New York Early Intervention

7232019 New York Early Intervention

httpslidepdfcomreaderfullnew-york-early-intervention 116

A PLACE TO GET STARTED

Copyright copy 2015 by ZERO TO THREE All r ights reserved

In the world o public policy innovative approaches andsolutions can make the difference between achieving

long-held goals and maintaining the status quo States areincubators or innovative ideas and oen set the trendsabout which policy strategies build momentum and which do not For the early childhood field this is an ex-citing time o policy innovation More attention is beingocused on the earliest years o lie than ever beore in ournationrsquos history Across states this new awareness aboutthe early years is translating into creative policy strategies

that promote responsible government while specificallyaddressing the needs o children prenatally to 3 years old

Research shows that to ensure a good start in lie allinants and toddlers need good health strong amiliesand positive early learning experiences Programs andservices that address these areas are critical however theyare only as strong as the inrastructure that supports themWhen states build comprehensive coordinated systems ohigh-quality prenatal-to-5 services it is possible to makethe most efficient use o resources to meet the needs o theyoungest children and their amilies

There is much to be gained by looking at how your statecan build on the strengths o existing state programs andtake new innovative steps toward a coordinated compre-hensive system o services or inants toddlers and theiramilies This paper eatures some o the inantndashtoddlerpolicy strategies currently garnering attention and provides examples o how states are implementing themThe approaches eatured here are only a sample o ideasabout where to begin in your work on inant and toddlerpolicy For a more complete array o policy options that

your state could consider download a copy o ZERO TOTHREErsquos Early Experiences Matter Policy Guide Additionalinormation on how states are implementing the strate-gies included in this paper and others that impactinants toddlers and their amilies can be ound in ZEROTO THREErsquos Baby Matters Database A Gateway to State

Policies and Initiatives

When reading these examples you may ask yoursel ldquoHowdid the states eatured here make their innovations hap-

pen And where did they startrdquo Our experience teaches usthat there is no wrong place to begin In act each state isunique and will ocus on the inantndashtoddler system areathat makes the most sense in its particular context To helpguide you through this process ZERO TO THREE devel-oped Infants and Toddlers in the Policy Picture a state sel-as-sessment tool With the assessment in hand A Place to GetStarted can act as a jumping-off point or your statersquos in-antndashtoddler strategic planning ZERO TO THREErsquos work with states has made it clear that collecting and analyzingdata is important in this process and can drive the policychoices you make It is critical to gather basic inormation

about the inants and toddlers in your state such as howmany children are under 3 years old where inants andtoddlers are being cared or and the economic environ-ment in which amilies with young children are living Inaddition states find it valuable to assess current policiesand practices that impact new policy decisions The keyis to start somewhere and be thoughtul about how yourpolicy choices fit within the context o a broader system osupports or inants toddlers and their amilies No mat-ter where you get started the ZERO TO THREE PolicyCenter is here to support your efforts

Innovation in Infant and Toddler State Policies





Copyright copy 2015 by ZERO TO THREE All r ights reserved 2

FEATURED POLICY STRATEGIES AT A GLANCE Page

Include an inantndashtoddler ocus in the priorities o collaborative planning and governance structures 3

Promote coordination across services that support expectant parents inants toddlers and their amilies 5

Implement a cross-sector proessional development system to support the inantndashtoddler workorce 7

Include a specific ocus on inants and toddlers in Quality Rating and Improvement Systems 9

Articulate an intentional strategy or maternal inant and early childhood mental health and embed itinto services and systems

10

Embed a developmental approach into child welare services or inants toddlers and their amilies 12

Maximize existing unding and create new financing mechanisms to sustain and expand services or

inants toddlers and their amilies

13

Include measures o inantndashtoddler health development and well-being in the statersquos desired outcomesor children and monitor key indicators

15

Policy Strategies Building a comprehensive coordinated early childhood system that addresses the developmental needs o inants andtoddlers requires strategies that cross the boundaries o agencies and programs The policies eatured in this paper il-lustrate concrete effective approaches that contribute to such a system Promising state examples are described beneatheach policy strategy

Photo Credits (page 1 le) copy iStockphotocomDragonImages

(page 1 right) copy iStockphotocommonkeybusinessimages

(top) copy iStockphotocomFamVeld

(bottom) copy iStockphotocomphakimata





When setting up effective planning and governancestructures or state early childhood programsColorado recognized that they needed a oundation upon which policy and planning decisions could be based Theresult was the creation o the Early Childhood Coloradoramework in 2008 which has become the rallying pointor all early childhood systems work in the state Coloradorsquosramework was developed by a diverse group o stakeholdersthat was spearheaded by the Lieutenant Governorrsquos officeand included all relevant state agencies as well as localnonprofits oundations universities and other privateorganizations It outlines the access quality and equity

outcomes that the early childhood system is aiming toachieve in the areas o early learning amily support andparent education social emotional and mental healthand health The ramework also describes the strategiesthat the state uses to attain the outcomes listed Inantsrsquoand toddlersrsquo needs are well-represented in the ramework which makes it easier or the state to think intentionallyabout the ull continuum o services that young childrenand amilies need The upront work o developing acommon vision has enabled the state to take advantage onew opportunities It provides the oundation or work

being done through the Early Learning ChallengeMaternal Inant and Early Childhood Home Visiting(MIECHV) program Project LAUNCH and other ederalgrants that benefit babies and their amilies

