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Part 3: Mixed Approach Programs
Early Head Start Program Profile
School District 17 Early Head Start
Sumter, South Carolina
October 20 - 22, 1997
School District 17 in Sumter, South Carolina operates a new Early Head Start program for 75 families. The Sumter School District 17 Early Head Start program provides center-based and home-based child development services to pregnant and parenting primary and secondary school-age students and young high school graduates who are employed. Most of the parents in the program are African American, teenage parents. Parents are required to spend time daily with their children in the centers, where caregivers model good parenting practices, learn about parents' concerns, and respond to them. Parent educators conduct weekly home visits with families whose children are not enrolled in the centers and less frequent home visits with other families to work with them on parenting and child development, help them identify their needs and goals, and link them to services in the community. Child development services are focused on teaching parents to take responsibility for themselves and their children, teaching them how to access resources they need to be better parents, and providing high-quality child care that is child-centered, child-directed, and adult-supported.
OVERVIEW
School District 17 operates the Early Head Start (EHS) program in Sumter, South Carolina. District 17 also operates a Title 1 preschool program for 4-year-old children, and all schools in the district have extended care programs providing child care to school-age children after school. EHS is the first program for teenage parents and their children operated by District 17; however, it builds on the District's Act 135 Parenting Program. The EHS program provides services in three locations: (1) Sumter High School, (2) South Sumter Resource Center, and (3) the Instructional Center.
Community Context. The School District 17 EHS program serves all of Sumter County. Sumter is a diverse county with a population that is approximately half white and half African American. About 40 percent of the population lives in rural parts of the county. Among the key problems facing the community are violence, school dropout, teenage pregnancy, and drug and alcohol abuse. Local service providers have formed collaborative groups to address these problems.
Program Model. Sumter School District 17 operates a mixed-model EHS program. The program provides center-based child development services to families in which parents are attending school, attending an adult education or training program, and/or working, as well as to other families in which the child is eligible for therapeutic child care or in which a parent will spend at least two hours per day with the child in the center. It provides home-based child development services to families that do not want center-based child care, that are on the waiting list for center-based care, or that have discontinued adult education, training, or working. At the time of the site visit, approximately two-thirds of EHS families were receiving center-based child development services.
Families. Most of the families served by the Sumter EHS program are African American; a small proportion are white. Most of the parents are single, teenage mothers. Less than one-fifth are 20 or older and only about 5 percent are married. Approximately one-third of the mothers were pregnant when they enrolled in the program. Approximately one-third were receiving welfare cash assistance when they enrolled.
Staffing. Since the Sumter EHS program began, it has reorganized its staff structure to build more effectively on staff expertise. In each center, a lead teacher oversees the work of teacher/caregivers and caregiver aides. The education/child development coordinator supervises and provides training for the lead teachers, monitors care provided in the centers, serves as a liaison with the school district, and oversees transportation services to the centers. The health/nutrition/disability coordinator and a health educator work with families and community health care providers to ensure that families have a health home and receive needed health services. The social service/family involvement and mental health coordinator oversees recruitment and enrollment, and she supports the work of three parent educators, who provide home-based services. The program director supervises and supports the coordinators, and she plays a leading role in several community collaborative groups. At the time of the site visit, the program had recently received a Head Start Quality Improvement grant and planned to add a parent educator and a lead parent educator to the staff.
RECRUITMENT AND ENROLLMENT
Program Eligibility. The target population of the District 17 EHS program consists of pregnant or parenting students and former students who live in Sumter County and meet the EHS eligibility criteria. To be eligible, the pregnant or parenting students must be attending middle or high school at the time of enrollment. Mothers under 26 years of age who are in adult education or General Education Development (GED) classes at the time of enrollment are also eligible. Mothers who are 21 years old or younger and have graduated from high school are eligible for EHS if they are attending a higher education institution or working at the time of enrollment.
Recruitment Strategies. EHS staff members are using multiple strategies to recruit families. They have made presentations at the Department of Health and Environmental Control (DHEC) prenatal clinic and encouraged the clinic staff to make referrals to the EHS program. They have also arranged for announcements on the local cable television station, and they have sent flyers to local radio stations, which got good coverage. Staff members have visited the Department of Social Services (DSS) several times and provided application forms that can be given to interested families. In addition, they have made presentations at schools and have developed good relationships with guidance counselors and the staff in the attendance office who may know eligible students. Staff members have talked to groups, such as sororities and groups of ministers, whose members may know pregnant girls and whose minds are open to programs for pregnant and parenting teens. The program hired three outreach workers--who were teenage mothers from the program??to work one day per week during the summer. These workers contacted girls they know who are pregnant and arranged appointments for staff members to visit the girls. Program staff members also asked participating mothers to provide the names of other eligible pregnant or parenting teenage mothers and offered a $50 savings bond to the mother who provided the most referrals leading to applications. The program has received many referrals from staff members in the adult education program, the DHEC prenatal clinic staff, and the DSS staff, as well as many inquiries from potential applicants.
