Author: Gayla Burris

COMMUNITY ASSESSMENT
2023

COMMUNITY ACTION RESOURCE & DEVELOPMENT, INC. HEAD START
2022
COMMUNITY ASSESSMENT

OKLAHOMA CHILDCARE NEED DATA– ALL BLUE TEXTS NEEDS UPDATE
Approximately only 60% of facilities accept DHS subsidy. In all areas, the need is greater than the licensed capacity. These trends have been the same for several years, but are increasing in severity. There is also a trend for requests for childcare for swing shift or weekends, as many families are working multiple jobs, or are working the jobs available despite the hours. The number of licensed child care providers has decreased by nearly 30 percent over the past decade,12 and 55 percent of children in Oklahoma live in a child care desert.
The OK DHS Annual report of 2019 data show that Oklahoma has lost 129 centers and 391 homes in the period from 2015 to 2019, and the number of slots diminished by over 9,000. Oklahoma childcare was struggling before the pandemic, and since then, more sites have closed.
Are parents working? State of Babies 2021 found that only 5.5% of families with infants and toddlers were not working. Mothers were working in over 56% of all households with infants and toddlers, and 17% of households with infants and toddlers were single parent homes.
The need for childcare for all ages, multiple shifts, is growing. The need is most acutely felt for the younger children, as it often costs more to provide the care than the center makes; these slots are often provided primarily for the childcare’s own employees so they can hire staff.
https://www.brookings.edu/research/why-the-federal-government-should-subsidize-childcare-and-how-to-pay-for-it/
https://okpolicy.org/expansion-in-federal-funding-is-improving-access-and-quality-in-oklahomas-child-care-subsidy-program/

COMMUNITY
ASSESSMENTS DRIVES
DECISIONS

SUMMARY OF CA
The Federal Office of Head Start requires all programs to conduct a thorough community assessment every 5 years and regular updates. Using census data, online research, program and community information, and feedback from stakeholders (parent, staff, community partners, etc.), data are organized into a document that includes strengths, needs and resources around the community and which is used but more importantly is used to inform the continuous planning cycle of CARD Head Start. This process guides the program in addressing the needs of the families we serve, as well as to identify needs that may not being met by current programming. Trends help the program anticipate future needs and make adjustments. CARD uses such information in planning program goals and programming, as well as outreach, site locations, hours of operation, and training needs for parents and staff.
While the complete community assessment occurs every 5 years, evaluation of data is ongoing and includes formal, vetted research as well as informal feedback from parents, staff and community agencies to measure not only satisfaction levels but to monitor needs and areas of concern. The use of this information can be seen in the selection criteria priorities, programming for families, choice of curriculum emphasizing mental health and wellness, and other important decisions made by the program

OVERVIEW OF ASSESSMENT
WHAT DATA? OLD ? data supportS continued emphasis on:
Safe and affordable childcare and high-quality early childhood programming
Health & Wellness for all Oklahomans
Drug and Alcohol misuse and a continuing opioid misuse
Mental health needs to include trauma, domestic violence, high rate of women incarcerated in Oklahoma
ACEs, including historical trauma
COVID19 pandemic issues
Housing and homelessness
Systemic inequity

Community Assessment Update 2022

CARD Head Start, originally funded as a summer program in the 1960’s, has consistently strived to improve the lives of children and families and communities through education and partnership with the families and communities. Data support that the need to strengthen families and communities continues to exist, though methods, means, and opportunities may change!

General Area Description – Demographics

Proposed service areas have not changed. Counties remain the same: Mayes, Nowata, Rogers, Tulsa, Wagoner and Washington counties, with the section of Tulsa county served being Broken Arrow. The governing structure has not changed. The latest available demographics follow..

County/ Area Population Washington 52,772 up
Nowata 9,202 down
Mayes 39,159 down
Rogers 6,695 up
Wagoner 84,050 up
Tulsa County/ BA only 116,330 up

SELECTED DEMOGRAPHICS

The population growth for the state has been 5.5% over the last 10 years, but for the first time, Oklahoma had more deaths than births in the period ending July 2021. The pandemic hit Oklahomans hard but there has been some move into the state during this time. Some areas have experienced marked growth (Rogers, Wagoner counties, Broken Arrow) and others have been dropped (Mayes has lost about 2,000 people and Nowata lost 10% of its population).
Kids Count Data from 2016 indicated that there was a trend upward in the population of Hispanic or Latino children, and this is anticipated to continue.
Economically, the State’s unemployment rate tends to be low (around 4 to 5%) but the current rate is even lower (2.8% in May 2022, per US Dept. of Labor) and wages also tend to be low. The Journal Record (March 2022) reported that Oklahoma’s wages are in the bottom 8% nationally, and noted that the rent index had increased 25% from November 2020.
Regarding state services, all state agencies were given a funding cut to their budgets, following several straight years of budget cuts. State services continue to shrink, though the population of Oklahoma has not diminished to such a degree in any area.
https://journalrecord.com/2022/03/17/study-oklahomas-workforce-near-bottom-of-earnings

Table 1: Comparison of areas, Basic Demographics

	Mayes	Nowata	Rogers	BA	Wagoner	Washington
Income per capita	$25,937	$24,532	$33,030	$55,758	$30,727	$31,113
Median household income	$43,304	$45,719	$67,243	$74,047	$66,375	$48,144
Poverty rate %	17.2	17.3	9.4	8.4	17.5	13.5
Poverty % under 18 yrs	25.1	25	13	9.5	29	20
Married %	56	57	60	59	53	53
Housing occupancy %	82	84	91	94	80	86
Educational level HS only %	41	42	33	24	37	34
No high school dip/GED %	12	13.5	8	5	14	9
B.S. Degree %	14.5	13.5	24.3	34.4	23.8	19
English Only %	95	98	91	86	99	94
Broadband in household	81%	67%	84%	93%	99%	79%
Geographic size Sq Miles	655	565	676	62	561	415

The geographic areas have several commonalities.

