Celebrating all things kids in RI
Rhode Island Kids Count releases its 23rd annual Factbook, with 72 indicators to measure health and well being of children
WARWICK – Bright and early on Monday morning, April 10, Rhode Island Kids Count will celebrate children in its annual rite of spring at the Crowne Plaza, when it releases its tome of data known as the 2017 Factbook, with more than 200 pages of detailed, comprehensive, evidence-based analysis of the health and well being of kids in Rhode Island.
A parade of politicians, including Gov. Gina Raimondo, Sen. Sheldon Whitehouse, Rep. Jim Langevin, Rep. David Cicilline, R.I. House Speaker Nicholas Mattiello, and R.I. Sen. Josh Miller, are scheduled to receive their individual copies of the Factbook, now in its 23rd edition.
They will also sing the praises of Rhode Island Kids Count and the advocacy and leadership of its executive director, Elizabeth Burke Bryant, in creating what has become the policy Bible for all things kids in Rhode Island.
For almost a quarter-century, Bryant and her team have been at the helm of a successful research enterprise, serving as optimistic, tireless advocates for children in Rhode Island, exhorting the belief that investing in children is the pathway to a better, more prosperous future.
“By implementing well-informed, data-driven policies, we can improve the health, development and education outcomes for Rhode Island’s children that will pave the way for the strong workforce and engaged citizens Rhode Island needs to thrive,” Bryant said, in the embargoed news release accompanying the Factbook.
The uplifting messaging, combined with the detailed data-driven facts, has provided Rhode Island policymakers with the gold standard of evidence-based analysis upon which to make good decisions.
In turn, most policymakers and elected officials will testify at the celebration that they are devout believers when it comes to quoting the “scripture” to be found in the Rhode Island Kids Count Factbook.
The longitudinal data, tracked and compared over years, broken down for each of Rhode Island’s 39 cities and towns, provide an unparalleled richness in metrics and trends.
But what happens when the reality of budgets, policies and partisan politics collide? What happens when the accurate details somehow get lost in translation?
A shift in the rotational axis
There has been a significant shift, it seems, in the tilt of the Earth’s rotational axis, reflected in the election of President Donald Trump, with the pendulum swinging away from scientific, fact-based evidence toward faith in the divine right of wealth and, in turn, a belief that the poor are somehow undeserving and unworthy of receiving benefits.
[For instance, members of the current Republican Congress have proposed that work requirements be attached to Medicaid benefits under the initial plan to repeal and replace Obamacare.]
As the latest edition of the Rhode Island Kids Count Factbook states explicitly, “poverty” is related to every one of the 72 indicators measured in five areas that affect the lives of children: family and community; economic well-being; health; safety; and education.
The numbers in the 2017 Factbook tell the story: “Between 2011 and 2015, 20 percent [43,282] of Rhode Island’s 212,038 under age 18 lived in households below the federal poverty threshold.”
At the same time, another take-away from the 2017 Factbook is that the number of births in Rhode Island has been in steep decline over the last decade.
• Between 2007 and 2016, the number of babies born to Rhode Island women living in Rhode Island declined by 15 percent, from 12,010 in 2007 to 10,212 in 2016. [In 2015, Rhode Island had the fifth-lowest birth rate in the nation, with 10.4 births per 1,000 women ages 15 to 44.]
One more telling detail: Of those 10,212 births in 2016, some 63 percent, or 6,475 newborns, screened positive by the R.I. Department of Health for one or more risk factors associated with poor development outcomes – being born to low-income mothers, being born to single mothers, being born to mothers without a high-school degree, or being born to mothers younger than 20.
With a declining birth rate and one-fifth of all children in Rhode Island living below the poverty line, the overarching question becomes: what are the best economic policy strategies to pursue to change that equation? Reducing or eliminating the car tax? Reducing business regulations? Raising the minimum wage? Building more healthy, affordable housing? Providing two years of free college education?
It is worth repeating what the 2017 Rhode Island Kids Count Factbook had to say about the significance of infants born at risk and the challenges to future economic and educational achievement:
• “The basic architecture of the human brain develops during the infant and toddler years. By age three, a child’s brain has grown to 90 percent of its adult size and the foundation of many cognitive structures and systems are in place. Early experiences lay the foundation for future learning, and strong, positive relationships are the building blocks for healthy development. Babies who have positive, predictable relationships with parents and other caregivers have a sturdy foundation to achieve healthy growth and development, while babies who do not have a strong relationship with a nurturing caregiver often encounter challenges in future learning and development.”
And, in terms of screening legislative priorities and economic incentive packages and tax breaks, here is one more resonant significant factor from the 2017 Rhode Island Kids Count Factbook:
• “Infancy is a time of great opportunity and vulnerability. A child’s development can be compromised by ‘toxic stress’ caused by a variety of adverse childhood experiences and risk factors.”
