Vermont Accountability,Collaboration and Results

2004 Community Indicators ConferenceMarch 13, 2004

Entrepreneurial Strategies

Clear Mission & Goals

Embrace Accountability

Redesign Production Processes

Adjust Administrative Systems

Performance Consequences

Change Organizational Culture

Clear Mission and

Goals

Mission

To work in partnership with communities to improve the

well-being of children familiesand individuals

Vermont State Team for Children, Families, and

Individuals

Mission

To work in partnership with local, state and national partners to improve the well-being of Vermont’s children, families, individuals and

communities.

Vision

Vermonters helping Vermonters thrive!

Vermont Association ofRegional Partnerships

Focus on Outcomes

Support Local Decision Making

Build Trust

Facilitate Inclusive Community Process

Monitor Local Data

Develop Strategies to Meet Local Strengths & Needs

Coordinate System Change

Evaluate Change in Community Conditions

Vermont Association ofRegional Partnerships

Core Partnership Functions To Build Community Capacity

EmbraceAccountability

Outcome 6Youth

Choose Healthy Behaviors

State Partners and Local Communities Working Together to Improve the Well-Being

of All Vermonters

A report from the VT State Team for Children, Families, and IndividualsFebruary, 2004

• Victims• Parents of children with SED• Parents of more than one child each with different disabilities• Reach-up parents• Offenders – incarcerated (male)

Offenders – incarcerated (female)• Offenders - in the community• Homeless adults with children or dependents• People with co-occurring disorders• Parents of children in protective services• People with chronic health care needs• Parents of children with autism• Foster parents• Teen parents• Woodside Juvenile Detention Facility residents• Special Education Directors• Psychiatric Survivors• NAMI (families who have adult children or spouses with mental illness)

Vermont Agency of Human Services Reorganization17 Focus groups were conducted between October 13 and November 12 and were held at various locations across the state selected by the partner groups

RedesignProductionProcesses

Vermont Agency of Human ServicesCommon Application

     

Easy enrollment!

• Apply for services in convenient community locations

• Provide application information only once • Access multiple programs offered by

multiple departments and some nonprofit organizations.

Family FriendlyFamily Advocacy Networks

Family Members As Navigators

Neighborhood Patch Sites

Parent & Professional Trainings

Adjust Administrative

Systems

AHS Sample Outcome Contract

I. Agency of Human Services Outcomes:

Check the AHS Outcomes this grant will address and delete the others:

Outcome 1: Families, Youth & Individuals are Engaged in Their Community’s

Decisions and Activities

Outcome 2: Pregnant Women and Young Children Thrive

Outcome 3: Children are Ready for School

Outcome 4: Children Succeed in School

Outcome 5: Children Live in Stable, Supported Families

Outcome 6: Youth Choose Healthy Behavior

Outcome 7: Youth Successfully Transition to Adulthood

Outcome 8: Adults Lead Healthy and Productive Lives

Outcome 9: Elders & People w/ Disabilities Live with Dignity & Independence in

Settings They Prefer

Outcome 10: Communities Provide Safety and Support for Families and Individuals

This page was developed to enable AHS Community Partners to access the grants data entered by all AHS departments. If you have any questions regarding the data, or if you would like help using the system, please contact:

brendahu@wpgate1.ahs.state.vt.us

Vermont Agency of Human Services Home

Office of Information and Network Systems

Report Menu

Vermont Agency of Human Services Home

Office of Information and Network Systems

AHS Grant Tracking Reporting Menu• Search Screens/Reports.• Report of Grants by specific deliverable• Report of Grants By Organization• Report of all Grants, ordered by

department, with subtotals• Outcome report for all Districts• Grant Summary report- Total by Dept- with

no details• List all Organizations

Main Menu

Performance Consequences

Vermont Uses Performance “Carrots”

Excerpts from a March 2003 letter from Charlie Smith, Secretary, VT Agency of Human Services…

I’m committed to continuing, and strengthening, the Agency’s emphasis on using outcomes as the benchmarks of our success.

With the publication of the latest Community Profiles, I want to take this opportunity to highlight some of the outstanding progress toward the outcomes your region is achieving, as well as some areas where further attention may be warranted. There are several trends to spotlight here:

• Rates of child abuse and neglect are substantially lower than the state average, and declined by 38 percent between 1996-98 and 1999-01.

• Rates of teen sexually-transmitted diseases are low.