How are the communities similar?
The average household sizes range from 2.5 to 2.7, with Wagoner having the highest at 2.7.
Gender is basically equal in each area. As populations age, the gender tends to tilt towards being more female than male.
There is a wide range in income per capita. Income tends to be higher in areas closer to the metro area, where the population tends to be more highly educated and employment which requires greater education and more richly rewarded skills tends to be more concentrated.
In all areas, married households predominate. Single parent households are more likely to live in poverty.
English as a primary language is predominate; Spanish is the other language most likely to be spoken, and in Broken Arrow, 3.4% speak an Asian language.
In no community is there a substantial number of people who use mass transit. Mass transit is scarce and often does not meet the needs of young families, as such services may provide services primarily to the elderly or those with disabilities, making it a poor fit for work place commuting. Schedules and routes are extremely limited; it makes it near impossible to use the public transit which does exist to meet work or school schedules.
In all areas the average commute to work is not less than 22 minutes. In some areas, commuters drive more than 30 minutes one way to work and typically leave the community for their employment. There are no state or federally funded programs to assist families who need a car or need car repair or maintenance.
Occupancy rates are particularly high in some areas, making it difficult to find affordable housing. This is particularly true in Rogers county, Broken Arrow, and Wagoner. The wait list for HUD housing is 9 months. Rental costs have also increased precipitously during the pandemic (25% per Journal Record stats).
Median home values do vary considerably. In the most rural county, Nowata, the median home value is only about 87,000, whereas in areas closer to the Tulsa metro, housing medians are 165,000 to 172,000. Compared to other measures nationally, housing cost is the only in which Oklahoma consistently scores quite well.

Housing affordability is one area where Oklahoma consistently tends to compare favorably when compared with other states, however rental rates have risen, and occupancy levels are very high.

Education

Educational Attainment in NE OK and the USA

Educational attainment tends to be strongly correlated to income and other predictors of quality of life. In rural areas tends to be plateau at the high school level, whereas areas closer to the metro area have larger percentages of people who have some college; however, these percentages do not meet the national average for people holding a BA/BS or better is 37.9%

Adults in rural areas such as Mayes, Nowata and Wagoner counties are more likely to have not completed high school than areas like Broken Arrow or Rogers county, which is more closely situated to the metro area.

Only 2 areas fair better than the national average in helping residents achieve a GED or HS diploma. Broken Arrow has only 5% of the population with less than this educational benchmark, as does Rogers County. These are also 2 places which are the most costly to live.
Income and education tend to be highly correlated; it is possible that those without even a HS diploma can simply not afford to live in these two locations

Oklahoma as a whole does not compare well with the USA for the percentage of its citizens holding at least a BS/BA degree. Teaching positions may have no qualified applicants in many areas.

Employment: Earning a Living

How are Oklahomans in these areas paying their bills? What are the major opportunities for work?
Table 2:

Table 2: Major Sources of Employment by Area

	Mayes	Nowata	Rogers	Tulsa	Wagoner	Washington
Accommodations & food		8%		8%		8%
Administration & support		7%		8%
Construction	9%		9%		13%
Farming	8%	20%
Government	12%	13%	12%	7%	7%	8%
Health	7%	11%	7%	13%		8%
Manufacturing	16%		13%	9%	9%
Mining						15%
Other Services					10%
Retail	12%	7%	10%	10%	13%	11%

Of interest:
Health and Retail sectors are significant employers. Health as an industry has many openings for employment. Retail and hospitality industries are also finding it difficult to hire.
Washington county has Mining as its largest employment sector due to a long history of the oil and gas industry in this area. Oil and gas is a “feast or famine” type of industry; while jobs may pay well, the positions may also be more dangerous than other positions and may also be more volatile and dependent upon the market. Currently barrels of oil are selling high, however this has not necessarily translated to increased economic wealth for the average person; in fact, energy prices are squeezing the average family’s resources.
Nowata relies heavily on farming as an industry, an industry where farmers may have a good income one year followed by 2 years of drought. Drought is an ongoing issue.
Mayes county is expecting expansion in the Google data system built in Pryor. While this plant is now a major employer in the area (400 employees), the plant is a data farm. There are some jobs as janitors and food service workers, most positions require specific, technical and educational backgrounds and are quite competitive. With only 11% of Mayes County residents holding a bachelor’s degree, many of these well-paid positions will go to commuters who are living closer to Tulsa for the many amenities and choices offered there, rather than living in the rural area. A partnership with Cherokee Nation to build a childcare center with The MidAmerican Industrial Park been announced; this will added needed childcare to the area. It will house 13 classrooms, but only 2 of those will be HS or EHS; the balance of these slots will likely be used for employees of the Industrial Park, few of which are income eligible for HS/EHS. This site will add 50 new jobs in the area, in an area where finding qualified teachers is a challenge. While this is good news for Mayes county, competition for teaching staff will likely increase.
Wagoner and Mayes counties sit on a major highway and rail systems which transport goods along the north/south corridor, creating good locations for industries such as manufacturing which require freight and trucking. Rogers county houses the port of Catoosa, on the Kerr-McClelland Navigational Channel, a major pathway for shipping goods to the gulf to ship overseas. These factors impact the industry in the areas.

Health and Wellness

Oklahoma ranks poorly in national statistics for health and wellness measures.
A third of adults are obese, and
In 2020 the percentage of uninsured adults ranged from 19 to 27%. Nationally, the CDC puts this rate at 14.7%.

Families are food insecure; many are on food stamps but SNAP will not adequately feed a family
The rate of disability is high in adults in Oklahoma

https://censusreporter.org/profiles/160001US4009050-broken-arrow-ok/
https://okpolicy.org/resources/countystats/

44th worse state for PRETERM BABIES

Oklahoma ranks 15th in births to unmarried mothers, 16th in Cesarean deliveries, and 26 in low birthweight babies.
In virtually every health measure, Oklahoma scores poorly. A state with poor insurance coverage, high ACE scores, significant historical and current trauma, a weak social safety net, and insufficient access to health services, this fact is scarcely a surprise.

