Highlights from the Past…
Planning for the Future…
December 3, 2005
Sheraton Hotel
Burlington, VT
The first things we need to do…are
• Organize our thinking and move beyond the
traditional outcome domains and silos around which
we have traditionally organized our work.
• Establish outcomes and indicators that cut across
these traditional domains.
• And construct a prevention oriented outcomes
approach.
Traditional Outcome Domains
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Health
Education
Employment Security
Safety
Sport
Culture
Etc.
The traditional outcome domains are the
way that governments, all over the world,
organize their work
But, that is not the way that
people organize their lives
…Following is a
Prevention Driven Outcomes
Model
For example
That is closer to how people organize
their lives
ALL
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Pregnant Women & Young Children Thrive.
Children are Ready for School.
Children Succeed in School.
Children Live in Stable, Supported Families.
Youth Choose Healthy Behaviors.
Youth Become Successful Adults.
Families & Individuals Live in Safe & Supportive
Communities.
• Elders and People with Disabilities Are Resources
in their Communities & Live with Dignity &
Independence in Places They Prefer.
And…here are two examples of
how…
We can measure these cross cutting
outcomes
An Outcomes & Indicator
Sampler
• Pregnant Women & Young Children Thrive
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Low Birthweight Babies
Pregnant Women Smoking Rates
% Births w/ Adequate prenatal Care
% Women w/ prenatal Care in 1st Trimester
Infant Mortality Rate
Toddler Immunization Rate
% of Young Children w/ Health Insurance
Rate of Injury Resulting in Hospitalization
Young Children Poverty Rate
An Outcomes & Indicator
Sampler
 Children Are Ready for School
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Child Abuse/Neglect Rates 0-6
Incidence of Childhood Lead Poisoning
Incidence of Childhood Asthma
Incidence of Hunger/Malnutrition
Preschool Participation
% Kindergartners Fully Immunized
% Children Ready for Kindergarten
Powerful Outcomes
& Their Indicators…are
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Clear & Declarative
Bigger than You
Connect Emotionally
Positive
Measurable
Comparable
Presented Over Time
Powerful Outcomes
& Their Indicators…are
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Extended Beyond Political Cycles
National, Statewide, Local
Interactive
Accumulative Over Time
Secondly…
We created a data array for the outcome
we wanted to work on over time, by
looking back as far as we could.
And…
• They didn’t get hung up on trying to do
everything at the same time…
• Because…
Anywhere Leads to Everywhere
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Infant Mortality- connected to
Pregnant Mom Smoking Rates - connected to
Higher Education Levels - connected to
Dropouts - connected to
Teen Pregnancy Rates - connected to
Child Abuse Rates - connected to…………...
And…
• We adopted some important statewide
strategies, which, over time, helped
bring more strong results.
Instead of Thinking Services …
Think Strategy
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Common purpose
Communities & families
Citizen participation
Service collaboration
Human relationships
Public health style communications
A Community Based Strategy:
All Families Receive ‘New Baby’
Visits
Improved
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% Children (0 - 5) with elevated lead levels
Child abuse & neglect victims
Late or no prenatal care
2 year olds fully immunized
Teen sexually transmitted diseases
Infant mortality
Child deaths
Children with health insurance
Parentage established
Child support cases with collections
Next…
We created data sets for our communities to
use to help decide which outcomes and
indicators were the most important to
change for the community.
Next…using the community
profiles
• We held data mirrors up to some of our
communities so they could see for the first
time real information about what was
happening in their community.
• And, many communities, with help from the
State of Vermont decided to do something
about what they saw.
We also worked hard…
To communicate our changing
indicators
The Results
Over time
10% to 30% Improvement
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Children with health insurance
Births to Women Receiving 1st Trimester Care
12th graders using alcohol (last 30 days)
Elders in nursing homes
Adults who are ‘binge drinkers’
Repeat births to teens
People with disabilities employed
Deaths from heart disease
Two year olds fully immunized
Adults that smoke
11.8%
13.9%
18.9%
20.0%
21.4%
22.1%
23.3%
25.0%
27.9%
29.7%
b
1984-2001
1980-2002
1993-2003
1992-2002
1990-2002
1986-2002
1990-2000
1990-2002
1989-2002
1982-2002
30% to 50% Improvement
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12th graders smoking (over last 30 days)
35.3%
Violent crimes (per 100M)
40.1%
Births to women receiving late or no prenatal care 40.7%
High school graduates to higher education
41.7%
Youth (16-19) not attending school or working 45.5%
Teen birth rate (age 15 – 19)
46.7%
Alcohol related teen motor vehicle deaths
47.1%
Deaths from motor vehicle crashes
48.9%
Property crime (per 100M)
49.6%
b
1993-2003
1980-2002
1980-2002
1978-2001
1986-2000
1974-2002
1990 -2002
1980-2002
1980-2002
Greater than 50% Improvement
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Young teen pregnancy rate (age 15-17)
Infant mortality
Alcohol related motor vehicle crashes
Institutionalized for mental illness
Institutionalized for developmental
Knowing who the father is
Child support cases with collections
Families receiving ‘new baby’ visits
Schools participating in school meals
51.7%
61.4%
63.9%
81.7%
100%
126%
175%
223%
537%
b
1974-2002
1980-2002
1988-2002
1980-2001
1998-2002
1988-2001
1985-2002
1994-2002
1989-2002
National implications…of the
Vermont outcomes and indicator work
– Vermont, over the last 15 years, has proven that the work
can contribute to significant and measurable results
– The work can bring agencies and communities together
around common purpose
– The work is low cost and high value
– Outcomes and indicators can bring a higher purpose to
the everyday work of our employees and contractors