Sonoma County looking to invest in future model citizens

Seated on a blanket on a green, leaf-strewn lawn in Santa Rosa's South Park neighborhood, Martha Solorio chatted with her nurse while her 11-month-old daughter, Selene Ramirez, built a tower out of colorful blocks and attempted her first teetering steps.

The nurse, Tracy Greenwald, offered the first-time mother who is dealing with an increasingly independent toddler some practical parenting tips — how to control temper tantrums, how to reinforce positive behavior, how to keep dangerous objects out of the child's mouth.

"You have a smart little cookie here," Greenwald said. "You're going to have to stay on your toes."

Greenwald has been meeting with Solorio twice a week since she was about 20 weeks pregnant, at first to talk about prenatal health, but more recently to chat about raising little Selene, who has apple-round cheeks, two front teeth and adorable pigtails.

For Solorio, 20, an Elsie Allen dropout who is taking high school equivalency classes and imagines one day being a preschool teacher, these sessions provide the tools to give her daughter a healthy childhood.

"I am learning how to help her learn things," Solorio said. "Now that she's growing, she is learning things in her own way. I need to teach her how to learn them in a good way."

Greenwald provides the service, which is free for low-income mothers, through Nurse-Family Partnership. It is one of a portfolio of programs that Sonoma County is pumping money into, and is designed to give children like Selene a head start.

County leaders hope these types of programs will reduce law enforcement and incarceration costs over the long run.

In 2007, officials realized that they were spending half the county's general fund budget battling gangs, keeping drugs off the streets and locking up criminals. Criminal justice costs were continuing to climb, said Deputy County Administrator Peter Rumble.

"We looked out a handful of years and tried to identify what are the main challenges we have coming up and how do we deal with them," he said. "The most significant challenge was related to an increase in criminal justice costs."

The solution? Invest in early childhood programs to save money on costly services later in life. This led to the creation of the Upstream Investment portfolio, a group of about two dozen county programs that have been proven to produce results.

The list includes programs that offer services such as early childhood education, prenatal healthcare and youth mentoring.

"These are evidence-based programs," said Oscar Chavez, assistant director of the county Human Services Department. "We want to make sure we are investing wisely."

The theory, Rumble said, is that a healthy baby will become a more attentive student. An engaged student will learn to read earlier. An early reader is more likely to graduate high school. And a high school graduate is more likely to stay out of jail.

There is early anecdotal evidence that investing in these types of programs is having an effect countywide, Rumble said. Third grade literacy rates have risen. Childhood obesity has declined. High School graduation has increased.

But it is too soon to measure the cost savings, said Efren Carrillo, a county supervisor and member of the Upstream Investments executive committee. The next step, he said, is for leaders to create a cost-benefit tool.

"The initiative has made significant strides, but we must recognize that it has a long-term focus," Carrillo said. "I see this initiative as making deep, lasting impacts on the community. It is not a sprint but a marathon."

To qualify for the portfolio, programs must prove that they can achieve results. This means a rigorous vetting process, looking at data to support those results.

Landing a coveted spot on the portfolio could help a service provider attract much-needed funding, said Elece Hempel, executive director of Petaluma People Services Center, which implements some of the Upstream programs.

"The first thing funders ask is 'Is it evidence-based?' Being on the portfolio is something that we can point to," she said. "When you have money to invest, you want to make sure the program you are investing in has the biggest impact."

Health Action, another long-term initiative with the goal of making Sonoma County the healthiest county in the state by 2020, works in tandem with Upstream Investments, program manager Jen Lewis said.

"Upstream is a tool box of best practices," she said. "We can link to that to address gaps with proven strategies."

The Nurse-Family Partnership, which is administered through the county health department, is one of the most tested and proven programs and a model for the Upstream portfolio, said Elisabeth Chicoine, the county public health nursing director.

"It's considered the gold standard of evidence-based programs," she said.

A Pew Research Center study of the nationwide Nurse-Family Partnership showed that the program has led to a 46 percent reduction in teenage crimes and arrests, and a 53 percent reduction in alcohol, tobacco and marijuana use in 12- to 15-year-olds, precisely the outcomes the county is seeking, Chicoine said.

"By investing early, we are doing a lot of preventative work improving a child's long-term health development," she said. "This is a great example of an early intervention program."

(You can reach Staff Writer Matt Brown at 521-5206 or matt.brown@pressdemocrat.com.)