural, and frontier), indicators that were in the top (highest values) and bottom (lowest values) quintiles (20 percent) were flagged. The number of each type of flag was summed for each county. As I seen in the 2010 Home Visitor risk assessment, a natural cut-off point for the "high" risk counties appeared for those counties with between three and four flags in the top quintile. Rural and frontier counties having four or more flags and urban counties having three or more flags in the top quintile were defined as being "high" risk counties. Urban, rural, and frontier counties with four or more flags in the bottom quintile of risk were defined as , being "low" risk counties. All other counties not meeting these criteria were deemed as "moderately" risked counties, meaning they contained a mix of indicators that were neither low nor high. These moderately risked counties contain indicators in both the 41 bottom and top quintiles. i 25 Note: An example of this would be if a large community and small community had the same rate of a given issue 41(i.e., crime, poverty, premature births, etc.) and given the percentage of the population effected; however, the number of people affected may be 10 or even 100 fold in the larger community. , Identifying at-risk Counties in Colorado 16 , 1 •• November, 2011 Colorado Early Childhood Needs Assessment • • Results • Expanding the 2010 Home Visitor risk assessment beyond identification of high risk • counties resulted in the risk classification (high, moderate/mixed, or low) for each of Colorado's 64 counties. Using the quintiles of risk approach, 15 Colorado counties were • identified as being"high" risk, including six urban, five rural, and four frontier counties. • Twenty-two (22) counties were identified as "low" risk, including six urban, seven rural, • and nine frontier counties.Among the 27 counties deemed "moderate" risk, there were five • urban, 12 rural, and 10 frontier counties. Figure 8 contains a map of each of the counties and their associated risk level.As seen in this map, the distribution of"moderate", and "low" • risk counties varies widely throughout the state; however,the distribution of"high" risk • counties is centered on or around the front range,the San Luis Valley in the south, and in • Mesa County in the western part of the state. See Appendix B for a closer look at risk status • for the urban, rural, and frontier counties. • Figures 9 - 11 provide detailed county data used to identify communities at risk for each of the urban (Figure 9),rural (Figure 10),and frontier (Figure 11) counties. Each of these • figures provides the indicator, metric used, data source,and county and compares the data • for each indicator to Colorado. Values marked in red indicate values in the top 20 percent while values in green represent the bottom 20 percent. • • • Strengths and Limitations of Analysis • The inclusion of both socio-demographic risk factors and maternal, infant, and child • outcomes in the risk assessment provides a comprehensive picture of early childhood in • Colorado and allows counties to understand factors influencing risk level. The strength of • this analysis is the alignment with the current home visitor program efforts as outlined in • the Affordable Care Act legislation. Expanding the original Home Visitor assessment allows both state and local early childhood professionals to communicate issues with one voice • and enables counties to see similarities and differences with neighboring counties or • counties of the same risk level. • The limitations of the 2010 Home Visitor assessment are that it defines early childhood as 0 - 5 years of age; whereas early childhood professionals in Colorado focus on ages 0 through • 8 years. The risk analysis concentrates on health outcomes and omits outcomes related to • education and family well-being; however, subsequent sections of this needs assessment • provide county-level education and family well-being indicators. This risk analysis • provides a summary of risk but it does not provide a complete picture of what is happening with the early childhood population at the community level.The County Data Profiles • presented in the next section were developed to fill in that gap and provide data specific to • the early childhood population in the four system domains outlined in the Framework. • • • • Identifying at-risk Counties in Colorado 17 I ti N_ N gt-- N "' C `-to O Y ,N U ft = u) . i A, O er U O3 a) -le ' in n) a a., a O I - c o co = o E 0 N E U 0J O 1 til Q .4 1 CC ,r U 1 W s a w S 1 w S a - W 1 N i.+ w ci > a -- +I F 0 4) La (U 0° 1 I z Y �C �i. _ 9) Z41 . ` Lo2 J tit 1 d .firI l f) ^' C L.. 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Q) o CC Q LL W Q CC 0 W z o Z Q Q w W C V O U O w ~ Q Z et] w J Z Z O Z J 1— z U Q l_7 U Z 3 QJ . z z Q } Z QN c‘ Z W J w Z 0 is a Q Z J LL g Q Q 3 Q i� z Q = W U ~ W Ln V1 Z W Y 3 0 0 O W LL [o + (D vZi 4:c v . o 2 Q Q W I Q D Q Z Q Q E... rot. Z Z QC Q Q Q Q `oil .641 O U m m U V U D V' 2 = Y Y :12 c to N N N J• Z IP II • • November, 2011 Colorado Early Childhood Needs Assessment • • Early Childhood County Data Profiles • • • Overview • The results of the risk analysis provide a broad statewide picture of risk and the location of • "at risk" populations in the state. However, this is not the full story of what children and • families experience in their community- even high risk counties vary in their outcomes for • children and families. The goal of the current section,the county data profiles, is to provide • counties with more specific information about the early childhood population across the four domains of the Early Childhood Colorado Framework: early learning; family support • and parent education; social, emotional and mental health; and health. • • The benefit of using the Early Childhood Colorado Framework as a conceptual base is that the framework illustrates how both positive (protective) and negative (risk) factors have a • profound effect on childhood growth and development during the critical period of early • childhood,when program interventions such as home visitation can strongly influence a • child's lifetime health and quality of life trajectory.26 The early childhood County Data • profiles consist of a set of 24 indicators selected by an advisory group comprising experts in epidemiology and the four system domains outlined in the Framework. For a complete • list of advisors, see the Acknowledgements section of this Needs Assessment. • • • Indicator Selection Methodology • • To paint a picture of Colorado children and families across the system domains, the • advisory group developed a set of criteria from which to select indicators for the early • childhood population. Criteria included the following: • • Focused on the child and the parents and providers who interact with the child • directly and indirectly (i.e. teachers, counselors) • Census data or population-based data that is generalizable to the population • • Data available at the county leve127 • • Data from a reliable and credible source • • Data is routinely collected (at least once every 2-3 years) • • Cross Sector- noting that some indicators will affect multiple early childhood system domains (See Figure 1, Early Childhood Colorado Framework) • • Salient and meaningful or connected to literature/research • • Easy to understand and communicate • • 26 The Health Status of Colorado's Maternal and Child Health Population,June 2010 report(Revised 09/01/2010),Colorado Department of Public Health and Environment,website:http://www.cdphe.state.co.us/ps/mch/healthStatus.html • 27 In some cases county-level data were unavailable and regional data were used • Early Childhood County Data Profiles 22 • • • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Aligns with Early Childhood Colorado Framework • • Aligns with current domain efforts - example,the health indicators align with • current early childhood prevention goals and activities • • Measuring something different than what was measured in the Risk Assessment - ID example, not including poverty because it is already in the Risk Assessment • • • Indicator Results • • Indicators Selected • A total of 24 indicators were selected for the Colorado Early Childhood Needs Assessment. Indicators describe the population and the four system domains in the Early Childhood • Colorado Framework. Below is a list of each indicator.A complete description of each • indicator is available in Appendix C. • 1. Total Population (number) 2. Early Childhood Population (0 through 8 years of age) (number) • 3. Early Childhood Population with Hispanic Ethnicity (0 through 8 years of age) (number) • 4. Speaks Language Other Than English at Home (percent) • 5. 3rd Grade Students Scoring Proficient or Above on Reading CSAP (percent) • 6. 3rd Grade Students Scoring Proficient or Above on Math CSAP (percent) 7. Individual Family Service Plan (0 through 3 years of age) (percent) • 8. Individual Education Plan (3 through 5 years of age) (percent) • 9. Days of Full Attendance during the Elementary School Year (percent) • 10. Kindergarteners in Full-Day Program (percent) • 11. Families NOT Reading to Children 3 or More Days per Week (percent) 12. Families relying on Low Cost Food (percent) • 13. Children with Mental Health/Behavioral Issues (percent) • 14. Children with Mental Health/Behavioral Issues Receiving Treatment (percent) • 15. 