INTRODUCTION
In February of 2002, the Network for Children presented an informational unit on “Support for Children & Families at Risk – Unfinished Business”, which chronicled events leading up to and resulting in formation of the Network for Children as an independent arm of the LWV Citizens’ Education Fund. (Copy of this Fact sheet is available from your discussion leader.) Today, as a resource committee of the League of Women Voters, we focus on events and changes (both good and bad) in public and private agency programs centered on early childhood development. We cover services available for children birth to 5-6, including childcare, pre-kindergarten, kindergarten and the continuum of services to meet various needs of young children and families. Results of legislation taken up in the 2005 General Assembly will be available at units.
Reaction to the Montgomery County League’s study “Focus on the Child (1995)”, plus the extensive research on the importance of brain development in young children, were catalysts for the adoption, after considerable community input, of the Children’s Agenda (1997). This set the stage for the future of early childhood services and the county council’s “Children’s Initiative” of 1999/2000, which states: “There is universal acknowledgment that our children and their families will flourish only if we begin to invest seriously in prevention, early intervention, and early childhood programs.” The Children’s Agenda as it has evolved since adoption is a blueprint of what Montgomery County wants for all of its children and families: “a community where children are safe, healthy, successful in school, prepared for life, and supported by a caring family and neighborhood.” The motto and logo above, “help me grow” was created to express this message. Overall we find that Montgomery County government has been very supportive, frequently stepping in to supplement state resources that are often less than promised. We have interviewed County Council staff, Collaboration Council staff, Children Youth and Families and Early Childhood staff, the manager of Child Mental Health, the Director of Child Welfare, and others.
Unfortunately, even as we find that the need for these resources is recognized –subsidies and services are insufficient or being cut and many parents must choose between paying for childcare or paying for rent and food. Where is the Village? There is much work to be done! At the end of our discussion, we hope to reach consensus on a number of questions.
SNAPSHOT OF MONTGOMERY COUNTY’S CHILDREN & FAMILIES
Montgomery County’s population has grown from 841,500 people in 1998 to 931,000 in 2004. It is expected to reach one million by 2010. It has changed from a suburban-rural community to an urban-suburban community with high population density downcounty and along the I-270 corridor. The population growth is due to both a historically high level of births and a high level of migration from other states and other countries. A greater percentage of births in the county are to minority women (persons other than white, non-Hispanic), increasing from 34 % in 1990 to 54 % in 2003.
International migration is second only to births as a component of Montgomery County’s population increase. Almost half of Maryland’s foreign-born population lives in Montgomery County, and one-third of the county’s population speaks a language other than English. In 2000 at least 1000 children spoke any one of the following foreign languages: Spanish, Chinese, French, Korean, African languages, Persian, Vietnamese and Russian. More than one-third of children ages 5 to 17 years old live in linguistically isolated households (defined as where all members 14 years old and over have some difficulty speaking English). This increased diversity is evidenced by the fact that no racial or ethnic group comprises a majority of the students in Montgomery County public schools.
Of the total population, one in four persons is under 18 – more than 230,000 children, with 139,000 enrolled in public schools. Between 1998 and 2003, 173,990 people moved into the county, typically married couples with children. In 2003, an estimated 69% of children lived in households where both parents worked (150,000 children).
In economic terms, the county is also becoming more diverse, although the economy is thriving. The 2002 median income was $79,115 – 79% higher than the nation and 36% higher than Maryland. The result of this affluence is that costs for housing, transportation and child care are much higher than elsewhere in the state, challenging a large number of people with lower incomes to provide for their families. In 2000, about 11,000 children lived in census tracts characterized by the presence of poverty; female headed households, low educational attainment, and non-participation in the work force. (Statistics from The Children’s Agenda, 2004 Data Book-Collaboration Council, Jan 2005.)
Maryland Committee for Children Child Care demographics, 2004: For a family of four with an infant and preschooler in child care, the average annual cost of that care, $17,700, was 18.6 % of family income. The average WEEKLY cost of care for a child up to 23 months was $177 in a registered family childcare home and $250 in a child care center. For a child 2-5 the cost was $152 in family care and $162 in a center. For a school age child, the cost was $136 in family care and $146 in a center.
