Focus Group Report

Children’s First Initiative
Focus Group Research Report

June, 2009

By Martin Merzer

CHILDREN’S FIRST INITIATIVE: FOCUS GROUP RESEARCH REPORT

Table of Contents

Executive Summary..………………………………………..…………………..3

Introduction…………..…………………………………………………………...8

Key Points…….…………………………..……………………………………..11

How It Worked…..………………………………………………………….…...13

Issue No. 1 – Health Care……………………...………………………………14

Issue No. 2 – Early Intervention and Screening.……..……………………...17

Issue No. 3 – Expand The School Year and School Day…………………...19

Issue No. 4 – Quality Child Care Programs……………….………………….21

Issue No. 5 – Quality Pre-Kindergarten Opportunities………………………23

Issue No. 6 – Parent Skill Building……………………………………………..25

Concluding Remarks……………………………….……………………………27

Methodology………………………..……………….……………………………28

Moderator Guide ………………………………………………………………...32


Executive Summary

“I don’t think that just my children deserve to have a life. I think all children deserve
to have a life.”
– young man in Fort Lauderdale

More than 800,000 Florida children do not have health insurance and most of them
are, in essence, medical orphans: They don’t have an ongoing relationship with a
pediatrician and, thus, they don’t have a medical home. Florida ranks 49th in the
nation when it comes to covering its youngest, most vulnerable citizens with
medical insurance.

Florida’s pre-kindergarten programs meet only four of 10 national standards for
quality education.

Ninety percent of a child’s brain development occurs during the early years of life,
yet Florida has not developed a statewide quality rating system for child care and
preschool sites.

Few Floridians would assert that Florida – and its people – are fully meeting their
obligations to the state’s children. The reasons for this failure are complex, an
amalgam of persistent economic pressure, warped priorities and deficient political
leadership.

In response, a ground-roots movement on behalf of children is gathering force in
Florida and around the nation. Its objective: to improve the availability, range and
quality of children’s services and programs.

Toward that end, 80 Floridians recently participated in eight focus groups
conducted in Tampa, Jacksonville, Fort Lauderdale-Hollywood and Miami. In two-
hour structured and facilitated sessions, they learned about, discussed, rated and
prioritized six children’s policies crafted by Florida leaders and child-care experts.
Each group considered four issues, presented on a rotating basis.


The six policies, in descending order of priority, as determined by the focus
groups’ final votes (weighted to account for frequency of appearance):

1. Health care and insurance for all children.
2. Early intervention and screening opportunities.
3. Expansion of the school day and the school year.
4. Quality child care programs.
5. Quality standards for pre-kindergarten operations.
6. Parental skill building.

The priorities

No. 1 – Health care: ensuring that every child in the state has access to an
ongoing relationship with a pediatrician, well-child visits, immunizations, other
preventative measures, and treatment for illnesses.

When it came to prioritizing the issues, health care led the pack by a wide margin.
Even when considered on a weighted basis, with results adjusted for the frequency
of each issue’s appearance before the participants, health care emerged as the
strong favorite.

“Health care,” said a young woman from Tampa, in explaining her first-place vote.
“Without that, how do you move to step B or C? Would expanding the school year
matter if my kid is a preemie at birth and fighting for her life?”

That explanation illustrates a key finding that emerged from the focus-group
sessions:
When offered a variety of programs for prioritization, participants instinctively
searched for a bedrock option – the choice that could serve as a foundation for all
other efforts to assist Florida’s children.

No. 2 – Early intervention: screening every child at birth and at ages 2, 4 and 6;
assessing within a month every child with a suspected special need; ensuring
timely access to speech, physical or behavioral therapy.

A strong contender, this option also was viewed by some as a foundation for all
other efforts on behalf of Florida’s children and families. “It’s just common sense,”
said a retired woman from Hollywood.


Others saw value in the economic argument – that money spent on early detection
could save much more money later in life, when previously undetected issues could
grow worse.

No. 3 – School year: lengthening the school year from 180 to 220 days and the
school day by two hours.

Supporters viewed this proposal as a possible solution for what they perceived as
the dreadful quality of many public school systems. Some also accepted the
contention that the current school schedule is a relic of the nation’s agrarian past
and leaves U.S. students at a competitive disadvantage in the global economy,

“Education in this country is poor and this would be a good starting point,” said a
young father from Jacksonville.

Opponents, however, feared burdening school children with additional work and
worried that this proposal would eliminate or curtail traditional summer vacations.

No. 4 – Quality child care programs: requiring a one-star, two-star, etc.,
statewide quality rating system for all child care and preschool sites, intended to
help parents make informed decisions.

It was preferred as the No. 1 choice by few participants, though it won considerable
favor as the second or third place choice, suggesting that more support for this
issue could be developed. Some participants shared their own misadventures in
finding quality day care for their children, but others expressed reservations about
government involvement.

“I gave it a nine, but it smells a little bit like another bureaucracy,” said a father from
Miami.

No. 5 – Quality pre-kindergarten opportunities: substantially enhancing quality
standards for Florida’s voluntary pre-K program by requiring associate degrees
and, eventually, bachelor’s degrees for classroom leaders, along with research-
based curricula and quality-based accreditation.

Most participants saw great value in this program, giving it marks ranging from eight
to 10, but only a few rated it as the top priority. Once again, some worried about the
prospect of greater government control.


No. 6 – Parent skill building: offering every new parent a free skill-building
program and every first-time and teen mother a home visit by a qualified pregnancy
and early childhood expert.

This option was unpopular during initial sessions. It gained favor after David
Lawrence Jr., who introduced each option, began focusing on the universal doubts
that strike new parents as they bring their child home from the hospital – an event
that Lawrence called “a profoundly scary moment.”

That resonated with many people, some of whom ended up rating this option as the
most important. “I had no idea what to do when I had my first child,” said a young
mother from Jacksonville.

Opposition remained strong in some quarters, however. Several participants
viewing this as redundant to current programs or as an unnecessary government
intrusion in private life.