3 or More Stressful Events During Pregnancy (percent) 16. Health Care Provider talked to Mothers about Pregnancy-related Depression (percent) • 17. Out of Home Placements (rate per 1,000) • 18. Children Exposed to Secondhand Smoke (percent) • 19.Women Smoking During the Last 3 Months of Pregnancy (percent) • 20. Breastfeeding at 6 Months of Age (percent) 21. Overweight and Obese Children (percent) • 22. Provider Screening for Developmental, Communication,and Social Behavior Issues • (percent) • 23. Dental Visit by Age 1 (percent) • 24. Children with Health Insurance (percent) • • • • • Early Childhood County Data Profiles 23 • • • • November, 2011 Colorado Early Childhood Needs Assessment • • The majority of the early childhood indicators selected are routinely observed and reported in state reports. Indicators were pulled from the following sources: • • American Community Survey28 (United States Census Bureau) • • Colorado Child Health Survey29 (Colorado Department of Public Health and • Environment) 11 • Colorado Child Welfare Service (Colorado Department of Human Services) • • Colorado Demography Section (Colorado Department of Local Affairs) • Colorado Pregnancy Risk Assessment and Monitoring System (Colorado Department • of Public Health and Environment) • • Colorado State Assessment Program (Colorado Department of Education) • • Colorado Truancy Rates (Colorado Department of Education) • • Individual Education Plan (Colorado Department of Education) • • Individual Family Service Plan (Colorado Department of Human Services) • 2011 KIDS COUNT in Colorado (Colorado Children's Campaign) • • Most indicator information is presented by county. However, because of sample size issues, • prevalence estimates from some data sources are provided at the health statistics region level.39 • • • County Data Profiles • • County data profiles are located in Appendix D. These profiles contain the county/regional ' rate for each indicator along with the state estimate. In addition to the profiles, a • description of each indicator, its source,years used, and technical notes are available in Appendix C.A state map for each indicator is provided in Appendix E. While many of these • indicators chosen for the County Data profiles are well known by early childhood • professionals, some may be new. • • • • • 28 For data obtained from the American Community Survey,five-year aggregates(2005-2009)were used to obtain county level estimates. Data were suppressed if estimates were unstable,defined as having a margin of error • greater than 50 percent. • 29 While three years(2007-2010)of Colorado Child Health Survey data are provided for the majority of estimates, • five-year aggregates(2006—2010)were also sometimes used. Data were suppressed if less than 50 individuals responded. • 30 Data from the Pregnancy Risk Assessment Monitoring System and the Colorado Child Health Survey are •presented at the level of state health statistics region. There are 21 health statistics regions as defined by the Colorado Department of Public Health and Environment.Some counties like Larimer, Pueblo, and Jefferson may • comprise their own health statistics region,while other counties are grouped into a single health statistics region. • Using health statistics region data was necessary to ensure an estimate could be provided,as county-level data is not available for many rural and frontier counties. • • Early Childhood County Data Profiles 24 • • • • • November, 2011 Colorado Early Childhood Needs Assessment •• Snapshots of Supports and Services • Thus far,we have presented a statewide picture of county risk as well as,within counties, • details of how children are faring across the 4 system domains - early learning, family • support and parent education, social, emotional, and mental health and health. It is also • important to understand, by county,what programs supports and services are available for these same children and families.31 Therefore, a series of snapshots were chosen to help • state and local early childhood professionals locate supports and services throughout the • state and to better understand the changing early childhood population. Like all snapshots, • not everything or everyone makes it into the picture. Exclusion does not suggest that these • early childhood programs and supports are not valuable, rather it suggests that the array of early childhood supports and services are far too numerous to include in this needs • assessment. Further, it is difficult to obtain data on where these supports and services are • located. • Using the Early Childhood Colorado Framework (see Figure 1) as the conceptual base,the snapshots chosen for this needs assessment align with the supports and services section. • Each snapshot contains a map32 or table and a narrative describing each program/support. • • The following is a list of all snapshots (snapshots follow the Summary): • • Snapshot#1: Individuals in Poverty in Colorado, 2005 - 2009 • Snapshot#2: Percent of Children 3 to 5 Years of Age Enrolled in the Colorado Preschool • Program, 2010 - 2011 Snapshot #3: Percent of Children 5 years of age and under in poverty and enrolled in Head • Start, Early Head Start or Migrant Head Start and the Colorado Preschool Program, 2010 • Snapshot#4: Results Matter Participation, 2010 - 2011 • Snapshot#5: Estimated Ratio of Children to Childcare Slots, 2010 Snapshot#6: Social and Emotional Programs Available in Colorado, 2010 • Snapshot#7: Medical Home, 2010 • Snapshot#8: Early Childhood Population Eligible but Not Enrolled in CHP+ or Medicaid, • 2008 - 2009 • Snapshot#9: Location of Mental Health, Oral Health, and School Based Health Centers, (School Year 2010 - 2011) • Snapshot#10: Early Childhood Developmental Supports for Providers, 2010 • Snapshot#11: Statewide Early Childhood Home Visitor Programs in Colorado, 2010 • • • • 31 Two criterion for selecting indicators(census or population-based,and focus on the child and the parents and • providers who interact with the child directly and indirectly) resulted in the exclusion of many early childhood • supports and services(i.e. programs)in Colorado. 32 Mapping support was obtained from professionals with skills in geographic information systems,as noted in the • Acknowledgements section of this needs assessment. • Early Childhood County Data Profiles 25 • • • • November, 2011 Colorado Early Childhood Needs Assessment • Summary • • • Data from this needs assessment should provide early childhood professionals with a • broad picture of the early childhood population residing in their community.The risk • analysis helps to identify Colorado Counties with the greatest early childhood risk in terms • of socio-demographic risk and poor infant and maternal health outcomes. The county data profiles take a closer look at the early childhood population in each of Colorado's 64 • counties. The snapshots help to identify the programs and services serving these children. • The combination of assessing both the needs and supports and services of the early S childhood population can assist local communities and state policy makers to analyze strengths and gaps and target resources to impact change across the early childhood • domains. To help the state and communities analyze and plan, guidance documents are • provided in Appendix F. These "user's guides" help stakeholders analyze the information at • community level data and may motivate the need to collect additional data, review priorities, or generate new partnerships and strategies. It is the Early Childhood • Leadership Commissions intention to provide updates to this needs assessment in the • coming years in the hope that new information continues to aid communities and the state • in their efforts to help all Colorado's children be valued, healthy and thriving. • • • • • • • • • • • • • • 0 0 0 0 0 Summary 26 • • • • • • N E in R3 O c6 C � c ro ' N• CI Cfl }Ca o r 6J x- r OD N U O E • o N o • CU M 0 L_ N O , oci o o &). 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' w a Q w o o amp o co U Q I C cu a a O1 Q n. m — v- Jcn w I O O E Q a w a. z 'c - 0 .4-7 E L / O _' 73 $` no �cri W Z cc W N N QJ CC co w0 o, W z W be U "C3 �- w �I Y u I- O ai 5 ° O a I z O Q m tr a o � � � �4-1 � I cu Lnre U ° a a) m O C o a w 5 o u cc •— c �' I 'p `� o - w a U Z Z +, �_ 4'' O CU v s a 5 o O 0 vcr c t ap C / � � L I O o z `J Z �' ° c' ° v w w < U L.) v) d ° N tt C o ( '7 a �1 z J > U a1 O1 CO N o O r9 O U L O + I I ro it 0 , w o Z � � v � �, N N I ) a ri I-- < W O O d a) I +-+ (, -� tu it 0 fl. 0 m qa O g CU a -�_ O g 0 I C9 w Ur .- - N U �..