• poverty
• homelessness
• distracted parents - use of technology and social media
• addiction
• abuse
• delayed interventions - deficiencies in community awareness of early intervention programs, lack of understanding, lack of will, "he'll catch up" or "she's just shy"
• lack of parent awareness & education ("is this normal?")
• parental needs for additional education (literacy, GED)
• lack of appropriate medical care (primary or specialty) - preventative or proactive intervention
• community trauma
• lack of a common definition across agencies/services
• access to services - transportation, language barriers, health care
• cultural barriers (both directions)
• lack of interest
• increase in kinship care
• agency fear ("they'll take my kids", "they'll take me" immigration issues)
• adult mental health
• child mental health - "security of attachment" issues, often due to trauma
• incarcerated parents
• basic needs take priority
• inability of programs to properly engage parents (approach?)
• staff fatigue/burn out
• parent/provider burn out
• major subjectivity in the Child Outcome Summary measures
• disconnect between state perspective and local experience (lack of understanding of the reality of issues affecting families) - training for/speaking to only a "perfect world" scenario
• need more access to preschool and affordable child care
• sandwich generation - balancing care of elderly parents and young children
• system is not keeping up with increased level of need for children currently in service (huge changes over 10 years)
• increase of kids referred with autism, intense medical needs vs. kids with language delays (10 years ago)
• more extreme behaviors exhibited, higher intensity of behaviors (2 year olds being kicked out of multiple day cares regularly)
• pending legislation that says you can't suspend or expel kids regardless of age (concerns about ability to support high needs kids, ensure safety of child and teacher/caregiver, trauma to other children in classroom, etc.)
• lack of resources and supports for families with kids birth to four
• capacity needs given intensity and volume of behaviors
• lack of data sharing between ITP, Child Find and K-12 (legislation that prevents some of this! ex. data sharing between Part C and Part B services)
• lack of data sharing between agency partners
• lack of data sharing across jurisdictions (county lines)
• issues with stigma that become a barrier to getting help/supports
• technology becomes a crutch with kids (phones, tablets, etc.) as a means of managing behaviors
• technology addiction and reliance with parents and kids
• could part of increase in referrals be due to changing social and cultural mores and children being seen in the community in care/play settings earlier than in previous generations (things not kept "behind closed doors")
• improvements in medical technology have helped kids with significant health issues survive
• increase in substance exposed newborns
• high rates of adverse childhood experiences (ACES study), lack of resilience/protective factors

• AACPS
• DSS
• Health Department
• AAMC
• Mental Health Agency
• Headstart
• Early Headstart
• Arundel CCC
• Library
• The Coordinating Center
• Arc of Central Ches
• Parent's Place of MD
• Military (Ft Meade)
• Parents
• Pediatricians
• Thrive
• Legal system - jails/prisons, judges, advocates, attorneys
• Legislature
• Constituent Services for County
• Churches
• Family Support Center
• Civic organizations - Junior League, Rotary, Kiwanis
• Community Foundation
• (Add other potential partners from notes)
• Villa Maria
• Children's Guild
• Innovative
• HACA, HCAAC
• Substance Abuse/Addiction Treatment Providers
• Homeless Shelter Providers (Sarah's House, Lighthouse)
• Child Care Providers (family or center based)

• Home visiting models
• Inter-agency collaboration
• EC CRICT
• early childhood behavioral/mental health interventions (BEST, CHAMPS, AACPS Early Childhood Interventions)
• Fussy Baby/FAN training
• Structural Family Therapy
• Parent engagement
• Holistic approach to school readiness like in Headstart (health services, basic needs, other resources, etc.)
• Developmental testing/screening in pediatric offices for early intervention
• Universal testing during pregnancy not just after birth
• Therapeutic Nursery Centers (Lourie Center)
• Universal full-day pre-k
• Parenting Education (raising kids doesn't come with an instruction manual)
• Broad scale PR campaigns to address issues
• Access to a living wage for all
• Circle of Security Parenting programs
• Parent/Child Interactional Therapy
• Engagement of innovative community partners (less hampered by policy and regulation) to drive change
• Collaboration with Substance Abuse/Addiction Treatment Providers to address early childhood issues for kids of patients/participants
• Programming inside jails/prisons (Open Book, BEST)
• Decrease in high school drop-out rate
• Increased availability to transportation options (change in policies, public transportation, human services "Uber" model)
• Universal Intervention for Children of Trauma/Early Childhood Trauma
• (Certified) Play therapy
• Trauma Focused/Trauma Informed Care (certifications)
• Experienced Early Childhood Mental Health Providers
• Summer Bridge
• Summer Meals Programs - mobile meals into communities to increase access
• Family Based Mental Health Services (ex. DHMH Pennsylvania)
  

• More robust in-home mental health services (real, effective therapeutic interventions not just consultations) - Family Based Mental Health Services (ex. DHMH Pennsylvania)

• PR Campaign - [could be local, state, or tie into national messaging]
• Creating a more cohesive horizontal team at LICC table (and identify other methods of engagement for other partners)
• Lobby decision makers with respect to policies around things like a living wage
• Present to/partner with local pediatricians (AA Co APA or Pediatric Service Meeting as Featured Topic)
• Therapeutic Nursery Program locally
• Increase our partnership with SICC
• Diversifying service delivery
• Creation of Home Visiting Certification programs
• Increase provider preparation (in university programs) for reality of family circumstances
• Encourage increase in students choosing teaching and related professions to ensure capacity
• Explore other countries best practices (family leave, supports, early childhood initiatives, etc.)
• Host an open house for decision makers

__________________________

Prioritized:

• Coordinate with ECC (perhaps Amelie from County Exec's office)/Strategic, collaborative project approach with ECC
• Engage decision makers - County Exec's office, State Officials (Anne Arundel County delegation?), Board of Ed, Judges/judiciary (Open House)
• Increased focus on collaborative service delivery - coordinated system of care (shared data systems/data platforms)
• Engaging with partners for specific populations (jails/prisons, substance abuse, homeless shelters, etc.) to bring services where high risk/high need families are

Next steps:

• Identify a "champion" in state legislature - talk to BOE legislative liaison
• Plan open house (frame the message!)
• Connect Wes and Pam Brown to establish collaborative relationship with ECC
• 9/19 meeting at 10 a.m. Annapolis Pediatrics with MHA

• Explore other countries best practices (family leave, supports, early childhood initiatives, etc.)
• PPMD will pull data for review in December 2017 (by zip) - three/four years data
• Child Find data on kids that don't qualify but need service (by zip) - three/four years data

Look at data for identified "what works" to ensure success