Other key points:

• None of the 80 participants challenged the underlying premise of the focus-
group sessions or offered a passionate defense of children’s services in
Florida. They universally recognized the importance of quality programs for
children and families, and nearly all found the current system lacking.

• At the same time, the overriding parental concern in Florida centers on the
day-to-day physical safety of their children. Regardless of its basis in fact,
this concern currently takes precedence over all other child-related issues.

• Several socio-economic undercurrents were exposed. Among them: Several
people insisted that many services were more available than they actually
are and that many existing services were underused. Some participants
believed that the families most in need of assistance might not avail
themselves of it.

• The sessions’ ground rules called for participants to ignore the potential cost
of these proposed programs, but many people had a difficult time doing so.

• A noticeable number of participants feared that several of the options might
become compulsory and/or develop crushing regulatory structures. A


surprising number seemed comfortable with their current health insurance
policies – or simply feared anything that might require them to adapt to a
new system.

In the end, the votes and views of this diverse group of 80 people reveal quite a bit
about the child- and family-related concerns that weigh upon Floridians as the state
and the nation approach the second decade of this new millennium.

The full report, which follows, describes and analyzes those votes and views.


Policy Priorities for Children and Families in Florida

“As human beings, we need to do the right things for our children. They are
our future and it’s important that they get very good care at an early age. We
are citizens of Florida and we have to do the right thing.”
– retired woman in Jacksonville

“I don’t think that just my children deserve to have a life. I think all children
deserve to have a life. This is America, the richest country in the world.”
– young man in Fort Lauderdale

“I don’t think we need more government bureaucracy and we don’t need to
throw a bunch of money at early childhood programs for everybody. I can’t
get away from the question of paying for it.”
– young man in Tampa

“I worry about kids who don’t have a good foundation. I worry about society
in general. I worry that these kids are going to take a route that is not a good
route.”
– a teacher and mother in Miami

Families without access to health insurance and children without consistent access
to pediatricians. Child-care and pre-kindergarten programs of uneven and often
unsatisfactory quality. Young parents left adrift, without a semblance of the skills or
training required to raise their children. Multiple, overlapping deficiencies in our
school systems.

It is difficult to imagine policies and trends more short sighted than those that short
change our children, but few people would deny that many such policies and trends
are in place today – in Florida and throughout the nation.

How it has come to this is a matter of economic hardship and deficient leadership,
the accrual of inattention and of moral drift. But that is the past, and some now are
acting on behalf of the future and the children who will inhabit it.

In recent years, a vigorous movement has come to life in Florida – and is beginning
to reach across the nation – on behalf of children and their families. The objective:
to improve the availability, range and quality of children’s services and programs.


This is no simple task, particularly during an economic crisis of rare proportions and
an environment plagued by severely curtailed budgets. But the need is manifest,
and so the effort presses forward .

A diverse cross-section of Floridians recently gathered in eight focus groups to
share thoughts and recommendations about a variety of proposed programs that
would provide quality services to the state’s children and their families. Eighty
Floridians participated in these focus groups. The sessions were conducted
between April 9 and April 30, 2009, in English in Tampa, Jacksonville and Fort
Lauderdale-Hollywood, and in Spanish in Miami.

The two-hour sessions were structured and facilitated, and they provided ample
opportunity for dialogue and decision-making. The participants openly, and in some
cases, eagerly shared views and concerns about the current state of child care and
education in Florida, and they determined their preferences going forward.

Six specific statewide children’s policies, each crafted by Florida leaders and child-
care experts, were presented on a rotating basis. Each group assessed four of the
programs and ultimately prioritized them.

The six policies, which will be described later in greater depth and detail, are
listed here in descending order of priority, as determined by the focus
groups’ final votes (adjusted to account for frequency of appearance):

1. Health care for all children.
2. Early intervention and screening opportunities.
3. Expansion of the school day and the school year.
4. Quality child care programs.
5. Quality standards for pre-kindergarten operations.
6. Parental skill-building.

Most of the participants had children, some had grandchildren, and one had great-
grandchildren. Some worked for health care entities or insurance companies, and
several were teachers, but none were child-care “experts” in the purely academic
sense. Many seemed to develop or perhaps amplify their views as the focus groups
progressed, illustrating the value of sessions that provide opportunities for
conversation and analysis.

Significantly, not a single participant questioned the underlying premise of the
exercise or otherwise rose to a full defense of children’s services in Florida. They
universally recognized and embraced the importance of quality programs for


children and families, and nearly all found the current system insufficient, to say the
least.

“I believe the more we do for our children, the better off we are in the future,” said
one man, a jury consultant from St. Petersburg. “I don’t think we do enough for our
children, and the more we can do, the better.”

Existing services underused?

At the same time, a small number of people insisted that many existing services
were underused. As the sessions advanced around the state, it became clear that a
sub-set of Floridians – for the most part, those who have not come into regular and
recent contact with currently available children’s programs – have an inaccurate,
inflated sense of the programs’ availability, magnitude, utility and quality.

“I think there’s enough services out there now that, if anyone really wants them,
they can get them,” a semi-retired man from Temple Terrace said in assessing the
proposal to offer early screening and intervention to all Florida children. Asked
about access to health care for all children, the same man said: “Go through the
phone book. It’s all there.”

A woman from the Tampa area who works for the federal government and has a full
range of conventional insurance options: “I agree that the [children’s and family]
services are out there. It’s a matter of going out to the community and letting the
people know about it. I think the services are out there.”

More nuanced view

Many others, however, had a more nuanced view of the current state of affairs. For
the most part, these were people who have tried to access the programs or who
work for medical offices or insurance companies and watch uneasily and
sympathetically as others attempt – and often fail – to navigate the system.

A young woman in the Jacksonville area who works for a medical practice that
treats high-risk maternal patients: “Some are on Medicaid, but if they don’t mail
something at exactly the right time, they’re dropped. They can’t come back and we
can’t treat them. Coverage is dropped and it shouldn’t be dropped due to a
paperwork problem.”