� 'QO CU a - zz w a ° N E _� O N E v z O w •- U O tip C ' > �- O > c .O z o o ° •>, U - - - - -- - U a = v H U - N a w I I I • • • November, 2011 Colorado Early Childhood Needs Assessment • Snapshot#3: Estimated number of children under age six in poverty, number of children • under 6 years of age enrolled in Head Start, Early Head Start or Migrant Head Start and • number of slots for the Colorado Preschool Program by county, 2010 • Head Start (HS), Early Head Start (EHS), and Migrant and Seasonal Head Start are federally funded programs providing child development services to low-income families. EHS serves birth • to 3 years of age, HS provides health development among low-income children three to five • years of age, and, Migrant Head Start provides services to children (six-months to five years of • age) of migrant and seasonal farm workers. Migrant Head Start is serving families in Weld • (n=922) and Otero (n=425) Counties. Data Source: Colorado Head Start Collaboration Office • (2009—2010 School Year). • The Colorado Preschool Program (CPP) prepares vulnerable children for elementary school and • provides high-quality preschool to qualified young children ages 0 through 5 years of age. • Eligibility is determined by various factors: low family income, foster care, violence/neglect in the home, education of parents, and delays in language and social development. In the 2010- • 2011 school year, there were 20,160 CPP slots. Data Source: Colorado Preschool Program, • Colorado Department of Education (2010—2011 School Year). • • Enrollment into these services depends on different factors, but one underlying factor is • poverty. Snapshot#3 shows the estimated number of children in poverty by county. This number represents that estimated number of children that may be eligible for HS/EHS/MHS, or • CPP and serves as point of reference to these numbers and slots. Note: There may duplicates in • the program data presented, i.e., a child enrolled in HS may be enrolled in CPP. Data Source: • American Community Survey, U.S. Census Bureau (2005—2009). • • • • • • • • • • • • • Snapshot#3: Estimated number of children under age six in poverty, number of children 29 • under 6 years of age enrolled in Head Start, Early Head Start or Migrant Head Start and • number of slots for the Colorado Preschool Program by county, 2010 • • November, 2011 Colorado Early Childhood Needs Assessment • Estimated number of Number attending • children under age 6 Head Start, Early Number of Colorado • years living below Head Start and/or Preschool Program • COUNTY poverty level Migrant Head Start Slots Adams 9393 545 2,505 • Alamosa 628 329 164 • Arapahoe 10199 752 2,192 • Archuleta * 38 52 • Baca * 38 • Bent 135 61 58 • Boulder 3408 406 634 Broomfield * NA • Chaffee * 112 69 • Cheyenne * 20t • Clear Creek * 47§ • Conejos 213 100 82 • Costilla * 70 25 • Crowley * 29 • Custer * 17 • Delta 587 68 203 • Denver 15672 2111 4,029 • Dolores * 29t Douglas 698 232 • Eagle 618 106 120 • El Paso 8799 1237 1,816 • Elbert * 56 • Fremont 648 245§ 261 • Garfield 526 99 314 • Gilpin * § • Grand * 60• • Gunnison * 47 • Hinsdale * # • Huerfano * 34 35 Jackson * • • Jefferson 4794 660 1,291 • Kiowa * t • Kit Carson * 67 • La Plata 453 235 226 • Snapshot#3: Estimated number of children under age six in poverty, number of children 30 • under 6 years of age enrolled in Head Start, Early Head Start or Migrant Head Start and • number of slots for the Colorado Preschool Program by county, 2010 • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Estimated number of Number attending • children under age 6 Head Start, Early Number of Colorado • years living below Head Start and/or Preschool Program COUNTY poverty level Migrant Head Start Slots • Lake 347 68 75 • Larimer 2715 585 574 • Las Animas * 161 125 • Lincoln 152 45 26 • Logan 353 83 144 • Mesa 2247 402 457 • Mineral * # • Moffat * 16 100 Montezuma 570 194 131 • Montrose 777 102 156 • Morgan 517 70 197 • Otero 498 269 168 • Ouray * 20 • Park * 62 • Phillips * 40 • Pitkin * 35 • Prowers 407 114 133 • Pueblo 3866 626 1,320 • Rio Blanco * 49 • Rio Grande 385 200 105 Routt * 60 • Saguache 198 129 52 • San Juan * # • San Miguel 152 39 I Sedgwick * 24 • Summit * 59 95 • Teller * 20 82 • Washington * 37 29 • Weld 4653 672 1,077 • Yuma * 34 67 *Data suppressed due to unstable estimates (margin of error>50 percent) • tCheyenne and Kiowa Counties combined §Clea rk Creek and Gilpin Counties combined • tOolores, Hinsdale, Mineral and San Juan Counties combined I • Grand and Jackson Counties combined NA= not available • Snapshot#3: Estimated number of children under age six in poverty, number of children 31 under 6 years of age enrolled in Head Start, Early Head Start or Migrant Head Start and • number of slots for the Colorado Preschool Program by county, 2010 • • November, 2011 Colorado Early Childhood Needs Assessment • • Snapshot#4: Results Matter Participation, 2010—2011 S Results Matter is a child assessment required for children participating in the Colorado • Preschool Program, Preschool Special Education, and Title I programs.33 The purpose of Results • Matter is to positively influence the lives of children and families by using child, family, and • system outcomes data to inform early childhood practices and policy. Many providers also participate voluntarily in Results Matter, including some School Readiness Quality Improvement program sites, Family Child Care Homes, Child Care Centers, Early Head Start, Head Start and • Charter School Preschool Programs. In the 2010—2011 school year, a total of 38,611 children • ages 3 to 5 were assessed through Results Matter. This table shows the percentage of students • who were assessed in each county and the percent of students achieving developmental milestones and school readiness.34 • Meeting Developmental Milestones • Developmental milestones are functional, foundational skills that most children develop by a • specific age. These milestones in development reflect minimum expectations for cognition, • communication, socialization, movement, and independence. Children who do not meet these milestones in one or more domains within an expected age range may have developmental • delays that require early intervention or special education services and supports. Although • children who do meet these basic milestones are generally considered to be typically • developing, some may still lack the more sophisticated level of knowledge and skills that is • predictive of school success. These children would be considered at risk for challenges in school. Technical derivative—defined by a child who scored a 6 or above on the Early Childhood Outcomes Center 9-point rating scale. Note: Some of the children in this column are also included in the next column ("meeting widely held expectations for school success"). • • Meeting Widely Held Expectations for School Success Children who meet widely held expectations for school success have developed at a level that is • predictive of success in managing the social, behavioral, and educational content demands of • traditional school environments. These children demonstrate age-appropriate functioning that • is generalized, sophisticated, and flexible, allowing them to solve problems and to apply • knowledge and behaviors fluidly across settings and situations. The risk of future challenges in • learning and development is low. These children, by definition, also meet the respective developmental milestones. Technical derivative—defined by a child who scored a 9 (highest • point) on the Early Childhood Outcomes Center 9-point scale. • • 33 Data Source:Colorado Preschool Program,Colorado Department of Education (2010—2011 School Year) ; 39 Note: Results are dependent on the quality of data and assessment completion rates within each county. Lower figures of children meeting indicators in certain counties may be due in part to incomplete data. • Note:The three targeted outcome areas are: 1)positive social-emotional skills, 2) acquisition and use of knowledge and skills, • and, 3) use of appropriate behaviors to meet one's needs. 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O c t O C Vl C y co, . l0 Y N O LD Ol M O Y • • O O a toot m t-I '-I '-I 0 • M CC C O — 'I) C C O (0 G C yv,' t0 • N U a Le, u C Q I- • "O m y O CN O. - I;-) ut a) d N yt ri U CI. 100 0 a) u * * L 6 J • u a) y O a) • Z n co a U L c 0 b o `^ y - l0 to N N 3 C u O O C YO celjp *I V LA 'a TJ To Co O �O :a f0 y N '-I CO • Y U H O. v A O C W O Q N N V • > O. 2E E «° Ct * * m ‘13 ro v • w U 3 cQJ x x p = E O .b c .0 a v • ra 0 m • p C U > U O b al 22 o v -0 • N . !0 _ > 0 L 3 c-1 �' V C — 23 Y Cl) • y N 3 Y O g L E E 0 C V • > L 3 CC L c U Y w c 3 c • Oao a)La U O 0 a) +' 31-1 a • z E °) m v E J c v 0 � 1- 3 3 >' * a * * • • November, 2011 Colorado Early Childhood Needs Assessment • • Snapshot#5: Estimated Ratio of Children to Childcare Slots, 2010 • • Parents in the labor force face numerous decisions, including selecting appropriate childcare. • This analysis shows the estimated number of children under six years of age whose parents are • in the labor force compared to the number of available licensed childcare slots. A higher ratio • indicates greater need for childcare slots. This data does not include non-licensed childcare providers, which may comprise a large number of childcare slots in a county. • • The state ratio of the estimated number of children under six years of age whose parents are in • the labor force to the number of available licensed childcare slots is 1.63. This suggests that for • every one licensed childcare facility slot there are 1.63 children in need of licensed childcare. • The highest ratios are observed in Moffat (3.2) and Elbert (3.0) Counties. But, a word of caution is