Thirty-one local Early Childhood Councils across thestate are tasked with implementing the ramework at thecommunity level The Councils were created throughlegislation in 2004 to improve and sustain the availabil-ity capacity accessibility and quality o early childhoodservices They consist o early childhood service providers

law enorcement business community leaders parentsand others The state has worked with the local councilsby (a) providing them system-building grants to betteralign services and (b) conducting public awareness out-reach The Early Childhood Leadership Commission is

updating the ramework in 2015 to incorporate the latestresearch and knowledge on early childhood and to reflectthe statersquos progress over the last 7 years

Washingtonrsquos Birth-to-3 Plan Forms theFoundation for Future Decision-Making

In response to legislation that was passed in early 2010three organizationsmdashWashingtonrsquos Department o Early

Learning the Office o Superintendent o Public Instruc-

tion and privately unded partner Thrive Washingtonmdashco-led an effort to develop a comprehensive birth-to-3state plan Many early learning stakeholders were involvedin the development o the plan which outlines actionablepolicy recommendations to improve services and achievemeasurable outcomes or inants toddlers and their am-ilies Many o the recommendations build on strategiesidentified in Washingtonrsquos Early Learning Plan a 10-yearplan to ensure school readiness or all children (prenatalto third grade) in the state Like the Early Learning Planthe birth-to-3 plan organizes recommendations aroundseven core areas childrenrsquos health and developmental well-being home visiting parents as their childrenrsquos firstand most important teacher amily riend and neighborcare high-quality proessionals and environment childcare subsidies that promote parent choice and access toaffordable care and inrastructure partnerships and mo-bilization

The policy recommendations serve as the oundation orbuilding statewide inrastructure making unding de-cisions developing public will and scaling up efforts to

Coloradorsquos Early Childhood FrameworkLeads to Opportunities forInfantndashToddler Planning

Include an infantndashtoddler focus in the priorities ofcollaborative planning and governance structures

Many states are developing coordinated governance structures or planning bodies to develop and implement a visionor a high-quality state early childhood system rom prenatal or birth through school entry or through third grade

When building this inrastructure state leaders have an opportunity to include specific inantndashtoddler policypriorities that are closely linked to the statersquos broader goals to improve outcomes or young children





achieve measurable success One o the innovative strate-gies resulting rom the plan was the creation o regionalearly learning coalitions and regional inantndashtoddlersteering committees These groups allow or enhancedtwo-way conversations between the state and regionalstakeholders as well as coordinated efforts or childrenbirth through 3 years old within the regions For exampleeach o the 10 regional coalitions worked with its steering

committee to develop models or providing inantndashtoddler child care consultation services based on findingsrom regional data summaries This important work hassignificantly improved the services and supports available

or young children and their amilies and has also raisedthe visibility o the work and its impact in local communities across the state to policymakers and legislators

Photo Credits (top) copy iStockphotocomIPGGutenbergUKLtd

(middle) copy iStockphotocommichaeljung

(bottom) copy iStockphotocombobbieo





Promote coordination across services that supportexpectant parents infants toddlers and their families

When amilies with very young children are in need o support one o the greatest challenges is navigating thearray o services and the differing processes that each service entails States can increase amiliesrsquo access to and

use o appropriate services by coordinating screening and reerral activities that take place in a variety o settingsincluding doctorrsquos offices child care centers and home visits establishing central intake hubs where amilies can

connect to multiple types o services at the same time and providing care coordination

Illinois Targets Developmental Screeningas a Model for Coordinating Services

Illinois has a long history o engaging in efforts to en-sure that all inants and toddlers have developmentaland social-emotional screenings and receive ollow-upsupports and services In 2003 the Commonwealth Fundlaunched its second phase o the Assuring Better ChildHealth and Development (ABCD II) a national initiativedesigned to assist states in improving the delivery o earlychildhood development services or low-income childrenand their amilies Through this initiative Illinoisanalyzed state Medicaid policy to identiy policy changesthat could promote better coordination improvescreening delivery and connect amilies with services

through reerrals Policy changes included adjustmentsto physician billing or screening during well-child visitsclarification o Part C early intervention eligibility orphysicians the use o both the Ages and Stages Ques-tionnaire (ASQ) and the Ages and Stages QuestionnaireSocial Emotional (ASQ-SE) as valid and reliable toolsor screening and flexibility or physicians to screenthe mother in order to identiy perinatal depressionUltimately all changes were made administratively andno legislation or state plan amendments were necessaryIllinois was also a recipient o an ABCD III grant in 2009 which allowed the state to continue its work to strengthenlinkages across screening reerral prevention and treat-ment programs A particular ocus was improving theconnection between early intervention and health careproviders This work continues to be expanded through-out the state and additional progress has been made insharing inormation through electronic transer o inor-mation and more timely communication

In Illinoisrsquo Quality Rating and Improvement SystemExceleRate Illinois a key element o a high-qualityprogram is ensuring that children and amilies obtain

screenings and reerrals or services To support programsin achieving this requirement Illinois has developed ascreening resource guide and sample agreements withearly intervention and local education agencies Universaland periodic developmental and social-emotional screen-ing is also at the center o a number o statewide strategicplans related to community systems mental health andhealth All o these efforts will advance the statersquos goal oensuring that a coordinated system exists so that all inantsand toddlers and their amilies can have their needs identified and addressed early