• Rates of poverty among elders (ages 65-plus) declined by 51 percent between 1989 and 1999.

Of course, to sustain and improve progress on the indicators requires ongoing work—so, don’t let up!

• The Year 2010 goal for 90 percent early prenatal care has not been achieved.

• Rates of low birth weight are high, relative to the state average.

• Lamoille County has a high rate, relative to the state average, of injuries resulting in hospitalization (ages 10-17, and 65-plus).

• Lamoille County has high rates of out-of-home placements (ages 25-plus), relative to the state average.

Progress-Index By Outcome

-10

-8

-6

-4

-2

0

2

4

6

8

10

Outcomes

Co

mp

osi

te In

dic

ato

r-P

rog

ress

Sco

re*

2003 2004

2003 6 0 -2 -4 2 -2 3 1 5

2004 -1 -3 5 0 3 5 0 0 -3

OC 1 OC 2 OC 3 OC 4 OC 5 OC 6 OC 7 OC 8 OC 9 OC 10

n/a

n/a

n/a

The “Outcomes Progress-Index” is an attempt to address these concerns, through a multi-faceted approach.

Each indicator’s data for the most recent year (as long as there are three or more years’ data) is scored three ways:

Direction

Is the indicator going in the “right” direction? (e.g., is percent low birthweight going down? Is median household income going up?)

Turning the curve

Does the most recent direction move the trend in a direction opposite from the previous year’s, or turn it more steeply in the same direction?

Beating the background trend

Is the most recent “local” trend significantly at-odds with the “background” (state, national) trend?

“Outcomes Progress-Index”

ChangeOrganizational

Culture

Promoting Youth Justice Through Restorative Alternatives

Helping Youth Stay in School in Your Community

Preventing Child Abuse and Neglect in Your Community

Promoting Positive Youth Development in Your Community

Preventing Teen Pregnancy in Your Community

Preventing Youth Disruptive or Violent Behavior in Your Community

Preventing Youth Substance Abuse in Your Community

“What Works” Series

Morrisville

6.8%

18.8%

54.5%

12.3%

1.9%

0.7%

0.9%1.6%

0.9%0.9%

0.7%

Families, youth, and individuals are engaged in their community's decisions and activities.

Pregnant women and newborns thrive.

Children are ready for school.

Children succeed in school.

Children live in stable, supported families.

Adults lead healthy and productive lives.

Youth choose healthy behaviors.

Youth successfully transition to adulthood.

Elders and people with disabilities live with dignity and independence in settings they prefer.

Communities provide safety and support to families and individuals.

N/A

Spending on Outcomes by AHS through Grants to Organizations

Statewide

10.1%

15.9%46.3%

15.9%

0.8%

2.7%0.3%

1.6%

3.6%1.8%

1.0%

Platforms of Accountability

External Authorization

Internal Inclusion

Results Management

Managing for Results

External

Authorization

TITLE 3: Executive, Chapter 53: Human Services 3 V.S.A. § 3026 Partnerships for children, families and individuals.

(a)  Establish a Research Partnership to study and make recommendations for improving the effectiveness of state and local health, human services, and education programs. Critical program outcomes relating to the well-being of Vermonters should be addressed… 10 outcomes embedded

(b)  Regional Partnerships shall develop and implement local strategies for improving the social well-being of Vermonters, and shall advise AHS and DOE …

(c)  The State Team for Children, Families and Individuals shall support the activities of the regional partnerships, and participate in the development and implementation of state policies and programs designed to improve the well-being of Vermonters. 

Added 2001, No. 63, § 97; amended 2001, No. 142 (Adj. Sess.), § 119.

2003 Act 45:AHS Reorganization

“The overall success of the reorganization project should be based on measurable indicators,

on trends and ultimately on realization of the statutory

outcomes itemized in3 V.S.A. §3026(a).”

InternalInclusion

State Team For Children, Families and Individuals

Managers of state agencies

State coordinators of interagency teams

Directors of service and family advocacy

Partners in higher educations institutions

Parents

Regional Partnership coordinators

VT Association of Regional PartnershipsRegional Partnerships are working closely with the State Team for Children, Families and Individuals to support new ways of improving the well-being of Vermonters. Community and state partners are mobilizing and coordinating the capacity of both the informal and formal support systems that we depend on. These partnerships work in the following areas:

• Focusing on outcomes that improve the well-being of Vermonters.

• Engaging diverse community members as partners.