noted. Demand for childcare is reduced when parents lose their jobs. The estimated number • of children under 6 years of age with a working parent is based on American Community Survey • responses over a five-year period (2005-2009). Therefore, using this number in conjunction • with 2010 estimates of childcare slots may overstate the ratio of children to childcare slots if the five-year estimates do not reflect the actual labor force participation of parents in 2010, • which may be lower than for 2005-2009. In addition, the number of children under 6 over the • period 2005-2009 may be higher than the number in 2010 because of a decline in total births in • the state since 2008;this too would also overstate the ratio of children to childcare slots.35 • • • • • • • • • • • • • • 3s The following counties were suppressed due to unstable estimates(margin of error relative to estimate is 50 . percent or greater) as recommended by the American Community Survey:Archuleta,Cheyenne, Clear Creek, Costilla, Crowley,Custer, Dolores, Hinsdale,Jackson, Kiowa, Mineral, Phillips,and San Juan. Snapshot#5: Estimated Ratio of Children to Childcare Slots, 2010 36 • • November, 2011 Colorado Early Childhood Needs Assessment • Estimated Total Number of Number of Licensed Childcare • Children under 6 Providers Total Number of Ratio of • years of age with (centers, Childcare Slots in Children to • a Working preschools, Licensed Childcare • County Parent* homes)§ Facilities¶ Slot Colorado 246753 5159 151823 1.6 • Adams 26949 360 10912 2.5 • Alamosa 678 16 616 1.1 • Arapahoe 29447 576 19192 1.5 • Baca 139 7 149 0.9 • Bent 182 6 194 0.9 Boulder 11511 295 9604 1.2 • Broomfield 2948 68 2930 1.0 • Chaffee 506 25 554 0.9 411 Conejos 433 6 256 1.7 • Delta 933 31 569 1.6 • Denver 32719 501 20451 1.6 • Douglas 15692 340 11249 1.4 • Eagle 3173 52 1475 2.2 Elbert 913 14 308 3.0 IIP El Paso 28096 563 15658 1.8 Fremont 1527 26 859 1.8 • Garfield 3160 85 1522 2.1 • Gilpin 284 2 110 2.6 • Grand 641 15 280 2.3 Gunnison 509 18 491 1.0 • Huerfano 224 5 153 1.5 • Jefferson 23825 518 18770 1.3 • Kit Carson 495 20 246 2.0 • Lake 343 9 226 1.5 • La Plata 2277 59 1184 1.9 Larimer 12780 351 8392 1.5 • Las Animas 733 11 419 1.7 • Lincoln 177 8 180 1.0 • Logan 1086 38 727 1.5 • • • • • • • Snapshot#5: Estimated Ratio of Children to Childcare Slots, 2010 37 • • November, 2011 Colorado Early Childhood Needs Assessment • Estimated Total Number of Number of Licensed Childcare Children under 6 Providers Total Number of Ratio of years of age with (centers, Childcare Slots in Children to • a Working preschools, Licensed Childcare • County Parent* homes)5 Facilities¶ Slot Colorado 246753 5159 151823 1.6 • Mesa 6913 168 3427 2.0 • Moffat 722 16 223 3.2 • Montezuma 1132 19 596 1.9 • Montrose 1749 57 1183 1.5 • Morgan 1738 44 1015 1.7 • Otero 1023 24 698 1.5 Ouray 155 4 121 1.3 Park 697 19 263 2.7 • Pitkin 688 16 559 1.2 • Prowers 717 19 596 1.2 • Pueblo 8095 205 3655 2.2 • Rio Blanco 335 9 151 2.2 • Rio Grande 719 14 387 1.9 Routt 1066 35 702 1.5 • Saguache 290 8 306 0.9 • San Miguel 323 11 302 1.1 • Sedgwick 73 3 78 0.9 • Summit 1031 35 888 1.2 • Teller 729 16 552 1.3 Washington 142 10 167 0.9 Weld 14099 318 6759 2.1 • Yuma 490 29 404 1.2 • *American Community Survey(2005—2009); both parents in labor force(if living with two parents)and mother or • father in labor force(if living with one parent) §Qualistar Colorado, 2010 • Qualistar Colorado, 2010(Slots=Capacity of all Licensed Childcare Providers for Children under 6 years of age) • II 38 • • • • November, 2011 Colorado Early Childhood Needs Assessment • Snapshot#6: Social and Emotional Programs Available in Colorado, 2010 • Colorado has successfully developed a number of resources, programs and initiatives that • address the needs of early care and education providers, parents and children related to social-emotional development and mental health.36 This list of social-emotional • development and mental health programs were identified base on the following • parameters: 4111 • Statewide infrastructure: Program must have a central agency or initiative that houses the program within Colorado. • Statewide Replicability: Program must be appropriate for implementation statewide; • however, it does not need to demonstrate that the program is currently obtainable in • every Colorado community, but that it can eventually be replicated or implemented statewide. • • • Social-Emotional Content: Program must specifically address promotion, prevention • and/or intervention related to young children's social-emotional development, • challenging behaviors and mental health in the context of early care and education environments. • The following is a list of the social and emotional programs available throughout Colorado. • Subsequent to this list is a description of each of the programs presented in Snapshot#6. • • • • • • • • • • • • • • • • 36 Data Source:The Partnership for Families and Children, Social-Emotional and Mental Health Community • Planning Template(August 2010). • Snapshot#6:Social and Emotional Programs Available in Colorado, 2010 39 • • November, 2011 Colorado Early Childhood Needs Assessment • • Expanding Quality in • Early Infant • Childhood Toddler The Pyramid Learning in • Specialist Care Incredible Kid Plus Nurturing Touch- County Program ECE-CARES Course Years Connects Center Communities points • Adams • Alamosa • Arapahoe • • Archuleta • A • • Baca Bent • Boulder • Broomfield • Chafee • Cheyenne • C • Clear Creek • C • Conejos • • Costilla • • • Crowley • Custer • Delta • Denver • Dolores • • Douglas • Eagle • El Paso • • • Elbert • Fremont • Garfield • • Gilpin • Grand • Gunnison • • Hinsdale • Huerfano • Jackson • Jefferson • • Kiowa . Kit Carson . La Plata . Snapshot#6: Social and Emotional Programs Available in Colorado, 2010 40 . • • November, 2011 Colorado Early Childhood Needs Assessment • Expanding • Quality in • Early Infant Childhood Toddler The Pyramid Learning in • Specialist Care Incredible Kid Plus Nurturing Touch- • County Program ECE-CARES Course Years Connects Center Communities points • Lake • • • • Larimer • • Las Animas • Lincoln • • Logan • • Mesa • • • • • Mineral • • • • Moffat • • Montezuma • • Montrose • • • • Morgan ' • Otero • • Ouray • • • • Park • Phillips ' • • Pitkin • • Prowers • • • • • Pueblo • Rio Blanco ' • Rio Grande • • Routt • • Saguache • • San Juan • • San Miguel • • Sedgwick ' Summit • • ' Teller • • Washington • • Weld • • Yuma ' • • • • • • Snapshot#6: Social and Emotional Programs Available in Colorado, 2010 41 • • • a - a) L ai Y N UN ry L -o a) ra Q • O o d H L C 3 Lfr, N J L U E C = L C O > > E L vOi c 00 3 C �[ L 'O 0) Q `) • (0 ' 0 7° -0 E N >. 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Ez Le- a-. 13 ID • C_ N a) C cc E13 y a c Z in 01 N Q O C Q C Y C • I a E 4 � v° c a • E v 'c E .n L m m o E o c • o a auu J LI ac° O • • November, 2011 Colorado Early Childhood Needs Assessment • • Snapshot#7: Medical Home, 2010 • • The American Academy of Pediatrics developed the medical home model and currently defines • a medical home as a model "for delivering primary care that is accessible, continuous, • comprehensive, family-centered, coordinated, compassionate, and culturally effective to all • children and youth, including children and youth with special health care needs." The medical home is not a physical building or hospital, but rather it is an approach to providing quality • comprehensive primary care. The Colorado Medical Home Initiative began in 2001 in response • to the Title V/ Maternal and Child Health (MCH) national outcome measure that all children • will receive comprehensive coordinated care within a Medical Home. • There are many poor outcomes associated with not having a medical home. In a recent study, • children without a medical home were nearly four times more likely to have unmet needs for • health care, three times more likely to have unmet needs for dental care, and were less likely to • have had a preventive health care visit in the past year.37 For a child and their family, the • patient centered medical home model provides a regular source of primary care, which is • associated with better health outcomes at lower cost. Ultimately, families feel supported in • caring for their child.38 • State-level data on the medical home are available; however, sub-state data will not be • available until summer 2013. Twenty-three questions on the Colorado Child Health Survey are • used to create one overall composite score. Five components are used to measure whether an • individual has a medical home: having a personal doctor or nurse; family centered care; getting needed referrals; having a usual source of care; and, effective care coordination. Results from • the 2010 Colorado Child Health Survey indicate that approximately 70 percent of respondents have a medical home. • • • • • • • • • • • • 37 Strickland, B.B.,Jones,J.R.,Ghandour, R.M., Kogan,M.D.,Newacheck, P.W.The Medical Home: Health Care • Access and Impact for Children and Youth in the United States. Pediatrics(2011). • 38 http://www.coloradomedicalhome.com/aboutMedicalHome.html Snapshot#7: Medical Home, 2010 44 . • • November, 2011 Colorado Early Childhood Needs Assessment • • Snapshot#8: Early Childhood