16th for Cesarean Sections

4OTH FOR MATERNAL DEATHS

MATERNAL HEALTH IN OKLAHOMA

Oklahoma consistently ranks in the worst of states for maternal mortality, typically at 40th in the nation, and the USA does not do well when compared with other wealthy nations. When compared with 10 other wealthy nations, the USA ranks last for maternal mortality with 23.8 maternal deaths per 100,000. (source: Researchers with the Commonwealth Fund pulled data from the fund's 2020 International Health Policy Survey and the Organisation for Economic Co-operation and Development to look at maternal mortality).
If the data are disaggregated to look at the outcomes in America for black women alone, the mortality rate soars to 55.3%.
For Native American women, the rate is 29.7%

Health disparity and inequality are clear contributors to the poor outcomes for women in America.

O

OKLAHOMA
ranks poorly in a
NATION that ranks poorly for caring for women

Many of the conditions that lead to maternal mortality can be impacted by accessible health care and early identification of risks
https://www.nihb.org/public_health/maternal_mortality.php

While child mortality progressively declined across all countries, mortality in the US has been higher than in peer nations since the 1980s.
From 2001 to 2010 the risk of death in the US was 76 percent greater for infants and 57 percent greater for children ages 1–19. Gun violence accounts for a substantial loss of life for older children.

What about the children?

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0767#:~:text=While%20child%20mortality%20progressively%20declined,for%20children%20ages%201%E2%80%9319.

Children’s Health In Oklahoma

The United States does not compare well with other developed wealthy countries, and Oklahoma does not compare well within the United States on virtually any health measure.
A smaller percentage of Oklahoma children have their preventive health care needs met, receive their vaccinations, receive preventative health services, have insurance, have a medical home,

On EVERY health measure, Oklahoma ranks more poorly than the USA as a whole.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0767#:~:text=While%20child%20mortality%20progressively%20declined,for%20children%20ages%201%E2%80%9319.

Health measures do not exist in a vacuum. Other factors confound health; poverty is a major determinant of later health outcomes, as is exposure to trauma.

Very high Incarceration rates of Oklahomans, particularly women,
High Domestic violence (per Oklahoma domestic Violence Fatality Review Board).
High Maternal mortality rate
High Drug overdose rate
Homicide rate (8.8 per 100K; USA is 6.2 which is 7.5 times higher than other high income countries) ncbi.nih.gov
Firearms injury rate (18.6 per 100K; USA is 12.0)
COVID-19 death rate (101.2 per 100K; 22 )

Current data published in 2018 from https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/ACEs/state/OK and CDC Stats of the States.

The State of Nutrition in Oklahoma

Oklahoma compares poorly against the rest of the country when looking at measures for breastfeeding (ever or 6 months) children/teens who are overweight or obese, children or who live in poverty who are overweight/obesity or children who live in families at least 400% over the FPL and who are overweight or obese. While income matters, Oklahoman kids are still more likely to be obese than the national average.

Food insecurity in Oklahoma is prevalent. During the pandemic, rates of SNAP have risen. SNAP and WIC are both supplemental programs and are not designed to meet the entire nutritional needs of a family or child.

Participation in WIC tends to be far lower than the number who would qualify, though the participation in WIC has increased during the pandemic. Oklahoma compares poorly in several areas related to nutritional status when compared to national averages. has lower rates of babies ever breastfed and breastfed at 6 months.
The free and reduced lunch program in Oklahoma has steady participation at 61.5% of children receiving this service, with a variation of approximately 1% per year (2017 data). http://sde.ok.gov/sde/sites/ok.gov.sde/files/documents/files/Fast%20Facts%20FY17%20December%2021%202017.pdfhttps://www.childhealthdata.org/docs/nsch-docs/oklahoma-pdf.pdf?sfvrsn=d65b9ce7_0
Annie E.Casey 2021 Kids Count State Profile OK State Department of Health website 7/21/22 State of Babies Yearbook 2021 https://stateofbabies.org/

21%
of Oklahoma’s children are food insecure
Versus
14.6% nationwide

32 to 42%
The range of obesity rates in CARD’s service area

36%
of Oklahomans
suffer from obesity

The State of the State

Oklahoma is in the bottom THIRD in:
Women’s clinical care
Women’s health (chlamydia rate, obesity, inactivity, smoking)
Public policies for women (insurance, health sources)
Breastfeeding
Dental Services
Prenatal services before last semester
Dedicated services for women’s health

For the general population, Oklahoma ranks poorly in:
high school graduation
obesity.
For children:
behaviors of infants and children
public policies for children
well baby checkups
immunizations
fluoridated water.

Opioids in Oklahoma

Updated data include a report from the Oklahoma Commission on Opioid Use (January 23, 2018) reported data previously unavailable. The number of overdose deaths has increased by 91% in the past 15 years. In 2014 Oklahoma ranked as #1 in the abuse of painkiller drugs. The number of drug-exposed newborns in 2017 was over 1000. According to the Mental Health Services Administration, Oklahomans misused opioids more than residents of any other state in 2017; over 68% of drug related deaths were related to prescription opioids. Oklahoma Bureau of Narcotics - Health officials estimated 50% of those admitted for treatment for opiate addictions in 2016 were between the ages 21 to 30. Research suggests children who live in homes where others are abusing drugs are more likely to suffer abuse and neglect. From November 2012 to March 2016, the Oklahoma Department of Human Services (DHS) received 40,938 referrals. In Wagoner County, prescription drug related deaths increased from 9 in 2015 to 13 in 2016; Mayes County reports a decrease from 12 in 2015 to 5 in 2016; Tulsa County also decreased from 92 in 2015 to 78 in 2016. The current Oklahoma Commission on Opioid Abuse 2020 report indicates a trend downward in prescriptions and prescription-related deaths in Oklahoma but does not report opioid deaths that were not prescription based. The most recent data from the Kaiser foundation also indicates a trend downward for opioid deaths
(https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-raceethnicity/?dataView=2&activeTab=graph&currentTimeframe=0&startTimeframe=21&selectedRows=%7B%22states%22:%7B%22oklahoma%22:%7B%7D%7D,%22wrapups%22:%7B%22united-states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D)
There are insufficient resources for children and young adults in dealing with drug abuse and addiction issues. Only 1 accredited recovery high school (privately funded) in the state, and only one program for student addiction on a college campus. There is only one to two programs that will serve pregnant women.