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Sumter is located in central South Carolina, about 45 miles east of the state capital (Columbia) and about 100 miles north of Charleston. Sumter County is a diverse county with a population that is mostly white (55 percent) and African American (43 percent). About 40 percent of the population lives in rural parts of the county. About one-fourth of families with children under 5 years old had incomes below the poverty level during the year prior to the 1990 census. Sumter, which used to have an agricultural economy, has transitioned to a largely industrial economy. Manufacturing industries account for 31 percent of local employment, while wholesale/retail trade and services account for 21 percent and 16 percent, respectively. Shaw Air Force Base is located in Sumter and accounts for 20 percent of area employment. Sumter has a relatively stable economy, but the median family income is considerably lower than in South Carolina as a whole, and unemployment is higher. Sumter was described by EHS staff members as "class-oriented and class-conscious." Neighborhoods tend to be segregated, but not completely, due as much to differences in socioeconomic status as to differences in race. All of the public schools, however, are integrated. Community representatives noted that a Unity program, implemented in collaboration with the National Association for the Advancement of Colored People, has brought a wide range of community groups together to work toward racial harmony. A distressing number of students drop out and fail to graduate from high school. On average, about half of eighth graders entering high school fail to go on to graduate. Reflecting the school dropout problem, 12 percent of teenagers are not attending school. Pregnancy rates among 14- to 17-year-olds are high (5 percent). Violence was reported by staff members to be a serious problem in Sumter. Family violence was described as "a way of life" and is rarely reported. Guns are easy to obtain. Drug-related violence tends to be limited to the housing projects and trailer parks, but many families with children, including some EHS families, live in these areas. Alcohol use by teenagers was also cited by EHS staff members as a problem, and they described drugs as easy to obtain. In 1997, 45 percent of high school students reported drinking alcohol, and 27 percent reported using marijuana monthly. Many services exist to meet the needs of disadvantaged families and children. A recent community needs assessment, however, identified unmet service needs in a number of areas, including emergency and affordable permanent housing, job training, case management, affordable child care, transportation, and substance abuse treatment. To some extent, services to meet these needs exist, but some families who need services are reluctant to seek them because of the time and commitment required, lack of information about available services, or mistrust of the system. Other needy families do not seek services because they believe that families should not get handouts and they fear stigmatization. Local service providers have been collaborating for several years to address community issues and unmet service needs. They noted that collaboration has taken a long time, but it is growing as service providers gain a better understanding of what other agencies and staff members do and as positive collaborative experiences build on each other. All local service providers participate in the Interagency Council, and subgroups of providers have formed other collaborative groups to address particular issues or needs. For example, concerns about children's health have prompted collaboration to ensure that children have medical homes and receive needed health services. Collaborative groups have also been formed to address the need for affordable housing and to promote coordination of services to prevent teenage pregnancy and alcohol and drug abuse. Local service providers reported that "turf issues" and difficulty seeing the "big picture" of how agencies fit together have posed the greatest challenges to collaboration. They noted that personal relationships developed in face-to-face meetings and staff continuity over time have been important in promoting collaboration. |
Enrollment. The District 17 EHS program is funded to serve 75 families. At the time of the site visit, 76 families, including 88 children, were enrolled. Sixty of these families are participating in the EHS evaluation research (16 families were enrolled before the research began). Since the program began enrolling families, 10 families have been removed from the program rolls because of lack of participation.
Most of the enrolled students are African American. More than 85 percent are teenagers. Most participate in the National School Lunch Program. Many have employed parents and families who provide social and financial support, but about one-third were receiving welfare cash assistance when they enrolled. Their greatest needs are support for continuing their education, including financial assistance, child care, transportation, and housing assistance. They also need help developing good communication skills, learning to be more assertive, improving their parenting skills, and developing self-sufficiency skills.
CHILD DEVELOPMENT CORNERSTONE
Overview. The District 17 EHS program provides child
development services in child development centers, as well as parenting
education by teachers in the centers and by parent educators during home
visits. At the time of the site visit, 53 families were receiving center-based
child development services, and 23 families were receiving home-based
child development services. Families whose children receive care in the
centers receive home visits by parent educators at least twice a year,
and many receive visits monthly. Parents who drop out of school, discontinue
adult education or training, or stop working receive child development
services during home visits by parent educators, which are scheduled weekly.