Population Eligible but Not Enrolled in Child Health Plan Plus or • Medicaid, 2008—2009 • • Health insurance is associated with improved access to health care and better health outcomes; however, there are a number of uninsured Colorado children who are eligible for public • insurance programs but not enrolled. The Colorado Health Institute publishes annual estimates • of Colorado children eligible but not enrolled in Medicaid and the Child Health Plan Plus (CHP+) • program by county to help state and local policymakers understand enrollment patterns in their • communities. The data presented in the table below represents the percent of uninsured • Colorado children 0—8 years of age who are eligible but not enrolled in Medicaid and CHP+ by county.39 In Colorado, approximately 5.9 percent or 37,711 children ages 0- 8 are eligible for • these programs but are not enrolled. • • Percent of Children 0-8 • years of age Eligible but Not • Medicaid or CHP+ Eligible Enrolled in Medicaid or County Total children (ages 0-8) but Not Enrolled CHP+ • Adams 67043 5800 8.7% • Alamosa 1406 70 5.0% • Arapahoe 76216 6307 8.3% • Archuleta 1348 136 10.1% • Baca 424 21 5.0% Bent 690 83 12.0% • Boulder 32949 1746 5.3% • Broomfield 6296 131 2.1% • Chaffee 1366 65 4.8% • Cheyenne 257 31 12.0% • Clear Creek 825 30 3.6% • Conejos 789 40 5.0% Costilla 344 17 5.0% • Crowley 635 76 12.0% • Custer 295 14 4.8% • Delta 3791 383 10.1% • Denver 81509 5476 6.7% • Dolores 251 25 10.1% • Douglas 40650 639 1.6% • Eagle 5778 170 2.9% El Paso 84628 1144 1.4% • Elbert 2287 274 12.0% • 39 Data Source:Colorado Health Institute(2008—2009) Snapshot#8: Early Childhood Population Eligible but Not Enrolled in Child Health Plan Plus 45 • or Medicaid, 2008—2009 • • November, 2011 Colorado Early Childhood Needs Assessment • • • Percent of Children 0 - 8 years of age Eligible but Not • Medicaid or CHP+ Eligible Enrolled in Medicaid or • County Total children (ages 0-8) but Not Enrolled CHP+ • Fremont 3880 186 4.8% • Garfield 7202 776 10.8% • Gilpin 421 15 3.6% Grand 1726 51 2.9% • Gunnison 1936 57 2.9% • Hinsdale 110 3 2.9% • Huerfano 739 37 5.0% • Jackson 259 28 10.8% • Jefferson 55439 3110 5.6% • Kiowa 187 22 12.0% • Kit Carson 922 111 12.0% La Plata 5984 605 10.1% • Lake 1084 32 2.9% • Larimer 33455 1686 5.0% • Las Animas 1429 72 5.0% • Lincoln 701 84 12.0% • Logan 2360 283 12.0% • Mesa 18660 2004 10.7% Mineral 115 3 2.9% • Moffat 2168 234 10.8% • Montezuma 3245 328 10.1% • Montrose 4553 460 10.1% • Morgan 3128 375 12.0% • Otero 1908 96 5.0% • Ouray 519 15 2.9% • Park 1221 59 4.8% Phillips 516 62 12.0% • Pitkin 2063 61 2.9% • Prowers 1667 200 12.0% • Pueblo 18450 636 3.4% • Rio Blanco 984 106 10.8% • Rio Grande 1166 58 5.0% . Routt 3238 349 10.8% • • Snapshot#8: Early Childhood Population Eligible but Not Enrolled in Child Health Plan Plus 46 or Medicaid, 2008-2009 • • November, 2011 Colorado Early Childhood Needs Assessment • Percent of Children 0-8 • years of age Eligible but Not • Medicaid or CHP+ Eligible Enrolled in Medicaid or • County Total children (ages 0-8) but Not Enrolled CHP+ • Saguache 556 28 5.0% San Juan 76 8 10.1% • San Miguel 898 91 10.1% • Sedgwick 316 38 12.0% • Summit 3266 96 2.9% • Teller 1728 83 4.8% • Washington 567 68 12.0% • Weld 39521 2281 5.8% • Yuma 1133 136 12.0% • • • • • • • • • • • • • • • • • • • Snapshot#8: Early Childhood Population Eligible but Not Enrolled in Child Health Plan Plus 47 • or Medicaid, 2008—2009 I I ri a I �rl w aJ O Lt vi c i ' N COtp _.;e"I `� U)I U i f0 N ° '_' `� I O b• U _C � I O L (6 —ma,CU �' cact' ro LL •O O _ vi Ori 0 ....3. ] o0 -- Cr " (� v) i v) (o I O ' i___ti� tz 9. O CCl _C 4 S N _ E rts w (13 (17 (1? 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( 4_, V },CD CU Ill a) cc CU ta0 4—I bp iii) LA Q t w iir if) n a] Y ww Oi_ i F a CCL • s - w GC co LIJ Cif CA ro Lx 'CS i o #a w jr 401• CCU o VI W z t� _ w w 0 > a p O w c=� O w La V1 4�- Zern • O w = O aO L + + V ja- • O)i IP Uce 4:t (0 o C 'O 0 l _c O C co 06 tts in Wo ca c Cef LfGo I- z 4J O Q O CO� VI CD C s- # ._ _I �� a sy V C N UO e crs • O a, O p o U40 4 - N a m \c.jc5 tt Ill rai d w O MI O • O ni Li. ICI m 0 o• E _ +- coL j C? Icr - J to N fo (0 I . j L �"' = O CU w o `"�. C O • o — O v O • t J %._ V O a V1 N # O • O z ________L____ _ • 1/4, _ �.� _ m v m oo • F- Q -o a cn • • November, 2011 Colorado Early Childhood Needs Assessment • • Snapshot#11: Statewide Early Childhood Home Visitor Programs in Colorado, 2010 • • Home visiting programs offer a variety of family-focused services to expectant parents and • families with new babies and young children through age five. They address issues such as • maternal and child health, positive parenting practices, safe home environments, and access to services. The following map illustrates the location of statewide early childhood home visitor • program offices. Note: these program offices may provide program services to counties outside • of the program office county. Below is a brief description of each early childhood home visitor • program. Data Source: Each program provided data via the 2010 Affordable Care Act Maternal, • Infant and Early Childhood Home Visiting Program Statewide Needs Assessment. . Bright Beginnings helps families support their children's physical, emotional, and intellectual • development during the critical first three years of life. Note: location data was available at the • county level so it is presented this way in the map. • The Colorado Home Intervention Program (CHIP) provides in-home, family-centered early • intervention services to children who are deaf or hard of hearing and their families, from birth • to age three. Home visits are conducted by a masters-prepared early interventionist, and are • typically one hour in length, with the frequency varying from one to four times per month. • • Early Head Start (EHS) is community-based, and serves low-income pregnant women, and families with infants and toddlers. The comprehensive, two-generation program includes • intensive services that begin before the child is born and concentrate on enhancing the child's • development and supporting the family during the critical first three years of the child's life.40 • Home Instruction for Parents of Preschool Youngsters (HIPPY) utilizes a peer-delivery model • where trained parents (from the population served) provide weekly, one-hour home visits for • 30 weeks, working one-on-one with parents of preschool children, ages 3-5. • The Nurse-family Partnership (NFP)targets low-income, first-time mothers and their children. • The NFP serves low income, first-time mothers. The client enrolls voluntarily by the 28th week • of pregnancy. Home visits continue up until the child's second birthday. • Parents as Teachers (PAT) is an early childhood home visitation program serving families from • prenatal to age five. For families identified as having high needs, visits can occur several times 4111 per month and last about 1.5 hours. The visits are designed to share child development and • parenting information, plus engage parents in meaningful parent-child interaction.41 • 40 Ibid. • 01 Melissa Kelley,Executive Director,Colorado Parent&Child Foundation • Snapshot#11: Statewide Early Childhood Home Visitor Programs in Colorado, 2010 50 • • • • • ci, O O • 2O d 0 U) • d O 0) c- a41- r N r • w ~ C ri O = co a �- C c 0 -cr r `Iin • C O LI C 5 E = _ = aLi_ < q) �` cc CO c N rn U.1 Q U w w = Z a o m r CV r o • © w c N ma. © o ° 0 0 . 0 0 w .a' ei o • N O Q °- CO 6 O • -D LL OO o fC U W © C • L O N # cc Nw co L tie • O 1• '� f I 1_4-0 • si. 4 u ,N Illi s_ 0 0 3 • N �-�_ u t z ° i 1O ® in en ce et • .a U O 2 a W ` • ro 4 l- ca cn CO ' a 0cn A L r O ( _ �„to LaoCAltb _..., ) 1 • Cll 3i 4 • z 4..CD UU Y LL r g ..C ill g it Q • . .ro f0 -- 3 0.1 xu u aO CU v S ,� < < fJ a (3 C 4 (n` W 4 IIP .d CZ �"� 5 % � s z Z D CI ri 'S 3 a z J -j x J U o o s • co I _Z_ . L) in r' Z Q. 4 Y d z all a re z ri Pt . UN a ?al, ti a� $ o . od (14C— III Cll o il i i -- 0 0 0 • • November, 2011 Colorado Early Childhood Needs Assessment ' • Appendix A: Early Childhood Resources • • • • Early Childhood Report Resources • Colorado Early Childhood Councils by the Numbers: • http://www.cde.state.co.us/early/ECC.htm • • Framework in Action State Plan 2010 - 2012: • http://earlychildhoodcolorado.org/search/?searchword=framework+in+action • Kids Count in Colorado, 2010: http://www.coloradokids.org/facts/kids count/kids count.html • • 2010 Colorado Statewide Needs Assessment for the Maternal, Infant, and Early Childhood Home Visitation Program: http://www.cdphe.state.co.us/ps/mch/ECHVgrantlnfo.html • • School Readiness Indicators Project: • httn://www.cde.state.co.us/cdeadult/documentLlB.htm • Smart Start Outcomes and Evaluation Task Force: • httn://chsa.omni.org/CHSA HomeReadMore.aspx • • Early Childhood Data Resources • American Community Survey: • http://factfinder.census.gov/servlet/DatasetMainPageServlet? program=ACS& submenul • d=& lang=en& ts= • Colorado Children's Health Study: • http://www.cdphe.state.co.us/hs/mchdatajmchdata.html • • Colorado Department of Education: http://www.cde.state.co.us/index stats.htm • Colorado Department of Human Services: http://www.colorado.gov/cs/Satellite/CDHS- • SelfSuff/CBON/1251590081279 • • Kids Count in Colorado: http://www.coloradokids.org/facts/kids count/online data.html • National Survey of Children's Health: http://www.nschdata.org/Content/Default.aspx Appendix A: Early Childhood Resources 52 • • • • November, 2011 Colorado Early Childhood Needs Assessment • 411 Appendix B • • • • Figure 12 : High, Low, and Moderate Risk Colorado Urban Counties Based on Analysis from the • Risk Assessment (N=17) • • ; riorc.. I JACKS i:, -i.i • ___PHILLIPS _ • MORGAN �� GRAND YIJNIA • tl k- :.I-:L-LL = NN6MNti'PON w• EkRLrrL.D EAGLE : I' .