8.1 Coordination with Partners to Expand Accessibility and Continuity of Care

Lead Agencies must coordinate child care services supported by CCDF with other federal, State/Territory, and local level programs. This includes programs for the benefit of Indian children, infants and toddlers, children with disabilities, children experiencing homelessness, and children in foster care. 8.1.1 Coordination with required and optional partners Describe how the Lead Agency coordinates and the results of this coordination of the provision of child care services with the organizations and agencies to expand accessibility and continuity of care and to assist children enrolled in early childhood programs in receiving full-day services that meet the needs of working families. The Lead Agency must coordinate with the following agencies: a. State Advisory Council on Early Childhood Education and Care or similar coordinating body (pursuant to 642B(b)(I)(A)(i) of the Head Start Act). Describe the coordination and results of the coordination: Two state advisory councils for DCDEE include the NC Child Care Commission and the Subsidy Advisory Committee. Child Care Commission: The NC Child Care Commission is a standing Commission with the authority to promulgate the NC Child Care Rules. Coordination: The coordination goals with the NC Child Care Commission are to consult with the NC Child Care Commission on the CCDF Plan and DCDEE Disaster Plan, update the Child Care Commission on CCDF activities, include the Child Care Commission in qualitative data gathering opportunities such as listening sessions, community meetings and surveys; support the Child Care Commission efforts to conduct a Curriculum and Formative Assessment Review Process as required by Child Care Rule and Law, and support the Commission’s role to promulgate Child Care Rules. This process is held every three years to approve curriculum for use in NC Pre-Kindergarten programs, in four- year- old classrooms of four- and five-star programs and in programs using curriculum to earn a quality point for the star-rated license. Results: Commissioners present at most qualitative data gathering meetings; A revised list of approved curriculum and formative assessments as of 2023; Invitations to three DCDEE Disaster Plan Office Hours; feedback on the CCDF Plan; Reviewed, amended, created or repealed Child Care Rules (2023-2024 Amend or develop rules to support QRIS modernization). Subsidy Advisory Committee: The Subsidy Advisory Committee (SAC) is comprised of advocates, representatives of professional associations, representatives from local Departments of Social Services (DSS), local purchasing agencies (LPA), CCR&R Council, and providers. SAC is a committee which gives input on program requirements and other relevant policies related to the Subsidized Child Care Assistance (SCCA) Program. Coordination: The committee develops recommendations for DCDEE’s consideration regarding needed subsidy policy changes and improvements. This committee also develops recommendations related to the program’s payment policies and practices and provides consultation for each market rate survey. DCDEE coordinates by holding quarterly meetings in which every member is invited to attend and participate. Agendas are provided ahead of the quarterly meetings in order for all participants to be aware of topics being discussed and be prepared with feedback/input, questions, and recommendations. Results: Some of the latest results of collaboration with the SAC is a vetted market rate survey, updated online program manual, and input and consultation on the CCDF Plan. b. Indian Tribe(s) and/or Tribal organization(s), at the option of the Tribe or Tribal organization. Describe the coordination and results of the coordination, including which Tribe(s) was (were) involved: DCDEE coordinates quarterly meetings with the Eastern Band of Cherokee Indians (EBCI) to ensure EBCI are aware of current DCDEE initiatives in the early childhood system and helpful resources. It also gives ECBI an opportunity to provide input into DCDEE activities. Results of this coordination include ECBI participation in Disaster Plan Office Hours, Consultation/input on CCDF Plan, and an opportunity to learn about and consider the early childhood technical assistance related to supporting families experiencing homelessness. [ ] Not applicable. Check here if there are no Indian Tribes and/or Tribal organizations in the State/Territory. c. State/Territory agency(ies) responsible for programs for children with disabilities, including early intervention programs authorized under the Individuals with Disabilities Education Act. Describe the coordination and results of the coordination: Department of Public Instruction, Office of Early Learning (OEL) and Office of Exceptional Children (OEC) DCDEE plans to coordinate services with the OEL, OEC and CCR&R to discuss professional development (technical assistance/coaching) which is needed by early educators to support caring and teaching for children with disabilities, and standards which would increase the quality of services to these children. The results of this coordination will be a list of recommended professional development for early educators who are caring for children with disabilities and recommended standards to increase the quality of care provided to children with disabilities. Another result would be an increase in the number of classrooms receiving technical assistance consultations. The number of collaborative professional development opportunities provided to support families with children who have disabilities. Division of Child and Family Well-Being (DCFW), NC Infant Toddler Program Child Care Resource and Referral and local Partnerships for Children refer families to the NC Infant Toddler Program of the DCFW. DCFW works with families whose children, ages birth to age 3 years, have an identified developmental delay or an established condition which has a high likelihood of leading to a developmental delay. The result of this coordination is that all families referred to the program receive information about their child’s disability as well as the services and programs available for children who have identified special needs. Department of Public Health, NC Child Care Health and Safety Resource Center Currently the DCDEE is coordinating with the Department of Public Health, NC Child Care Health and Safety Resource Center, to create a new segment to the required Emergency Preparedness and Response in Child Care course which will include how to care for children with special needs, including those with disabilities in emergencies. The result of this coordination will be a new segment to the course with added resources to support children with disabilities. d. State/Territory office/director for Head Start State collaboration. Describe the coordination and results of the coordination: Head Start State Collaboration Coordination: North Carolina’s early childhood Parent Engagement and Leadership Framework was developed in 2019 by a 74-person coalition of NC early childhood providers from different sectors on both state and local levels, as well as parents themselves. The NC Head Start State Collaboration Initiative was involved in the development of the Family Engagement and Leadership Framework. Head Start parents attended development meetings with Family Engagement Coordinators and presented about the meaningful engagement and leadership opportunities they had experienced, such as being part of their Parent Policy Council. NC DCDEE has continued engage state-level education partners in efforts to support NC Pre-K/preschool to Kindergarten Transition. Head Start has participated in Preschool Development Grant transition to kindergarten activities by being a participant on the Transitions Leadership Team. NC Head Start State Collaboration is also involved in Yay Babies, an advocacy group which promotes access to early childhood services for young children experiencing homelessness. Along with DCDEE and several other early childhood and homeless service providing agencies, Head Start collaborates on Yay Babies to consider ways we can support the implementation of the Action Plan for an Early Childhood Homelessness Support System. Also related to homelessness, the Head Start Collaboration Office is working to foster relationships between Early Head Start, Head Start Programs and NC Homeless Liaisons (McKinney Vento Liaisons) in the same service area by meeting to create work plans with the purpose of identifying, recruiting and serving more children and families experiencing homelessness. Results: The Family Engagement and Leadership Framework and toolkit is available on the NC Partnership for Children (NCPC) webpage and has been adopted for use by many local NCPC partnerships. The NC Framework is intended for agencies and organizations across early childhood sectors. The result of Head Start State Collaboration Office participation on the Transition Leadership Team will be a standardized process for NC Pre-Kindergarten to Kindergarten transitions, including the development of transition plans statewide. 