Another young woman, from the Tampa area, speaking about health care services
for her children: “I have tried to utilize the resources out there and they’re not out
there. They’re not always available to you. Their budgets are not what they were.
Because of the state of the economy, a lot of people who had opportunities don’t
have them now. A simple visit to the emergency room can turn into thousands of
dollars that you just can’t pay, and anybody can lose their benefits tomorrow.”

This disparity in assessing the current state of children’s services in Florida
suggests that a robust public information campaign – focused on the overarching
needs of the state’s children and families – should precede or accompany any effort
to muster support for improved services.

Other key points

Several other significant themes or trends consistently emerged during the
discussions:

• As concerned as Floridians are about health care and social services for the
state’s children, it is the fundamental physical safety of their children that
dominates their thoughts.

Asked to share their single deepest worry as grandparents, parents or
potential parents, the overwhelming majority mentioned physical security.
Some cited the perception that pedophiles were growing more numerous
and aggressive; some cited drugs and violence on the streets and in our
schools; some cited the current economic downspin and what it heralded
about their children’s future prospects; some simply cited a general,
pervasive, ominous sense of foreboding.

Whether this fear is based on reality or on media-fed waves of mass
hysteria may be open to question, but the fact remains: It exists and it is
wide and it is deep.

“My children are married, and I don’t worry about them anymore,” said one
middle-aged woman from Jacksonville. “I worry about my grandchildren –
that something terrible will befall them.”

A woman from the Hollywood area with two children: “Safety, every day
safety. You send kids to the store these days and a lot of them don’t come
back.”


• Another key concern focused on the public education system. Numerous
participants, often without prompting, launched broadsides at the quality of
the education their children were receiving, the dedication and
professionalism of some teachers, and the perceived lack of security within
many public schools.

“I worry about what they’re learning because…when I retire, they are the
ones who will be managing the world,” a lawyer from Miami said. “I’m
thinking, ‘What are they teaching these kids?’ Most of those who are
graduating, I’m sorry to say, they are mostly idiots. You ask them a question
and it’s like looking at a blank wall.”

A young woman from Jacksonville: “Early education is great, but my son is 7
and the middle school near us is crap. Every middle school around us is
crap.”

• A significant number of participants expressed concern that the families
most in need of assistance might not avail themselves of it, regardless of
the nature and quality of the programs offered. Many asked how Floridians
would learn of any new programs (and seemed satisfied when told that
public information campaigns would be commissioned). Some cited
socioeconomic factors, asserting that the most needy were likely to be the
least educated and least aware of their child-care responsibilities.

• Other participants seemed concerned that the proposed programs were
intended to serve only the lower rungs of Florida society – designed to help
only the underclass, though everyone would end up paying for them. They
needed frequent reassurance that the programs would fill significant gaps in
the current system and would be universally available.

• Though the clearly expressed ground rules called for participants to – for the
purposes of this exercise – ignore the potential cost of these proposed
programs, many people had a difficult time doing so.

“I don’t know how you would be able to justify that cost of all of this,” said
one mother from Fort Lauderdale.

It should be noted that the sessions were conducted during the nadir (so far)
of the economic collapse and as the legislature and state and local agencies
struggled with another round of budget shortfalls. In addition, a noticeable


number of the participants had recently been laid off or were in the process
of being laid off.

• At the same time, concerns occasionally were raised that proposed
programs could be compulsory in nature. Many participants had to be
reassured that no one would be compelled to accept any form of assistance
and that none of the programs, such as guaranteed access to child health
care, would overwrite or replace current programs, including their current
medical insurance policies.

How it worked

Each group of participants, pre-selected from voter rolls through brief telephone
surveys, was welcomed by the facilitator and briefed on the process and the ground
rules. Among those rules: There are no wrong answers. Respect each other’s
views. At this stage, please disregard the potential costs of the programs. The
sessions are being observed and recorded. All information is confidential insofar as
no one would be identified.

This briefing included a summary of the current state of the national movement “to
give priority to the need for quality services and programs for children and families.”
Participants were told that eight Florida counties – Hillsborough, Pinellas, Broward,
Miami-Dade, Palm Beach, Martin, St. Lucie and Okeechobee – have dedicated and
independent funding sources for children’s programs, and that other counties are
considering such arrangements.

They also heard a brief summary of the central role of David Lawrence Jr. (and,
during the Miami sessions, of Ana Sejeck) in the growing campaign on behalf of
children in Florida and around the nation. They were told that Lawrence (or Sejeck)
soon would join them and would introduce – and briefly respond to questions about
– each of the four options offered for the group’s consideration.

After hearing about each option, the participants graded its importance on a scale
that ranged from 0 (not important at all) to 10 (extremely important) and explained
his or her decision. At the conclusion of the two-hour session, each participant
ranked the issues by order of perceived importance and also explained that
decision.

In the end, a measure of consensus emerged as the focus groups prioritized the
options. In so doing, each participant seemed to search for what he or she


considered the bedrock issue – the choice that would best serve as a foundation for
all other efforts to assist Florida’s children and their families.

Here is a look, in some depth and in descending order of popularity, at the six
issues, the priorities assigned to them, and the discussions they generated.

No. 1 – Health Care for All Children

The most popular option, by far: Health care for all children.

“The child has a good foundation if he is healthy,” said a woman from Miami who
has three children. “If they’re healthy, they can do everything else.”

She and other participants who considered this option were told that it would
ensure that every child in the state of Florida has access to health care that
provides immunizations, well-child visits and other preventative measures, along
with treatment for illnesses.

They learned that Florida is 49th in the nation when it comes to covering children
with health insurance, leaving 822,000 Florida children without coverage.

Those two statistics were among the most dramatic and memorable takeaways of
the entire exercise. Numerous participants in all cities repeated them as they
explained their assessment of this issue. Any campaign on behalf of universal
health care for Florida children should employ those statistics as a core element of
the message.

The groups were told that the proposal specifically called for providing every child
with adequate health insurance from birth through age 18 – coverage that would
include vision, dental, and behavioral and physical needs, including periodic
screening and treatment. That all children would have a “medical home” – a doctor
who gets to know the child and has access to the child’s complete medical history.
That the program would be publicized through a public information campaign, and
that – through the efficiencies of bulk purchases in the marketplace – it could lower
the cost of health services for children.

