Chapin Hall Center for Children, Spielberger, Julie, Rich, Lauren, Winje, Carolyn, Scannell, Molly, and Gouvea, Marcia
This is the fifth and final report of a longitudinal study examining the use of a comprehensive system of prevention and early intervention services in Palm Beach County, and how its use relates to the outcomes of children and families living in four targeted geographic areas (TGAs) with high rates of poverty, teen pregnancy, crime, and child abuse and neglect. Data sources included vital statistics and administrative service use records on Palm Beach County families who gave birth in 2004 and 2005; data from annual in-person household surveys with a baseline sample of 531 low-income mothers drawn from the cohort of mothers in the TGAs who gave birth in 2004 and 2005; and qualitative data from interviews with a subgroup of 40 mothers randomly selected from the larger survey sample. The authors' main concern was the system of prevention and early intervention services funded by the Children's Services Council (CSC) of Palm Beach County, particularly the Maternal Child Health Partnership (MCHP) system that was designed to serve pregnant and newly delivered mothers. Results indicate that the MCHP system initially identified mothers with many important risk factors, and that mothers with greater needs were more likely to receive services and more days of services than other mothers. Of mothers screened "at risk" who did not receive services, however, almost a third could not be located, and 15 percent declined services. Service use was affected by many other factors, including individual family characteristics, service type, and program characteristics. Receipt of MCHP services in year 1 was also associated with other service use in years 2, 3, and 5. One reason, according to mothers' reports, was that MCHP providers served an essential bridging or "brokering" role between parents and basic services, including Medicaid, food assistance, and childcare subsidies. One of the clearest findings was the disadvantaged status of children born to foreign-born mothers relative to those born to U.S.-born mothers. At the end of the study, as the focal children were getting ready for kindergarten, children of foreign-born mothers were more likely to be living at or below the poverty level, even though their caregivers were more likely to be married or living together. In light of their relative disadvantaged status, it is encouraging to note that foreign-born mothers, and particularly foreign-born Hispanic mothers, were more likely to receive treatment services from the MCHP system. On the other hand, they used fewer services outside of the MCHP system compared to U.S.-born mothers. In conclusion, study findings make clear that the emerging system of care in Palm Beach County is successfully engaging many at-risk families in needed services through the MCHP around the birth of a child. The authors end with the following set of recommendations: (1) Improve the quality and effectiveness of parenting supports and education; (2) Improve access to and quality of early care and education; (3) Increase efforts to help families stay involved in or become re-connected to needed services over time; (4) Enhance training of service providers; (5) Making location and timing of services convenient for families; (6) Improve channels of information and communication about services; (7) Strengthen relationships between the CSC system of care and other community supports and services; and (8) Improve data systems and other sources of information on service availability, use (duration, intensity), and need. Appended are: (1) Longitudinal Study Sample and Methods; (2) Additional Data on PBC and TGA Birth Cohorts, 2004-2009; and (3) Additional Data on Year 5 Study Sample. A bibliography is included. (Contains 118 tables, 13 figures and 84 footnotes.) [For the previous report, "Supporting Low-Income Parents of Young Children: The Palm Beach County Family Study Fourth Annual Report," see ED529450.]