• 'c SUIMAIT Cr.t .L�—..._.-) • _ ____ 4 Urban Communities at Risk DOUGLAS a BERT qT CARSON . I + L Low Risk Counties (6) Ill I LINCOLN -` Moderate Risk Counties (5) DELTA Z TELI FP Z CNAFFFE F P' Pen" , ..j High Risk Counties (6) • 'hI II l t j a __ _____ _ • MOIiTRon _/'L. rktt,„o„i„,_---,. —, \___ ____ . , i.c.,/,....„ _ ,00,. . SNI LL% DALEI.JL &AGUACHEittpuzkueiBENT I PROINERS . f%7LORE5 , ) OTERO _ JV I MMERAL i sac cn10 're • /! ( RIO GRANGE 7 J.( ALA/AOSA �\ JI MOUTfZUMA -I • r1 LA PIMA cOSTRWL Lere LASAI*MAs RAGA JJ ARGNUIEI• i tMt+J05 • _ _ - • • • • li ill II Ill • • • 11 Appendix B: Risk Assessment Maps 53 411 III November, 2011 Colorado Early Childhood Needs Assessment , I Figure 13: High, Low, and Moderate Risk Colorado Rural Counties Based on Analysis from the I Risk Assessment (N=24) 1 I I I lsCiC ;ial `. LARIMER p YT3FFAti _rr_ %echo -Tog _. I I GRAIIO EIOUICER ' RN7RlMCC irootAns.b NaRSM11GTc11 i YUMA -----d�� ADAMS CREAR - � � -�ppp err F=GLE CREEK !r ARAPAHCE I EPF • _ ' s; 1e6lir — JSONYe Rural Communities at Risk lOCVGLAS KIT CARSONELE I I:5.ria. j Low Risk Counties (7) , - MK ' _ — "sesA uNCOLN Moderate Risk Counties (12) , Cam TEttER aR*so High Risk Counties (5) C:�•• eE — ' 'iUNN159N R¢Pit kUSE _ Fk56kV R KIOWA I I �..IRAY -- . _ PUEBLO _ I SAGIJACNE 1 6ANi�611Et NSCALEr—tb, 1l : i„ rcror,v;. �`L, f3;'S / OOIORES _SAN JUNI i,/ 1 �b / ^ _ _ - RIO GRANGE 11 J/ 1 4..;.,ti FYV+da tt L., FL“.... , T COS,11EUi L�f LA54Naw ' 1 i I I I I I I I I Appendix B: Risk Assessment Maps 54 I • 0 • November, 2011 Colorado Early Childhood Needs Assessment • • Figure 14: High, Low, and Moderate Risk Colorado Frontier Counties Based on Analysis from • the Risk Assessment (N=23) • __ I--' • „_:._, _1.:!•c.: LARIMER 1 • I L • - LIDRGIt�I GAMED mom DER Klo&mco i i (_ -- — wAS+MNan7H WM. • J ( \-. i j— ADAMS - uEAR GARAELO EAGLE)I ARARUM • rd KJT CARB Frontier Communities at Risk casous L18£R• oDi • PlTgt! J LAKE r Low Risk Counties (9) LEua C,..N1 Moderate Risk Counties (10) [ ' :NE • cHASFEE L�vaso High Risk Counties (4) ', u:, nl • I LIJMRO}E FRRCJT n.-.:•. I rim • cl IH?r — . Al2 O'TERO • 1, FA►n WIC E2UmArsel • J LA PI MA• 1 nC� LASiANIMAS 9Arrt --/- - ARDIULETA !' .__'-.- 1\ • • III ID Ill Ill ill Ill II II SI II • Appendix B: Risk Assessment Maps 55 • • November, 2011 Colorado Early Childhood Needs Assessment • • Appendix C: Indicator Descriptions • • • • Population • • 1. Total Population (number) Population estimates provided by the Colorado Demography Section, Colorado Department • of Local Affairs (2010). Estimates collected on July 29, 2011. • • 2. Early Childhood Population (0 through 8 years of age) (number) • Number of children 0 through 8 years of age. Population estimates provided by the Colorado Demography Section, Colorado Department of Local Affairs (2010). Estimates • collected on July 29, 2011. • • 3. Early Childhood Population with Hispanic Ethnicity (0 through 8 years of age) (number) • Number of children 0 through 8 years of age of Hispanic ethnicity. Population estimates • provided by Elizabeth Garner, State Demographer, Colorado Demography Section, Colorado • Department of Local Affairs (2010). • 4. Speaks Language Other than English at Home (percent) • Number of persons 5 years and older who sometimes or always speak another language • other than English at home divided by the total population surveyed. Five -year estimates • obtained from the American Community Survey, U.S. Census Bureau (2005 - 2009). • • Early Learning • 5. 3rd Grade Students Scoring Proficient or Above on Reading CSAP (percent) • Percent of students in 3rd grade who scored proficient or above on the 2010 Colorado State • Assessment Program (CSAP) in reading. Data provided by the Colorado Children's • Campaign, original data source is the Colorado Department of Education (CDE). CDE does • not report CSAP data if the number of students taking the test is too small; suppressed data • are indicated by low number of events (LNE). County data are based on scores from the districts that comprise each county. • • 6. 3rd Grade Students Scoring Proficient or Above on Math CSAP (percent) • Percent of students in 3rd grade who scored proficient or above on the 2010 Colorado State • Assessment Program (CSAP) in math. Data provided by the Colorado Children's Campaign, original data source is the Colorado Department of Education (CDE). CDE does not report • CSAP data if the number of students taking the test is too small; suppressed data are • indicated by low number of events (LNE). County data are based on scores from the • districts that comprise each county. Appendix C: Indicator Descriptions 56 • • • • November, 2011 Colorado Early Childhood Needs Assessment 7. Individual Family Service Plan (0 through 3 years of age) (percent) • Number of children 0 through 3 years of age with an Individual Family Service Plan divided • by the total number of children 0 through 3 years of age. Data provided by the Colorado • Department of Human Services (October 1, 2009). Results from the Early Childhood Longitudinal Study Birth Cohort(sample of 10,200 children) indicate that among children 24 • months of age, approximately 13 percent of children were eligible for Part C early intervention.1 These study results indicate a higher prevalence of developmental delays than • initially estimated. Study authors suggest that the current intervention service rate of two • percent set by the United States Department of Education for the birth-through-three age population may be underestimating the true percentage of children eligible for Part C • intervention.2 Screening and early identification of children at risk for developmental delay • enables timely referral and access to early intervention services that can improve children's • developmental trajectories and long-term outcomes.3 • 8. Individual Education Plan (3 through 5 years of age) (percent) • Number of children 3 through 5 years of age with an Individual Education Plan. In 2010, a • total of 11,753 children 3 through 5 years of age had an Individual Education Plan. Of these, • a county was assigned for 10,086 and the other 1,667 were served by Boards of • Cooperative Educational Services (BOCES). The estimates presented are therefore an underestimate of the true numbers of children 3 through 5 years of age with an Individual • Education Plan. Data provided by the Colorado Department of Education (December 1, • 2010). • 9. Days of Full Attendance During the Elementary School Year (percent) • Total days attended for all students divided by the total days possible to attend by all • students. Data provided by the Colorado Department of Education (2010). Extended • periods of school absence may be an early sign of distress in school, community or home.4 • 10. Kindergarteners in Full-Day Program (percent) • Number of kindergartners enrolled in full-day kindergarten divided by the number of • students enrolled in all public kindergarten programs. Data provided by the Colorado • Department of Education (2010). Benefits of full-day kindergarten include greater • academic success and improved social skills. • • • • 'Rosenberg,S.A.,Zhang, D., Robinson, C.C. Prevalence of Developmental Delays and Participation in Early • Intervention Services for Young Children. Pediatrics 2008; 121;e1503-e1509. Ibid. 20 • 3 Schor, E. (2007,July). EPSDT,well-child care and children's development. In E.Schor(Chair). Presented at the • ABCD Screening Academy learning session, Houston,Texas. 4 Chang, H.N.and Romero, M. Present, Engaged,and Accounted For:The Critical Importance of Addressing Chronic • Absence in the Early Grades. National Center for Children in Poverty, 2008. • Appendix C: Indicator Descriptions 57 • • November, 2011 Colorado Early Childhood Needs Assessment • • Family Support • 11. Families NOT Reading to Children 3 or more Days per Week(percent) • Number of children 1 through 5 years of age whose family members read to them less than • 3 days per week divided by the number of children 1 through 5 years of age whose parents • responded to this survey question (excludes unknowns and refusals). Health statistics • regional data provided by the Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment (2006 - 2010). • • 12. Families Relying on Low Cost Food (percent) • Number of parents of children 1 through 14 years of age who often or sometimes rely on a • few kinds of low-cost food to feed a child because they were running out of money to buy food divided by the total number of children 1 through 14 years of age whose parents • responded to this survey question (excludes unknowns and refusals). Health statistics • regional data provided by the Colorado Child Health Survey, Health Statistics Section, • Colorado Department of Public Health and Environment (2008 - 2010). • Social, Emotional, and Mental Health • • 13. Children with Mental Health/Behavioral Issues (percent) • Number of children 1 through 14 years of age with mental health/behavioral issues divided • by the number of children 1 through 14 years of age whose parents responded to this • survey question (excludes unknowns and refusals). Health statistics regional data provided • by the Colorado Child Health Survey, Health Statistics Section, Colorado Department of Public Health and Environment (2008 - 2010). • • 14. Children with Mental Health/Behavioral Issues Receiving Treatment(percent) • Number of children 1 through 14 years of age with an identified mental health/behavioral issue who are receiving treatment divided by the total number of children 1 through 14 • years of age whose parents responded to this survey question (excludes unknowns and • refusals). Health statistics regional data provided by the Colorado Child Health Survey, • Health Statistics Section, Colorado Department of Public Health and Environment (2008 - • 2010). • 15. 