Family Health Services Oklahoma State Department of Health Institute on Child Welfare for Governors’ Health and Human Services Policy Advisors Edd D. Rhoades, MD, MPH June 16, 2005 PUBLIC HEALTH AND CHILD ABUSE PREVENTION IN OKLAHOMA

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Public Health Tradition Prevention Focus - reduce conditions associated with child abuse and neglect before it occurs Multi-level Strategies - programs to strengthen communities and families, train professionals, and increase public awareness Statewide Approach - needs assessment, best practices, evaluation, service accessibility and accountability

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Public Health - Human Services Continuum

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Family Support and Prevention Service Office of Child Abuse Prevention Child Abuse Training and Coordination Community-based Child Abuse Prevention Grant Children First Nurse Family Partnership

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Child Abuse Prevention Act 1984 Proclaiming child abuse in Oklahoma a public health crisis and declaring prevention a priority

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Office of Child Abuse Prevention Child Abuse Prevention State Plan State Interagency Task Force 17 District Task Forces Community-based child abuse prevention projects Training, technical assistance, evaluation, and quality improvement

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Office of Child Abuse Prevention Community-based Projects Criteria –Mother may enroll prenatally or up to three months postpartum –Families that qualify for C1 do not enroll in OCAP unless C1 is at capacity –OCAP not restricted to first-time mothers

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Office of Child Abuse Prevention Community-based Projects Services provided by community service contractors or health departments prenatally and up to the child’s fifth birthday Healthy Families Critical Elements Parents As Teachers Curriculum Services available through 21 sites – not statewide

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Office of Child Abuse Prevention Community-based Projects Services Provided –Homes visits –Center-based support and education groups –Family Events –Child development assessments –Links to community resources

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Counties served exclusively by SFY2005 CAP Fund Contractors TEXASCIMARRONBEAVER HARPER WOODS WOODWARD ELLIS WASHINGTON GRADY POTTAWATOMIE LINCOLN MCCLAIN ALFALFA GRANT GARFIELD MAJOR DEWEY CUSTER WASHITABECKHAM ROGER MILLS BLAINE CADDO CANADIAN KINGFISHER LOGAN PAYNE CREEK OKFUSKEE OKMULGEE HUGHES PONTOTOC GARVIN STEPHENS COMANCHE KIOWA JACKSON TILLMAN COTTON JEFFERSON LOVE CARTER GREER HARMON MARSHALL BRYAN ATOKA COAL PITTSBURG LATIMER PUSHMATAHA CHOCTAW MCCURTAIN LEFLORE SEQUOYAH MUSKOGEE CHEROKEE ADAIR DELAWARE OTTAWA MAYES ROGERS NOWATA WAGONER TULSA HASKELL OSAGE PAWNEE KAY NOBLE OKLAHOMA CLEVELAND MURRAY JOHNSTON CRAIG SEMINOLE Counties included In Districts: IPittsburg, Haskell, Leflore, Latimer IIAdair, Cherokee, McIntosh, Muskogee, Okmulgee, Sequoyah, Wagoner IIICleveland, Coal, Garvin, McClain, Pontotoc IVCanadian, Kingfisher, Logan VHughes, Pottawatomie, Seminole VICaddo, Comanche, Cotton, Grady, Jefferson, Stephens VIIOklahoma VIIIGreer, Harmon, Jackson, Kiowa,Tillman IXBeckham, Blaine, Custer, Dewey, Roger Mills, Washita XBeaver, Cimarron, Ellis, Harper, Texas, Woodward XICreek, Lincoln, Okfuskee, Pawnee, Payne XIITulsa XIIICraig, Delaware, Mayes, Nowata, Ottawa, Rogers, Washington XIVAlfalfa, Garfield, Grant, Major, Woods XVCarter, Johnston, Love, Murray XVIAtoka, Bryan, Choctaw, Marshall, McCurtain, Pushmataha XVIIKay, Noble, Osage SFY 2005 COMMUNITY-BASED FAMILY RESOURCE AND SUPPORT PROGRAMS BY DISTRICT AND COUNTIES I II IV V VI VII VIII IX X XI XIII XIV XV XVI XVII XII SFY2005 Contractors III Counties served exclusively by the Chickasaw Nation and the Comanche Nation of Oklahoma County served by CAP Fund Contractor and Comanche Nation Tribe MCINTOSH