Poverty and Race in Oklahoma

15%
of Oklahomans
live in poverty

Of those in poverty,
20%
are children

44th—Oklahoma’s overall ranking in poverty

Oklahoma is a diverse state. Oklahoma was originally unassigned and tribal lands, lands designated for the relocation of the Native tribes in the 1830’s. Oklahoma was further settled by land runs which brought people from throughout the country hoping for a homestead for the price of working the land.

https://www.census.gov/library/stories/state-by-state/oklahoma-population-change-between-census-decade.html#:~:text=Race%20and%20ethnicity%20(White%20alone,or%20More%20Races%2010.2%25).

Oklahoma’s Population

The fastest growing demographic in the state are those who identify as Hispanic or
Latino.

Oklahoma is becoming more diverse; in the last 10 years, the percentage of the population who identify as something other than “white, non-Hispanic) fell by over 4% while who identify as white alone, not Hispanic or Latino, increased by more than 3%. The third largest racial group in Oklahoma is now those who identify as two or more races, but not Hispanic or Latino, which represents 9.4% of Oklahomans. Three of the counties CARD serves showed substantial growth during this period: Rogers, Wagoner, and Tulsa counties.
The chart (usafacts.org data 2020) represents all categories as “non-Hispanic) except for the 11% which may be of any race and are Hispanic or Latino.

The State of the State

Those living in Poverty in Oklahoma are more likely to be any race other than White.

Only 7% percent of Oklahomans identify as Black, but of those living in poverty in Oklahoma, more than a quarter are Black. Almost 2/3 of the population of Oklahoma are white, yet the same population comprises just under 12% of those in poverty. This is not unique to Oklahoma, but follows national demographics.

Those Who Are Without Housing

As of January 2020, Oklahoma had an estimated 3,932 experiencing homelessness on any given day, as reported by Continuums of Care to the U.S. Department of Housing and Urban Development (HUD). Of that Total, 255 were family households, 325 were Veterans, 290 were unaccompanied young adults (aged 18-24), and 1,128 were individuals experiencing chronic homelessness.
https://www.usich.gov/homelessness-statistics/ok/#:~:text=As%20of%20January%202020%2C%20Oklahoma,and%20Urban%20Development%20(HUD).
Public school data reported to the U.S. Department of Education during the 2018-2019 school year shows that an estimated 23,372 public school students experienced homelessness over the course of the year. Of that total, 774 students were unsheltered, 1,668 were in shelters, 615 were inhotels/motels, and 20,315 were doubled up.

1 in 14 of every Oklahoma child under age 6 is homeless
1 in 4 are struggling with hunger
(OKDHS website 1-2017)

State of Babies 2021

OK’s HOUSING INSTABILITY is 3 times higher than the national average and increased to 8.3% in 2021

65%
Of Oklahoma’s low income families do not receive any rental assistance & are at risk for homelessness.
Ameriashealthrankings.org

Oklahoma and COVID19

58% of Oklahomans are fully vaccinated (78.5% in USA)

For the FIRST time in history, more people DIED than were BORN in Oklahoma in 2020-2021.

WORK
13% unemployment in 2020
2.8% unemployment (5/2022)

Employment
Oklahoma’s unemployment rate was at 13% at the height of the pandemic shutdown in Oklahoma (2020). In Oklahoma, the unemployment and participation numbers have returned to basically pre-pandemic records, however, those who are not actively looking for employment are not counted. The market is tight; most positions that are open are lower paying positions. Childcare continues to be a sparse. Oklahoma cut off federal unemployment benefits early- believing the reason it was hard to hire was because people did not need to work due to assistance. Time has shown that is not the case. It is still hard to hire.
(OK Dept of Numbers)

Protecting Against COVID19

The state led the nation vaccine roll out, but saw that advantage quickly lost due to vaccine hesitancy.
Only 58 % of Oklahomans are fully vaccinated, and in several of CARD’s counties, that measure is considerably less.
Oklahomans who are older are most likely to have been vaccinated. Just over 15% of children 5-17 have been vaccinated.
.

Co-Morbidities makes Oklahomans particularly at risk for serious illness with a COVID19 infection. Obesity, heart disease, diabetes, asthma, etc. place Oklahomans at high risk.

Oklahoma and COVID19

3rd worst in rate of deaths due to COVID19 in the US.

Given the high rate of co-morbidities in the population in Oklahoma, this virus is a significant risk.
Additionally, Oklahomans have not had a unified approach to the virus. While the state does have some very “science-minded” individuals and is blessed with dedicated and compassionate health care workers and leaders, many of those in leadership positions and many of those in the general population are not well-versed in science and medicine.
-

https://www.statista.com/statistics/1109011/coronavirus

Barriers to Vaccination in Oklahoma
Legal prohibitions regarding mitigation allowed in schools, public places, etc. Example: public schools are prohibited from implementing masking, etc.
Historical resistance to vaccines overall, and this vaccine in particular.
Cultural/societal issues based in religion, politics, and a distrust of science
Widespread inaccurate information about vaccines, the virus, etc.
The educational attainment of the average Oklahoman is low; understanding the science regarding immunology can be a challenge.
Fear of the vaccine.
Religious opposition to this vaccine in particular.