If these parents are willing to spend at least two hours daily with their
child in the center, their child may continue to attend the center, and
they receive home visits monthly. Children enrolled in the centers who
are at risk of abuse or neglect receive higher-quality therapeutic child
care and receive home visits twice a month.
| The Sumter EHS program staff members believe that their program will improve child development outcomes by teaching parents to take responsibility for themselves and their children, teaching parents about their children's development, teaching them how to access resources they need to be better parents, and providing high-quality child care that is child-centered, child-directed, and adult-supported. |
Center-Based Child Development Services. The program provides regular and therapeutic child care in on-site child development centers at three locations: (1) Sumter High School, (2) South Sumter Resource Center, and (3) the Instructional Center, an alternative school in the Jackson Wing of the former Edmuns High School. The Sumter High School and South Sumter Resource Center child development centers operate for 10 months (during the school year). The center at the Instructional Center operates year-round.7 One caregiver from each of the two 10-month centers will move over to work at the Instructional Center during the summer to provide continuity of care for children from their centers who need child care during the summer months while their parents are in summer school or working. The Sumter High School center operates from 8:00 a.m. to 4:00 p.m. The centers at the South Sumter Resource Center and the Instructional Center operate two 4-hour sessions, one in the morning and one in the afternoon. If parents of children enrolled in these centers need full-day care and meet eligibility requirements, they may receive extended care funded by the state's ABC Voucher program. Parents must pay $3 to $5 per week for child care funded by the ABC Voucher program. At the time of the site visit, 12 families were receiving subsidies for extended care.
Center staff members subscribe to the High/Scope philosophy that programs should be child-centered, child-directed, and adult-supported. The program uses the High/Scope infant/toddler curriculum, which provides a framework rather than a highly structured curriculum and incorporates other materials such as those from WestEd's Program for Infant/Toddler Caregivers. The Sumter Head Start program uses the High/Scope curriculum, so the coordinator expects that using it in the EHS program will facilitate children's transitions into Head Start.
Therapeutic child care is funded by Medicaid for infants and toddlers who are at high risk of being abused or neglected. The program uses a checklist for assessing risk factors and determining whether children will receive therapeutic child care. At the time of the site visit, 23 children were receiving therapeutic child care, 11 at the South Sumter Resource Center, 6 at Sumter High School, and 6 at the Instructional Center.
Center staff members work with the families of children in therapeutic child care to develop an individual treatment plan, which is reviewed and revised quarterly. Primary caregivers in the centers develop individual daily lesson plans for children in therapeutic child care and record observations of children's progress daily. The lead teachers review the daily reports and prepare summary reports weekly. Primary caregivers for children in therapeutic child care must have special training. Center staff members talk weekly with Medical University of South Carolina (MUSC) staff members who offer guidance in providing therapeutic child care.
Each child is assigned to a primary caregiver, who cares for no more than four children if providing regular child care and no more than three children if providing therapeutic child care. Maximum group sizes range from 10 for infants to 14 for toddlers. Primary caregivers are assigned to children soon after they enroll, based on observations of their interactions with caregivers. In the case of infants, the staff tries to match temperaments and avoid assigning too many "lap babies" to one caregiver. When children move from the infant room to the toddler room, they are assigned to a new primary caregiver. Primary caregivers facilitate the transition between rooms by spending time with the child in his or her new room for several weeks before the room change is made.
The Sumter EHS program participates in the Child and Adult Care Food Program, which provides snacks for children in the child development centers. Lunches are provided by the school district with funding through the National School Lunch Program. Nearly all of the children qualify for free lunches.
At all three child development centers, parents are expected to bring their children to the center themselves and to spend half an hour per day before or after school in the center with their children. Parents are welcome anytime, and some spend more time with their children in the center. During this time, center staff members build relationships with the parents and model good parenting practices. The program uses the Partners in Learning curriculum, which allows parents to choose activities to engage in with their children. Parents are also expected to attend a one-hour parenting session facilitated by a parent educator at the center each week.
Parents are also encouraged to keep a journal and to write in it at least twice a week. Parents write about their children and what is happening in their lives. Center staff members read the journals and enter responses.
Home Visits. Every family is assigned a parent educator who visits the family at home and provides both child and family development services. Parent educators attempt to visit families whose children receive regular child care monthly and to visit families whose children receive therapeutic child care twice a month. They plan weekly 90-minute home visits with families whose children are not enrolled at one of the EHS centers. The parent educators use Parents as Teachers (PAT) and Early Learning Accomplishment Profile (ELAP) resource materials to plan child development activities during home visits. Using the PAT curriculum and other resource materials, the parent educators help parents understand what can be expected for their child at each stage of development and work with parents and children on appropriate learning activities.