It became clear that, when offered a variety of programs for prioritization,
participants instinctively searched for a bedrock or foundational option. Health care
for all children was chosen as that option above all other programs. It also


earned an average score of 8.9 (of a possible 10) when considered on its own
merits.

“It’s important for kids to have health care in order to get the early intervention, in
order to go to school, in order to maintain a healthy life style,” said a woman from
Temple Terrace who works for a utility and is a single parent.

A young mother from Tampa: “Health care. Without that, how do you move to step
B or C? Would expanding the school year matter if my kid is a preemie at birth and
fighting for her life?”

A young man from Jacksonville: “I can’t think of one reason why it should not be
done.”

As was often the case as each of the offered programs was discussed, participants
tended to view the issue at hand through the lens of their personal experiences.

One Jacksonville-area man, recently laid off after 23 years of employment at a
communications company, said he acquired a new perspective on the health-care
system when he brought one of his four children to a hospital emergency room for a
few stitches. When he was employed and covered by a top-notch insurance policy,
the man said, his son’s procedure would have cost him $50. “But this time, we sat
there for three hours and he got three stitches and I got a bill for $680,” the man
said. “I got a letter back that said, ‘You haven’t met your deductible and you have to
pay the whole thing.’ ”

This man rated health care for all children as the evening’s top issue. “Every child
deserves it,” he said. “Clearly, the winner.”

A young father from the Fort Lauderdale area, who also preferred children’s health
care: “I personally know people and families who can’t afford health care and
they’re suffering. I know people who take their kids to the hospital for chicken pox
and it’s just ridiculous.”

At the same time, however, some people raised concerns about the proposal.
Among those concerns: It seemed, to them, like a significant step toward a
government-run medical system that could ration services and/or mandate
compulsory participation.

“I’m not really too sold on socialized medicine,” said a business man from Miami,
who also mentioned personal responsibility. “If you’re going to have a family, you


have to plan. You have to make decisions. How many children can I have? How
many should I have? In the last resort, you can’t depend on the state for
everything.”

Lawrence responded to one such question this way: “It’s ultimately up to mommy
and daddy. This is not socialism I’m talking about. This is decency. Everyone would
have access to a medical home. If they choose not to use it, that’s their
responsibility.”

Interestingly, though the cost and bureaucratic complexity of health insurance
policies are frequently criticized by the public, many participants seemed
comfortable with their current coverage and feared that it would be replaced by the
proposed program.

“Would this be for people who can’t get insurance or for everyone?” asked a retired
woman from the Fort Lauderdale area.

“Would this be based on income? Would I still have access to health insurance
from my employer?” a middle-aged woman from Jacksonville asked Lawrence.

His response, in essence, described the program as a safety net for all, though that
precise term was not used because it carries connotations of a limited service for
those on the lowest rungs of the economic ladder.

As was the case during the discussions of other proposed programs, Lawrence
(and Sejeck) urged participants to consider the proposal as a general concept, with
details to be filled in at a later time.

But many craved more details – what would be covered and what wouldn’t be
covered, who would run the program – and some found themselves unable to
ignore the program’s potential cost.

“You say you have to push aside how it’s going to be funded, but if you’re saying
it’s for everybody, that’s a very big issue,” said a middle-aged man from
Jacksonville. “That’s a very big dollar amount, and you have to look at that very
carefully.

“Also, who’s going to manage it?” he asked. “The HMOs? The PPOs? I need more
nuts and bolts about how it’s going to work.”


Still, in the end, the proposal attracted not only the most support, but also the most
passionate support.

“It’s the easiest one of the night,” said a young father from Jacksonville. “The
bottom line for me is that we are the richest country in the world. There is zero
reason why every child in this nation should not have health insurance.

“There’s a lot of issues that I have with why they don’t, but the bottom line is they
should have it.” he said. “One of the issues is people having children who shouldn’t
have children, but the children didn’t have any say in that. It’s not the child’s fault.
They deserve to have a healthy life.”

No. 2 – Early Intervention and Screening, and Availability of Services

Another popular choice proved to be a proposal to screen all children in Florida for
special developmental, physical or behavioral needs. It finished in a distant second
place to health care on the priority list, but it received high scores when weighed on
its own merit.

Participants were told that about 10 percent of all children have such needs, which
could include speech delays, physical delays, behavioral issues, medical issues,
and autism and similar conditions. They learned about research that clearly shows
the value of early intervention in discovering and treating these needs. These early
diagnoses can lead to greater developmental gains and fewer challenges later in
life.

They also learned that such services are only sporadically available now (often with
long waiting lists), are of inconsistent quality and efficacy, and that research
indicates that money spent early in life to assess and treat these needs can save
society much more money down the road.

Specific proposals included the screening of every child at birth and at ages 2, 4
and 6. Parents who suspect a special need could have their children assessed
within a month. Families would have timely access to speech therapy, physical
therapy or behavioral treatment. A substantial public information campaign would
publicize the availability of these services.

Once again, those participants who selected this proposal viewed it not only as the
most important, but also as a foundation for all other efforts to assist Florida’s
children. When considered on its own merits, it earned an average score of 8.9.


“I think early intervention and health care go hand in hand,” said a mother from the
Tampa area. “You have to figure out what the needs are and they can go to caring
for those needs, and then the child is ready for everything else.”

Many people who didn’t rank this proposal as the No. 1 priority still viewed it as
quite valuable, basing that view largely on sheer common sense and as a matter of
fairness and equity.

“Why have this pain at 12, 13, or 14 years old when we could have had it handled
when they’re 2, 4 or 6?” asked a young man from Fort Lauderdale.

Said a man from Tampa: “I think it’s important that everyone has a fair shot. Any
problems should be identified.”

“It’s just common sense,” said a retired woman from Hollywood. “A child with a
disability should have the privilege of being screened and so on.”

The economic argument also resonated with many people.

“The earlier we can detect a problem with a child, the sooner we can help the family
and the child,” said a young woman from Tampa. “If the government is going to end
up paying for it, the sooner we can find out what’s wrong and help the child, the
less it’s going to cost.”