3 or More Stressful Events During Pregnancy (percent) • Number of women who report 3 or more stressful events during pregnancy divided by the • total number of women responding to this survey question (excludes unknowns and • refusals). Health statistics regional data provided by the Colorado Pregnancy Risk Assessment and Monitoring System, Health Statistics Section, Colorado Department of • Public Health and Environment (2007 - 2009). • • 16. Health Care Provider Talked to Mother about Pregnancy-Related Depression (percent) • Number of women whose healthcare provider discussed what to do during pregnancy or • after delivery if they felt depressed divided by the total number of women responding to • Appendix C: Indicator Descriptions 58 • • • • • • November, 2011 Colorado Early Childhood Needs Assessment • this survey question (excludes unknowns and refusals). Health statistics regional data • provided by the Colorado Pregnancy Risk Assessment and Monitoring System, Health • Statistics Section, Colorado Department of Public Health and Environment (2009). • • 17. Out of Home Placements (rate per 1,000) Number of children removed from their homes by the Department of Human Services per • 1,000 children under age 18. Data provided by the Colorado Children's Campaign, original data source is the Child Welfare Services, Department of Human Services (2010). Health 18. Children Exposed to Secondhand Smoke (percent) • Number of children 1 through 14 years of age who are exposed to secondhand smoke • divided by the total number of children 1 through 14 years of age whose parents responded to this survey question (excludes unknowns and refusals). Health statistics regional data provided by the Colorado Child Health Survey, Health Statistics Section, • Colorado Department of Public Health and Environment (2008 - 2010). The current • Colorado Winnable Battle public health indicator reports secondhand smoke exposure • among children 1 through 14 years of age who live with a smoker in the home. The five-year Colorado estimate(2006-2010) is 34 percent This estimate is much higher than the percent of all children exposed to secondhand smoke, 6.8 percent(2008- al 2010). The later indicator was chosen to ensure availability of regional data. • 19. Women Smoking During the Last 3 Months of Pregnancy (percent) Number of women smoking during the last three months of pregnancy divided by the total number of women who responded to this survey question (excludes unknowns and • refusals). Health statistics regional data provided by the Colorado Pregnancy Risk • Assessment and Monitoring System, Health Statistics Section, Colorado Department of Public Health and Environment (2007 - 2009). • 20. Breastfeeding at 6 Months of Age (percent) • Number of children 1 through 5 years of age whose mother breastfed them at six months of age divided by the number of children 1 through 5 years of age whose parents responded • to this survey question (excludes unknowns and refusals). Health statistics regional data • provided by the Colorado Child Health Survey, Health Statistics Section, Colorado • Department of Public Health and Environment (2006 - 2010).This indicator is a Colorado • Winnable Battle public health indicator. • 21. Overweight and Obese Children (percent) Number of children 2 throughl4 years of age with a body mass index (calculated off of • height and weight) placing them in the overweight and obese category divided by the • number of children 2 through 14 years of age (with a height and weight) whose parents responded to this survey question (excludes unknowns and refusals). Health statistics regional data provided by the Colorado Child Health Survey, Health Statistics Section, • Colorado Department of Public Health and Environment (2008 - 2010). This indicator is a • Colorado Winnable Battle public health indicator. • Appendix C: Indicator Descriptions 59 • • November, 2011 Colorado Early Childhood Needs Assessment • • 22. Provider Screening for Developmental, Communication,and Social Behavior Issues (percent) • Number of children 1 through 5 years of age whose parents were asked by a healthcare • provider to fill out a questionnaire about development, communication, or social • behavioral issues divided by the number of children 1 through 5 years of age whose parents responded to this survey question (excludes unknowns and refusals). Health • statistics regional data provided by the Colorado Child Health Survey, Health Statistics • Section, Colorado Department of Public Health and Environment (2008 - 2010). • 23. Dental Visit by Age 1 (percent) • Number of children 1 through 5 years of age who visited the dentist by 12 months of age • divided by the number of children 1 through 5 years of age whose parents responded to • this survey question (excludes unknowns and refusals). Health statistics regional data • provided by the Colorado Child Health Survey, Health Statistics Section, Colorado • Department of Public Health and Environment (2006 - 2010). This indicator is a Colorado Winnable Battle public health indicator. • • 24. Children with Health Insurance (percent) • Number of children 1 through 14 with any kind of health care coverage (private, HMO's, • governmental plans) (insurance divided by the total number of children 1 through 14 years of age whose parents responded to this survey question (excludes unknowns and refusals). • Health statistics regional data provided by the Colorado Child Health Survey, Health • Statistics Section, Colorado Department of Public Health and Environment (2008 - 2010). • • • • Appendix C: Indicator Descriptions 60 • • • • November, 2011 Colorado Early Childhood Needs Assessment • • Appendix D: County Data Profiles • • The county data profiles contain a select group of 24 population, early learning, family • support, social, emotional, and mental health, and health indicators.A complete description • of each indicator is available in Appendix C. • Because of sample size issues, data from two of the population-based data sources • (Colorado Child Health Survey and the Colorado Pregnancy Risk Assessment Monitoring • System) were reported at the health statistics region level. Since county-level data are often • unavailable for many rural and frontier counties health statistics region data was used to ensure some estimate could be provided. County-level data from the Colorado Child • Health Survey and Colorado Pregnancy Risk Assessment Monitoring System are • regional estimates with the exception of Adams,Arapahoe, Denver, Douglas, El Paso, • Jefferson, Larimer, Mesa, Pueblo, and Weld Counties. Counties in each Health Statistics Region Region 1: Logan, Morgan, Phillips, Sedgwick, Washington, Yuma • Region 2: Larimer • Region 3: Douglas Region 4: El Paso Region 5: Cheyenne, Elbert, Kit Carson, Lincoln • Region 6: Baca, Bent, Crowley, Huerfano, Kiowa, Las Animas, Otero, Prowers • Region 7: Pueblo . Region 8: Alamosa, Conejos, Costilla, Mineral, Rio Grande, Saguache Region 9: Archuleta, Dolores, La Plata, Montezuma, San Juan • Region 10: Delta, Gunnison, Hinsdale, Montrose, Ouray, San Miguel • Region 11: Jackson, Moffat, Rio Blanco, Routt • Region 12: Eagle, Garfield, Grand, Pitkin, Summit Region 13: Chaffee, Custer, Fremont, Lake • Region 14: Adams • Region 15: Arapahoe • Region 16: Boulder, Broomfield • Region 17: Clear Creek, Gilpin, Park, Teller Region 18: Weld Region 19: Mesa Region 20: Denver . Region 21: Jefferson For counties in which data is missing, data was either unavailable or was suppressed. For data obtained from the American Community Survey, data were suppressed if estimates were unstable, defined as having a margin of error greater than 50 percent. 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TS m 00w W C U ro En CoGsz • eu 8 C 1.3 ` O_ E W W a.+ • W = ^` CO VI II Ncu 4. a W — C C/1 ¢ r. ca • v)J 5 ,`- Wtr i9 u .n a t 65(1g lei a; II tn _ S n zs O it o W e7@ W , (0• Y--di. i ! a. c cL) RI �/ ' co t 4) : • c U cti W -- � U o0 • y �^I V ts LL S co <. a 2 •1J • u r lU y, 1--• 0 CD O Y g 8 t o • U N o o e, • r-- • • • • 0 1 1 November, 2011 Colorado Early Childhood Needs Assessment 1 1 Appendix F: Guidance Document for Early Childhood Professionals 1 This guidance document was created to help early childhood professionals and other 1 stakeholders interpret the data and information presented in the Colorado Early Childhood 1 Needs Assessment. Why use this guidance document? 