WHO DOES WHAT FOR CHILDREN AND FAMILIES?
Montgomery County Dept. of Health & Human Services- Children, Youth and Family Services
The mission of this office is to promote opportunities for children to grow up safe, healthy, and ready for school and for families and individuals to be self-sufficient. The department provides protective, prevention, intervention and treatment services for children and their families, and education, support and financial assistance for parents, caretakers and individuals. With the arrival of a new chief, Carolyn Colvin, in 2003, the Department was reorganized. Ms. Colvin has made children and families a priority, together with a major emphasis on service integration and a seamless data system. There is now a central DHHS Information line, 240-777-1245.
The Early Childhood Services Division has established many innovative programs as part of the integrated early childhood outreach. Two of the most effective are ChildLink, (240-777-GROW), which offers a bilingual telephone line to help parents and caregivers reach the services they need. Follow-up calls are made to ensure that callers who need intervention services have made the connection. In FY04 1,333 callers and 1,329 children were served, and 18% of callers received services in Spanish (2004 Data Book). In addition, Learning Parties take place in various convenient locations around the County, providing low income and many non-English speaking parents and children an opportunity to meet other families, learn about child and family services in a comfortable setting over lunch or supper, and talk with counselors about their needs and hopes. A wealth of written material, books for children, etc. are provided in several languages.
The Behavioral Services Division, which includes the Core Service Agency, (CSA), partially funded by the State Health Dept., has placed a new emphasis on finding solutions to the crisis in mental health services (well-documented by the 2003 Blue Ribbon Task Force on Mental Health) for both children & adults. A child mental health manager was hired in 2004, and a child mental health plan is on the books. However, progress in real solutions has been slow. Plans are progressing for a pilot project to deal with 200 of the most intensive needs children through a “case rate” or “wraparound” system. Montgomery County and Baltimore City will participate, with 100 children each, funded through a state initiative.
The Collaboration Council for Children, Youth and Families
The Governor’s Office for Children, Youth and Families (GOCYF) seeks to ensure coordination of services to children and families through Local Management Boards (LMBs) in all 24 county jurisdictions. The Montgomery County Collaboration Council is our jurisdiction’s LMB. In 2004, the council was restructured as a quasi-public, non-profit entity, to achieve greater flexibility, especially in contracting and advocacy. Their mandate is to facilitate the implementation of a local, interagency service delivery system for children, youth and families. Together with the many other public and private child serving organizations, they implement the shared vision of The Children’s Agenda. Also over the next year, they will update the County’s five-year Comprehensive Strategic Plan, which integrates the plans of child-serving agencies, and identifies gaps.
Three primary priorities are established for 2004 and 2005: 1) community-based services for children with intensive needs, including those children referred for out-of-state residential placement; 2) after school care; and 3) early childhood issues and needs. These three priorities determine in which areas the Collaboration Council will concentrate its help in funding and/or coordination of county resources. They also relate to one or more of the seven results for child well-being, described in the Children’s Agenda 2004 Data Book, (see above) published by the Collaboration Council in January 2005. This book provides data on children in Montgomery County compared with statewide (and in some cases, national) data, mapping of areas of population and family characteristics, comprehensive information on all services for children and youth in the county, with extensive background on outcomes, indicators for child well being, and a wealth of other useful data. The DATA COLLABORATIVE, a multi-agency collaboration among data providers from public and private child serving agencies, was established as an initiative of he Collaboration Council in 2003, and contributed much to this publication.
Prevention and Early Intervention
Prevention - Early pre-natal care improves the health and well being of both mother and child, and is more likely to be effective if women begin receiving care early in pregnancy. Women who receive care too late or not at all increase their risk of complications such as low birth rate or even infant mortality. Unfortunately, the number of women receiving prenatal care in the first trimester has declined in both Maryland and Montgomery County: in MD 86.4% in 2000 to 83.7% in 2003, and in Montgomery County – from 91.3% in 2000 to 85.1% in 2003. This may be due to a reduction in access to private obstetricians for women on Medicaid, although the picture is not entirely clear.
