Oh, Baby! Getting it Right from the Start April 2012 J.M. Gruendel 1

Whats Inside 2 Four Fast Facts Unpacking the DCF Year One Transformation Moving Forward in Connecticut A Few Points to Ponder Web Resources

Four Fast Facts about Young Children in Connecticut 1.About 40,000 babies are born in CT each year, although the number is declining each year 2.One quarter (or more) of the states younger children experience elevated stress in their lives due to adverse childhood experiences. Among children birth to three, this equals about 30,000 youngsters at any point in time. 3.Fewer than half of entering kindergartners consistently demonstrate basic readiness skills. This means that – each year -- about 20,000 five-year olds are not fully ready for the grand adventure of schooling. 4.On any given day, the Department of Children and Families has 7400 children ages birth through 6 on its caseload, about 1400 of which are in placement. Of these, about 4300 are ages birth through three. 3

4 Experiences Build Brain Architecture: Harvard Center on the Developing Child To open in Slide Show, click on the Play Button To open in PPT, right click on the Play Button

THE YEAR 2 AGENDA STRAIGHT TALK & PARTNERSHIP POLICY CHANGES AND RESULTS YEAR 1 SIX CROSS CUTTING THEMES FOUR STRUCTURE CHANGES MISSION REVISION DCF Transformations 5

MISSION REVISION Each day the Department serves 25,000 – 30,000 children and youth on its caseload. To serve them, and their families, more effectively, we have shifted from a focus predominantly on safety and placement to the following: All children and youth served by the Department will grow up healthy, safe and learning, and will experience success in and out of school. The Department will advance the special talents of the children it serves and will make opportunities for them to give back to the community. 6

In January-February of 2011, the new administration found a department with a very with a siloed and chain-of- command structure in its structure in Central Office, facilities that operated functioned like islands, and a 20-year old federal child welfare lawsuit. Four structural changes were quickly implemented: 1.Elimination of CO service bureaus and creation of two divisions based on a Collaborative Team Leadership model 2.Consolidation of two DCF mental health facilities into the Albert J. Solnit Childrens Center, North & South Campuses 3.Creation of a 6 th region and re-envisioning the regions as comprehensive childrens service systems 4.Launch of the DCF Academy for Family and Workforce Knowledge and Development 7 FOUR STRUCTURE CHANGES

SIX CROSS CUTTING THEMES 1.Expanding family-centered policy and practice 2.Increasing trauma-informed practice 3.Applying of the neuroscience of child and adolescent development 4.Improving state interagency, family and community partnerships 5.Improving leadership, management and accountability 6.Building a learning organization 8

Toxic Stress Derails Healthy Development: Harvard Center on the Developing Child To open in Slide Show, click on the Play Button To open in PPT, right click on the Play Button

POLICY CHANGES & RESULTS YEAR 1: Placements 1.Congregate Care Rightsizing and Redesign Report July We all need somebody: Supporting Children, Families & the Workforce in CTs Family Foster Care System September 2011 A nearly 50% decrease in out-of-state placements from 364 to 192 and congregate placements for children ages 12 and young from 163 to 92 Nearly eliminating congregate placements for children ages 6 and younger, from 38 to 6 A 54% increase in the number of initial placements going into kinship care (i.e., relative and special study care) No negative Juan F measures: No increase over this period in in- or out-of-home repeat maltreatment, a slight decrease in re- entry to DCF custody, and no change in multiple placements. 10

1.Statewide implementation a Strengthening Families Practice Model with four core components, beginning in 2011: Family Engagement Purposeful Visits Family Assessment Family Teaming (begin 2012) 2.Implementing a Differential Response System, called the Family Assessment Response (FAR) System, in March 2012 and awarding $4 million across six contracts for community services, including wrap funds, one per region. 3.Launching a Foster Family Care support campaign to improve child welfare staff support across the agency for foster families 4.RFP and the award of new contracts for 60 new professional parent foster families starting September 2012 POLICY CHANGES: Family- Centered Everything 11

Serve and Return Interaction Shapes Brain Circuitry Harvard Center on the Developing Child To open in Slide Show, click on the Play Button To open in PPT, right click on the Play Button