Translated, without the necessary nurturing and supports in place for children under age 3, all the rest is commentary.
Perhaps the R.I. General Assembly needs to apply its own toxic stress risk factor screening assessment for all of the legislation it seeks to enact in the name of economic progress.
The limits of evidence-based “facts”
Call it a disliked fact: there are some distinct limits on policy based upon evidence-based, data-driven analysis, when saving money in the budget comes into conflict with saving lives.
Those limits have been exposed by two recent scandals:
• The botched roll out of the $364 million Unified Health Infrastructure Project, which has torn huge holes in the safety net for many of the Rhode Island’s poorest, frail and most vulnerable residents. The underlying presumption was that a software system built by Deloitte as a single technology portal for all Rhode Islanders receiving government benefits would create efficiencies, save money, and improve access to services. In advance of the launch on Sept. 13, 2016, dozens of employees at the R.I. Department of Human Services were laid off, with many being switched to jobs at the R.I. Department of Children, Youth and Families.
• The report by the Office of the Child Advocate on the deaths and near deaths of six young children in Rhode Island, whose families were well known to the R.I. Department of Children, Youth and Families. Most of the incidents under investigation took place while the agency was under the leadership of former interim director Jamia McDonald, who left her position to take a job as a consultant with Deloitte.
As ConvergenceRI reported in its March 27 issue: “A scathing report by the Office of the Child Advocate [was released on March 23], examining four deaths and two near-deaths of children between Oct. 12, 2016, and March 1, 2017, in which all six families were well known to the R.I. Department of Children, Youth and Families and its Child Protection Services.
The 56-page report put DCYF’s dirty laundry in a full-frontal display of the facts: inadequate staffing, a high rate of turnover, high caseload numbers that exceed national standards, the breakdown of hot-line services, among other findings.
To quote the report: “As of March 1, 2017, every social worker within the Monitoring and Intake Units [was] carrying caseloads above the national best practice standard. Eight of the nine social workers in the Intake Unit are carrying caseloads equivalent to double the national best practice standard of 12-15 cases and three of the nine workers [were] assigned triple the number of cases than what is recommended. With such demanding caseloads, it is extremely difficult to appropriately assess, monitor and support the needs of the families assigned.”
To be clear: none of the shortcomings of DCYF are related to 2017 Rhode Island Kids Count and its Factbook, which accurately reported and analyzed the numbers under the category “Safety” for child deaths, youth violence, gun violence, homeless and runaway youth, youth referred to family court, youth at the training school, children of incarcerated parents, children witnessing domestic violence, and child abuse and neglect.
For instance, the Factbook reported: “Between 2015 and 2016, the numbers of unduplicated child maltreatment reports increased by 4 percent, completed investigations decreased by 8 percent, and 'indicated investigations' decreased by 7 percent.”
Further, the Factbook reported: “Of the 14,942 maltreatment reports in 2016, 53 percent [7,948] were classified as “information/referrals” [formerly “early warnings”]. Information/referrals are reports made to the CPS Hotline that contain a concern about the well-being of a child but do not meet the criteria for an investigation.”
However, as the March 23 report by the Office of the Child Advocate noted: “Each of the six cases under review presented with numerous risk factors for the victims and their families. Even though the allegations fit the criteria and standards for an investigation, many of the calls were placed in the category of an Information/Referral.”
Translated, although the Rhode Island Kids Count Factbook accurately identified the trends and the numbers, the meaning behind the numbers was not fully understood – until the deaths and the near-deaths of six children provided the context: cases that should have been investigated by DCYF as a result of calls to the hotline were instead, apparently in contradiction to DCYF policy, being placed into the category of Information/Referral without an investigation.
[The new DCYF director, answering questions before the House Oversight Committee, said that she had hired more than a dozen new frontline workers at the agency. When asked why she had been able to fill the positions so quickly and why the positions had not been filled, she said she didn't know.]
A conversation with Elizabeth Burke Bryant
In advance of the release of the 2017 Rhode Island Kids Count Factbook, ConvergenceRI talked at length with Elizabeth Burke Bryant, the executive director of Rhode Island Kids Count. Here is the interview.
ConvergenceRI: What stands out for you in this year’s Factbook?
BRYANT: No matter how many times we’ve published the Factbook, I’m still learning more about children and families and the interrelationships of these issues. It is the reason we do our work.
We have created a tremendous reservoir of information, but it strikes me, more and more, how important it is to paint the fullest picture of children in Rhode Island.
What jumped out again this year is that we are seeing a decrease in the population of children in Rhode Island. The number of babies born to women in Rhode Island had declined by 15 percent over the last decade, from 12,010 in 2007 to 10,212 in 2016.