The Home Visiting Consortium (HVC) coordinates and integrates nine home visiting programs in Montgomery County to improve school readiness. These include Healthy Start, Infants at Risk, Infants and Toddlers, Early Head Start (Reginald S. Lourie Center), Early Head Start (Family Services Agency Inc.), Families Foremost, Healthy Families, Black Babies SMILE and Frameworks for Families (The Children’s Agenda: 2004 Data Book). Funding for these programs totals more than $22 million statewide and consists of a combination of Federal, state, county, city, and private funds. These programs improve readiness for children entering school by providing a coordinated system of prevention and early intervention services including assessment and ongoing services for families with children birth to five years old.
Early Intervention - The Healthy Start Case Management Program provides community nurse and community service aide interventions for some thousand families where the children, from birth to age two, are seen to be at risk. The Infants and Toddlers Program, for children from birth to age 3, provides services when a child is found to have a disability or developmental delay. After evaluation, which includes discussion with parents, observation, testing if needed and review of medical reports, the family and Infants/Toddlers staff develop an Individual Family Service Plan (IFSP). A principal service is often help for the family in day-to-day care for the child, usually provided in the home, child care or other natural setting, to help in the development of age-appropriate skills. Service providers may include speech, physical or occupational therapists, special educators, nurses, mental health professionals or para educators.
Infants/Toddlers, a federally mandated entitlement, receives some federal and state money but is 80% funded by the county. As families and physicians became more aware of the value of early intervention, participation has continued to rise. In 2004 almost 3000 families were served, a 143% increase in the five years since 1999. Another factor appears to be the tremendous increase in premature and multiple births, from 160 in 1998 to 481 recorded in 2003.
A problem is seen for the middle group – those who receive only a few hours of therapy each week. The school system is responsible only for the therapy. The family has lost the supportive services of the Infants and Toddlers staff. Low-income families often cannot obtain good day care or access to Head Start or the few pre-Kindergarten classes for low-income families that would provide valuable developmental experiences for the child as well as a site for the therapy.
Preschool Education Program. (PEP) classes are located in twelve elementary schools, preferably along with other preschool or day care classes to provide alternative grouping opportunities. Most children are in the PEP Classic half-day classes, with a smaller number in the Intensive Needs or Beginnings classes for children with more severe disabilities. MCPS also has a preschool group for children with hearing disabilities at Rock Terrace School and with the Montgomery Preschool Achievement Center Program for intensive intervention for children with autism. Non-public schools serving preschoolers with disabilities in Montgomery County include the Community School for children with autism, Montgomery Preschool Achievement Center and Ivymount, for children with a range of developmental disabilities, and the Lourie Center for children with emotional- behavioral disabilities. Entitlements are paid for by the public school system, with some reimbursement from Medicaid.
Child Care, Early Childhood Education and Development
It is clear that in a variety of family situations, quality childcare is the key to providing young children with the support and developmental education they need to flourish and be ready for school at kindergarten. Regulation of childcare providers and centers is handled by the State, and there are several levels of professional standing currently in place. The basic level is licensed or registered childcare – which requires a minimum guarantee of health and safety by the provider in the location of the child care home or center. All providers must be at this level. All are encouraged by the profession to pursue advanced education and work toward their Child Development Associate national credential. The primary source of help and training for providers is the Montgomery County Child Care Resource and Referral Center, which provides technical and financial assistance to help providers attain advanced status; mentoring for new providers; intensive training and mentoring in implementing the Maryland Model for School Readiness; and training workshops on a variety of special topics such as early literacy, SIDS (sudden infant death syndrome) and children with special needs.
This network also provides access to local and statewide services such as ChildLink, the Home Visiting Consortium, health and mental health, counseling and support, assistance with housing, etc., on an “as needed” basis. Centers are located statewide, and provide a vital link to services for all families with children.
Child Care is provided in a variety of settings, including family childcare, group programs (child care centers), nursery schools, camps and in-home child care. Several models for early childhood care and education include Head Start, early Head Start, community-based centers, MCPS pre-kindergarten, kindergarten, Judy Centers and others. The growing need for quality childcare is slowly being met, but is endangered by the uncertainty of subsidies for providers and families (see below).