Connecticut Puts Developmental NeedsFirst With Help Me Grow

In the 1990s Connecticut applied a developmentalapproach to how it connected at-risk children with the

services they needed With Help Me Grow (HMG) Con-necticut a system or improving access to existingresources or children birth to 8 years old there is acentral point o contact or amilies o young childrenas they navigate services and coordinate care The Child

Development Inoline which is a specialized call center othe United Way o Connecticutrsquos 2-1-1 system is the accesspoint or HMG Rather than providing direct servicesHMG builds collaboration across sectors including childhealth care early care and education and amily sup-port Through comprehensive physician and communityoutreach and centralized inormation and reerral centersamilies are linked with needed programs and services





Doctors who received training rom HMG were twice aslikely to identiy and reer children or services aer beingtrained HMG Connecticut connected more than 2000amilies to more than 3000 services in 2014 Ongoing datacollection and analysis help identiy gaps in the systemand barriers to accessing resources As the program hasgrown new efforts are adding targeted attention to inantsand toddlers HMG Connecticut recently embarked on acampaign to raise public awareness o the need or earlyidentification and intervention through the developmen-tal screening o 2-year-olds in a number o Connecticutcommunities This effort includes statewide and local pro-motion activities as well as local events involving parentsproessionals and community partners

The HMG concept has been so well-received that itevolved to include national expansion efforts including aNational Center based at Connecticut Childrenrsquos MedicalCenter initially unded by the WK Kellogg FoundationThe National Center expanded HMG to 19 affiliate statesand continues to work toward expansion o the modelnationwide The Help Me Grow National Center (HMGNational) is developing a comprehensive data system tosupport HMG affiliates with data collection tracking andutilization

Photo Credits (top) copy iStockphotocomleungchopan

(middle) copy iStockphotocommolka

(bottom) copy iStockphotocomJBryson





Implement a cross-sector professional development systemto support the infantndashtoddler workforce

Proessionals working with young children and amiliesmdashwhether in child care home visiting programs or othersettingsmdashneed the skills to effectively support childrenrsquos development and learning Although all states offer training

opportunities to inantndashtoddler proessionals leading states are building a coordinated cross-sector proessionaldevelopment system that leverages state resources to build the capacity o the inantndashtoddler workorce

Community- and State-Level AssetsStrengthen Californiarsquos

InfantndashToddler Workforce

At the community level Los Angeles County ismaking great strides in the area o cross-sectorcompetencies or the inantndashtoddler workorce First 5LA partnered with the ZERO TO THREE Western Office(ZTT) to acilitate the Prenatal through Three WorkorceDevelopment Project The project began with the orma-tion o a workgroup o community experts in five sectorsthat comprise the P-3 workorce (early care and educationearly identification and intervention inant and earlychildhood mental health physical health and socialserviceschild welare) Through an exhaustive literaturereview o existing competencies the workgroup identified

sector-specific competencies and used them to inorm thedevelopment o the P-3 Cross-Sector Core Competenciesor the multidisciplinary workorce in Los AngelesCounty In addition ZTT is developing online training andcommunities o practice orging new relationships withservice providers and creating county and state policy rec-ommendations to better oster cross-sector partnershipsWith continued investment rom First 5 LA a process iscurrently underway to encompass competencies neededby proessionals serving young children 3ndash5 years old andtheir amilies

Caliorniarsquos Early Childhood Educator Competenciesdeveloped by the state Department o Education andadministered by the Caliornia Child DevelopmentTraining Consortium (CDTC) provide the rameworkunder which proessional development opportunities arestrengthening Caliorniarsquos inantndashtoddler workorce Oneo CDTCrsquos services is a training portal that offers 122inant- and toddler-ocused trainings or courses CDTCalso hosts the Caliornia Community Colleges Curricu-

lum Alignment Project (CAP) which developed a pro-gram o study or early care and education teachers thatincludes eight courses on the earliest years o child devel-opment CAP added ldquoInant Toddlerrdquo as a specialty areaand 12 colleges now offer one or both o the approved

Inant Toddler courses WestEdrsquos Program or Inant Toddler Care (PITC) curriculum offerings can be accessedthrough the CDTC training portal Through PITC morethan 7000 people have been trained as trainers and cen-ters or groups o amily child care providers receive onsitetraining observation and coaching rom inantndashtoddlerspecialists

New Mexicorsquos InfantndashToddlerProfessional Development Track

Builds a Strong Workforce for the State

With a mandate rom the New Mexico Office oChild Development (OCD) in 1996 New

Mexico created a statewide system o proessional devel-opment or the workorce across various sectors working with children rom birth through 8 years old and theiramilies The proessional development system includes atrack or Family Inant Toddler Studies Proessionals whopursue this track are primarily home visitors and earlyinterventionists striving to work toward an associatersquos or abachelorrsquos degree and corresponding levels o certification

A Career Lattice illustrates how Family Inant ToddlerStudies corresponds to other early childhood courses ostudy and assists providers in identiying career path op-portunities as they obtain deeper knowledge and trainingThe state created the NewMexicoKidsorg website as aportal that eatures resources or state providers amiliesOCD staff training and technical assistance providers andparticipants in the Tiered Quality Rating and Improve-ment System (TQRIS) all in one place