Group Child Development Activities. Families receiving home-based child development services are encouraged to attend parent support group meetings at the child development centers. During the summer, group meetings are held weekly with families receiving home-based services, and during the school year, these meetings are held monthly.
Other Child Care Services. The District 17 EHS program provides center-based child care to about two-thirds of enrolled families. As EHS families' needs for child care increase, program staff members anticipate that they will need to make referrals to other child care centers in the community. At the time of the site visit, they were planning to monitor the quality of care provided to EHS children by the other centers and to work with the centers to provide child development services to EHS children. At the time of the site visit, program staff members were also considering developing a collaborative agreement with a family child care provider, who would be trained by the EHS program to care for EHS children.
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The district 17 EHS program provides center-based child care to families that need child care. Some EHS families need child care during nonstandard hours and must rely on relatives or friends for child care. EHS staff members reported that there are very few other child care centers in Sumter, and in general, the quality of care they offer is minimal. Centers were described as having a preschool focus and lacking a knowledge base about infants and toddlers. Family child care exists, but it is very expensive. As a result, many families rely on informal care by relatives, neighbors, or friends. |
Child Development Assessments. Center staff members use the ELAP to assess children's progress and plan daily activities. Staff members discuss the ELAP results with parents and give them an opportunity to develop their own goals for their children. Using the ELAP, center staff members develop an individualized daily plan for each child. Staff members record observations of children's progress in these activities weekly. The staff expects to assess children's progress using the ELAP twice a year.
Health Services. Parent educators, the program's health educator, and the health/disabilities/nutrition coordinator help families make health care appointments and follow up to make sure that children get the health services and immunizations they need. Program staff members also make sure that EHS children receive the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) developmental screenings (which include the Denver Developmental Screening Test II) to which they are entitled. Parent educators watch out for health problems and ask the health educator or the health/disabilities/nutrition coordinator to follow up on any problems they detect. The health educator and the health/disabilities/ nutrition coordinator also observe children in the child development centers to detect signs of health problems. Parent educators sometimes accompany parents on initial health care visits to increase their skills and self-esteem in dealing with health care providers.
Other Child Development Services. At the time of the site visit, MUSC was planning to offer intensive home-based treatment to EHS families of children at high risk of abuse and neglect. The treatment includes 8 to 12 weeks of therapy with a therapist who is available 24 hours a day.
Services for Children with Disabilities. BabyNet is the local Part C program operated by DHEC. In South Carolina, families with a child under age 3 who has a diagnosed disability are eligible to receive Part C services. BabyNet develops an individual family service plan for families of children with disabilities who are receiving Part C services, and all service providers, including the Sumter EHS program, follow that plan. At the time of the site visit, one child had been referred to the EHS program by BabyNet, and two other children were reported to have disabilities. The health/disabilities/nutrition coordinator attends BabyNet staff meetings and follows up to try to recruit families that are eligible for EHS.
Transitions. The Sumter EHS program starts preparing children for the transition into Head Start in February of the year they will graduate from EHS. Parent educators help families with the required paperwork, ensure that information about disabilities is conveyed to the Head Start program (which is not operated by the school district), and facilitate a meeting with the Head Start staff. Program staff members also take the graduating children on a field trip to the Head Start program. The program has arranged with Head Start to consider applications from EHS children early in the Head Start enrollment period to ensure that there are enough spaces for all EHS children. During the year prior to the site visit, 10 children made the transition to Head Start.
FAMILY DEVELOPMENT CORNERSTONE
Needs Assessments and Service Planning. Parent educators attempt to develop an individual family service plan (IFSP), using the Head Start Family Needs Assessment, with all families within 30 days after they enroll. At the time of the site visit, parent educators had completed IFSPs with about half of enrolled families and had begun developing them with an additional 40 percent of families. Parent educators update the plans continuously, as families achieve their goals and move on to new ones. They build on the individual treatment plan developed by the center staff with families whose children receive therapeutic child care. At the time of the site visit, the Sumter EHS program was planning to use the new Head Start Family Information System Family Partnership Agreement forms.