Strategic Communications Morning Musings reaches over 4,000 individuals several times each month, signaling changes, celebrating progress and identifying challenges Strategic communications national TA from the Communications Consortium Media Center (June 2012) Partnerships The DCF Continuum of Care Partnership now involves over 100 individuals and organizations advising the Department on the implications of its policy shifts, service gaps and opportunities for joint training and professional development DCF participates on the Early Childhood Education Cabinet, Health Care Reform Cabinet, Health Equity Commission and the Achievement Gap Task Force STRAIGHT TALK and PARTNERSHIP 13

" Sometimes, said Pooh, the smallest things take up the most room in your heart." 14

Building a Very Early Childhood Agenda for Year Two Building the Knowledge Base & Moving from Fact to Act June 18 th Partnerships First 1000 Days 15

Building the Knowledge Base Applying the Neuroscience Strengthening Families Reducing Trauma & Adverse Childhood Experiences 16

17 To open in Slide Show, click on the Play Button To open in PPT, right click on the Play Button Brain Hero: UCLA & the Harvard Center on the Developing Child Moving from Fact to Act

Launching the First 1000 Days 18 Zero to Three Keynote: ACE Study Months of Webinars Web Support & Strategic Communications Other State & Community Forums

Early Childhood Education Cabinet Health Care Reform Cabinet Early Childhood Alliance Casey Family Programs Right from the Start: WCGMF June 18 th Partnerships 19 Early Childhood Alliance CHDI CGA Select Committee on Children Head Start UCONN Pappanikou Center DCF, DPH, DSS, DDS, DMHAS, SDE CT AIMH

20 some points to ponder Very early childhood: A critical period for child growth and investment in families and communities

Courtesy of Bruce Perry, MD, PhD PROPORTIONAL BRAIN GROWTH Early Brain and Child Development

Early Brain and Child Development The Early Growth of Neural Synapses

ADVERSE CHILDHOOD EXPERIENCE STUDY The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease. Lanius & Vermetten, 2009 Collaboration between Kaiser Permanentes Department of Preventive Medicine in San Diego and the CDC Largest study ever done on this subject. Decade long -- 17,000 people Looked at effects of adverse childhood experiences over the lifespan: Sexual abuse Emotional abuse Emotional neglect Physical abuse Physical neglect Substance abuse in home Mental illness in home Incarceration of family member Parental separation or divorce Witness violence against mother Adapted from P. Dworkin. MD Presentation to DCF Nursing Community of Practice, 2012

Some Results from the ACES STUDY Individuals with 4 or more of the 10 ACES are: Nearly 2 times more likely to smoke cigarettes 4 ½ times more likely to engage in drug abuse 7 times more likely to suffer from chronic alcoholism 11 times more likely to abuse drugs via injection 19 times more like to have attempted suicide More likely to have later health problems that put them at risk of early mortality, including heart disease, obesity, diabetes Adapted from P. Dworkin. MD Presentation to DCF Nursing Community of Practice, 2012

Birth Early Infancy Late Infancy Early Toddler Late Toddler Early Preschool Late Preschool Age Prenatal 6 mo 12 mo 18 mo 24 mo 3 yrs 5 yrs Ready to Learn School Readiness Trajectories At Risk Trajectory Delayed/Disordered Trajectory Healthy Trajectory Parent education Emotional health Health literacy Early literacy Quality ECE Appropriate discipline Poverty Inaccessible health services Family discord Graphic Concept Adapted from Neal Halfon, UCLA Center for Healthier Children, Families, and Communities Health services

The Productivity Argument for Investing in Young Children James J. Heckman and Dimitriy V. Masterov

Chamberlin RW. Preventing low birth weight, child abuse, and school failure: the need for comprehensive, community-wide approaches. Pediatr Rev 1992;13(2):64-71 The most effective long-term strategy appears to be the development of a comprehensive, coordinated, community- wide approach focused on preventing low- and medium-risk families from becoming high-risk, as well as providing intensive services to those who already have reached a high risk status. Adapted from P. Dworkin. MD Presentation to DCF Nursing Community of Practice, 2012 Advice from Two Decades Ago

28 All Connecticut children healthy, safe and learning… What if we really meant it? Deputy Commissioner CT Department of Children and Families

29 Harvard Center on the Developing Child //developingchild.harvard.edu //developingchild.harvard.edu Zero to Three Right from the Start CT Early Childhood Education Cabinet CT Early Childhood Alliance DCF Morning Musings