21,278 transition reports were created by the end of the 2022-2023 school year. As of June 2023, DCDEE and State Transition to Kindergarten Leadership Team has coordinated training and technical assistance efforts to support 44 counties in developing transition plans and implementing transitions practices. Implementation of selected goals in the Action Plan for an Early Childhood Homelessness Support System found at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/A/Action_Plan_Early_Childhood _Homelessness_Support_REPORT.pdf. A result of these meetings is the number of workplans developed by the Head Start, Early Head Start and NC Homeless Liaisons. e. State/Territory agency responsible for public health, including the agency responsible for immunizations. Describe the coordination and results of the coordination: NC DHHS, Division of Child and Family Well-Being Coordination: To develop strategies for professional development and practices of early childhood education (ECE) providers to support children’s behavioral health, including consideration of establishment of EC Mental Health Consultation model to support teachers to address behavioral health concerns of children in the classroom. Results: Collaboration with a newly created position at the Division of Child and Family Well-Being to develop the described strategies. Future results will be the strategies developed and successful implementation of those strategies. NC DHHS, Division of Public Health, Immunization Branch Coordination: The Immunization Branch collaborates with the DCDEE to promote child care provider completion of the required annual immunization report. Using CCDF funds, DCDEE contracts with the NC Child Care Health and Safety Resource Center to fund professional development for Child Care Health Consultants who provide technical assistance about the immunization report. NC Partnership for Children funded Child Care Health Consultants also help Directors complete immunization reports on their visits with programs requesting technical assistance. DCDEE promotes completion of the annual immunization report by including communications about it in the Raising NC Newsletter which is widely distributed to child care programs. DCDEE includes reminders about the report and potentially technical assistance in annual compliance visits with child care providers. Results: Number of immunization reports completed by child care programs. Per the Immunization Branch of the Division of Public Health, in 2023 3,560 immunization reports were completed by regulated child care programs. f. State/Territory agency responsible for employment services/workforce development. Describe the coordination and results of the coordination: The North Carolina Department of Commerce is the state’s lead agency for economic, community and workforce development. The Department works with local, regional, national, and international organizations to fulfill its mission to improve the economic well-being and quality of life for all North Carolinians. As part of the Department of Commerce, the NCWorks Commission is the state’s Workforce Development Board as designated under the federal Workforce Innovation and Opportunity Act. The NCWorks Commission recommends policies and strategies that enable the state’s workforce and businesses to compete and be successful. Led by a private sector chair, the 37-member NCWorks Commission includes representatives from the business community, heads of state workforce agencies, educators, and community leaders. The mission of the NCWorks Commission is to ensure that North Carolina has an innovative, relevant, effective, and efficient workforce development system that develops adaptable, work-ready, skilled talent to meet the current and future needs of workers and businesses to achieve and sustain economic prosperity. Coordination: Goal one of the North Carolina Department of Commerce Strategic Plan, entitled First in Talent, is focused on preparing North Carolina’s workforce for career and entrepreneurial success. The first strategy for this goal is to increase access to high-quality early childhood education and decrease child care expenses for working families. The NCWorks Commission 2023-2025 Strategic Plan focuses on eliminating barriers to education and workforce opportunities, including the lack of quality child care available. North Carolina has an insufficient supply of high-quality child care, which impacts both the available workforce and the well-being of children and families. The issue touches all sectors ￿ private, public and nonprofit. Many businesses understand the importance of high-quality child care for their employees, but are uncertain how and whether they can assist their employees with these complex issues. There is an identified need to provide outreach to businesses and work on strategies and resources to help businesses interested in providing child care support to their employees, so that they better understand the options available. Results may be the number of businesses which respond with supports to assist their employees with child care. The NCWorks Commission is engaged in increasing access to quality child care and creating a teacher pipeline for early childhood. The NCWorks Commission funded a grant for the Western North Carolina Childhood Workforce Development Program. This grant supported the expansion of a program that started in Buncombe County to train more early childhood educators. The program has addressed the shortage of early childhood teachers by recruiting candidates in under-resourced communities and providing them with training, substitute placement and coaching. Partners include the Buncombe County Partnership for Children, Inc. (project lead), Mountain Area Workforce Development Board, Smart Start of Transylvania County, Children & Family Resource Center of Henderson County, Smart Start Partnership for Children of Henderson County, Madison County Partnership for Children and Families, and Community Action Opportunities, Inc.. Recently the North Carolina Department of Commerce hired a Child Care Business Liaison who will work to address the insufficient supply of high quality and affordable child care in North Carolina. The new Child Care Business Liaison will partner with businesses, local communities, government and philanthropic organizations to develop strategies employers can utilize to provide child care support to their employees. The result will be an increase in the number of businesses offering child care support to their employees. North Carolina Business Committee for Education, Office of the Governor The DCDEE coordinates with the NC Business Committee on Education to provide Pre- Apprenticeship as well as Apprenticeships in early childhood education statewide through a pilot called Building Bright Futures (BBF). BBF offers technical assistance, financial support, and resources to pre-apprentices and apprentices, child care centers, school districts, community colleges, and other partners that are part of a registered apprenticeship program through ApprenticeshipNC. Participants in this initiative can receive year-round financial support for wages, training, and professional development, and access to a network of industry professionals and enrichment opportunities to advance knowledge in the field. Buildingbrightfuturesnc.org. The BBF program runs through December 31, 2024. Results: 243 Apprentices and 25 Pre-Apprentices; 