Vermont
Accountability,
Collaboration
and Results
2004 Community Indicators Conference
March 13, 2004
Entrepreneurial Strategies
Clear Mission & Goals
Embrace Accountability
Redesign Production Processes
Adjust Administrative Systems
Performance Consequences
Change Organizational Culture
Clear
Mission and Goals
Vermont State Team for
Children, Families, and
Individuals
Mission
To work in partnership
with communities to improve the
well-being of children families
and individuals
Vermont Association of
Regional Partnerships
Vision
Vermonters helping Vermonters thrive!
Mission
To work in partnership with local, state and
national partners to improve the well-being of
Vermont’s children, families, individuals and
communities.
Vermont Association of
Regional Partnerships
Core Partnership Functions To Build Community Capacity
 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
Embrace
Accountability
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 Individuals
February, 2004
Vermont Agency of Human Services Reorganization
17 Focus groups were conducted between October 13 and November 12 and were
held at various locations across the state selected by the partner groups
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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)
Redesign
Production
Processes
Vermont Agency of Human Services
Common 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 Friendly
Family 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
Vermont Agency of Human Services
Office of Information and Network Systems
Home
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
Report Menu
Vermont Agency of Human Services
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
Home
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
Composite Indicator-Progress Score*
10
8
6
4
2
0
-2
-4
-6
-8
-10
OC 1
2003
2004
n/a
n/a
OC 2
OC 3
OC 4
OC 5
OC 6
OC 7
OC 8
OC 9
OC 10
6
n/a0
-2
-4
2
-2
3
1
5
-1
-3
5
0
3
5
0
0
-3
Outcomes
2003
2004
“Outcomes Progress-Index”
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?
Change
Organizational
Culture
“What Works” Series
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
Spending on Outcomes by AHS through Grants to Organizations
Morrisville
Statewide
15.9%
12.3%
1.6%
2.7%
0.3%
0.8%
3.6%
1.8%
1.0%
0.9%
1.6%
0.7%
0.9%
0.9%
1.9%
0.7%
10.1%
6.8%
54.5%
15.9%
18.8%
46.3%
Families, youth, and individuals are engaged in their
community's decisions and activities.
Youth choose healthy behaviors.
Youth successfully transition to adulthood.
Pregnant women and newborns thrive.
Adults lead healthy and productive lives.
Children are ready for school.
Elders and people with disabilities live with dignity and
independence in settings they prefer.
Children succeed in school.
Children live in stable, supported families.
Communities provide safety and support to families and
individuals.
N/A
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 in
3 V.S.A. §3026(a).”
Internal
Inclusion
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 Partnerships
Regional 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 FOR
FAMILIES AND INDIVIDUALS
Indicator Reports
Community Profiles
http://www.ahs.state.vt.us/03compro/03ComProExpl.cfm
Social Well Being of Vermonters
http://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 Report
http://www.ahs.state.vt.us/PDFFiles/OutcomeBasedPlanning03.pdf
Managing
For
Results
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 Individuals
February, 2004
State Team Outcome # 6
State Team Outcome # 6
Youth Choose Healthy Behaviors
Youth Choose Healthy Behaviors
Heartening Indicators
Troublesome Indicators
Youth Risk Behaviors Decline with Number of Assets
Percent of surveyed 8th-12th graders reporting the
behavior
70
Ever Had Sex
60
Alcohol Use (past 30 days)
Physical Fighting (past year)
Marijuana Use (past 30 days)
50
Cigarette Smoking (past 30 days)
Binge Drinking (past 30 days)
40
Planned Suicide
30
20
10
Source: 2003 VT Youth Risk Behavior Survey,
volunteer sample (N=31,814).
0
0
1
2
3
4
5
6
Number of Self-Reported Assets*
*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.
Grades Earned Among Students Whose Parents Talk or
Do Not Talk to The Regularly about School
45%
40%
35%
Monthly or Less
Weekly or More
30%
25%
20%
15%
10%
5%
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.
At Risk or OVerweight Status of Vermont Students
Grades 8-12
25%
At Risk
Overweight
20%
15%
10%
5%
0%
2001
2003
Percent of Students who Used Marijuana
1 or more days during past 30 days
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).
50%
2001
2003
40%
30%
20%
10%
0%
8
9
10
11
12
F
Grade
M
ALL
Gender
0%
Mostly B's
Mostly C's
Reductions in 30 day prevalence of alcohol, cigarette
and marijuana use among 8-12th grades in New
Directions communities
60%
50%
1997
50%
2001
41%
36%
40%
31%
30%
22%
26%
20%
10%
0%
Alcohol
Cigarettes
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.
D's and below
Marijuana
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.
Vermonters Who Have Used Heroin and Received Treatment
Substance Abuse Treatment by Age
500
450
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.
400
Number of People
Mostly A's
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.
350
300
250
200
150
100
50
0
1998
1999
2000
2001
2002
2003
Fiscal Year
<18
18-24
25-34
35-44
45+
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.
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 Line
Good Results
Have Avoided Costs
Of Approximately
$247,000,000
Toward An Economics Of Prevention – Nov 2000
http://www.financeproject.org/vermont.htm