Home Visits. Parent educators provide family development
services during their home visits with families to evaluate their physical
and social environments and assess the quality of their interactions,
teach parenting skills, enhance the informal support available to the
young parents, and link parents with and promote appropriate use of community
services. Parent educators also talk with parents often by telephone,
at the child development centers, in their office, and when accompanying
them to appointments.
| Family development services, which are provided during regular home visits, are based on the belief that long-term gains in the parent-child relationship and child competence cannot be expected when the intervention is primarily in the child care environment, removed from the family environment. The staff also believes that teenage parents should be held responsible, with assistance, for caring for their children. |
At the time of the site visit, the three parent educators were responsible for conducting home visits with all enrolled families. They had caseloads ranging from 17 families (the parent educator who is assigned to families with children in therapeutic child care) to 29 families. Families receiving home-based services were evenly split between the two parent educators whose caseloads do not include families with children in therapeutic child care, so that they each have 10 to 12 families with whom they need to schedule weekly home visits. At the time of the site visit, the program had recently received a Head Start Quality Improvement grant which provided funding for additional parent educators. Staff members were interviewing candidates for two additional parent educators (a lead parent educator and a regular parent educator) and expected to reduce the caseloads of the current parent educators.
Parent educators are required to have a high school diploma, two years of experience working in child care and working with families, and plans to obtain further training and PAT certification. A bachelor's degree is highly desired, and two of the current parent educators have bachelor's degrees. The social services/family development and mental health coordinator, who supervises the parent educators, seeks candidates who are enthusiastic about working with children, are aware of their own strengths and weaknesses, have good verbal and writing skills, can work independently and follow through on tasks, can work well in teams, and are not afraid to conduct home visits.
Education Services. The Sumter EHS program provides mathematics tutoring once a week for EHS parents who are Sumter High School students, and tutoring is also provided weekly at the South Sumter Resource Center. Program staff members would like to provide tutoring more frequently.
Parents are invited to participate in the in-service training
sessions and the child development associate (CDA) classes for the staff.
Starting in spring 1998, parents also have the opportunity to complete
child development classes at the high school and receive credits for them,
which may lead to an early childhood development certificate from Central
Carolina Technical College, which is located in Sumter.
Health Services. The District 17 EHS program ensures that all pregnant
teenage mothers receive prenatal care by collaborating with local health
care providers, primarily the health department clinic that serves Medicaid
clients. Staff members refer pregnant mothers to Tuomey Hospital for free
prenatal classes and car safety classes.
Other Services. The program provides transportation to enable parents to access needed services. Transportation is offered on a need-only basis, unless parents are attending Sumter High School. Buses pick up children and parents and bring them to the child development centers. At the time of the site visit, 44 families were receiving transportation to the centers. Parent educators assist parents in obtaining transportation aid available from Medicaid or the Family Independence program (South Carolina's new welfare program), and they often provide transportation themselves when parents are stranded or have occasional transportation needs.
The EHS program offers incentives to parents for participating in activities and meeting expectations. Parents receive a "big buck," which has spaces for "little bucks." They receive a "little buck" each time they attend a meeting, take their children to get immunizations, are on time to appointments, or attend a workshop. When they fill up their "big buck" with "little bucks" they can turn it in for items such as diapers.
The EHS program provides opportunities for parents who need financial assistance to perform minimal services in exchange for assistance. Parents who need money for textbooks or registration fees to enroll in GED or adult education classes or need money for special items for their infant help the office staff with filing or assist in the centers in exchange for assistance.
Father Involvement. The District 17 EHS program encourages the fathers of participating children to take part in the program and become involved in their children's lives. In August 1997, six fathers were actively participating in program activities. At the beginning of the 1997-1998 school year, the Sumter EHS program entered into a new agreement with the Salvation Army Boys and Girls Club, which will recruit fathers identified by the EHS program for recreational activities, parenting classes, and job training that it offers. The program has also entered into an agreement with the local Head Start program to include five EHS fathers in its new fathers program.
Parent Involvement in the Program. Parents of children in each center are invited to participate on the center's parent committee, which elects two parents and two alternates to serve on the EHS Policy Council. Parents receiving home-based services also have a representative on the Policy Council. The EHS Policy Council meets monthly. Parents also serve on various committees, including the executive, grievance, internal dispute, personnel, and finances committees. Parents volunteer in the EHS centers, where they read to children and help center caregivers, and at the EHS administrative offices, where they help with copying, typing, preparing application packages, and other tasks.
The Sumter EHS program sponsors many training sessions, workshops, and other events for parents throughout the year. At the beginning of each year, the program holds an orientation session for parents, in which staff members explain the program and its rules and regulations. At that time, parents receiving center-based care select a class time and center, and they receive a yearly calendar that provides detailed information about the program and its components, a community resource list, and dates for program activities. In addition, parents have been offered tickets to the "Little Theater," have been invited to participate in the Family Fun and Health Fair, have been encouraged to attend cardiopulmonary resuscitation (CPR) and first aid training, and have been invited to attend the Parent Disabilities Conference. The program also hosts a Holiday Fest and an end-of-the-year banquet annually.