322 apprentices since the program started January 3, 2023. g. State/Territory agency responsible for public education, including pre-Kindergarten. Describe the coordination and results of the coordination: DHHS, Division of Child Development and Early Education, the NC Pre-Kindergarten Program administered through NC DCDEE has a goal to provide high-quality educational experiences to enhance school readiness for eligible four-year-old children. The NC Pre-K Program is administered by NC DCDEE; however, it is implemented at the county or regional level by Local Education Agencies, Smart Start Agencies, or Head Start programs and operated in 4- and 5-star-rated classrooms in public schools, child care centers and Head Start programs. Lead Teachers in these classrooms must hold or be working toward a North Carolina Birth- through-Kindergarten or Pre-K Add-on License issued by the North Carolina Department of Public Instruction. Lead teachers participate in a coaching/mentoring program. This licensure is obtained through the Early Educator Support unit within DCDEE and in collaboration with the Department of Public Instruction. Results- Annual NC Pre- Kindergarten Evaluation Report and the number of teachers who have earned a NC Birth through Kindergarten or Pre-K Add-on License. DCDEE coordinates with DPI to implement best practices to support the successful transition of children in NC Pre-K/preschool to kindergarten through offering trainings, technical assistance in developing transition plans, and facilitating the sharing of data between preschool and kindergarten programs. DCDEE and NC DPI has continued to convene a state-level Transition Leadership Team monthly to coordinate planning, implementation and evaluation of transition to kindergarten efforts. The State Transition to Kindergarten Leadership Team consist of members representing DCDEE, the NC Department of Public Instruction, NC Partnership for Children/Smart Start, Head Start, the SERVE Center at UNC-Greensboro, and the Child Care Resource & Referral Council. Results: The number of counties developing transition plans and implementing transition practices. In June 2023 N= 44. To facilitate the sharing of child formative assessment data between NC Pre-K/preschool and Kindergarten programs, DCDEE has continued its partnership with NC DPI and Teaching Strategies to provide NC Pre-K and Title I preschool programs (including developmental day programs) access to Teaching Strategies GOLD®. To support this process, DCDEE partners with North Carolina’s Early Childhood Integrated Data System team to assign unique identifiers (UIDs) to child records. Results are the number of child records matched with an existing NC ECIDS UID. As of August 30, 2023 reporting, 34,065 child records added in the 2022-2023 school year, have been matched with an existing NC ECIDS UID. Educators completed Transition Reports for 21,278 of these child records at the end of the 2022-2023 school year. As of September 30, 2023, the Department of Public Instruction has provided Literacy Essentials for Teachers of Reading and Spelling (LETRS) training to all NC Pre-K lead teachers and site administrators in the original cohort groups to ensure developmentally appropriate instruction grounded in the Science of Reading and outcomes promoting reading achievement in students. Result: There was a 93% participation rate among the original cohort participants. Those who did not participate included retirements, resignations, and teachers who moved to teach in other programs. The Department of Public Instruction is continuing to fund and provide the training to accommodate staff turnover in NC Pre-K programs statewide to ensure sustainability. h. State/Territory agency responsible for child care licensing. Describe the coordination and results of the coordination: Since child care licensing, Regulatory Services Section, resides with the Lead Agency, Division of Child Development and Early Education, coordination goals do not apply. i. State/Territory agency responsible for the Child and Adult Care Food Program (CACFP) and other relevant nutrition programs. Describe the coordination and results of the coordination: Division of Child and Family Well-Being: Community and Nutrition Services Section Coordination: The NC Division of Child Development and Early Education coordinates with the CACFP of the Division of Child and Family Well-Being with the goal to provide trainings related to the Meal Patterns, nutrition, and physical activity. The public and NC DCDEE staff can access trainings on the CACFP website. The result of this coordination is the number of trainings provided on the CACFP website. Coordination occurs at the local level as child care consultants coordinate regularly with food program representatives in their territory to share information and ensure consistent monitoring. Whether it be over the phone or at collaborate partner meetings, DCDEE also coordinates with the Child and Adult Care Food Program by referring programs to the CACFP summer food program. Result: The result is the number of programs participating in the Child and Adult Care Food Programs . j. McKinney-Vento State coordinators for homeless education and other agencies providing services for children experiencing homelessness and, to the extent practicable, local McKinney-Vento liaisons. Describe the coordination and results of the coordination: NC Homeless Education Program NC DCDEE participates in the NC Yay Babies initiative with state McKinney Vento coordination staff to increase early intervention and early education services delivered to children birth to 5 years experiencing homelessness. In response to a recent publication, Action Plan for an Early Childhood Homelessness Support System, DCDEE will be participating with the State Coordinator, North Carolina Homeless Education Program, on the Partnership for Structure and Governance (PSG) as the PSG convenes to prioritize recommended strategies in the Action Plan. Result: Implementation of selected strategies identified in the Action Plan. k. State/Territory agency responsible for the TANF program. Describe the coordination and results of the coordination: NC DHHS, Division of Social Services, Work First NC DCDEE meets with Work First staff among several other agencies on the Economic Programs Committee which works to streamline guidelines and policies administered by local departments of social services. Joint letters are sometimes written to federal funders asking questions about the available funding and related rules for securing funds. DCDEE coordinates with DSS/TANF to get feedback on the CCDF Plan and DCDEE in turn provides feedback on the TANF Block Grant. The results are CCDF and TANF block grant updates to meet agency/public needs. l. State/Territory agency responsible for Medicaid and the State Children’s Health Insurance Program. Describe the coordination and results of the coordination: NC DHHS, Division of Health Benefits Division of Health Benefits houses NC Medicaid which provides access to physical and behavioral health care services to improve the health and well-being of North Carolina citizens. Coordination: DCDEE has supported a December 1, 2023 NC Medicaid expansion by asking Neimand Collaborative, a DCDEE contractor, to develop a communication strategy focused on early childhood professionals. DCDEE markets Medicaid benefits to early childhood professionals by including articles about it in the Raising NC Newsletter. Results: The result of this marketing strategy will be an increase in the number of early childhood teachers who have medical insurance. m. State/Territory agency responsible for mental health services. Describe the coordination and results of the coordination: Division of Child and Family Well-being Coordination: DCDEE plans to coordinate with the Division of Child and Family Well-Being to develop strategies for professional development and practices of ECE providers to support children’s behavioral health, including consideration of establishment of Early Childhood Mental Health Consultation model to support teachers to address behavioral health concerns of children in the classroom. Results: DCDEE and DCFW have participated in an Infant Early Childhood Mental Health Planning Group convened by DCFW