Child Care Providers: As of February 2005, Montgomery County had 1,004 registered family childcare providers, with a capacity for 7,166 children. There are 421 licensed group programs (child care centers) with a capacity of 23,248 children. In addition, in 2004 there were 90 youth camps, 125 nursery schools, 105 kindergarten classes, 32 Head Start or Early Head Start classes, and 62 public pre-kindergarten classes (not licensed for child care). Of the 4,402 children seeking regulated child care in 2003-04, 68% were age 2-4, 76.6% were cared for near their homes, and the others near school or parents’ employment. The majority needed care due to their parent’s job (MD Committee for Children).
Family Support Centers, Families Foremost (MHA), Parent Resource Centers: These provide a variety of supports for families and children with limited resources, including parenting skills, pregnancy counseling and help, health services, nutrition training, and information on developmental problems, child care availability, etc. (some are partially state-funded). The Parent Resource Centers are drop-in centers for parents and children living in public housing. They provide a pleasant place to go to increase parenting skills, meet other parents with children, talk to counselors and learn of available services. There are currently three (not full time) under auspices of the Housing Opportunities Commission (HOC).
Head Start, a federally financed program for 3 & 4-year olds from families whose income meets the Federal Poverty Guidelines, has several kinds of programs. The traditional Head Start includes social services, parent involvement/parent education/health/dental and mental health services. Classes are 3.25 hours four days a week, held in elementary schools. Lunch, art, music, and PE instruction are provided by MCPS certified teachers with one teacher and para-educator, plus a volunteer, for approximately each 20 children. Two home visits per year are provided, as is bus transportation. Cost per child is $8,566. Head Start currently serves 648 children in 35 classrooms at 32 sites.
Head Start, Expansion model is Head Start plus day care. The program operates from 7am – 6pm, with the
3.25 hour class program directed by a MCPS teacher (called plug-in). No transportation is provided, but the usual family and child social services (health, dental, meals, snacks, etc.) are included. The cost per child is $12,430 (including all-day care). The program currently consists of 17 children in the Peppertree Children’s Center and 17 in the Colesville Children’s Center. The cost for child care outside of the Head Start program is covered by child care subsidies.
Community Based Model is center housed, with community based classes that are full day, full year programs in two child care centers: the Silver Spring YMCA (15) and the Silver Spring Presbyterian Church Children’s Center (15). To participate in this program, parent(s) must be working full time or enrolled in school full time and be eligible for child care assistance, such as Purchase of Care - POC (state), or Working Parents Assistance - WPA (county). All teachers meet Head Start criteria, and in addition to educational programs for children, there are programs and services for parents. The cost per child is $11,987. Expansion of the community based model into various local settings, such as apartment buildings, or community centers, has been suggested by the executive director of Centro Familia, a Latino based family service agency providing a variety of services to non-English speaking parents and children. The County Council has asked for a plan for such a center, plus the cost.
MCPS Pre-K Program is located in 59 elementary schools, with a total of 97 sessions. Some schools have both am and pm sessions. This 2.5 hour program for 4-year olds is for families with limited incomes, eligible for FARMS (free and reduced meals). There is a family service coordinator who provides social services and referrals to community resources as needed by the families. Teachers make one home visit per year. The pre-K children’s health needs are taken care of by the school nurses or the health room tech. Cost for MCPS Pre-K is $3,076 per child for the 2.5 hours. Transportation is provided. Together, pre-K and Head Start enroll 2,517 children, according to the report given Jan. 25, 2005, to the Community Action Board, which is the Head Start Grantee Agency.
The Subsidy Dilemma
"Without access to child care subsidies, parents are unable to continue employment and their children are at risk of entering substandard care; child care businesses are threatened with closure due to insufficient numbers of children, and the County loses tax revenue from failed businesses and unemployed parents. In short, the lack of funding for child care subsidies can mean losses to Montgomery County in at least four ways: parents can’t work, child care businesses may close, tax revenue is decreased, and the current and future health and academic promise of our chldren are compromised."(Commission on Child Care, 2003-04 Annual Report.)