Early childhood proessionals administrators andinantndashtoddler specialists who wish to obtain certification inFamily Inant Toddler Studies are able to expand their proes-sional skills as defined by core knowledge and competenciesInant-toddler-specific content is spread throughout the com-petencies The Family Inant Toddler pathway includes corecourses and upper-division courses specifically or theinantndashtoddler workorce Associatersquos degree students ocus

on courses in relationship building caregiving or inantsand toddlers and inantndashtoddler growth and developmentBachelorrsquos degree students including those going into earlyintervention and home visiting take courses in research as-sessment public policy and advocacy and reflective practiceInant mental health competencies are integrated into allcoursework or those wishing to obtain endorsement

Photo Credits (top) copy iStockphotocomHalpoint

(middle) copy iStockphotocomKTPhoto

(bottom) copy iStockphotocomcrPrin





New York Raises the Bar on InfantndashToddlerCare Program Standards and

Incentivizes Quality Improvement

Field-tested in 2010 New Yorkrsquos QUALITYstarsNY is aproject o the statersquos Early Childhood Advisory Coun-

cil (ECAC) and provides program quality standards oreach modality o early childhood programs (centerspublic schools and amilyhome providers) Currentlymore than one third o programs participating in QUALI-TYstarsNY serve inants and toddlers Inantndashtoddlerprogram standards are a key component o the system andreflect the unique needs o this age group The inantndashtoddler program standards address daily interactions andrelationships physical learning environments develop-mental screening and assessments curriculum children with special needs environmental saety and physicalhealth nutrition and physical activitymdashall rom thedevelopmental perspective o the very youngest childrenOne example o an inantndashtoddler standard is as ollowsldquoProgram promotes the quality and continuity o teacherndashchild relationships through teacher training teacherscheduling and other policies such as ensuring no morethan one transition within the childrsquos first two yearsrdquo

In addition to the standards QUALITYstarsNY provides

participants with financial supports or quality improvementSupports typically come in the orm o grants materialsupplies and scholarships or staff training and credit-bearingcoursework For instance PITC trainers provide onsite tech-nical assistance to inantndashtoddler programs and scholarshipsare offered to providers seeking the statersquos inantndashtoddler cre-dential and the inantndashtoddler Child Development Associate(CDA) With additional resources coming into the systemQUALITYstarsNY intends to expand financial incentives tohelp programs bridge the gap between the cost o providingquality care and the ees that they are able to charge amilies

Include a specific focus on infants and toddlersin Quality Rating and Improvement Systems

State early care and education (ECE) Quality Rating and Improvement Systems (QRIS) are an increasinglycommon state approach to measuring and improving the quality o ECE programs Through QRIS states defineseveral tiers o ECE program quality and programs volunteer to receive a quality rating States typically provide

financial support and technical assistance to participating programs to improve quality and share ratingspublicly to inorm parent choices Because many o the programs participating in QRIS serve

inants and toddlers state leaders have an opportunity to ensure that QRIS standards and supports reflectbest practices in providing high-quality ECE or the youngest children

Indianarsquos Paths to QUALITY Recognizesthe Unique Developmental Needs

of Infants and Toddlers

Indianarsquos QRIS Paths to QUALITY is a voluntarystatewide rating system or early care and education

programs It began as a local initiative in the 1990s and was implemented statewide in 2008 aer an evaluationshowed that participating providers made significant qual-ity improvements over a 3-year period Participating providers include licensed child care centers licensed childcare homes and unlicensed registered child care min-istries The levels o Paths to QUALITY move providersrom basic health and saety with licensure or voluntaryregistration at Level 1 to national accreditation at Level

4 Levels 2 and 3 are aligned with the statersquos early learn-ing guidelines and ocus on environmental supports tochildrenrsquos learning and a planned curriculum that guideschildrenrsquos development and school readiness Providersmust meet all o the requirements or the previous levels(including those specific to inants and toddlers i applicable) in order to advance or maintain a level rating

Adding to the systemrsquos success is the way in which it differenti-ates the needs o inants and toddlers rom older children byidentiying particular requirements that must be met when

caring or the youngest children Specific inantndashtoddlerstandards are included at all levels o Paths to QUALITY inrecognition that inants and toddlers have different develop-mental needs than older children Inantndashtoddler indicatorscover continuity o care providerndashchild interactions materialsdaily schedules and language and literacy development Inaddition Indianarsquos statewide network o Inant Toddler Special-ists provides training and individualized technical assistance asneeded including to programs participating in Paths to QUALI-TY that care or inants and toddlers Currently more than halo licensed child care programs in Indiana that serve inants andtoddlers participate in Paths to QUALITY





Michiganrsquos Pioneer Spirit OffersProfessional Opportunities for itsEarly Childhood Mental Health System

Michigan is a pioneer in the I-ECMH field creating copy-righting and licensing competency standards and an en-

dorsement system to promote inant mental health The stan-dards and the endorsement recognize proessionals rom manydisciplines who incorporate inant mental health principlesinto their work with amilies as well as mental health proes-sionals who specifically work with the mental health needs oinants toddlers and parents at risk or with identified mental

health conditions In the mid-1990s the Michigan Departmento Education (MDE then the lead agency or Part C early intervention) assembled representatives rom the early interventionfield who recommended five areas o core competency or thestatewide proessional development plan A number o people who participated in the proessional development planningprocess were members o the Michigan Association or InantMental Health (MI-AIMH) a nonprofit association whosemission is to promote inant mental health principles andpractices across systems o care MI-AIMH built upon the PartC standards by providing the perspective and reflective process

o I-ECMH and systems expertise The association expandedthe core competencies to include a broad array o proessionalsrom education health and mental health fields and designat-ed our levels o competencymdashinant amily associates inantamily specialists inant mental health specialists and inantmental health mentors