• Mobilizing resources to enhance local support services and systems.

Results

Management

Vermont’s Outcomes

FAMILIES, YOUTH AND INDIVIDUALS ARE ENGAGED IN AND CONTRIBUTE TO THEIR COMMUNITY'S DECISIONS AND

ACTIVITIES 

PREGNANT WOMEN AND YOUNG CHILDREN THRIVE

CHILDREN ARE READY FOR SCHOOL

CHILDREN SUCCEED IN SCHOOL

CHILDREN LIVE IN STABLE, SUPPORTED FAMILIES

YOUTH CHOOSE HEALTHY BEHAVIORS

  YOUTH SUCCESSFULLY TRANSITION TO ADULTHOOD

  ADULTS LEAD HEALTHY AND PRODUCTIVE LIVES

  ELDERS AND PEOPLE WITH DISABILITIES LIVE WITH DIGNITY AND INDEPENDENCE IN SETTINGS THEY PREFER

COMMUNITIES PROVIDE SAFETY AND SUPPORT FORFAMILIES AND INDIVIDUALS

Indicator Reports

Community Profiles http://www.ahs.state.vt.us/03compro/03ComProExpl.cfm

Social Well Being of Vermontershttp://www.ahs.state.vt.us/pdfFiles/03SWB.pdf

Healthy Vermonters 2010      http://www.healthyvermonters.info/admin/pubs/hv2010/pdf/hv2010.pdf

Youth Risk Behavior Survey  http://www.state.vt.us/adap/yrbs2003.pdf

Outcomes Based Planning Reporthttp://www.ahs.state.vt.us/PDFFiles/OutcomeBasedPlanning03.pdf

Managing

For

Results

2003

Community Profile

For the Community Served by:

Lamoille North

Supervisory Union

Prepared By:

Vermont Agency of Human Services

Planning Division

www.ahs.state.vt.us

Outcome 6

YouthChoose Healthy Behaviors

State Partners and Local Communities Working Together to Improve the Well-Being

of All Vermonters

A report from the VT State Team for Children, Families, and IndividualsFebruary, 2004

State Team Outcome # 6

Youth Choose Healthy Behaviors

Troublesome Indicators

There are a growing number of youth who are at increased risk for diabetes, cardiovascular disease and hypertension because of obesity. Many factors are related to the increasing number of children who are overweight or at risk for being overweight: increased consumption of fast food (high in calories and fat) in large quantities, less than optimal levels of physical activity, increased hours of TV and video watching. School based interventions focusing on nutrition education, physical education classes, informal opportunities for activity and cafeteria nutrition will only be successful if linked to community based and family opportunities for fitness and healthy eating.

The good news is that Vermont's rates declined From '99 to '01. The bad news is that marijuana use in Vermont is significantly higher than use rates nationwide. 30% of 9-12th grade youth in Vermont used marijuana compared to 24% nationally. Marijuana continues to be an issue because community norms are favorable to use, it’s easy to obtain and is often a gateway drug to other substances.

There has been an increase of over 160% in the number of people seeking treatment for heroin use between fiscal 1999 and 2002. A dis-proportionately large portion of this increase is driven by 18 to 24 year old clients. Since not all heroin users seek treatment, the population in need of treatment is expected to be much larger. Youth don’t just wake up one day and start using heroin. According to the 2001 Youth Risk Behavior Survey alcohol is the most commonly used drug among youth. While using marijuana and alcohol do not necessarily cause young people to use heroin, using these substances set up patterns of behavior to take the next step. Comprehensive prevention efforts work.

Vermonters Who Have Used Heroin and Received Treatment Substance Abuse Treatment by Age

0

50

100

150

200

250

300

350

400

450

500

1998 1999 2000 2001 2002 2003

Fiscal Year

Nu

mb

er

of

Pe

op

le

<18 18-24 25-34 35-44 45+

Note: All age ranges except

the 18-24 group cover 9 years. Thus,

the increase in the number of heroin clients in this group from 1997 to 2003 is even

more remarkable.