beginning in February 2024, which is developing priorities and an action plan for coordinated efforts in this area. The Planning Group has focused on the need for development of a shared vision and specific strategies for supporting Infant Early Childhood Mental Health across DCFW and DCDEE, including increasing awareness of the importance of infant early childhood mental health and the need for increased early childhood workforce development in social emotional health and trauma-informed practices, in alignment with NC DHHS 2024-2026 Strategic Plan (https://www.ncdhhs.gov/dhhs-strategic-plan-2024-2026/open), Goal 2, Objective 1.5. DCDEE and DCFW will participate together in an Infant and Early Childhood Mental Health (IECMH) Summit hosted through the Preschool Development Grant in July 2024. The Summit is designed for state teams to strengthen and advance IECMH efforts to support the mental health of young children, families, and the early care and education workforce. Key guidance from ACF that supports this work includes ￿Using the Child Care and Development Fund to Promote the Mental Health and Well-being of Children, Families, and the Child Care Workforce￿ at https://www.acf.hhs.gov/sites/default/files/documents/ecd/CCDF%20Mental%20Health% 20IM.pdf and ￿Using PDG B-5 to Promote the Mental Health and Well-being of Children, Families, and the Early Care and Education Workforce￿ at https://www.acf.hhs.gov/sites/default/files/documents/ecd/PDG%20B- 5%20Mental%20Health%20IM.pdf n. Child care resource and referral agencies, child care consumer education organizations, and providers of early childhood education training and professional development. Describe the coordination and results of the coordination: Child Care Resource and Referral Agencies DCDEE partners with the NC Child Care Resource and Referral Council and the fourteen NC CCR&R Regions to support a strong child care resource and referral statewide system. Though DCDEE works with the NC CCR&R Council on multiple projects, selected goals of coordination with the NC CCR&R Council include: 1) Statewide technical assistance with early childhood professionals. A recent specific goal is to consider how to embed Practice-Based Coaching in the current approach to technical assistance. Result: The result of this coordination and goal will be an evidenced-based and standardized method of technical assistance statewide. 2) Feedback and Input on the DCDEE Disaster Plan. Result: The result will be a revised DCDEE Disaster Plan incorporating, where applicable, CCR&R feedback. 3) Strengthen supports for family child care home (FCCH) providers. Through a contract with Southwestern Child Development Commission, a CCR&R Council Lead Agency, the FCCH Program Coordinator continues to work with multiple stakeholders, community partners and FCCHs, providing training, technical assistance and Community of Practice opportunities, including mentoring/coaching programs for FCC. Further coordination includes start up grants awarded to selected new programs, and business grants to selected currently operating programs. Results: 80% of new FCCH programs which receive start up supports will achieve a minimum of a 3-star license after receiving 9 months of services; 75% of programs with 3 stars or less that increase stars licensure by at least 1 star and/or achieve NAFCC Accreditation, and 25 FCCH operators will be provided with start-up supports. 4) Increase early childhood professional compensation. The T.E.A.C.H. Early Childhood® NC Scholarship Program provides scholarships for early education professionals to complete a degree in the field of early childhood education. Other programs, WAGE$ and Infant Toddler Educator AWARD$ Plus provide education-based salary supplements to low-paid teachers, directors and family child care providers working with children in regulated child care programs with the goal of improving the education and retention of the early childhood workforce. Results: According to the Child Care Services Association Annual Report in 2022-2023, 2,333 early childhood professionals received a T.E.A.C.H. scholarship representing 947 licensed child care facilities. 4,122 early childhood educators received a supplement through WAGE$ and 1,483 early educators received Infant Toddler AWARD$ Plus. 5) DCDEE coordinates with the Child Care Resource and Referral Council to focus on Healthy Social Behaviors The Promoting Healthy Social Behaviors in Child Care Settings (HSB) project administered through Child Care Resources, Inc. is designed to assist teachers through technical assistance (TA) and training to create prosocial classroom environments and teaching practices, thus addressing challenging behaviors, reducing the incidence of suspension and expulsion, and helping to ensure that children develop the social-emotional competencies needed for success prior to entering school. Results: Selected results of this project include the number of child care providers receiving technical assistance consultations; and the number of classrooms receiving coaching. In mid-year FFY 2024, 129 unduplicated classrooms are participating in Foundational Coaching, 316 unduplicated classrooms are receiving traditional Advanced Coaching services, while 44 unduplicated classrooms have participated in both types of Pyramid Model coaching. Birth to three quality Coordination: The purpose of this coordination is to establish and manage a system of specialized technical assistance to be provided to the child care workforce serving children ages birth to three. Technical assistance will include Practice-Based Coaching to fidelity, teacher mentorship and workforce professional development. Results: Selected results of this project include percentage of birth to three teachers participating in practice-based coaching that measurably improve their relationships and interactions with children enrolled in their classroom in accordance with selected assessment tools; 85% of birth to three coaches providing PBC services to fidelity School-age NC DCDEE coordinates with the NC CCR&R School Age Initiative to provide support for school-age afterschool and summer child care. This special initiative oversees technical assistance with licensed school age programs and summer camps, including quality enhancement, workforce development, administration support, and licensing assistance. The NC CCR&R School Age Initiative also oversees technical assistance and training support of statewide CCR&R staff on school age topics through statewide meetings and Community of Practice sessions. Along with technical assistance support, the NC DCDEE coordinates with the NC CCR&R School Age Initiative to develop school age trainings. The NC CCR&R School Age Initiative centers their school age trainings on topics ranging from quality enhancement, teacher skill building, mental health awareness, and administration building. The Initiative also oversees the development and distribution of the Basic School Age Care training, which is required for all licensed school age providers via state legislation. Results: Selected results of the NC CCR&R School Age Initiative include the number of school age classrooms receiving technical assistance consultations. In mid-year FFY 2024, 74 unduplicated classrooms are participating in technical assistance services throughout the state. Results also include the number of school age professionals receiving professional development training. In mid-year FFY 2024, 112 unduplicated school age professionals received professional development training. A third selected result is the creation of a certain number of new training topic course hours. Mid-year FFY 2024 5 new hours of training content were created. Other results from the NC CC&R School Age Initiative include the creation of statewide resource guides for providers and statewide Community of Practice sessions for other CCR&R staff. In mid-year FFY 2024, 2 new resource guides were created and 3 Community of Practice session have been conducted. 