Other Resources and Educational Programs for children and families
Linkages to Learning is a comprehensive school-based program that provides some direct social services, and facilitates access to health and mental health services, mentoring and tutoring, ESOL (English as a second language) classes, etc. The program collaborates with MCPS, DHHS and private agencies, community organizations and others, to serve the whole family. The program empowers families to find what they need. Currently at 22 sites, it is expected to expand to two more in the ‘06 budget – (Weller Road and Wheaton Woods).
Judy Centers are state sponsored comprehensive service centers funded throughout the state by grants from the Judith Hoyer Foundation. They provide a wide range of children/family oriented services, including ESOL classes, child care referrals, outreach to immigrant and low income families needing parenting skills, language help and partnering with community groups (primarily in the surrounding community). There are two Judy Centers in Montgomery Co.- Takoma Park at Rolling Terrace, and at Gaithersburg Elementary School. The foundation funds the director and some staffing, while the programs included may have other revenue sources, but the subsidy issue is again in play. This comprehensive approach is very successful, and perhaps could be copied more widely.
Public Libraries support many reading, early education and play programs.
MCPS and the Recreation Dept. reach out to new residents, provide after school programs for homework assistance, sports and recreation, sponsor sports events and special celebrations.
DHHS Children's Services, in cooperation with many other public and private agencies, sponsors the "Month of the Young Child"(MOYC) celebrations at Lake Forest Mall, Gaithersburg, and Westfield Shoppingtown in Wheaton every April. They attract hundreds of families with children for a day of fun, entertainment and learning activities. Health and community fairs, Arts and Theatre events at public and private venues are often offered free of charge.
Count Down to Kindergarten is a statewide public awareness campaign about early learning and the importance of early childhood experience. A free booklet - Tips for Turning Everyday Activities into Learning Activities- is being distributed widely, and their website: www.countdownMD.org presents a wealth of information and resources for parents.
Children's Health Care
As stated in The Children's Agenda, 2004, "When children and their families lack access to health care, it has a profound impact on each family member as well as on the entire family's ability to function. Chronic or severe physical illness, poor nutrition, untreated depression, infectious diseases, and low birth-weight are among the leading risk factors associated with poor health outcomes for children and youth." Services such as Infants and Toddlers, described earlier, can greatly increase a child's chances of success later in life.
Data collected regarding Montgomery County report that the children residing here fare better than peers across the state of Maryland regarding the provision of health services. However, many areas of concern continue to exist which must be addressed. "Although the infant mortality rate has declined over the past twelve years, the rate among births to African-American women has remained consistently higher." With the advent of health initiatives focused on African-American women as well as Asian and Latino women, these data are gradually showing improvement. The overall infant mortality rate in Montgomery County dropped from 7.0 per 1000 live births in 1998 to 5.1 per 1000 live births in 2003.
Healthy Families Montgomery (HFM) provides preventive supportive services for first-time parents and their infants in order to promote positive parenting and healthy growth and development.” The main goal of HFM is to prevent child abuse and neglect as well as other negatively related outcomes. HFM offers services to families for up to five years, if necessary, providing support from pregnancy through a child's transition to school. HFM is funded by the Governor's Office for Children, Youth and Families, and other private grants, and participates in the Home Visiting Consortium. 136 parents with 166 children were assessed as eligible to enroll in HFM services in 2004. Of these, 66% were unemployed and 55% were single. Among the 166 children, 99% of the children 2 months or older were linked to a health care provider.
School Based Health Centers (SBHCs), another Montgomery County program, provides comprehensive health care case management and health education services to two schools in high need communities- Harmony Hills and Broad Acres Elementary Schools. At these sites, dental services as well as medical services and case management are provided through the Montgomery County Department of Health and Human Services School
Health Services. During FY’04 over 95% of the children attending Harmony Hills and Broad Acres, including younger siblings, were enrolled in the program. 200 children previously uninsured have a medical home at the SBHCs.
Service eligibility units review the financial eligibility of individuals or families at four health centers in the county for public and private programs, including: M-CHIP; Care for Kids, Maternity care, Family planning, Project Access, and Audiology. Some dental services are also provided. The four health centers are Germantown; Piccard Drive, Rockville; Silver Spring; and East County Regional Service Center.