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Office of Child Abuse Prevention Community-based Projects State Fiscal Year 2004 –1,052 families received home visitation –15,421 home visits were completed –978 families received center-based services Funding $2.68 million

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Child Abuse Training and Coordination Child Abuse Training and Coordination Council Multidisciplinary and discipline-specific training Multidisciplinary team (MDT) training Technical assistance to MDTs Assessment of multidisciplinary teams

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health CAPTA (Title II) Community-based Child Abuse Prevention (CBCAP) Support community-based efforts to develop, operate, expand, enhance, and, where appropriate, to network, initiatives aimed at the prevention of child abuse and neglect, Support networks of coordinated resources and activities to better strengthen and support families, and Foster an understanding, appreciation, and knowledge of diverse populations

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Community-Based Child Abuse Prevention Activities Training and technical assistance Respite services Fatherhood Initiative Native American home visitation services Evaluation Network coordination Public education Oklahoma Funding FFY 05 approximately $900,000

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health NURSE FAMILY PARTNERSHIP THREE GOALS 1.Improve pregnancy outcomes 2.Improve child health and development 3.Improve parents’ economic self- sufficiency

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health NURSE FAMILY PARTNERSHIP CONSISTENT RESULTS ACROSS TRIALS Improvements in women’s prenatal health Reductions in children’s injuries Fewer subsequent pregnancies Greater intervals between births Increases in fathers’ involvement Increases in employment Reductions in welfare and food stamps Improvements in school readiness

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health NURSE FAMILY PARTNERSHIP Elmira Trial 56% Reduction in Emergency Room Visits (12-24 Months) 80% Reduction in Child Maltreatment (Poor, Unmarried Teens)

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health NURSE FAMILY PARTNERSHIP NATIONAL REPLICATION Now operating in over 250 counties in 23 states serving over 12,000 families per year.Now operating in over 250 counties in 23 states serving over 12,000 families per year. Children First – Oklahoma’s Nurse Family Partnership established in 1997Children First – Oklahoma’s Nurse Family Partnership established in 1997

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Children First Public health nurses provide home visitation to parents expecting to deliver and/or parenting their first child Based in county health departments with services delivered in every county Mothers must be enrolled prior to 28 weeks of pregnancy and low income (185% FPL) Research based practice

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Children First Services Child and maternal health assessments Child development screenings Parenting education Health, safety, and nutrition education Linking families with health care, child care, mental health services, job training, and other community services Information and referral services

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Children First Prevention Outcomes OUHSC evaluation concluded that Children First ( ) prevented: –22 very premature births –14 very low birthweight babies –24 infant deaths Babies born to C1 mothers were at about one-half the risk of death within the first year of life compared to babies of non-C1 mothers

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Children First Services SFY ,869 families received services 56,426 home visits were made Funding State $10.9 million Federal $800,000

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Smart Start Oklahoma HB 1094, the Oklahoma Partnership for School Readiness Act, in April 2003 Coordinates private and public funds to support Smart Start communities Builds statewide public awareness of Oklahoma’s school readiness needs and solutions. State Partnership Foundation Smart Start Communities

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Smart Start Oklahoma Outcomes Oklahoma children will live in families where adults nurture, teach and provide for them. Oklahoma children will be born healthy and remain healthy. Oklahoma children will learn and play in high quality child care settings when their families need those services. Oklahoma children will enter school healthy and equipped with the age-appropriate cognitive, emotional, pre-literacy and social skills needed for learning.

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health Smart Start Oklahoma Department of Human Services Child Care Stars Program Dept of Education 4 Year Old Pre- Kindergarten Program Maternal and Child Health Early Childhood Comprehensive Systems Initiative

Child Abuse Prevention Oklahoma June 16, 2005 Oklahoma State Department of Health Health CAPTA and Early Intervention Keeping Children Safe Act of 2003 amended CAPTA States required to develop “provisions and procedures for referral of a child under the age of 3 who is involved in a substantiated case of child abuse or neglect to early intervention services funded under Part C of the Individuals with Disabilities Education Act Procedures implemented in SFY 05 for referrals of children in Oklahoma