6) DCDEE coordinates with CCR&R to ensure families and the community have access to high quality services. Family Referral Specialists in each of the fourteen regions provide consumer education for those who call, including information about available child care in a family’s area, information about how to choose quality child care, connections to early intervention, and supports for families experiencing homelessness. Results: Number of families statewide receiving education and assistance finding child care. In 2022 N = 28,610. Citation: ￿North Carolina Statewide Fact Sheet￿. CCR&R Council. (March 14, 2023). Accessed June 21, 2024. https://cms.childcarerrnc.org/wp-content/uploads/statewide- 2022.pub_.pdf o. Statewide afterschool network or other coordinating entity for out-of-school time care (if applicable). Describe the coordination and results of the coordination: NC DCDEE coordinates with the NC CCR&R School Age Initiative to provide support for school-age afterschool and summer child care. The initiative oversees technical assistance with licensed school age programs and summer camps, including quality enhancement, workforce development, administration support, and licensing assistance. The NC CCR&R School Age Initiative also oversees technical assistance and training support of statewide CCR&R staff on school age topics through statewide meetings and Community of Practice sessions. Along with technical assistance support, the NC DCDEE coordinates with the NC CCR&R School Age Initiative to develop school age trainings. The NC CCR&R School Age Initiative centers their school age trainings on topics ranging from quality enhancement, teacher skill building, mental health awareness, and administration building. The Initiative also oversees the development and distribution of the Basic School Age Care training, which is required for all licensed school age providers via state legislation. Results: Selected results of the NC CCR&R School Age Initiative include the number of school age classrooms receiving technical assistance consultations. In mid-year FFY 2024, 74 unduplicated classrooms are participating in technical assistance services throughout the state. Results also include the number of school age professionals receiving professional development training. In mid-year FFY 2024, 112 unduplicated school age professionals received professional development training. A third selected result is the creation of a certain number of new training topic course hours. Mid-year FFY 2024 5 new hours of training content were created. Other results from the NC CC&R School Age Initiative include the creation of statewide resource guides for providers and statewide Community of Practice sessions for other CCR&R staff. In mid-year FFY 2024, 2 new resource guides were created and 3 Community of Practice session have been conducted. NC Center for Afterschool Programs NC DCDEE coordinates with the NC Center for Afterschool Programs (NC CAP), the statewide afterschool network in a variety of ways. Those areas include: -NC CAP reserves a seat on their Advisory Board for a representative of the CCR&R network. The Advisory Board works with NC CAP to advocate, convene, inform and support afterschool providers statewide. Members of the Advisory Board share professional expertise; diverse knowledge of constituent perspectives; connections to local, regional, or state resources, colleagues, or peers; and other forms of needed support. They also help to plan the annual Synergy Conference for afterschool staff and school age providers, youth development leaders, policy-makers, and other stakeholders. This conference meets professional development needs of more than 250 school-age providers each year through workshops and sessions covering topics such as supportive afterschool environments, building and sustaining strong afterschool and summer learning programs, academic support and learning recovery, science/technology/engineering/math, college and career promise, and collaboration and community engagement. It offers the opportunity for school age providers to engage in shared learning and peer networking on research-based practices, effective programs, and public policies that impact students’ success in school and life. -The statewide School Age Project and NC CAP also coordinate regularly to support professional development for school age providers; build systems and structures to support quality afterschool and summer learning programs; support the school age workforce; and support school-age program licensure by reducing barriers to licensure for unlicensed programs . Results: Number of school-age staff who participate in Synergy (In 2023 n= 230) DCDEE will work with NC CAP to pilot a statewide landscape analysis to better understand the supply, demand, challenges, needs, and current practices in licensed and unlicensed school age care. The result will be an analysis of the supply of school-age care in more than 21 counties. This analysis may also provide information to support increasing the supply of school-age programs. p. Agency responsible for emergency management and response. Describe the coordination and results of the coordination: Department of Public Safety, North Carolina Division of Emergency Management (NCEM) is the lead state agency designated by law (GS 166A) to coordinate information and tools that help NC citizens manage and respond to emergencies. The agency oversees the development and implementation of the Risk Management Portal which is an online platform that shares information about common hazards in the state; provides disaster planning tools, including the Child Care Emergency Preparedness and Response Plan; and provides resources to help citizens prepare for emergencies. Coordination: DCDEE coordinates with NCEM by serving as a member of the State Emergency Response Team (SERT) along with other Divisions in the Department of Health and Human Services (DHHS). On that team DCDEE coordinates with NCEM to identify DCDEE roles and responsibilities in the State Emergency Operations Plan. The team develops scenarios to test response measures and functionality of emergency software. The team also is consulted in the review and edits of the DCDEE’s Disaster Plan. DCDEE's Disaster Plan provides specific actions or planning considerations that the Division implements in response to disasters. Further, DCDEE coordinates with NC EM prior to a disaster by monitoring child care programs’ completion of Emergency Preparedness and Response Plans which are created through the NCEM Risk Management portal. During an emergency or disaster DCDEE coordinates with NCEM and DHHS by providing up to date ￿situational￿ reports which are included by NCEM in another tool called NC State Preparedness And Response Tracking Application (SPARTA) which is used by NCEM to provide real time event information to help county officials make informed decisions on key areas of response, such as where to locate shelters and what resources to provide at which locations. DCDEE can use information from NC SPARTA to assist when relocating children in affected child care settings, assessing the ability of DCDEE/SERT/partner agencies to function, assessing providers' needs, provision for the establishment of temporary child care, and the continuity of child care programs within communities. The tool is used to communicate and collaborate with government, military, and nonprofit partners during and in the recovery phase of the disaster. Results: The result of the coordination is completed emergency preparedness and response plans for child care centers and family child care homes (2023 n= 1,823 published plans; since 2015 8,106 published plans/duplicated). Another result is an updated DCDEE Disaster Plan which incorporates SERT feedback; and lastly a result is efficient and effective response when disaster occurs. DCDEE will be coordinating with NC EM to update the EPR in Child Care portal using Supplemental Funds for Disaster Recovery Funds from Hurricane Ian. We have also consulted with Emergency Management to provide input on the content of the NC FAST portal upgrade which will allow providers to report impacts from disasters. q. The following are examples of optional partners a Lead Agency might coordinate with to provide services. Check which optional partners the Lead Agency coordinates with and describe the coordination and results of the coordination. i. [ ] State/Territory/local agencies with Early Head Start – Child Care Partnership grants. Describe: ii. [x] State/Territory institutions for higher