Impacts on Childcare from COVID19 (https://okpolicy.org/covid-19-worsened-an-existing-crisis-for-child-care-in-oklahoma/ 3/2022
Countless Oklahomans rely on access to high-quality, affordable child care in order to work. However, the COVID-19 pandemic has had a devastating effect on our state’s child care industry, impacting parents’ ability to work and businesses’ ability to recruit and retain a reliable workforce.

Due to underfunding, Oklahoma’s child care system for providers and families was in crisis long before the first COVID-19 case at a child care center was reported.
Countless centers have closed their doors
The cost of providing childcare has gone up 47%
There are insufficient childcare slots for people to return to work which is IMPACTING HIRING for businesses, schools, Head Start, etc.

The OKHSD reimbursement rate only provides 60.3% of the true cost of care, costing families hundreds of dollars each month. OKPolicy.org

Childcare and ECE in Oklahoma

7%
Maximum that should be paid

26%
Of median income for 2 kids in care or $15,181

Child care is expensive. The US Department of Human Services has stated that “affordable childcare” is no more than 7% of a family’s income. Most families in America are spending more than this amount in childcare costs.
Child care is an essential infrastructure service; workers need safe, affordable, accessible childcare to work.

In OKLAHOMA
Two-thirds of children 5 and under have ALL their caregivers working outside the home.

55%
Of ALL Oklahomans live in a child care desert

68%
Of RURAL Oklahomans live in a child care desert

Average cost for childcare for an infant in Oklahoma in 2020
$7,820.00

College Tuition at OSU in 2020
$11,518

For every ONE slot, there are more than 2 children needing care. High quality slots are concentrated in metro areas.

Child Care Subsidy reimburses at a rate under 60% of the COST to provide the care.

Infant care is particularly costly. In general, the younger the child, the harder it is to find affordable and high quality childcare.

Childcare and ECE in Oklahoma

Income thresholds for families was raised in 2018, and the reimbursement rates for subsidy to providers also increased but still lags behind the national target of 75% of market value.

Many childcare centers simply find it economically disadvantageous to accept subsidy, particularly for the younger age children. A single parent earning only $18,000 a year and with one child in care, will pay 90.00 a month for his/her childcare copay, or a couple where each parent makes 10.00 an hour in full time jobs and have 2 children in childcare and 2 children in public school do not qualify for assistance. Approximately only 60% of facilities accept DHS subsidy. In all areas, the need is greater than the licensed capacity. These trends have been the same for several years, but are increasing in severity. There is also a trend for requests for childcare for swing shift or weekends, as many families are working multiple jobs, or are working the jobs available despite the hours.

The number of licensed child care providers has decreased by nearly 30 percent over the past decade,12 and 55 percent of children in Oklahoma live in a child care desert. The need for childcare for all ages, multiple shifts, is growing. The need is most acutely felt for the younger children, as it often costs more to provide the care than the center makes; these slots are often provided primarily for the childcare’s own employees so they can hire staff.
The OK DHS Annual report of 2019 data show that Oklahoma has lost 129 centers and 391 homes in the period from 2015 to 2019, and the number of slots diminished by over 9,000. Oklahoma childcare was struggling before the pandemic, and since then, more sites have closed.
Are parents working? State of Babies 2021 found that only 5.5% of families with infants and toddlers were not working. Mothers were working in over 56% of all households with infants and toddlers, and 17% of households with infants and toddlers were single parent homes.
https://www.brookings.edu/research/why-the-federal-government-should-subsidize-childcare-and-how-to-pay-for-it/
https://okpolicy.org/expansion-in-federal-funding-is-improving-access-and-quality-in-oklahomas-child-care-subsidy-program/
http://www.okdhs.org/OKDHS%20Report%20Library/S19034_DHS2019AnnualReport_ccr_11122019.pdf

The 1st years are THE MOST CRITICAL for brains!

I in 3
Oklahoma childcare facilities closed from 2015 to 2019. More were lost during COVID19.

Childcare and ECE in Oklahoma

Oklahoma has broad availability of publicly-funded Pre-K programs.
State spending for PreK was 4600 per child in 2019-20
Oklahoma ranks in the top 5 for PreK access in the US.

100%
Of Oklahoma’s School Districts offer Pre-K Programs

Fewer than 5% of Oklahoma’s 3 year olds are enrolled in PreK. The only state funding for this is through the Oklahoma Early Childhood Program (OECP), a passthrough funding stream to selected school districts, none of which are in the CARD service area.
Schools do have services for 3 year olds who qualify for a IEP as required by public law.

43%
Of Oklahoma’s 4 year-olds are NOT enrolled in public school PreK . Enrollment tends to increase each year.
.

Some of the 57% that are enrolled in PreK programs which the Public Schools Head Start collaborations.
Over 28,000 Oklahoma children are served in Head Starts

Trends in Public Education in Oklahoma

Movements to privatize education through vouchers and virtual schooling
Homeschooling (OK had the 4th highest increase of any state)
Underfunding consistently
Increased scrutiny of public schools
School safety concerns & gun violence

46th in public education nationally. Oklahoma consistently ranks towards the bottom on educational measures.
https://worldpopulationreview.com/state-rankings/public-school-rankings-by-state

Spotlight on the CARD Counties

Mayes County

Mayes county, situated in a beautiful rural area of NE Oklahoma, has about a quarter of the population comprised of Native Americans, with the predominate group identifying as White. The Cherokee Tribal government is seated in an adjoining county. This county has very few other racial groups. It is likely that many of those listed as more than one race count as one of those races Native American.

While Mayes county is about 67% white, the children who live in poverty are only 43% white.

Children of color are disproportionately living in poverty in all our counties
Children who are Native, who are Latino, or who are of more than one race comprise 56% of the children in poverty, yet those groups comprise only 32.7% of the overall population.