A few cautionary trends emerged, however. One involved privacy and the issue of
“labeling.” Several people worried that early screening would lead to a lifetime
tattoo for many children, especially when it comes to autism.

“I’m not extremely well educated on autism,” said a young man from Jacksonville.
“I’m just worried it’s going to lump all these kids into one category. What exactly is
this screening? I need it to be more scientific.”

Two participants who gave the proposal top scores of 10 also expressed this
concern.

“I don’t like the idea of all these kids getting labels,” said one of the two, a teacher
and mother from Miami. “I think we have to make sure they have a real illness.”

And, once again, some worried that a proposal designed with the best of intentions
would evolve into a compulsory, intrusive government program.


“In this program,” asked one man from Tampa, “are we talking about every child?”

Lawrence: “This is America. We’re not forcing things on people, but every child
would have access to this screening and treatment.”

In the end, however, most participants gave high marks to this proposal, some
based on their own experiences, others with a more altruistic approach.

“I had a child that had trouble with reading and paying attention and we didn’t find
out until the second grade,” said a middle-aged woman from Jacksonville. “I wish it
would have been caught sooner. We had to hold him back a year and that always
bothered him.”

Said an older man from Jacksonville: “I feel we are talking about the quality of life
here. I feel it’s extremely important.”

No. 3 – Expand the School Year and School Day

A proposal to lengthen the school year and the school day overcame the initial
doubts of many participants and was viewed as the third most important proposal. It
also earned an average score of 8.1.

The focus groups were told that the U.S. public schools’ 10-month, 180-day, six-to-
seven-hour day calendar is a relic of an early time, when the demands of an
agrarian society dictated that children be available to help with summer harvests.

At the same time, the public school system has fallen well behind its counterparts in
other nations, leaving our children at a distinct competitive disadvantage in the
global economy. The long summer break requires much of the fall term to be
dedicated to review, and the limited time now available for teaching – along with
budget cuts – have contributed to the demise of once popular extra-curricular
activities.

Specific proposals called for year-round schools, with shorter breaks, that would
increase the school year to 220 days, and two more hours in the school day –
which could allow for the return of arts, music, physical education and other
activities that have disappeared from many schools. In addition, teachers would
receive 12-month contracts and higher pay scales.


This issue generated the greatest range of responses and the most distinct
disparities.

Supporters focused on this proposal as a possible solution for what they perceive
as the dreadful quality of many public school systems.

“I see it as something important, a step in the right direction,” said a young father
from Jacksonville. “Education in this country is poor and this would be a good
starting point.”

A married but childless man from Miami: “I gave it a 10 because I couldn’t give it an
11. We’re supposed to be the greatest nation in the world, but we have to give kids
more education. They don’t even know where Iraq is on a map. Education is up
there with health care for me.”

They also tended to agree that the long summer break required too much time to
be wasted on reviews in the fall.

“How much do they lose between the last day of school and the first day of school
of the next year?” asked a young woman from Jacksonville. “We have to get them
ready for the real world, where eight-hour work days don’t exist anymore. Six-hour
school days don’t really prepare them for anything anymore.”

But opposition also was strong, with many people bonding to tradition – and the
traditional summer vacation for their children and, in some cases, for the entire
family.

“I’m in agreement with lengthening the days but not [cutting into] the summer
[vacation],” said a middle-aged woman from Miami Lakes. “I’m thinking of my
children. They go crazy waiting for the summer vacation. They need that break.”

A father of two children in Miami called the summer vacation “sacred.” “My concern
also is that they need the time off,” he said, “though it doesn’t matter to me if they
extend the days.”

Others feared overburdening the state’s children.

“I personally don’t think it’s that important,” said a young Tampa woman. “I feel like
children are overworked. They don’t have time when they come home. They don’t
have time for extracurricular activities. They don’t have time for home work. This


will just put more pressure on them, unnecessarily. I think it will lead to kids turning
themselves off and they will lose interest in school.”

And the potential cost was mentioned, despite the sessions’ guidelines.

“I gave it a zero,” said a young man from Tampa. “It’s hard for me to think of this
without talking about money. We talk about children and how they’re not doing
physical activity in school because the budgets are being cut. So to not consider
budgets when schools are going to be open longer and teachers are going to be
working more, it just doesn’t make sense.”

No. 4 – Quality Child Care Programs

A proposal to develop and impose a statewide quality rating system for all child
care and preschool sites attracted some support but also some doubts, in a few
cases seemingly related to the controversial FCAT rating system that now
dominates many discussions about Florida’s public school system.

Though it finished in fourth place, its average score was a respectable 8.3 and it
gained considerable favor as a second or third priority. This suggests that support
for this option might grow if a more effective entry point and approach were found.

Participants were told that this proposal would ensure that all families who need
child care would have access to programs that are affordable and, importantly, of
high quality.

They were told that 80 percent of brain development occurs during the first three
years of life and that 90 percent of brain development occurs during early
childhood.

These statistics, much like those associated with the health care issue, proved
extremely memorable and influential – and also should be considered for central
use in any campaign intended to attract support for early childhood programs.

They also learned of the questionable and inconsistent quality of many early
childhood programs in Florida and that high-quality programs have a demonstrably
positive effect on youngsters. “Children who attend a high-quality early childhood
program have higher school achievement, go to college more often, earn more
money and are involved with the criminal justice system less often,” the focus
groups were told.


Once again, an economic rationale was offered, and once again it gained traction
with many people. Long-term studies, they were told, have shown that every dollar
invested in high-quality early childhood programs can save society $4 to $17 in the
future.

Specific elements of the proposal included a statewide quality rating system for all
child care and preschool sites – a one-star, two-star etc., system intended to help
parents make informed comparisons and decisions. Publicly financed subsidies
also would be offered to enhance the educational quality of child care and
preschool programs, achieve smaller class sizes and develop more qualified
teachers.

As was often the case during other discussions, participants’ views on this subject
often were influenced by their personal experiences.