education, including community colleges. Describe: NC Community College System (ACCESS) NC DCDEE coordinates with the NC Community College System (ACCESS) to develop different aspects of the professional development framework, including aligning QRIS modernization with Coaching Towards Mastery efforts. Ways are discussed to remove barriers for the workforce to complete formal education, and DCDEE coordinates to create a strategy to increase interest in the early childhood field. Results: Updates to the NC Professional Development Framework including revised pathways, competencies, and measurement of competencies; strategies to increase interest in the early childhood education field. iii. [x] Other federal, State, local, and/or private agencies providing early childhood and school-age/youth-serving developmental services. Describe: The CCDF Plan was sent for review and input to the President of the North Carolina Partnership for Children. The CCDF Plan was sent via email for review and feedback from the NC Association of Directors of Developmental Day Centers (NC ADD). Further input into the development of the CCDF Plan was made available via email, mail, and the Public Hearing. DCDEE meets on a regular basis with these entities to determine goals and strategies. iv. [x] State/Territory agency responsible for implementing the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs grant. Describe: NC DHHS, Division of Child & Family Well-Being, Whole Child Health Section Coordination: The NC Division of Child and Family Well-Being, Whole Child Health Section, Child and Family Wellness Branch administers North Carolina’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. The purpose of this program is to implement evidence-based home visiting practice to improve the health and safety of young children. The NC Division of Child and Family Well-Being supports local implementation of two evidence-based home-visiting interventions including Healthy Families America and Nurse-Family Partnership. These models are ￿designed to improve child health and development, pregnancy outcomes, and parenting skills (NC Department of Health and Human Services, 2024). Citation: "Home visiting programs. Child and Family Wellness." NC Department of Health and Human Services: Division of Child & Family Well Being. (2024). Accessed June 21, 2024. https://www.ncdhhs.gov/divisions/child-and-family-well- being/whole-child-health-section/child-and-family-wellness/home-visiting- programs. Several state initiatives informed by DCDEE and the NC Division of Child and Family Well-Being (e.g., the NC Early Childhood Action Plan, Healthy North Carolina 2030, the Birth-Five Strategic Plan, the Home Visiting and Parenting Education Systems-Building Collaborative) have acknowledged the importance of home visiting programs to early childhood development and have outlined strategies and recommendations to increase children and families access to high- quality home visiting and early child care services. For example, the 2024-2026 NC Perinatal Strategic Plan outlined several strategies leveraging programs and services administered by DCDEE or in partnership with DCDEE partners like the NC Partnership for Children. To expand home visiting supports, the plan includes a recommendation to develop a statewide structure for maternal home visiting to ensure equitable access for all pregnant and postpartum women. To increase accessible high quality child care for all children (including infants, toddlers, and those with special health care needs), the plan recommends expanding the availability of child care subsidies and by increasing the subsidy rate to more adequately meet the cost of care. In support of early childhood outcomes these strategies will aim to ￿increase the percentage of children ages 0 to 2 years whose families receive child care subsidies and are enrolled in 4- or 5-star centers (NC Department of Health and Human Services, 2022). Citation: "NC Perinatal Health Strategic Plan 2022-2026". NC Department of Health and Human Services: Division of Public Health. (2022): 1-32. Accessed June 21, 2024. https://wicws.dph.ncdhhs.gov/phsp/docs/PerinatalHealthStrategicPlan- 9-15-22_WEB.pdf. DCDEE will continue to partner with the NC Division of Child and Family Well- Being to support state-level initiatives, and promote evidence-based home visiting and parent education programs (a core strategy of North Carolina’s Early Childhood Action Plan). DCDEE will share information on and resources to support home visiting programs in referring families to the Subsidized Child Care Program to access affordable and high-quality child care services. Additionally, through the Preschool Development Grant, Birth-Five Renewal Grant, DCDEE partnered with the Division of Child and Family Well-Being to integrate home visiting data from Nurse-Family Partnership and Healthy Families America into NC’s Early Childhood Integrated Data System (NC ECIDS). NC ECIDS is a single source web-based platform for early childhood integrated data for selected education, health, and social services programs to help answer key policy and program questions. NC ECIDS provides counts of children who receive multiple early childhood services from participating programs. Citation: NC Department of Health and Human Services. (2024). North Carolina early childhood integrated data system. https://www.ncdhhs.gov/about/department-initiatives/early-childhood/early- childhood-data/north-carolina-early-childhood-integrated-data-system. Results: Through the Preschool Development Grant, Birth-Five Renewal Grant, DCDEE partnered with the Division of Child and Family Well-Being to integrate home visiting data from Nurse-Family Partnership and Healthy Families America into NC’s Early Childhood Integrated Data System (NC ECIDS). Integration of the data has been completed as of December 30, 2023 and by March 30, 2024, DCDEE will publicly launch the new NC ECIDS Data Dashboard which will include data for these two home visiting programs beginning from 2013. Continuing beyond the PDG B-5 Renewal Grant period, DCDEE is leveraging state appropriations to sustain staffing support for the NC Department of Health & Human Services Data Office and Information Technology Division and maintain internal capacity to complete annual data integration of data for all featured early childhood programs. In addition to the two home visiting programs (Healthy Families America and Nurse-Family Partnership), the additional early childhood programs include the NC Infant Toddler Program (Early Intervention ￿ IDEA, Part C), NC Pre-K, Subsidized Child Care, Special Education ￿ IDEA Part B (619), Food & Nutrition Services, Child Protective Services, Temporary Assistance for Needy Families, and Early Hearing Detection and Intervention. DCDEE will continue to track and report on the following indicators from 2025- 2027: The number of presentations, webinars and resources developed and delivered on the Subsidized Child Care Program enrollment and eligibility process provided to home visiting program administrators and providers. The percentage of children ages 0 to 2 years whose families receive child care subsidies and are enrolled in 4- or 5-star centers. The number of home visiting programs existing in NC ECIDS that have current and accessible data. North Carolina Partnership for Children Coordination: While North Carolina has leveraged federal funding to offer a range of home visiting programs, during the 2020 Birth-Five Needs Assessment, a need to provide universal home visiting was identified. From 2020 ￿ 2023, DCDEE partnered with the NC Partnership for Children to pilot Family Connects as a universal home visiting model. Three local Smart Start Partnerships were selected to pilot the model serving children and families in eight counties including Ashe, Avery, Cumberland, Henderson, Hoke, Polk, Robeson and Watauga. Results: Through this pilot, 3,630 families were served over 5,987 visits, connecting over 88% of the families that needed a referral to additional resources. PDG B-5, Renewal Grant funding supporting the implementation of the pilot ended December 30, 2023. Looking forward to the coming years, two local Smart Start Partnerships in the Northwestern and in the Southeastern region of the state have developed