In 2002 aer several years o working with the MI-AIMHCompetency Guidelinesreg as training and proessional development standards that promote inant mental health

Articulate an intentional strategy for maternalinfant and early childhood mental health

and embed it into services and systemsInant and early childhood mental health (I-ECMH) sometimes reerred to as ldquosocial and emotional developmentrdquois how children rom birth to 5 years old develop the capacity to orm secure adult and peer relationships experiencemanage and express a ull range o emotions and explore the environment and learnmdashall in the context o amilycommunity and culture Because the parentndashchild relationship is a critical component o early development themental wellness o adults plays a critical role in how very young children develop States can improve young childrenrsquos

social and emotional development by implementing strategies along a promotion prevention and treatment contin-uum and embedding maternal and I-ECMH supports into all aspects o the early childhood system

MI-AIMH proessionals developed a workorce devel-opment plan the MI-AIMH Endorsement for CulturallySensitive Relationship-Focused Practice Promoting Infant

Mental Healthreg The standards and the endorsement pro-cess proved important to many outside o Michigan By2014 20 state inant mental health associations two largechildrenrsquos agencies and one international inant mentalhealth organization had entered into licensing agreementto use the MI-AIMH Competency Guidelinesreg MI-AIMH

Endorsement reg or both In 2014 MI-AIMH divided intotwo organizations MI-AIMH (ocused on state efforts)and the Alliance or the Advancement o Inant Mental

Health (ocused on continued national and internationalactivity specific to global support or use o the MI-AIMHCompetency Guidelinesreg and the MI-AIMH Endorsement reg research and practice)

Ohiorsquos Maternal Depression ScreeningProgram Creates Synergy Between

Home Visiting and Mental Health Services

In 2004 the Ohio Department o Mental Health and Ad-

diction Services (MHAS) the Ohio Department o Health(ODH) pediatricians mental health providers and home visitors came together to improve awareness and screeningor maternal depression The Ohio Pediatric Research Con-sortium partnered with the state agencies to train primarycare pediatricians and pediatric residents who screen andreer mothers with or at risk o depression In 2006 MHASand ODH worked together to develop a Maternal Depres-sion Screening and Response Program (MDSR) Aer apilot phase in seven counties MDSR became a required





component o Ohiorsquos home visiting and early interventionprogram or expectant first-time and other parents at high-est risk MDSR operates in all 88 counties

In 2012 the screening became mandatory in order ormothers to participate in the home visiting program andit remains optional or mothers participating in the Part Cearly intervention program Positive screens are reerred toparticipating community mental health therapists or services which are delivered concurrently with home visitingThere is regular contact between mental health providersand home visitors with cross-system training and monthly

conerence calls to support mutual problem solving resolveissues and motivate ongoing participation Home visitorsattend one o the final therapy sessions to review the impact

o treatment and to acilitate ollow-up support Early HeadStart and mental health screeners have also become involved with the MDSR A web-based data system is utilizedto enter screening inormation and make acilitated mentalhealth reerrals Data are analyzed and shared with partici-pating programs which allows or better communicationbetween the program and MHAS around services providedto mothers and young children in each county

Photo Credits (top) copy iStockphotocom monkeybusinessimages

(middle) copy iStockphotocompetrograd99

(bottom) copy iStockphotocom Vstock





Arkansas Promotes Stability for VeryYoung Children in the Child Welfare System

In Arkansas state and community leaders are recognizingthat stability or inants and toddlers in the child welare

system can be dramatically improved when stakeholdersacross service sectors work together to provide developmen-tally appropriate services The Arkansas Sae Babies CourtTeam which operates within the 10th and 11th DivisionCircuit Courts in Pulaski County exemplifies this vision bybringing together a team o more than 50 members rom 12different disciplines to provide comprehensive developmen-tally appropriate support to inants and toddlers in the child welare system The Court Team incorporates a developmen-tal approach into child welare services by engaging in theollowing strategies concurrent planning holding monthlyCourt Team meetings with all service providers to prob-lem-solve systemic issues and track amiliesrsquo progress acili-tating Family Team Meetings or amilies involved with theSae Babies Court Team increasing parentndashchild visitationand providing mental health services or birth parents andchildren to improve the parentndashchild relationship

In addition Arkansasrsquo Project PLAY (Positive Learning orArkansasrsquo Youngest) promotes quality and stability in childcare or children within the oster care system ProjectPLAY is a partnership between the University o Arkansasor Medical Sciences the Department o Human Services

(DHS) Division o Child Care and Early Education andthe DHS Division o Children and Family Services ProjectPLAY (a) prioritizes early childhood mental health consul-tation services or centers serving children in oster care(b) engages in broad educational outreach about the impor-tance o high-quality stable child care placements to case workers oster parents the courts and Court AppointedSpecial Advocates volunteers and (c) creates materials orchild care providers that better prepare them to supportchildren who have experienced trauma

Embed a developmental approach into child welfare servicesfor infants toddlers and their families

Children under 3 years old are the age group most vulnerable to child abuse and neglect and its aermath And yetmost child welare services and policies do not consider the unique developmental needs o the inants and toddlers

in their care By inusing guiding principles or inant and toddler development into child welarepractices and policies states can help to ameliorate the adverse effects o maltreatment on very young children