“I have a child and I remember when I was looking for day care,” said a Tampa-
area woman, who gave the proposal a top score of 10. “Some of the day cares I
interviewed, I didn’t find quality. They’re poorly paid, poorly trained, pretty much
everything he [David Lawrence] talked about.

“I did find one, finally, that was much better than the others, but you pay the price to
get that…and most people who work for a living can’t afford something like that, so
it would be nice to trust the system to have something better for them.”

A middle-aged man from Jacksonville, who has four children, shared a hard-
learned lesson about the value of quality day care.

“My oldest two didn’t go to day care and they struggled in school,” he said. “My
younger two did and they did phenomenal. I gave it a nine. How would you deal
with it to make it uniform throughout the state – that’s my only question. But the
concept…a great concept. Start them early. Great concept.”

Others, however, raised concerns about increased government regulation and
about government taking over another role perhaps best handled by individuals.

“I’m not sure I understood it,” said a teacher who lives near Tampa. “I think it’s a
parent’s responsibility to be looking for accreditation. All of that is available. I don’t
need anybody else to tell me. I think it’s the parent’s responsibility to go out there
and look.”

A retired man from Lutz, near Tampa, agreed.


“When I had children, I had to spend the night in a line to get my kids into a good
child care situation,” he said. “I think this rating system would be OK, but if parents
take a tour and an active interest, they’re going to know which are the one stars
and which are the five-star facilities.

“Unfortunately, there is a rating system right now and it’s the price you pay for these
facilities,” he said. “Right now, that’s the real rating system.”

A father from Miami: “I think it’s important. I gave it a nine, but It smells a little bit
like another bureaucracy. A commission for this, a commission for that.”

A public school teacher from Miami, apparently sensitive to the FCAT issue: “I think
it’s important for kids to learn before kindergarten because there are higher
expectations now, but they give you those stars…especially places that are
privately owned. It’s just another dog and pony show, as we call it.”

No. 5 – Quality Pre-Kindergarten Opportunities

A proposal to mandate a variety of quality standards for Florida’s voluntary pre-
kindergarten program also earned considerable support. It finished in fifth place,
and was awarded an average score of 8.7 during the discussions.

The focus groups were reminded that Floridians passed a constitutional
amendment in 2002 that required state officials to provide a voluntary, high quality,
pre-kindergarten program to all 4-year-olds. But, they were told, the Florida
Legislature failed to require high standards for the program.

More than 145,000 Florida children currently attend a pre-K program, participants
learned, but the state’s effort meets only four of 10 national standards for quality
education. This leaves thousands of children ill-prepared for school, struggling to
bridge a readiness gap when it comes to reading and other skills.

“The legislature was supposed to set the standards, and they did a lousy job of it,”
Lawrence told one group. “This is not about, ‘Do we have a safe place for your
children?’ It needs to be safe, but it’s also about education and standards. Is this
what people voted for?”

Specific proposals included the beefing up of teacher requirements, with every
classroom to be led by a teacher who must receive an associate degree within
eight years and a bachelor’s degree within 12 years. Research-based curricula that


links children to their later work in elementary school. Quality-based accreditation
for every pre-K program, and entry and follow-up assessments for every child in a
pre-K program.

Driven by their own experiences or dismay over the things they had just learned,
most participants gave this proposal marks ranging from eight to 10.

“I’ve looked at a pre-K program and it looks like glorified babysitting, like a day
care,” said young woman from Tampa. “We need someone who knows what they’re
doing to teach our kids.”

A young father from Miami said his daughter was in a program and “each time they
[the teachers] sent home work home in Spanish or English, the words weren’t
correct in either language. They’re teaching my children and they don’t know how to
write?”

The legislature’s failure to mandate quality standards infuriated many attendees,
fueled their interest, and generated many of the high ratings for this proposal.

“I don’t understand. It doesn’t make any sense,” said a young man from the Fort
Lauderdale area. “Why aren’t we getting our money’s worth?”

A man from Tampa: “This is a program that’s already in place and it just doesn’t
have any teeth in it, not if we meet only four of 10 standards.”

“When I heard about the amount of money they’re spending on it and the lack of
standards, I was getting angry,” said a Fort Lauderdale-area woman who two
children. “If there was an 11, I would give it an 11. The reason we’re in so much
trouble in this country is that the standards have been lowered in every level of life.
We’re throwing money away and it’s our tax dollars. How can the legislators do this
to us?”

Once again, several people viewed this option as foundational for any and all other
efforts to help children.

A Miami man with two children rated it a 10 “because it’s very important that they
start with a good base and good development.”

And, once again, some people saw it as an unnecessary governmental intrusion.

A Miami woman saw some merit in the proposal but gave it only a five.


“I think the educational system is very mediocre, but I don’t know if this is the
solution,” she said. “I like the fact that teachers would be certified, but I don’t know
that, to take care of 4-year-olds, you need certification. I think there are other
problems out there. I have too many doubts.”

No. 6 – Parent Skill Building

A proposal to help expecting and new parents develop effective child-raising skills
seemed destined for an early demise, scoring so low in early sessions that it was
considered for elimination from future sessions.

But a new approach fashioned by the team resulted in a noticeable turnaround.
Still, this proposal finished last in the priority rankings and with the lowest average
score – only 7.8 – during the discussions.

The basic proposal called for programs that would help parents and other
caregivers gain access to information that would help them achieve effective
parenting skills, which in turn would help their children learn and grow.

The focus groups again were told that 80 percent of the brain develops before age
3, which means there is extraordinary learning potential during the early years of
life. They were reminded that parents and families form the first and most important
link to a child’s development and success. Many parents, they were told, would
benefit from programs that build their knowledge and skills with a view toward
maximizing their children’s early crucial years.

Specific proposals included a program to offer every parent of every child from birth
to five years old a free skill-building course with real standards, taught by trained
professionals. All first-time and teen mothers would be offered a home visit by a
qualified expert, who could provide advice about pregnancy and the first two years
of a child’s life. Early literacy counseling and health-service referrals also would be
offered.