promising strategies to sustain implementation through 2024. Family Connects Northwest has transitioned services to the local health department which will implement a newborn home visiting model that they have developed to ensure families continue to receive these services. Family Connects Southeastern intends to continue home visiting services for their community and is working on securing additional funding as well as planning to achieve Family Connects model certification which will allow them to expand their service region in the future. Both are planning to utilize locally allocated Smart Start funds to cover the programs’ costs. DCDEE will continue to support the NC Partnership for Children in conversations with state and local partners to explore and identify opportunities for Local Partnerships to invest in universal newborn home visiting and family support activities, exploring evidence-based models and best practices expanding beyond Family Connects. If implementation continues through 2025 ￿ 2027, DCDEE will continue to track and report on the following indicators: The number and types of home visiting models utilized by local Smart Start Partnerships. The number of local Smart Start Partnerships providing home visiting services. The number of children and families served through home visiting services provided by the NC partnership for Children. v. [x] Agency responsible for Early and Periodic Screening, Diagnostic, and Treatment Program. Describe: The CCDF Plan was sent for review and input to designated staff within NC Division of Medical Assistance. Further input into the development of the CCDF Plan was made available via email, mail, and the Public Hearing. Result: Potential feedback on NC CCDF Plan. vi. [x] State/Territory agency responsible for child welfare. Describe: The CCDF Plan was sent for review and input to designated staff within NC Division of Medical Assistance. Further input into the development of the CCDF Plan was made available via email, mail, and the Public Hearing. Result: Feedback on CCDF Plan. vii. [x] Child care provider groups or associations. Describe: NC DCDEE maintains ongoing communication and regular meetings with local and state child care provider associations. With the NC Licensed Child Care Association, DCDEE participates in monthly ongoing meetings. Coordination goals are developed in response to the needs of the members. DCDEE participates on three workgroups with the NC Institute for Child Development Professionals, a volunteer organization, with goals related to supporting the early childhood workforce. 1) Early Childhood Compensation Workgroup- A significant focus for this workgroup is to expand upon the work of the NC Model Salary Scale created by the NC Compensation Collaborative. In 2023 this workgroup developed the Institute Salary Scale Toolkit- a tool for employers to use for recruitment related to the salary scale and pathways to career advancement. This tool has been made available to be included in workforce supports provided to programs through the CCR&R & Smart Start Partnership technical assistance systems. It has also been made available in the community college system for those who are teaching early childhood courses such as Admin 1 and 2 (EDU 261 and 262), as well as other courses. The workgroup has collaborated with the Division to incorporate the toolkit into the pre-licensing workshops so that new operators can become aware of mechanisms to incorporate a salary scale and other supportive business resources into their business. The workgroup will continue to identify mechanisms to disseminate and train on the toolkit, as well as to identify additional resources to support providers in addressing compensation challenges. 2) Early Childhood Professional Development Workgroup- The current goal of the Professional Development workgroup is to create and distribute a statewide survey to gather information about the NC professional development and technical assistance landscape. The information gathered will be used to determine needs and inform improvements in the professional development system and the Institute's PD and TA endorsement system. The survey will be distributed from the Institute through the CCR&R and Smart Start Partnership networks. 3) The recently combined NC Institute for Child Development Professional’s Higher Education and Advancing the Education of the Workforce Workgroup is currently planning to strategize and convene around the federal recommendations related to the Power to the Profession's Unifying Framework for the Early Childhood Profession. Potential opportunities for how the Institute can support further progress in NC related to the Framework's recommendations will be explored. In addition, this workgroup will continue to oversee and update as needed NC's Early Educator Certification (EEC) system including establishing additional certification rewards and benefits and exploring opportunities to align NC's EEC system to the Unifying Framework's ECE I, II and III designations. viii. [x] Parent groups or organizations. Describe: Parent representative on NC Child Care Commission Coordination: A parent representative on the NC Child Care Commission is the Senior Campaign Director, North Carolina of MomsRising, a parent group with the mission of increasing family economic security, decreasing discrimination against women and moms, and building a nation where both businesses and families can thrive. Commissioners get opportunities throughout the rulemaking or rule review process to give input on the developing, amending, or repealing of child care rules. Result: Parent perspectives are offered when the Child Care Commission makes decisions about child care rules which impact child care programs and families statewide. MomsRising Coordination: MomsRising, with NC Partnership for Children and through Preschool Development Grant funds, co-created a train the trainer, ￿Starting Strong￿, a comprehensive set of tools to support agencies as they develop cross- sector coalitions and family engagement practices. DCDEE coordinated to market this training to early childhood partners. Results: The number of early childhood professionals who receive information about Starting Strong in the Raising NC Newsletter. Family Engagement & Leadership Coalition/ Accelerator Team: Coordination: In 2019, DCDEE partnered with the NC Partnership for Children to form the Family Engagement and Leadership Coalition (FELC) and the Accelerator Team (A-Team), a workgroup of the Coalition. FELC is comprised of over 100 members, including 49 family leaders and over 50 members representing cross- sector organizations that serve young children and their families. A subset of FELC members (including family leaders) serve on the A-Team, which meets monthly to plan for and lead the work of the FELC. This coalition is open to any parents with young children interested in supporting family engagement and leadership at the state level, and links families to ongoing opportunities to share their lived experience and input to help shape programs and services for young children and their families across the state. DCDEE partnered with the NC Partnership for Children in organizing these groups during the 2019 PDG B-5 Planning Grant with the goal of developing the North Carolina Early Childhood Family Engagement and Leadership Framework, which identifies definitions, guiding principles and best practice tools for family engagement. FELC and the A-Team continued to meet under the leadership of DCDEE leveraging the PDG B-5 Renewal Grant to share best practices and guide North Carolina’s family engagement and leadership efforts. The staff and funding to support FELC and the A-Team under DCDEE’s leadership ended December 30, 2023. While the FELC will not continue, the working body of the Coalition, the A-Team will be sustained under the leadership of the NC Partnership for Children. The Partnership will continue to convene the A-Team through quarterly meetings. Initial efforts in 2024 will focus on defining the groups strategic direction as it aligns with the Smart Start partnership family engagement priorities. The NC Partnership for Children will also work to expand the A-Team’s members with plans to engage state partners like Prevent Child Abuse