Mental Health Services are separated from the general health systems. A work plan for the implementation of the Children and Youth Mental Health Plan was generated in 2002. A new director of child Mental health, David T. Jones, was appointed in June 2004. One of the goals of the work plan is to develop strategies that will infuse mental health wellness concepts/resource information and early identification techniques with the visits to child care centers/family resource centers by nurses and other health professionals. Needs have been identified by means of a survey of all early childhood programs that identified existing programs as well as gaps in services. An Early Childhood Link was initiated in the fall of 2002. Designed to serve as an entry point to services for young children and their caregivers; it will provide supports for child care centers, family child care homes and nursery schools. These supports are being planned and slowly initiated. Much needs to be done in order to complete the acquisition of mental health providers for young children in therapeutic settings, wellness centers and daycare agencies.
There are two outpatient mental health clinics serving children, adolescents, and their families who have Medicaid, no health insurance, or are un-documented. They are located at 8818 Georgia Ave., Silver Spring, and 7300 Calhoun Place, Suite 600, Rockville.
Child Welfare Services
Child Welfare Services (CWS), a division of DHHS, is the child protection agency in Montgomery County, but is primarily state funded. CWS is responsible for determining the best method of protecting children whom are suspected of being abused or neglected by their parents or caretakers. In fiscal 2004, 2,590 children were reported to Child Welfare Services. They are responsible for Children in Need of Assistance as declared by the circuit court. Many children are in foster care, and some are being supervised by the CWS on a voluntary basis.
Problems with child care impact CWS directly, as more children are left alone and reported to CWS as neglected. The dearth of subsidized child care for potential foster parents is a problem because employed persons who might qualify as foster parents have incomes too high to qualify for subsidies This is also true for family members who might be willing to take on foster children. Several Bills in the legislature dealing with kinship care, at relatively lower cost than foster care, will be discussed at units. The cost of day care or pyschotherapy for children is affordable for some, but with the growing number of poor and immigrant populations who need culturally appropriate services, it is unavailable without subsidies.
There are only 6 shelter beds available in the county for teens, and because of this lack of resources there are 50 emotionally disturbed teens placed out of the County. This separation from home interferes with timely therapy, and contributes to the child’s sense of abandonment. More therapeutic foster homes (in which the foster parents are trained to care for disturbed children) would facilitate having more children remain in the community, would allow their parents to visit them and participate in family counseling, and lead to an improved situation.
Working with MCPS is difficult because when children move from their own home into temporary foster care, they must frequently attend a new school, an unsettling experience for the child who may be leaving their family for only a short time. Also, MCPS often has difficulty meeting the complicated needs of CWS children.
Securing access to mental health services for children committed to CWS is a huge burden because of lack of mental health resources, overwhelming paperwork required for reimbursement by the Medicaid system, and lack of therapists with the special skills to treat the children. Poor reimbursement and time wasted also apply when
therapists are needed to accompany children to court. Child Welfare is working on a system to pay some therapists directly, including compensation for court appearances. Child Welfare would then seek reimbursement from the State, protecting the therapists from battles over payment.
The long awaited Child Assessment Center has finally opened, with space in CWS in Rockville. A nurse and (part-time) physician with the assistance of a social worker and an interdisciplinary team are available to assess sexual and physical abuse of children and make recommendations re the child’s safety and placement.
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NFC Committee: B. Baldwin, J. Clarren, D. Ehrenstein, C. Gross, J. Karasik, P. Plunkett, B. Steckel, J. Surr, S. Tuttle.
CONSENSUS QUESTIONS
1) It is a well-established fact that our children’s success in school is largely dependent on
development and education in their early years (0-5). Child care providers and teachers in
pre-school and nursery school, or in other child care/early education settings are very poorly
compensated, regardless of the amount of training or degrees they may have. This results in
constant turnover and little incentive for entry into this very important field, especially when
MCPS teachers are so much better paid.
2) Should the county support adequate subsidies for low-income parents (families) so they can afford quality
child care and be able to continue working, and if necessary, supplement state subsidies (based on the federal poverty level) to provide assistance to families with slightly higher incomes, but still struggling to afford child care, through:
3) The process of getting children ready for school takes place in a variety of settings in Montgomery County. Listed are several types of programs currently available. Should the county support any or all of the following to ensure that lower income children receive quality care and are ready for school? Should some services be left out?