STAFF DEVELOPMENT CORNERSTONE
Training. The Sumter EHS program develops an annual staff training plan based on staff members' responsibilities and observations of their performance of assigned tasks, staff members' input regarding training they need, and advice from technical assistance providers. Parent educators have received training in a variety of areas, including various aspects of child development, therapeutic child care, PAT curriculum, multiculturalism, conflict resolution, child abuse and neglect, communication and interviewing skills, and conducting home visits. Center caregivers have received training on therapeutic child care, the High/Scope curriculum, disabilities and early intervention, curriculum and child growth and development, management skills, CPR, conducting ELAP assessments, and family-staff communication. Health educators have received nutrition and PAT training.
The EHS program also encourages staff members to seek other staff development opportunities by reimbursing them for tuition, up to $325. Central Carolina Technical College offers training to obtain the Advocates for Better Child Care (ABC) child care credential for center-based caregivers and to obtain the CDA. The EHS program will provide a CDA advisor at no charge. The EHS program encourages child care center aides to get their CDA credential. The program also encourages parent educators to get PAT certification, and two parent educators are pursuing a CDA home visitor certificate.
Some funds are available for memberships in professional organizations, subscriptions to professional publications, and professional license fees. Staff members may arrange for time off to attend professional meetings.
Staff Supervision and Support. The EHS program director and coordinators hold regular weekly meetings to provide supervision and support to staff members. The program director meets weekly with the three coordinators to assess progress in meeting weekly goals. The coordinators meet weekly with the staff members they supervise. In addition to the scheduled meetings, coordinators are available as needed for consultation on specific cases or situations.
The education/child development coordinator meets weekly with lead teachers to discuss the therapeutic and regular child care they provide (addressing daily plans, whether strategies are working or not, and paperwork) and to provide training. Lead teachers in each center meet with primary caregivers for half an hour per week. Staff members involved in providing therapeutic child care also participate in a weekly consultation with staff from MUSC.
The social service/family involvement/mental health coordinator meets with parent educators for two hours weekly. MUSC staff members participate during part of each weekly meeting. In addition, the social service/family involvement/mental health coordinator accompanies each parent educator on at least one home visit per month, either at the parent educator's request or when a family is facing a crisis. The coordinator and parent educators also meet for group staff meetings when parent educators need advice and guidance on how to serve a particular family.
The program director and coordinators also participate in weekly meetings that support their work. The program director meets weekly with a District 17 administrator who makes recommendations and seeks approval from the Board of Trustees for program changes when necessary. The director and coordinators meet weekly with MUSC staff members to discuss program improvement.
Formal performance assessments are conducted with staff members once a year. In addition, the coordinators discuss job performance with staff members throughout the year in individual conferences. Salaries are based on the District 17 salary scale. Staff members receive fringe benefits that are much more generous than those offered by local child care providers.
The Sumter EHS program sponsors activities to encourage good staff morale. The staff has an advocacy committee and a hospitality committee, which often work together and plan monthly staff activities. The program has an incentive plan by which all staff members who miss less than one or two days during the month get part of the "pot" (proceeds from selling doughnuts and from other fund-raisers). The program hosts parties for the staff during the winter and at the close of school. The program director has placed a suggestion box at each center to give staff members opportunities to contribute ideas and activities that would benefit the program.