and the Early Education Coalition in systems-level family engagement and leadership efforts. Results: The number of parents and caregivers engaged on advisory groups and in other leadership roles to plan for, implement, and inform their work. The number of state- and local- early childhood system partners serving as active members of the Accelerator Team (A-Team). NCPC has established infrastructure (including resources allocated for staff and professional development) to support family participation on advisory groups and in other leadership roles including processes to provide stipends and address barriers to participation like transportation, food, child care and translation. Seat at the Table Family Engagement Hub: Coordination: Through the PDG B-5 Renewal Grant, DCDEE partnered with the Michigan Early Childhood Investment Corporation (ECIC) to launch ￿Seat at the Table￿ a nationwide online matching resource hub developed by the National Center for Family & Parent Leadership and powered by ECIC. The goal of ￿Seat at the Table￿ is to strengthen partnerships between state and local programs and services and the families who use them. ￿Seat at the Table￿ is designed to provide an online solution to make it easier for state programs and families to connect. This hub platform allows families of children birth-to-8 to find leadership opportunities, and for local and state early childhood organizations to find family leaders to engage on advisory groups or in other leadership roles to ensure family voice is part of strategic decision-making and program design. North Carolina is the first state to fully leverage the platform and ECIC has reported that 516 family members and parent leaders have been provided access to ￿Seat at the Table￿ to connect parents to leadership opportunities in state-level early childhood programs and services. In planning for sustainability beyond the PDG B-5 Renewal Grant, the NC Partnership for Children will serve as the administrative home for ￿Seat at the Table￿ and will continue to work with ECIC to maintain access to this free platform, promote the use of the platform to state system partners and connect families to leadership opportunities. Results: Number of family members and parent leaders provided access to the ￿Seat at the Table￿ Family Engagement Hub to connect to leadership opportunities in state-level early childhood programs and services. Number of early childhood professionals representing early childhood organizations that are provided access to the ￿Seat at the Table￿ Family Engagement Hub to connect with parents interested in serving as members of advisory groups or in other leadership roles. Number of relevant local and state-level early childhood parent leadership opportunities available and accessible through the ￿Seat at the Table￿ Family Engagement Hub. Number of parent leaders matched with early childhood parent leadership opportunities through the ￿Seat at the Table￿ Family Engagement Hub. ix. [ ] Title IV B 21st Century Community Learning Center Coordinators. Describe: x. [x] Other. Describe: NC Partnership for Children (NCPC)/Smart Start Coordination: DCDEE will collaborate with NCPC to establish a two-year pilot program to implement the Tri-Share Child Care program required by NC Session Law 2023- 134. This program creates a public/private partnership to share the cost of child care equally between employers, eligible employees and the State to: Make high quality child care affordable and accessible to working families. Help employers retain and attract employees. Help stabilize child care businesses across the state. Results: The results will be available within six months of completion of the pilot program. By this time, the DCDEE will submit a report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division. The report will include the number of children served by age and county, total pilot program costs, the amount of funds needed to expand the program statewide, the list of employers participating in the pilot program and other relevant information. Coordination: Through Preschool Development Grant funds, DCDEE was part of a coalition with NCPC to develop and refine the NC Family Engagement and Leadership Framework. DCDEE will continue to coordinate with the North Carolina Partnership for Children on integration of family engagement on local, community and state levels. NCPC and the Smart Start Network will utilize Starting Strong: Tools for Effective Family Engagement and Leadership tools and train the trainers, and will promote the ￿Seat at the Table￿ family voice Connection Hub, which connects families with leadership opportunities via an online matching system. Results: The significant result of the partnership with NCPC is the Family Engagement and Leadership Framework which is housed on their website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/F/FEandL_Framework.p df?ver=2020-10-28-142947-087 in English and in Spanish. Increase in the number early childhood entities in the system implementing recommended family engagement strategies. PBS NC PBS NC in partnership with Book Harvest, East Carolina University and parent leaders will design the Child Care 101 web-based series to introduce parents to the early childhood system and components of quality child care. With intent of leveraging the 2025-2027 Child Care Development Fund, DCDEE proposes to continue its partnership with PBS NC to continue to review and update consumer education resources designed for providers and families. This will include managing updates and enhancements for a virtual 360 child care center tour designed to expose parents to quality early childhood programs practices to align with current early childhood trends, practices and requirements. This will also allow continued development and dissemination of webinars and other print/virtual assets to educate and communicate providers, families and the general public. DCDEE also proposes to use the funds to support PBS NC in maintaining access to their professional learning platform to allow providers, families and the public to assess free and high-quality professional development trainings, communities of practices and resources. Results: +The development and dissemination of high-quality consumer education and professional development resources for families and providers, accessible in English and in Spanish. +Increase in the percentage of early childhood providers and families surveyed who will report that the provided trainings and educational resources increased their knowledge of the State’s early care and learning network, programs, resources and family services. +Increase in the percentage of early childhood educators surveyed who will report that the trainings and educational resources have increased their ability to develop plans for their own professional development and identify resources to support their professional development and career growth. NC Early Childhood Foundation The NC DCDEE is a collaborative stakeholder member of the EarlyWell Coalition/Coordinating Team (formerly the NC Initiative for Young Children’s Social-Emotional Health), which consists of over 100 early childhood service providers, clinicians, and advocates for children’s social, emotional, and mental health. NC Child, in collaboration with early childhood leaders including the NC Early Childhood Foundation, originally launched this initiative in 2019 with the aim of building a robust, evidence-based and accessible early childhood mental health system in NC. Utilizing an equity lens and building upon family voices, the EarlyWell Coalition has identified and is focused on six policy priorities that strengthen mental health support for infants, toddlers, and young children and families in NC: Family Support Services for Children with Mental Health Challenges, Supporting the Early Childhood Workforce with Professional Development on Mental Health, Supports for Foster Care Caregivers and the Child Welfare Workforce, Doula Care, Group Prenatal Care, and Reach Out and Read. Results: The EarlyWell Coalition is prioritizing and leading implementation of policy and practice recommendations in three waves with implementation for the first wave completing in 2025 and implementation for wave two occurring between 2025- 2027.