The option attracted scant support during the first few sessions, with many people
giving it low marks and critical reviews. Here is a sampling of those comments:

A Tampa man with two children, who rated it as a three: “I just think there are other
programs out there. You can contact your church and they have a program.”


A Jacksonville man with three children, who gave it a four: “It’ not very important. I
think there are programs out there now. People are too busy, too lazy to research
this.”

A semi-retired father from Tampa: “I think the most at risk for this would shy away
from it because it would bring an authority figure into the home. I think it’s a waste
of time. I gave it a two. I should have given it a one.”

A single mother from Tampa, who gave it a six: “I think it’s important, but the people
who would benefit from it are not going to use it. The ones who really, really need
the service just won’t accept it.”

A Jacksonville man with four children: “I believe a lot of the same programs are out
there and it’s a redundant situation. When my child got sick, I called mom. “Mom I
don’t know what to do.” And she came over. I got married at 16, my first kid came at
17. That’s who young teens call in situation like that.”

Several other people said that, when they were new parents, they turned to their
own parents for advice. They didn’t seem aware that many of today’s young
parents simply do not have those kinds of role models.

With the issue teetering on the brink of elimination, the team huddled and
suggested that Lawrence focus to a greater extent on the deep and nearly universal
doubts that strike brand new parents as they take their child home from the
hospital. Call it the “What do we do now?” syndrome.

Beginning with the fourth session, Lawrence emphasized that theme during his
introduction of this topic, calling the trip home from the hospital “a profoundly scary
moment” for most new parents.

“If you want to drive a car, you need a license,” he told the second focus group in
Jacksonville. “If you want to shoot something or catch something in the water, you
need a license. If you want to have a child…you have sex.”

That approach resonated with many people and helped produce an immediate
turnaround that continued during subsequent sessions, with the majority of
participants now giving the proposal high marks – and some ultimately considering
it the most important of all proposals.

There is a lesson here for anyone fashioning a fundraising, political, electoral or
lobbying campaign around any of these children’s issues: There is an absolute


necessity to identify and stress common – even universal -- experiences, concerns,
impressions and aspirations. The more specific and the more universal, the better.

To wit:

A young mother from Jacksonville gave it a nine. “I had no idea what to do when I
had my first child,” she said.

A middle-aged woman from Jacksonville gave it a 10: “With my first child, I was
scared to death,” she said.

A man from Fort Lauderdale, who gave it a nine: “My wife always says it’s sort of a
joke, but a lot of it is true that parents should have a license to have children. If
parents have the opportunity to learn, it would definitely be a good thing.”

A woman from Fort Lauderdale gave it what she called “an exciting 10.”

“People perish from lack of knowledge,” she said. “It would be like a manual.
Everything we buy comes with a manual. Well, human beings need manuals.”

But this option still proved a tough sell to a few people.

“I just don’t buy this one,” said a young father from Jacksonville, even after listening
to the new approach. “I think there’s adequate stuff out there.”

Concluding Remarks

Key findings and impressions were shared near the beginning of this report and
during the examinations of each of the six proposals.

But in summary, support appears strong for health care, early intervention and
screening, and other programs that would improve services offered to Florida’s
children and their families. Many people hedge that support, however, pending
explanation of the details of these programs and – importantly – some insight into
how the programs would be funded.

In addition, a considerable segment of the population is not aware of the
deficiencies of many elements of the state’s network of child-care and family-
assistance programs.


Vigorous public information efforts will be required during the initial and
intermediary stages of any campaign on behalf of improving these services.

A major caution that is worth repeating: The overriding parental concern in Florida
clearly centers on the day-to-day physical safety of the state’s children. Regardless
of its basis in fact, this concern seems to take precedence over all other child-
related issues, at least at the moment and at least until public information
campaigns on behalf of other child-related issues are launched.

But, though each person’s priorities may differ, the focus groups made clear that
Floridians care about their children and they are aware that much work needs to be
done on behalf of the state’s youngest citizens.

It may be a self-evident, mundane observation. It may seem trite and cliché. But
these Floridians repeatedly noted that children represent our hopes and
expectations and dreams, and we all bear a responsibility to treat them well and
clear their paths to success.

“You have to take care of the kids,” said a Tampa-area man who has two children.
“Adults can make a choice, but the kids…you have to take care of them. The kids
are the future.”

Methodology Used for Forming the Focus Groups

The focus groups were recruited by Bendixen & Associates in coordination with
Herron Associates in Tampa, Irwin Research Services in Jacksonville, Plaza
Research in Hollywood, and Ask Miami in Miami.

All 80 participants were registered voters. All were pre-screened to ensure that the
focus groups represented their respective markets in terms of political affiliation.
Fifty percent were Democrats, 39 percent were Republicans, 11 percent described
themselves as independents. Fifty-seven percent earned more than $50,000 a
year; the balance earned less. Sixty-one percent of the participants were under 50
years old. Forty-three percent were Anglo, 39 percent Hispanic, 18 percent black.
Each group was evenly divided by gender. Participants each were paid $125 to
participate.


A note about the scores:

The six issues were shown on a rotating basis to the eight focus groups, in that,
some issues were shown to seven of the eight focus groups, while the other were
shown to four or five of the groups. In order to rank the issues, points were
assigned to the type of votes that each issue received. For instance, each time an
issue received a vote for first place it was awarded 10 points, second place
received 7 votes, third place received 4 points and forth place received 1 point.
The total points that each issue earned over all eight focus groups were then tallied
and this number was multiplied by an adjusted decimal for the number of times
each issue was presented. Thus the rankings are equalized to account for the
rotating presentation of the issues.

Here are the results on a weighted basis, using a formula that accounted for the
number of times each issue was presented:

RANKING BY FORMULA

1. Health insurance 690
2. Early Intervention 471
3. School year 387
4. Child care 350
5. Pre-K 332
6. Parent skills 296

***

Martin Merzer, formerly The Miami Herald’s senior writer, recently retired after a 35-
year career at the newspaper and at The Associated Press.


MODERATOR GUIDE – DRAFT

Children’s First Initiative

GROUND RULES AND INTRODUCTIONS (10 min.)