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Implementation of welfare reform changes began in October 1996 in Sumter County (in most other South Carolina counties, changes in welfare policy under a federal waiver began prior to 1996), and at the time of the site visit, a representative of the Department of Social Services indicated that officials were just beginning to get a feel for what they were doing. In South Carolina, welfare recipients are now limited to 5 years of cash assistance over their lifetime, and cash assistance is limited to no more than 24 months out of 120 consecutive months. Recipients must engage in work as soon as they are judged able to do so; however, parents of infants under 1 year old are exempt from the work requirement. Families may receive up to 24 months of transitional Medicaid and child care benefits. Approximately one-third of EHS families were receiving cash assistance when they enrolled in the program. EHS staff members expected that the new work requirement and limits on cash assistance would increase the need for child care and for extended child care hours. At the time of the site visit, welfare reform changes had not yet had major impacts on EHS families. Program staff members reported that many families did not yet understand the ramifications of the new rules and saw them as just another threat. The Sumter EHS program, however, had begun planning changes to respond to the changing needs of families. Although the staff had planned to keep only one of the child development centers open during the summer, the staff anticipated that it would be necessary to keep two and possibly all three of them open to accommodate the needs of parents who must work. The staff was working with the ABC Voucher program to arrange subsidies for care during the summer. Staff members also noted that many of the young mothers receiving Temporary Assistance for Needy Families (TANF) cash assistance were getting jobs during nonstandard hours, and staff members were beginning to look for funds to enable them to keep the EHS centers open 24 hours a day. Because more young parents were getting jobs, the need for child care had increased, and the program had begun working with the ABC Voucher program to take more applications and make arrangements to refer parents to other centers in the community. Ensuring high-quality child care in these arrangements, however, will present a challenge for program staff. Because the new welfare rules emphasize employment and discourage young parents from finishing school, the program director reported that the EHS program's eligibility rules may need to be changed to include not only young parents who are in school or training but also young parents who are employed. Sumter EHS staff members also anticipated that they would need to offer more parent training to build self-sufficiency skills, such as money management. Finally, the program had entered into a work support agreement that allows TANF recipients to assist in the EHS centers. |
Staff Turnover. At the time of the site visit, staff turnover had been low. Since the program began, three center caregivers had left the program and been replaced (two left shortly after the program began). One parent educator left the program in the summer of 1997.
COMMUNITY BUILDING CORNERSTONE
Program Collaborations. The District 17 EHS program has written agreements to collaborate with nine agencies. EHS staff members also collaborate informally with many local agencies and programs. Four of the written agreements include the provision of services to EHS staff members or families. The agreement with the Wateree Head Start program includes cross-training of staff and cross-referrals of families and invites participation by an EHS parent on the Head Start Education Advisory Committee. In addition, the education/child development coordinator serves on Head Start's Transition Committee, offers workshops for Head Start parents transitioning to public school, and coordinates with other Head Start education coordinators and public school coordinators in implementing the High/Scope curriculum. As noted earlier, the Head Start program has also agreed to include five EHS fathers in its new fathers program.
The collaborative agreement with Central Carolina Technical
College will provide an opportunity for EHS parents who are students at
Sumter High School to take child development classes taught by a Central
Carolina Technical College staff person at Sumter High School starting
in spring 1998. As noted earlier, they will receive college credit toward
a certificate in early childhood development. The agreement also includes
opportunities for Central Carolina Technical College to use the EHS classrooms
for laboratory experiences for its students and to provide staff members
with ABC-approved credits for the 15 hours of annual training required.
The agreement with the Clemson University Extension Service includes prenatal
and parenting classes for teenage parents, as well as other staff and
parent training. The Extension Service works with EHS families on budgeting,
home management, and other topics that parents select. At the beginning
of the 1997-1998 school year, the Sumter EHS program entered into a new
agreement with the Salvation Army Boys and Girls Club, which will recruit
fathers identified by the EHS program for recreational activities, parenting
classes, and job training that it offers.
Interagency Collaboration. The EHS program is a member of the Teenage Pregnancy Prevention Collaboration Council, which has met monthly since 1989 to plan for unmet needs and to refine interagency agreements. It is coordinated by the Clemson Extension Service. Participation in this group facilitates referrals among agencies.
EHS staff members also participate in the meetings of many other community agencies, including the Interagency Council (a collaborative group of all Sumter agencies formed five or six years ago), Wateree Children's Council (BabyNet local interagency coordinating group), and Project Ideas, and they serve on several agency advisory boards. EHS staff members play a leading role in the Interagency Council, which meets monthly to discuss upcoming funding opportunities, strategies, activities, and resources. The program director belongs to various community and state councils on child care and parenting. The director serves on the Advisory Board of the Salvation Army Boys and Girls Club and is active in the South Carolina Head Start Directors Association. The social services/parent involvement and mental health coordinator serves on the Community Disabilities Board and the YWCA board. The health/nutrition/disability coordinator is an active member of the March of Dimes, BabyNet, and Tuomey Regional Hospital Family Center advisory groups.
Community-Building Among Parents. The District 17 EHS program promotes community building among parents by encouraging participation in each center's parent committee. The program was also planning to identify opportunities for parents to become involved in the community through volunteer activities and employment opportunities. The EHS program will sponsor four social functions for families per year.
Community Support for EHS. The EHS program encountered some initial opposition in the Sumter community, but support for the program has grown as community members have become more familiar with the program. Some community groups were opposed to the EHS program (for example, the Chamber of Commerce and some white church groups) because they prefer sending a pregnancy prevention message rather than supporting intervention for teenage parents. Local ministers raised questions about whether the EHS program would promote marriage among the teenage mothers. Other opposition arose from concerns that local tax dollars were paying for the program, and that the program would promote teenage pregnancies.