Percent of Students who Used Marijuana 1 or more days during past 30 days

0%

10%

20%

30%

40%

50%

8 9 10 11 12 F M ALL

Grade Gender

2001 2003

At Risk or OVerweight Status of Vermont Students Grades 8-12

0%

5%

10%

15%

20%

25%

2001 2003

At Risk Overweight

New Directions coalitions are successful in reducing alcohol, cigarette and marijuana use among youth in their communities by implementing multiple, integrated strategies focused on reducing substance use. From 1997 to 2001, New Directions, reductions in tobacco and marijuana use, as compared with the rest of the state, were statistically significant. In 2000, the VT Tobacco Control Program was funded to carry out a comprehensive strategy of curricula, no smoking policies, media campaigns, community coalitions, smoking cessation programs, and youth empowerment anti-tobacco programs such as VT Kids Against Tobacco and Our Voices Xposed. From 1997 to 2003 the percentage of Vermont students who had smoked fell from 36% in 1997 to 20% in 2003.

Communication with parents on school-related topics may be seen as a measure of a young person’s closeness to his or her parent, as well as an indicator of parental involvement in this important arena. “Connectedness” to parents, and parental involvement in schooling, have been linked with greater likelihood of academic success, emotional health, and avoidance of harmful behaviors ("Murphey, Lamonda, Carney, and Duncan, unpublished).

Increasingly, we know that we cannot define positive youth development as simply the absence of risk behaviors; we must also identify those strengths in the lives of young people that contribute positively to their well-being. Recent analysis of Vermont Youth Risk Behavior Survey data shows the cumulative effect that just six “assets” have on the likelihood that teens will engage in either risk behaviors or healthy behaviors. The six are: getting good grades in school, talking with parents frequently about school, feeling that students help decide what goes on in school, participating in after-school programs, volunteering in the community, and feeling that “I matter” in the community. The more of these six assets students report having, the less likely they are to venture into risky behavior, and the more likely they are to adopt health-promoting practices.

State Team Outcome # 6

Youth Choose Healthy Behaviors

Heartening Indicators

Youth Risk Behaviors Decline with Number of Assets

0

10

20

30

40

50

60

70

0 1 2 3 4 5 6

Number of Self-Reported Assets*

Per

cent

of s

urve

yed

8th-

12th

gra

ders

repo

rting

the

beha

vior

Ever Had Sex

Alcohol Use (past 30 days)

Physical Fighting (past year)

Marijuana Use (past 30 days)

Cigarette Smoking (past 30 days)

Binge Drinking (past 30 days)

Planned Suicide

*Surveyed assets included: talking with parents about school, feeling students in my school help make decisions, getting mostly As or Bs in school, participating in youth programs (excluding sports), volunteering in the community, and feeling valued by the community.

Source: 2003 VT Youth Risk Behavior Survey, volunteer sample (N=31,814).

Grades Earned Among Students Whose Parents Talk or Do Not Talk to The Regularly about School

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Mostly A's Mostly B's Mostly C's D's and below

Monthly or Less Weekly or More

Reductions in 30 day prevalence of alcohol, cigarette and marijuana use among 8-12th grades in New

Directions communities

50%

36%31%

41%

22%26%

0%

10%

20%

30%

40%

50%

60%

Alcohol Cigarettes Marijuana

1997 2001

A Decade Of Turning The Curve From 1990 (or date indicated) to most recent data available

% Change

People With Health Insurance +1%

Children With Health Insurance +3%

Smoking During Pregnancy -7%

Homicide Rate -9%

Deaths From Motor Vehicle Crashes -14%

Violent Crime Rate -17%

Child Abuse & Neglect – Substantiated -17%

Elderly In Nursing Homes (1992-2002) -18%

Teen Drinking (1993-2003) -19%

Deaths From Cardiovascular Disease -19%

Repeat Births To Teens -21%

Youth Unemployment -26%

Suicide -27%

2 Year Olds Immunized (1989-2002) +28%

Teen Birth Rate -31%

Child Deaths -32%

Infant Mortality -35%

Teen Smoking (1993-2003) -35%

Rate of Property Crime -43%

Alcohol Related Teen Motor Deaths -47%

Late Or No Prenatal Care -50%

Young Teen Pregnancy Rate -50%

Alcohol Related Motor Vehicle Deaths -52%

Elevated Lead Levels (children 0-5) (1994-2000) -59%

Institutionalization For Mental Illness -60%

Parentage Established (1991-2002) +63%

Child Support Cases With Collections +98%

Families Receiving New Baby Visits (1994-2002) +223%

School Meals +368%

The Bottom LineGood Results

Have Avoided Costs Of Approximately

$247,000,000

Toward An Economics Of Prevention – Nov 2000http://www.financeproject.org/vermont.htm