Mayes county has a major highway that is a north-south corridor used heavily by trucking companies.
There are also many rail lines through this area.
The MidAmerica Industrial park is home to manufacturing as well as the Google Plant.
The largest town is Pryor, and there are several other small towns in the county.

551 children 0-4 in poverty

483 pregnant women living in poverty

2504
children ages 0-4 in Mayes county

About 41,000 people live in Mayes County.

1/3 of households are single parent families

Spotlight on the CARD Counties

Nowata County

Nowata is the most sparsely populated county in the CARD area. Nestled against the Kansas border, it is a rural county of about 10,000.
Nowata also has a significant Native population and is close to the Osage and Delaware tribes, as well as Cherokee

Children of color are disproportionately living in poverty in all our counties

Towns are very small and families have lived there for generations. There are few new industries and few resources for the families. Many drive about an hour to commute to work.

582 children ages 0-4

82 pregnant women living in poverty yearly

128 children 0-4 living in poverty

2 childcares in county serving up to 70 children

Spotlight on the CARD Counties

Rogers County

Rogers county has been one of the fastest growing areas of Oklahoma over the last 15 years. The county seat is about a 35-45 minute drive into Tulsa.

PreK enrollment in Rogers county
734

5313
children aged 0-4
Child care capacity 0-4 1591

1169
Children 0-4 living in poverty

1177
Pregnant women living in poverty

Economic disparity is clearly present.
About three quarters of the population are white, yet under half of children living in poverty are white. The fastest growing segment of the population based on race or ethnicity is the Hispanic/Latino population which now comprises about 5% of the population.

Spotlight on the CARD Counties

Tulsa County—Broken Arrow

https://www.census.gov/quickfacts/fact/table/tulsacountyoklahoma/BZA210220

Some data sources break apart Hispanic/Latino within Race, and others report separately. Tulsa’s percentage of Hispanic/Latino people regardless of race is almost 14% (13.9).

While white children are greater in sheer numbers, the risk of being a child in poverty is much greater for all other races.

1625 low income pregnant women in BA

Broken Arrow has approximately 8700 children 0-4 yrs who live in poverty

Broken Arrow has 950 children enrolled in PreK
Childcare Capacity is 2009 for 0-4 year olds
Of those only 873 are in facilities with DHS subsidy contracts

Approximately 2/3 of children under 5 have all caregivers working. The deficit of licensed slots is more than 6000 for Broken Arrow

Spotlight on the CARD Counties

Washington County

Children in poverty 0-4 years
724

Women who are low income and pregnant in Washington County
547
Has local hospital that delivers

1508 childcare slots; 2/3 are DHS subsidy

3309 children 0-4 years

Spotlight on the CARD Counties

Wagoner County

Definition for Race is that race ALONE.
https://www.census.gov/quickfacts/fact/table/wagonercountyoklahoma,oklahomacountyoklahoma/PST045221

964 pregnant women who are low income.
NO Deliveries in county

1954 children under 5 living in poverty

4792 children under age 5

Only 1186 licensed care slots with DHS contracts

Eligible Children in the CARD Area

The number of children who are income-eligible and age eligi ble continues to be much higher than the availability of early childhood programming.
Race and ethnicity data (most recent available) indicates the areas by counties served have continue to have increasing numbers of families living in Spanish-speaking homes.
.

The rate of homelessness has likely risen due to the pandemic, but numbers are not readily available. The last published data indicated that in Oklahoma, on average 9.9 persons per 10,000 are without a stable residence (data gathered PRIOR to the pandemic). Between 2007 and 2020, Tulsa county’s rate of unsheltered rose by 272%. The percentage of these which are families rose by 16%. It is likely that there are many more who are unsheltered and are not counted in these statistics. (National Alliance to End Homelessness https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness-dashboards/?State=Oklahoma )

The number of children living in poverty who have English as a 2nd language continues to grow.

Oklahoma’s rates have ranged from 7.7 to 20.6. Nationally the rate is 8.4

The trends in data on the children in foster care indicates increasing numbers of children in foster. State of Babies 2022 noted that the rates of children removed from the home in Oklahoma compared to the national average is quite high: 13.5 vs 7.1. Infant & toddler maltreatment was also high at 32.3 vs 15.9. Rates of ACEs (adverse childhood experiences) were considerably higher than the national average (29% have one ACE vs 19.6% nationally, and 15.8% of Oklahoma children have 2 or more ACEs versus less than half at 7.3% nationally)

44th – Oklahoma’s overall ranking in poverty

https://talkpoverty.org/state-year-report/oklahoma-2020-report
https://www.census.gov/library/stories/state-by-state/oklahoma-population-change-between-census-decade.html#:~:text=Race%20and%20ethnicity%20(White%20alone,or%20More%20Races%2010.2%25)

All areas except Wagoner had rates above 13.3 for confirmed CAN

Oklahoma has high rates of children in Foster Care

20% of those in poverty in OK are children

Child Services In CARD Areas

Child Care Availability
In the State, since 2012, the number of licensed facilities has decreased 23%. The current data from the DHS Licensed facility childcare sites and the capacity for each county or area shows a significant decrease from 2016 in all areas except Washington county, which saw a slight increase overall, but a marked decrease in the slots at childcare centers which have DHS subsidy, sites which are more likely to meet the needs of families living in poverty. While the need for childcare is increasing, available, affordable, licensed care is decreasing, especially for young children.