Hawaii Is at the Forefront of DevelopmentallyAppropriate Practice in Child Welfare

H

awaii is taking a number o steps to ensure that itschild welare system is intentionally addressing the

unique developmental needs o the inants and toddlersin its care The statersquos ocus on training o staff and osterparents demonstrates a commitment to the very youngest vulnerable children For example oster parents receivesupplemental training on how to serve as partners withbirth parents oen serving as mentors to help them bettersupport their childrenrsquos healthy development Two stateprograms ocus on special training or oster parents ochildren rom birth to 3 years old (a) Project First Caretraining intended or placements o 60 days or ewer where reunification or relative placement is highly likelyand (b) Hale Malama a program or oster parents omedically ragile inants and toddlers In addition Hawaiirsquos

Keiki Placement Project was created to ensure ocused effortto place children rom birth to 3 years old with relativesThe project increased placements with kin and has sinceended because making timely relative placements oryoung children has been successully integrated into regu-lar practice

Recognizing the importance o maintaining relationshipsbetween young children and their birth parents Hawaiirequires more requent visitation between birth parents

and young children in oster care than most other statesmdashat least 3 hours per week in natural settings like the osterhome parks and libraries The state also instituted theAttachment Behavioral Catch-Up Program which is anoptional service within the child welare systemrsquos con-tracted home visiting program or inants and toddlersin oster care This evidence-based program uses speciallytrained practitioners to conduct a 10-week curriculumaimed at improving parentsrsquo sensitivity attachmentand involvement with their babies and toddlers using astrengths-based approach





Maximize existing funding and create new financing mechanismsto sustain and expand services for infants toddlers and their families

Programs serving inants toddlers and their amilies historically have been developed in a patchwork ashion in responseto specific needs To provide the coordinated and comprehensive early childhood services that very young children and

their amilies need states must develop fiscal policies that incentivize braiding and blending o unding streams andleveraging o ederal state local and private dollars across systems Thinking creatively about how to prioritize inants

and toddlers in state budgetsmdashthrough set-asides or specific line itemsmdashcan also increase access to services

History of Creative FinancingPuts Kansas on the Map

Since 1998 Kansas has used creative state financing

approaches to supplement ederal unding or theEarly Head Start (EHS) program Former Governor BillGraves first approved the transer o Temporary Assistanceor Needy Families (TANF) block grant unds to theChild Care and Development Block Grant (CCDBG) toestablish the state-unded EHS program In subsequentyears policymakers utilized state general revenue Chil-drenrsquos Initiative Funds rom tobacco settlement dollarsand ederal CCDBG quality set-aside unding to servechildren birth to 4 years old and pregnant women Thishistory o innovation set a useul precedent when thestate launched an effort to create the Kansas Early Child-

hood Block Grant (ECBG) to (a) support high-qualityevidence-based child development services or at-risk in-ants toddlers and their amilies and (b) expand and en-hance preschool opportunities or 3- and 4-year-olds TheECBG and Smart Start Kansas programs were combinedin 2013 and received a total o $181 million in dedicatedunding rom the Childrenrsquos Initiative Fund At least 30o the ECBG unding must be spent on programs orat-risk inants and toddlers Grantees are required to raisea 10 cash match New tobacco settlement payments areassigned to the Childrenrsquos Initiative Fund which supportsthe ECBG as well as other initiatives In Fiscal Year 2015

$1778 million was awarded through the ECBG in theorm o 25 grants to school districts Head Start and EarlyHead Start providers child care centers and community-based programs that provide evidence-based program-ming to at-risk children Grantees expect to serve morethan 4500 children birth to 3 years old with these undsIn February 2015 Kansas transerred $12 million rom theKansas Endowment or Youth (KEY) Fund to address thegap between revenue and the approved FY2015 budget

Blending Funds for Home Visiting Leads toEnhanced Coordination in Rhode Island

Rhode Islandrsquos 2005 early childhood system plan Suc-cessul Start provided the oundation upon which

state leaders could seize opportunities to expand servicesto support the healthy development o the statersquos young-est children The plan identified the need or sustainableblended unding streams across agencies as well as en-hanced evidence-based home visiting services or amilies

with young children at high risk Rhode Island KIDSCOUNT a state policy and planning organization workedas the intermediary organization to identiy and bringtogether all o the state agencies and programs utilizing various ederal unding streams related to home visitingTogether they collaborated to identiy goals and out-comes o the various unding streams (eg to prevent andreduce child maltreatment to improve maternal economicsel-sufficiency to improve child and maternal health)and mapped those onto the goals and outcomes o home visiting programs The points o overlap and intersectionbecame opportunities or agencies to pool unding

In 2008 Rhode Island was awarded a 5-year ederalEvidence-Based Home Visiting (EBHV) grant to workacross agencies to establish and sustain an anchor NursendashFamily Partnership site When the ederal MaternalInant and Early Childhood Home Visiting (MIECHV)program was established the Rhode Island Department oHealth was able to capitalize on the initial collaborativecross-agency work to dramatically expand evidence-based

The KEY Fund is the endowment that makes transerseach year to the Childrenrsquos Initiative Fund Although this will have no impact on current ECBG grantees it couldresult in less money being available in the uture





home visiting programs in the state (adding Healthy Fam-ilies America and Parents as Teachers) and build strongcross-agency reerral service coordination and continuousquality improvement systems or home visiting Rhode