1 The guidance document will help make sense of the data presented and help make it 1 useable for activities such as: • Local Early Childhood Systems Assessments and Strategic Planning • Assist with Early Childhood Grant Opportunities • Communicating with Grant Funders about Local Early Childhood needs and 1 priorities 1 • Conducting routine needs assessments (education, public health, mental health, etc.) 1 that involve the early childhood population • Planning Community-based Early Childhood Literacy Initiatives • Local Health Integration Planning • Activities to build public awareness and engagement 1 • Communication with policymakers and state agencies about local needs and 1 priorities Should I work through the guidance alone or collaborate with partners? 1 While individual study is encouraged,the purpose of this guidance document is to facilitate 1 a discussion with groups of stakeholders to assist policy makers, programs, and early childhood professionals to make data-driven decisions. Working collectively through the guidance will help early childhood professionals prioritize needs and activities at the local level. 1 A few key questions to consider during this process: 1 1. Looking across all of the indicators presented,what is happening with children and families in your community? 2. Which of these key issues do you address in your current work? 1 3. What is the story behind this data in your community? 1 4. Where do you see an opportunity to integrate collaborative solutions? 5. What are the informal and formal opportunities to put this data to use? How can I better understanding the data presented? 4 The needs assessment contains many different types of data from different data sources. 1 For example, all of the data presented from the Colorado Child Health Survey is regional data and not county-level data except for a few large counties (i.e. Denver, Larimer, etc.). It's important to read footnotes and clarifications. In addition,the following definitions are provided to help you better understand the data presented. 4 I Appendix F: Guidance Document for Early Childhood Professionals 150 4 I I • November, 2011 Colorado Early Childhood Needs Assessment •• • Census—refers to a total count. A census is taken by systematically acquiring and recording information about all the members of a given population. Examples of • census-based data include some early learning indicators (i.e. 3rd grade proficiency on • the CSAP, kindergartners in full-day program, etc.), which are derived from data about • all children in school. Other census data come from the U.S. Census, which is carried out • every 10 years and counts all residents in the U.S. • • American Community Survey-The American Community Survey (conducted by the • U.S. Census Bureau) provides demographic data for Colorado such as estimates of the • age of the population every year (i.e. early childhood population 0 through 8 years of • age). Data from the American Community Survey is derived from a sample of the population and not from the whole population; these data are subject to margins of error. Estimates with a margin of error greater than 50 percent are deemed unstable • and data are suppressed. • • Prevalence estimates- the number of cases of the risk factor in the population • (numerator), divided by the number of individuals in the population at a given time • (denominator) multiplied by 100. The prevalence, expressed as a percentage, is an • estimate of how common a risk factor is within a population. • Prevalence estimates are provided from the Colorado Child Health Survey (i.e. percent • of families NOT reading to children 3 or more days per week, or percent of children • exposed to secondhand smoke) and the Colorado Pregnancy Risk Assessment and • Monitoring System (i.e. percent of women smoking during the last three months of • pregnancy). Data are suppressed for estimates with fewer than 50 survey respondents. • • Rates- refers to the number of people affected by an event (numerator), divided by the • number of persons in the population who are at risk of experiencing the event • (denominator) within a specified time frame multiplied by 1,000 or 100,000. For example, out of home placement rates are usually expressed per 1,000 population, and • deaths due to neglect and abuse are expressed per 100,000 population. Using these • different multipliers provides an easier way than using percentages to express the • frequency of relatively rare events. • Small Numbers- It is especially important to remember that small numbers affect . percentages and rates. Typically, rates based on large numbers provide stable • estimates of the true, underlying rate. Conversely, rates based on small numbers may • fluctuate dramatically from year to year, or differ considerably from one small place to another small place, even when there is no meaningful difference. Small numbers of • events and/or a small population size can be misleading by making a problem seem • more acute than it actually is. • • . Appendix F: Guidance Document for Early Childhood Professionals 151 • • November, 2011 Colorado Early Childhood Needs Assessment • Step 1: Meaning Behind the Data (30 Minutes) � This step requires the group to assess the data from the risk assessment analysis • conducted as part of the Colorado Early Childhood Needs Assessment. Take a few minutes to review the methods and answer the following questions. Question 1: Looking at Figures 9 through 11, find your county(ies). Indicate how • many of the indicators are low risk(green), mixed risk (black), and high risk(red). • Low Risk (Green) Mixed Risk (Black) High Risk(Red) • Question 2: Write out the high-risk indicators (in red), the county estimate, and the • state estimate. • • High Risk Indicator County Estimate State Estimate • • • al A. Did any of these estimates surprise you? If so, which ones and why? • ill • • B. Are there partners at the table currently addressing these issues? If no,who is • missing that might provide insight into these estimates? • • • • Appendix F: Guidance Document for Early Childhood Professionals 152 . • • • November, 2011 Colorado Early Childhood Needs Assessment Question 3: Write out the low-risk indicators (in green), the county estimate,and the state estimate. • • Low-Risk Indicator County Estimate State Estimate • • A. Did any of these estimates surprise you? If so,which ones and why? Ill B. Are there any partners at the table currently addressing these issues? If no,who II is missing that might provide insight into these estimates? Ill Ill ID ID ID C. What other assets may help to explain these desirable results? • ID ID 5 Appendix F: Guidance Document for Early Childhood Professionals 153 ID November, 2011 Colorado Early Childhood Needs Assessment • • Step 2: Understanding Your County Data (30 Minutes) • Looking at the indicators in the County Data Profiles, answer the following for each of the • four system domains. 5 Question 4: Do any of the early learning indicators stand out? If so,which ones?Why • do they stand out(i.e.lower than the state average, much higher than the state • average)? Please explain. • • • I Question 5: Do any of the family support indicators stand out? If so,which ones?Why do they stand out(i.e.lower than the state average, much higher than the state average)? Please explain. • 41, Question 6: Do any of the social, emotional,or mental health indicators stand out? If ; so,which ones?Why do they stand out(i.e.lower than the state average, much higher than the state average)? Please explain. • Appendix F: Guidance Document for Early Childhood Professionals 154 • • • November, 2011 Colorado Early Childhood Needs Assessment • • Question 7: Do any of the health indicators stand out? If so,which ones?Why do they stand out (i.e. lower than the state average,much higher than the state average)? • Please explain. • • • • • • Step 3: Assessing Resources (30 Minutes) • Question 8: Looking across all of the Snapshots presented in the Needs Assessment, • what are your early childhood resources? Ill Question 9: Thinking about all of the resources in your community, do these resources match the needs of the early childhood population in your community? If not,what additional resources are needed to support the early childhood • population? ID Ill Ill Il Ill Il Appendix F: Guidance Document for Early Childhood Professionals 155 • November, 2011 Colorado Early Childhood Needs Assessment • • Step 4: Reflection (30 Minutes) • Question 10: Looking across all of the indicators presented,what is happening with • children and families in your community? • • • Question 11:Which of these key issues do you address in your current work? • • Question 12: What is the story behind this data in your community? • • Question 13: Where do you see an opportunity to integrate? • • Question 14: What are the informal and formal opportunities to put this data to use? • • • Appendix F: Guidance Document for Early Childhood Professionals 156 • Hello