County	Prek 2018-19	Childcare capacity 0-4	DHS contracts	DHS slots
Mayes	462	467	8	270
Nowata	99	73	1	43
Rogers	734	1591	13	1321
Tulsa/BA	950 BA	2009 BA	12 BA	873 BA
Wagoner	437	1231	28	1186
Washington	521	1508	18	1036

A recent survey indicated that the number of families who receive DHS Childcare assistance is down to 22% from 38% in 2015, despite the low-income levels in Oklahoma.
How many low- and moderate-income infants and toddlers in Oklahoma are in CCDF funded childcare?
Very few. Of Oklahoma’s infants and toddlers, 46% are low income or in poverty and yet only 8% are in CCDF funded childcare.
Oklahoma’s system does still have significant copays
Oklahoma’s system requires that a single parent file child support on the other parent. Many single parents find this barrier for a variety of reasons.
Kith and kin may “watch” the baby more cheaply than the copay.
Income thresholds for families was raised in 2018, and the reimbursement rates for subsidy to providers also increased but still lags behind the national target of 75% of market value. Many childcare centers simply find it economically disadvantageous to accept subsidy, particularly for the younger age children. A single parent earning only $18,000 a year and with one child in care, will pay 90.00 a month for his/her childcare copay, or a couple where each parent makes 10.00 an hour in full time jobs and have 2 children in childcare and 2 children in public school do not qualify for assistance. accept DHS subsidy. In all areas, the need is greater than the licensed capacity. These trends have been the same for several years, but are increasing in severity. There is also a trend for requests for childcare for swing shift or weekends, as many families are working multiple jobs, or are working the jobs available despite the hours. The number of licensed child care providers has decreased by nearly 30 percent over the past decade,12 and 55 percent of children in Oklahoma live in a child care desert.
The OK DHS Annual report of 2019 data show that Oklahoma has lost 129 centers and 391 homes in the period from 2015 to 2019, and the number of slots diminished by over 9,000. Oklahoma childcare was struggling before the pandemic, and since then, more sites have closed.
Are parents working? State of Babies 2021 found that only 5.5% of families with infants and toddlers were not working. Mothers were working in over 56% of all households with infants and toddlers, and 17% of households with infants and toddlers were single parent homes.
The need for childcare for all ages, multiple shifts, is growing. The need is most acutely felt for the younger children, as it often costs more to provide the care than the center makes; these slots are often provided primarily for the childcare’s own employees so they can hire staff.
https://www.brookings.edu/research/why-the-federal-government-should-subsidize-childcare-and-how-to-pay-for-it/
https://okpolicy.org/expansion-in-federal-funding-is-improving-access-and-quality-in-oklahomas-child-care-subsidy-program/

Approximately only 60% of facilities accept DHS subsidy. In all areas, the need is greater than the licensed capacity. These trends have been the same for several years, but are increasing in severity. There is also a trend for requests for childcare for swing shift or weekends, as many families are working multiple jobs, or are working the jobs available despite the hours. The number of licensed child care providers has decreased by nearly 30 percent over the past decade,12 and 55 percent of children in Oklahoma live in a child care desert.

Child Services In CARD Areas

The OK DHS Annual report of 2019 data show that Oklahoma has lost 129 centers and 391 homes in the period from 2015 to 2019, and the number of slots diminished by over 9,000. Oklahoma childcare was struggling before the pandemic, and since then, more sites have closed.
Are parents working? State of Babies 2021 found that only 5.5% of families with infants and toddlers were not working. Mothers were working in over 56% of all households with infants and toddlers, and 17% of households with infants and toddlers were single parent homes.
The need for childcare for all ages, multiple shifts, is growing. The need is most acutely felt for the younger children, as it often costs more to provide the care than the center makes; these slots are often provided primarily for the childcare’s own employees so they can hire staff.
https://www.brookings.edu/research/why-the-federal-government-should-subsidize-childcare-and-how-to-pay-for-it/
https://okpolicy.org/expansion-in-federal-funding-is-improving-access-and-quality-in-oklahomas-child-care-subsidy-program/
https://okpolicy.org/expansion-in-federal-funding-is-improving-access-and-quality-in-oklahomas-child-care-subsidy-program/

“Families need high quality, affordable, accessible childcare to resume working. Childcare in Oklahoma is NOT “OK”—It is on life-support.”

Child Services In CARD Areas

Special Services for children
All areas do have public schools providing services to children who are identified as those with special needs, and Part C is offered in home (or virtually during the pandemic) for families with children under 36 months. Within most small towns there are additional services, however commuting a few times a week for services is not feasible for many parents from a time, transportation, or financial perspective.
State of Babies 2022 reports that for the state of Oklahoma, 3% of infants and toddlers receive IDEA Part C services as compared to 7.2% nationwide; this data is from 2019, the most recent data. Given the health, psychosocial, and economic risk factors alone, it is not likely that there are fewer children in OK who need Part C services. The area of Part C services was impacted severely during the pandemic, and appears to have not yet recovered. The Part C program provided only virtual services for a lengthy period; families with children under 3 found this unhelpful and dropped services.
CARD has since noticed that children who would have previously been qualified and provided intervention are not being served. There are implications for program services, with the recognition that it is more likely that programs will be identifying children in need of Part C relatively often, as opposed to having all the children referred into the program, since many are not identified/receiving services. Based on the program’s experience, it is likely these numbers are lower for the Part C services.

Only 3 % of children 0-3 qualify for EI services in OK, compared to 7.2% nationally

Given the higher rates of children with disabilities on an IEP in the public school districts, it would appear that there would be a sizeable population of children 0-3 and 3-4 that are in need of identification and services

	children with disabilities in largest district	Sooner Start Part C & Part B available	Other private therapy services available <30 miles
Mayes	8.6%	Yes	Yes, local
Nowata	.5%	Yes	20-30 min. commute
Rogers	12.7%	Yes	Yes, commute for some
Broken Arrow	5.2%	Yes	Yes
Wagoner	10.3%	Yes	Yes
Washington	6.2%	Yes	Yes

Services In CARD Areas

Transportation and Communication
No changes are noted in this area. Public transit is not a viable choice for the families in the areas served. Many families also lack access to broad band or internet, a basic utility for life. Most families own a car (car ownership is roughly the same as nationally, at 2 cars per household), but there are no social programs to assist with car repair, etc. so families of living in poverty often struggle when they need car repair or maintenance.