We are also seeing a growing trend toward more racial and ethnic diversity in Rhode Island, with a decline of the non-Hispanic White population of 21 percent between 2000 and 2010.
This trend reflects the national trend. In 2015, 52 percent of all U.S. children were non-Hispanic White; by 2023, more than half of all children in the U.S. will be children of color.
In Rhode Island, the latest data shows that for young children ages 0-4, 56 percent are non-Hispanic White in 2015.
The way the trend is looking at this point in Rhode Island mirrors the national trend, that the percentage of “minority” children will become the majority over time.
ConvergenceRI: Where do you see the biggest challenges? Are we at the end of an era? Is the pendulum swinging back against the gains made for children in the last decade?
BRYANT: What the Factbook really shows is the importance of investment in things like preventive health care, to get in early with primary care, to reduce the costs of emergency care.
We can show that prevention works. You save so much money in mental health care, dental care.
A big part of that effort is a strong commitment for health insurance in Rhode Island for children. We have 97 percent coverage, which is almost universal coverage.
We know that a big part of that is our state’s commitment to health coverage for children, which relies on the significant federal commitment to Medicaid and CHIP [Children’s Health Insurance Program].
It is our hope that the federal government will continue to prioritize the reauthorization of CHIP.
It is good news that the American Health Care Act did not pass; we need to closely monitor Congressional action. The fight is not over; really good information flowed about what is at stake with proposed changes to the kinds of [insurance] benefits that are very essential to positive health outcomes. It’s very much on the radar screen.
We’ve come so far, with very good outcomes, with cost-effective results, to do all that we can to keep children and parents and pregnant women insured.
ConvergenceRI: The recent report by the Office of the Child Advocate investigating four deaths and two near deaths of children under DCYF care has raised questions about the policies in place to protect children at the agency. Is there data within this year’s Factbook that is relevant to this discussion?
BRYANT: We do have data that is very relevant to the extremely terrible deaths of four infants and two near deaths.
This is an unusually high number in a small period of time. There is always a lag time in the data and the complete confirmation of deaths.
What we found in the Factbook is that when comparing data between 2015 and 2016, there was an increase of 4 percent in the number of child maltreatment reports, while completed investigations decreased by 8 percent, and 'indicated investigations' decreased by 7 percent.
That points to a concern about the ways that determinations of cases are made, which warrant an investigation, and which do not.
Another point of concern noted in the Factbook: Of the 14,942 hotline calls, 53 percent were classified as information referrals and not referred to investigations.
The data points to the importance of criteria to assess risk by the department, [particularly for] those families with prior involvement with DCYF, which was one of the findings of the Child Advocate report.
ConvergenceRI: In terms of the ongoing epidemic with substance use disorders and overdose deaths in Rhode Island, which have now reached 336 for 2016, do you think there is a need to look further at what sociologists are now calling the diseases of despair, connected with economic issues related to de-industrialization?
BRYANT: That’s a really good question. We continue to say, that while we have 72 indicators of child well being, poverty is the number-one indicator. It has impact on everything we track.
The percentage of children living in poverty in Rhode Island is 20 percent, 40,556. It’s about one in four for children under the age of six.
Economic stress definitely has been shown to be related to suicide and drug addiction.
ConvergenceRI: Where do you see the next generation of leaders coming from to advocate on behalf of children, given all the changes at the State House and in the R.I. General Assembly?
BRYANT: First of all, Rhode Island Kids Count is constantly reaching out to our partners in government, to provide the best research and information around what works to move the [needle] in the right direction.
There are always changes. We are continuously gratified when to go to hearings at the State House, legislators are using the data from our Factbook.
We know that the Governor’s office uses the Factbook all the time.
We have had a lot of leadership, some of it still in place, as well as new leaders, wanting to be champions of good policy [on behalf] of children.
ConvergenceRI: What haven’t I asked about that you would like to talk about?
BRYANT: We are continuing our comprehensive look at education in Rhode Island. All of our kindergarteners now have access to full-day kindergarten in Rhode Island.
We continue to focus on improving third-grade reading levels; we have seen a small amount of progress in the last year, moving from 37 to 40 percent [in reaching that level].
We are still showing gaps by income and by race and ethnicity.
This year we’ve added college enrollment and completing college, the companion indicators to college preparation and access. It really goes to the heart of the opportunity gap in Rhode Island.
By 2020, 71 percent of the jobs will require post-secondary education beyond high school. Yet overall in Rhode Island, only 34 percent of those between the ages of 25 and 64 have a bachelor’s degree or higher.
The graphic on Page 162 of the Factbook flags the opportunity gap, showing the large difference between low-income students and higher-income students.
While 59 percent of higher-income students who graduated high school in 2015 immediately enrolled in four-year colleges, college, only 25 percent of lower-income students enrolled in four-year colleges, showing that there are huge gaps in access to college. It’s a huge conundrum.