In response to the opposition, the EHS program prepared a flyer addressing seven myths about the program. It also held community meetings and invited community members to visit the program to learn about what it is doing. Program staff members and school district officials believe that these efforts have increased public acceptance of the program. EHS has received many requests to expand to other neighborhoods.
CONTINUOUS IMPROVEMENT AND LOCAL RESEARCH
Early Program Support. The EHS program received technical assistance in setting up its centers from Wateree Head Start, the state Head Start Collaboration office, the Department of Education, and Shaw Air Force Base Child Development Center. Wateree Head Start social services has invited staff and parents to attend its training workshops.
The EHS program has asked representatives from the Technical Assistance Support Center (TASC) and the Resource Access Project (RAP) to assess the program and its technical assistance needs. These representatives, however, have asked the program to make specific requests for technical assistance. At the time of the site visit, EHS staff members were planning to work with their TASC representative on interactions with toddlers. Program staff members have attended regional workshops on fiscal management, new program orientation, and disabilities.
The program also receives support in providing therapeutic child care through weekly telephone consultations with Medical University of South Carolina staff. In addition, the program has received support from its federal project officer and Zero to Three consultant.
Continuous Program Improvement. A team of researchers from the Medical University of South Carolina's Family Services Research Center is the Sumter EHS program's partner for continuous program improvement and for local research as part of the national EHS evaluation. The MUSC team, which is led by a psychiatrist with expertise in services for substance-abusing and mentally-ill families, first met with the EHS staff after receiving the EHS grant.
To help the District 17 EHS program with continuous program improvement, MUSC staff members plan to (1) conduct a survey of the program staff every six months and provide feedback to the program; (2) assess whether the program is meeting standards for therapeutic child care and intensive home-based services for families at risk, using an existing protocol and providing weekly feedback; (3) document the in-home parenting services and provide feedback; (4) conduct interviews with key community leaders and agency heads; (5) conduct focus groups with a subset of participants; and (6) assess how well EHS is integrated into the school district and provide feedback to the program and, eventually, to the school district. At the time of the site visit, the local research team had recently worked with the staff to implement a time sampling procedure to assess how staff members' time is spent. The local research team leader meets with program staff weekly by telephone or in person to share information and discuss families.
Local Research. The local research will extend the national evaluation to examine the differential effects of intensive EHS services in a target population of teenage mothers affected by substance abuse or mental illness. Specifically, the local researchers will explore whether teenage mothers with substance abuse or mental illness who receive intensive home-based treatment or therapeutic child care have decreased substance use, improved mental health, and better school and family outcomes than their counterparts in the comparison group. The local research will also explore patterns of parent and child outcomes over time in families receiving regular EHS services, EHS therapeutic child care, and EHS intensive home-based treatment. The local research team is conducting assessments of parent and child outcomes at enrollment and 6, 12, 18, 24, and 36 months after enrollment, and staff members are collecting information on services biweekly. The local research team is also collecting qualitative information to document service planning and referral processes, parents' experiences in the program, and the process of program intervention.
PROGRAM SUMMARY
The Sumter EHS program serves primarily teenage parents and offers much-needed child care services to enable them to continue their education or pursue a job. The program provides state-funded therapeutic child care, with lower staff-child ratios, to eligible at-risk children. For parents who are not in school and do not have a job, the EHS program provides child development services in weekly home visits. At the time of the site visit, the program had recently received Head Start Quality Improvement funds and planned to add new staff members to strengthen its home visiting services. At the time of the site visit, the program was also taking steps to adapt its services to the changing needs of families affected by welfare reform.
PROGRAM DIRECTOR
Anita Kieslich
Sumter School District 17
P.O. Box 1180
Sumter, SC 29150
LOCAL RESEARCHERS
Susan Pickrel
Medical University of South Carolina
Department of Psychiatry and Behavioral Sciences
Annex III
171 Ashley Avenue
Charleston, SC 29425-0742
Richard Faldowski
Medical University of South Carolina
Department of Psychiatry and Behavioral Sciences
Annex I, Room 117
171 Ashley Avenue
Charleston, SC 29425-0742
Michael Brondino
Medical University of South Carolina
Department of Psychiatry and Behavioral Sciences
Annex III
171 Ashley Avenue
Charleston, SC 29425-074
7 Because the new welfare requirements are increasing the need for child care, the program anticipates that it will need to keep at least two of the centers open durring the summer of 1998. [back]
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