• Ground rules

o There are no wrong answers.
o Each person’s opinion is important.
o Sessions are recorded. There are people behind the mirrors who are
part of our research team.
o Be considerate; please do not interrupt other participants.
o All information obtained is treated as strictly confidential.

• Introductions (Name, occupation, any children/grand children or other
children close to)

I. INTRODUCTION TO CHILDREN’S FIRST INITIATIVE (15 min.)

A. Introduction

Since the beginning of the 21st century there has been a national movement to give
priority to the need for quality services and programs for children and families.
Many changes have occurred in local politics that reflect this new priority and there
are several advocates and experts interested in changing the statewide priorities in
Florida.

Tonight, we will be discussing potential policy priorities for children and families in
Florida. In order to properly inform you on the proposed policies, we have invited
someone who is fully versed in the issues and policies for children in Florida to
introduce the policies to you. Some of you may have heard of our guest, Dave
Lawrence, before as he was the publisher of the Miami Herald up until 1999 when
he retired to work in the area of early childhood development and readiness.


Dave Lawrence is president of The Early Childhood Initiative Foundation and
“University Scholar for Early Childhood Development and Readiness” at the
University of Florida. He serves on the board of the Foundation for Child
Development in New York and the Executive Advisory Board for the Frank Porter
Graham Child Development of the University of North Carolina-Chapel Hill. The
Dave Lawrence Jr. K-8 Public School in Miami opened in 2006. For six years,
Dave Lawrence was the chair of The Children’s Trust, a dedicated source of
funding for children and family early intervention and prevention programs in Miami-
Dade County. Dave collaborated with an array of child advocates, political leaders,
concerned citizens and leading public figures to have The Children’s Trust
approved in 2002 and then reauthorized in 2008 with 85 percent support from
voters.

Inspired by the success of The Children’s Trust reauthorization, Dave and many
other individuals across Florida who care about children and families decided that a
campaign needed to be created that would result in politicians giving children and
families a higher priority in the legislative agenda in Florida. The hope of this
campaign is that it will result in the enacting of innovative policy for children in the
state of Florida.

The process began with a series of meetings around the state where all types of
leaders were asked to share their policy ideas about children and Florida. From
these meetings we came away with six new policy ideas that the experts believe
are the most important for children and families in Florida. Tonight, we will
introduce four of the policies to you to get your opinion on which of the policies you
think is the most important for children and families in Florida. We will also have
focus groups around the state – Jacksonville, Fort Lauderdale, and Miami – to see
what folks around the state think of these six policy ideas.

B. Instructions

The format tonight will be as follows. Four statewide children policies will be
introduced and you will be asked to rate each one. Dave will introduce the
proposed statewide policy for children and then will answer your questions on the
particular policy. Once everyone has a general understanding of the proposed
policy we will ask you to rate the policy in terms of how important you think it is for
children in Florida. At the end of the night, when you have heard all four proposals,
I will ask you to rank all four in terms of which one you think should be the priority
for children in Florida.


Rules

• We are not going to discuss how these programs would be paid for, that is
for the state politicians to decide.

• We need your judgment on which of these programs would be most
important for improving the quality of life of children and families in Florida.

II. PARENT SKILL-BUILDING________________________ _(20 min.)
(Moderator note: To help children reach their fullest possible potential, parents and
other caregivers need access to information and other resources as to how children
learn and grow, and parents need effective parenting strategies.)

• Dave Lawrence introduces the issue.
Why is this important?
What is the specific proposal?

• Dave Lawrence answers preliminary questions.

• Please rate the proposed statewide legislation on how important you think it
is for children in Florida between 0 and 10, with 10 being extremely
important, 5 being somewhat important, and 0 being not important at all.

• What rating did you give to the policy and why did you give it that rating?

III. HEALTH CARE FOR ALL CHILDREN_______________ ________(20 min.)
(Moderator note: Health Care for All Children is ensuring that every child in the
State of Florida would have access to health care that provides preventative care,
such as immunizations and well-child visits, and care when ill.)






IV. QUALITY PREKINDERGARTEN OPPORTUNITIES (20 min.)
(Moderator note: Florida passed a voluntary pre-kindergarten amendment in 2002,
providing a free prekindergarten experience for every 4 year old whose parent
wants one. Florida’s program meets only 4 of 10 national benchmarks for an
excellent pre-K experience; there is significant room to improve this program.)





V. EARLY INTERVENTION, SCREENING AND AVAILABILITY OF SERVICES
(20 min.)
(Moderator note: While most children develop in ways that are predictable, about
10% of children have special developmental, physical or behavioral needs. These
needs might include speech delays, physical delays or behavioral issues. The
sooner special needs can be identified and treated, the greater the likelihood that
the children can grow to meet their fullest potential.)






VI. EXPAND THE SCHOOL YEAR AND SCHOOL DAY* (20 min.)
(Moderator note: The U.S. public school system, designed more than a century
ago, has become less equipped to help children compete in this 21st century global
economy. By making structural changes in our school through a longer school day
– that incorporates and arts and physical activity, and a longer school year --
Florida can lead the nation in creating a cutting-edge school system.)





VII. QUALITY CHILD CARE PROGRAMS* (20 min.)
(Moderator note: All families who choose and need to access child care should
have access to high-quality, affordable early learning opportunities.)






VIII. RANKING OF ALL FOUR AND CLOSING_____ (20 min.)

• You have heard four proposals tonight, health care for all children, quality
childcare programs, quality pre-kindergarten opportunities, and expand the
school year and school day. Please rank the proposed statewide
legislations in order from the policy that you think is most important to the
one that is the least important.
o The ranking is: 1 is most important and 4 is lowest importance

• Why did you choose the policy you have as most important?

• For the policy that you think is most important, is it so important to you that
you would actively support it on the ballot as a constitutional amendment,
would you support a candidate for governor or other public office on the
basis of their support for the policy, would you write a letter to the editor or
do you not have time to be involved in it?

Thank you for your time and participation this evening.

*Only four issues were discussed with each focus group.

Focus Group Report

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