Island also leveraged resources through Part C early

intervention Community-Based Child Abuse PreventionTANF and Medicaid Blended unding not only increasedservices or amilies but it enhanced collaboration andprompted critical discussions about service coordination

program standards and proessional development

Photo Credits (top) copy iStockphotocomwebphotographeer

(middle) copy iStockphotocomhanhanpeggy

(bottom) copy iStockphotocommichaeljung





Include measures of infantndashtoddler health developmentand well-being in the statersquos desired outcomes

for children and monitor key indicators

Many states have identified measurable outcomes or children and amilies within state strategic plans and otherplanning processes Yet ew state plans include outcomes on the health development and well-being o inants and

toddlers Articulating outcomes that are specific to children under 3 years old and regularly collecting and analyzingdata related to those outcomes can equip states with the inormation they need to assess current practices and make

changes necessary to improve their early childhood systems

Vermontrsquos Data Reporting SystemHelps Build Bright Futures for

Their Infants and Toddlers

Building Bright Futures (BBF) the governance structure orVermontrsquos early childhood system leverages the capacity o

Vermontrsquos communities to improve child and amily well-beingBBF serves as a conduit between 12 regional councils and thestate by connecting resources convening stakeholders commu-nicating inormation and promoting early childhood systemimprovements to better outcomes or all Vermont children Part o BBFrsquos governance unction includes acquiring and re-porting data on key indicators o well-being or inants tod-dlers and their amilies such as early prenatal care and low

birth weight rates To accomplish this BBF sponsors VermontInsights a web-based early childhood data reporting systemVermont Insights is a data hub or current early childhooddata systems as well as a place to house integrated prenatal tograde 12 data in the uture It also includes economic hous-ing transportation environmental and public saety datarom related public nonprofit and private data sourcesData elements specific to inants and toddlers are intentionallyincluded when analyzing questions o child well-being Forinstance data collected to answer the policy question ldquoAre ouryoung children achieving optimal health and developmentrdquo

includes inantndashtoddler data elements ranging rom earlyprenatal care rates and low birth weight to developmentalscreening and high-quality early childhood experiences Dataelements are collected through data-sharing agreements (ensur-ing that individual-level data is protected and kept confidential) with governmental and nongovernmental organizations at thenational state and local levels they are also acquired throughpublic datasets such as the Census Bureau Vermontrsquos long-term vision is to integrate and use these data to track child amilyand community well-being stimulate dialogue and learningand inorm policy and investments so that childrenrsquos healthdevelopment and learning flourish

Pooling Data Across Agencies GivesMinnesota a Roadmap to

Improve InfantndashToddler Well-being

In 2012 the Minnesota Department o Health (MDH) was asked to lead the creation o a plan or improving

the health and well-being o children prenatal through 3years old in order to eliminate health disparities based onrace ethnicity and geography Stakeholders involved in theprocess began by developing a PrenatalndashAge Three Frame- work which is intended to be a roadmap or uture actionOne o the key eatures o the ramework is a set o desiredoutcomes in health education well-being and systems orchildren prenatal through 3 years old their amilies andtheir communities Indicators were identified to track each

outcome Much o the data needed or tracking the indica-tors was already being collected but stakeholders neededto identiy which agencies had the data to fit each indi-cator and ensure that the correct data were being pulledto match indicator definitions Examining the data acrossagencies is allowing Minnesota to gain a greater under-standing o how policies influence very young childrenand their amilies in their communities

Concurrently MDH was also delving deeper into the issueo health equity or all its citizens by looking at the social

determinants o health many o which are rooted in earlychildhood Because some o the same people at MDH wereinvolved in both processes it allowed or a cross-pollinationo ideas Minnesota also has been looking more closelyat its data on young children disaggregated by race andethnicity This data breakdown brought to light significantdisparities especially in inant mortality Now Minnesota istaking steps to develop policy system and environmentalinnovations to address racial inequity or the prenatal to 3years old population and their amilies




ConclusionWithin states across the country leaders are working collaboratively and creatively to provide a solid uture or young children and

their amilies And although programs and services exist to support early childhood the specific developmental needs o inants

and toddlers can oen prove more challenging or states to address A Place to Get Started hopes to ease this process or your state

We find that learning rom one another is an effective tool or states that are striving to take the next steps toward a coordinatedcomprehensive system o services or inants toddlers and their amilies By building on the innovations happening within states

together we can establish the types o early childhood systems that our youngest children need to develop grow and thrive

About UsThe ZERO TO THREE Policy Center is a nonpartisan research-based nonprofit organization committed to promoting thehealthy development o our nationrsquos inants and toddlers To learn more about this topic or about the ZERO TO THREE PolicyCenter please visit our website at wwwzerotothreeorgpublic-policy

Authors Debbie M Rappaport ZERO TO THREE Policy Center Consultant Jamie Colvard Technical Assistance SpecialistAllyson Dean Senior Technical Assistance Specialist and Barbara Gebhard Assistant Director o Public PolicyMarch 2015

ZERO TO THREE National Center or InantsToddlers and Families Baby Matters DatabaseA Gateway to State Policies and Initiativeshttppolicydbzerotothreeorgpolicyphomeaspx

Early Experiences Matter Policy Guide wwwzerotothreeorgpublic-policypolicy-toolkit

Inants and Toddlers in the Policy Picture A StateSel-Assessment

wwwzerotothreeorgpublic-policypolicy-toolkit checklistsinglesmar5pd

Arkansas

Arkansas Sae Babies Court Team wwwzerotothreeorgmaltreatmentsae-babies-court-teamarkansas-sae-babies-courthtml

Project PLAY (Positive Learning or ArkansasrsquoYoungest)httpamilymedicineuamseduresearch-and-schol-arly-activity-continuing-medical-education-cme community-research-amily-and-preventive-medicine ecpdprojectplay

CaliforniaChild Development Training Consortiumhttpswwwchilddevelopmentorgcscdtcprintht-docsabouthtm

Program or InantToddler Care

wwwpitcorgpubpitc_docshomecsp

First 5 LA Prenatal through Three Workorce Devel-opment Project

wwwfirst5laorgindexphpr=sitearticleampid=1636

ColoradoColorado Early Childhood Framework httpearlychildhoodcoloradoorgResourceCenter tabid93ID235ECC-Frameworkaspx

Connecticut Connecticut Help Me Grow

wwwctgovoeccwpviewaspa=4544ampq=535732

Help Me Grow National Center wwwhelpmegrownationalorg

HawaiiState Child Welare Policies and Practices thatSupport Inants and Toddlers Webinarhttpwwwzerotothreeorgpublic-policywe-binars-conerence-callsstate-child-welare-poli-cies-and-practiceshtml

Hale Malama wwwcatholiccharitieshawaiiorgprogramsgovern-ment-agency-reerrals

IllinoisIllinois ABCD Project

wwwnashporgabcd-stateillinois

ExceleRate Illinois wwwexcelerateillinoiscom

IndianaPaths to QUALITYhttpchildcareindianaorg

KansasBuilding on the Promise State Initiatives to Expand

Access to Early Head Start or Young Children andTheir Families (p 27)httpmainzerotothreeorgsiteDocServerBuilding_on_the_PromisepddocID=5281

Early Head Start Initiative wwwzerotothreeorgpublic-policypdstate-ehs-pro-fileskansas-ehspd

MichiganNurturing Change State Strategies or ImprovingInant and Early Childhood Mental Health (pp 8ndash9)

wwwzerotothreeorgpublic-policypdnurtur-ing-changepd

Inant Toddler and Early Childhood Mental HealthCompetencies A Comparison o Systems (pp 12ndash13)

wwwzerotothreeorgpublic-policypdinant-men-tal-health-reportpd MinnesotaPrenatal to Three Planning Process

wwwhealthstatemnusdivscfprogrampto3

Prenatal to Age Three Framework wwwhealthstatemnusdivscfprogrampto3contentdocumentpdrameworkpd

New MexicoNew Mexico Kidshttpsnewmexicokidsorg

New YorkQUALITYstarsNYhttpqualitystarsnyorgindexphp

OhioNurturing Change State Strategies or Improving In-ant and Early Childhood Mental Health (pp 12ndash13)


Inant Toddler and Early Childhood Mental HealthCompetencies A Comparison o Systems (pp 15-16)

wwwzerotothreeorgpublic-policypdinant-

mental-health-reportpd

Rhode IslandMaternal and Child Home Visiting

wwwhealthrigovhomevisiting

Vermont Vermont Insightshttpvermontinsightsorg

WashingtonBirth to Three Plan

wwwdelwagovpublicationsresearchdocsBirthto-3Planpd

SOURCES




Copyright copy 2015 by ZERO TO THREE All r ights reserved 2

FEATURED POLICY STRATEGIES AT A GLANCE Page

Include an inantndashtoddler ocus in the priorities o collaborative planning and governance structures 3

Promote coordination across services that support expectant parents inants toddlers and their amilies 5

Implement a cross-sector proessional development system to support the inantndashtoddler workorce 7

Include a specific ocus on inants and toddlers in Quality Rating and Improvement Systems 9

Articulate an intentional strategy or maternal inant and early childhood mental health and embed itinto services and systems

10

Embed a developmental approach into child welare services or inants toddlers and their amilies 12

Maximize existing unding and create new financing mechanisms to sustain and expand services or

inants toddlers and their amilies

13

Include measures o inantndashtoddler health development and well-being in the statersquos desired outcomesor children and monitor key indicators

15

Policy Strategies Building a comprehensive coordinated early childhood system that addresses the developmental needs o inants andtoddlers requires strategies that cross the boundaries o agencies and programs The policies eatured in this paper il-lustrate concrete effective approaches that contribute to such a system Promising state examples are described beneatheach policy strategy

Photo Credits (page 1 le) copy iStockphotocomDragonImages

(page 1 right) copy iStockphotocommonkeybusinessimages

(top) copy iStockphotocomFamVeld

(bottom) copy iStockphotocomphakimata






















































































































































H








































































Arkansas







































SOURCES






















































































































































H








































































Arkansas







































SOURCES



































































































































H








































































Arkansas







































SOURCES

























































































































H








































































Arkansas







































SOURCES








































































































H








































































Arkansas







































SOURCES































































































H








































































Arkansas







































SOURCES












































































H








































































Arkansas







































SOURCES



































































H








































































Arkansas







































SOURCES














































H








































































Arkansas







































SOURCES

























H








































































Arkansas







































SOURCES














H








































































Arkansas







































SOURCES



































































Arkansas







































SOURCES
















































Arkansas







































SOURCES





































Arkansas







































SOURCES















Arkansas







































SOURCES

Documents

New York Early Intervention