Resources Available to Address Needs of Eligible Children and Families.
What resources (aside from those that CARD provides) exist in communities to help with the education of children and the support of the parents in the very challenging job of raising little humans? Each county has its own set of available resources.
Resource: ParentPro.org
Several programs have qualifying or limiting requirements:
Children’s First is limited to first time parents who enroll at or before 29 weeks gestation
Sooner Start and Sooner Success serve only children with qualifying developmental delay or disability.
Tribal programs often prioritize tribal members.
Some programs do charge fees or bill on insurance.
All Tulsa PAT programs exist outside of the area CARD serves
In the past few years, several parenting resources have disappeared from the area; it is likely that the need for parent education and hone visiting is greater than the availability of services.
The most consistently available resources are those which address children with special needs; the number of children identified as having special needs in Oklahoma is disproportionate to the population, according to national data. With the funding cuts to local educational agencies, schools are struggling to evaluate and implement service plans for children. During the pandemic, many children did not receive services at all, or only virtually; many families found that not helpful and ceased services.

Services & Strengths

The state Medicaid agency has cut $445 million from provider rates and health care benefits since 2010. Following public vote to expand Medicaid, the state has launched a new program on 7/1/2021. While the state did propose requiring all recipients of Medicaid who were adults to work or volunteer, this provision was defeated, thankfully. Oklahoma, a state which is considered “medically underserved,” has fewer doctors and PC providers than is needed to adequately serve the population. This continues to be true of metro areas, but the need is especially pronounced in small towns and rural areas, leading to long waits for routine services, etc. This also extends to dentists, and it is worth noting that dental services to pregnant women are limited to emergency extractions and cleaning. As this program rolls out, it is hoped that the state’s uninsured rates will drop.

After a year of having Medicaid expansion, the state’s uninsured rate has dropped significantly though it is still higher than the national average. The state leadership would like to privatize this program, though the populace has not supported that. There are also moves to privatize most government functions in Oklahoma.

Pregnant women can more easily get medical coverage now

Oklahoma’s income limit—138% of the federal poverty guideline
US’s income limit -200%
Many still cannot access care

Services In CARD Areas

Community Strengths
https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/ACEs/state/OK
Since the 2016 edition, well-woman visits among women aged 18-44 increased 9% from 58.5% to 64.0%
Since the 2016 edition, maternal mortality decreased 10% from 26.0 to 23.4 deaths per 100,000 live births
Since the 2016 edition, tobacco use among adolescents aged 12-17 decreased 34% from 11.0% to 7.3%
Low prevalence of excessive drinking among women
High percentage of publicly-funded women's health services needs met
Low prevalence of substance dependence or abuse among adolescents
Statewide, the majority of public high schools offer con-current enrollment with higher education (98%) which is far higher than the national average of 75%.
While it is difficult to find new and existing resources in the services area, within the past two years the program is always eager to form new partnerships. During the Pandemic, most new partnerships were informal, as all agencies were embracing flexibility to serve those in need. In May 2018, Catholic Charities, located in North Tulsa, was identified by Family Worker staff as providing an extensive number of resources to anyone in need in Northeast Oklahoma; Catholic Charities has no “requirements” other than a person be in need. Additionally, C.A.R.D. staff had, prior to the pandemic, increased attendance at community meetings in the service area where several agencies come together to address the needs of the community, making connections with agency representatives to coordinate services for our families whenever possible. Catholic Charities is also the entity which settled the refugees from Afghanistan and CARD reached out to make sure they knew about HS/EHS.
http://sde.ok.gov/sde/sites/ok.gov.sde/files/documents/files/Fast%20Facts%20FY17%20December%2021%202017.pdf
What About Good Health Policies, Family Strengths, and Resources? (source State of Babies 2022)
WIC coverage is estimated to be 100%.
Crowded housing is less of an issue in OK than nationally (11.7% vs 15.4%)
Family resiliency is rated at 87.6% vs 84.9% nationally

Services In CARD Areas

Head Start Enrolled Children and Families
In most demographics, there have been insignificant variation from when last reported. Notable trends: continued shift downward in the prevalence of age for the HS section. Each year more children are served at younger ages. Since 2015, the program has seen the percentage of 3’s served go from 64% to 79%. The program is also seeing fewer children enrolling for a 2nd year in HS each year, and of course, fewer expected to transition to Kindergarten. These data support the premise that the 4 year olds are usually attending the public school’s 4-year-old program (though in some districts, that IS CARD), and that 3-year-old are underserved. Wait lists tend to be longer for younger age children, and fewer families are admitted with public assistance, TANF, WIC, and SNAP; though Oklahomans continue to live in poverty, the services are not being utilized by many who could benefit. These program participant trends coincide with the public trends. For example, the number of children/families who receive WIC and SNAP have decreased each year, and the number typically decreases between the start of the year and the end of the program year. The participation rates may decrease because of barriers to program participation in these programs; if families have to miss work to re-certify for the program, then they may not be able to do that, for example. Recertification processes are often daunting for families who have little energy to deal with issues beyond what they are experiencing at the particular moment. Currently, many of our parents who were previously working outside the home have not yet been able to resume work due to uncertainty around their children’s education in the public school system, and finding programming for their children so they can work.
The children’s BMI data also reflect the State’s general pattern of data, though the program’s children’s BMI has trended downward recently. Food insecurity continues to be a challenge in the state, and for program participants. Other data appear to be stable, with little change.

Gardening has been a rewarding endeavor for education staff, the children and the families. It really encourages healthy eating, noted one parent.

Services In CARD Areas

Head Start Staff
Demographically, racially and ethnically the proportions of staff do not appear to have changed substantially. Educationally, the program’s staff have always compared very favorably with the national statistics for HS staff. Currently, the program would say that is is more challenging than every to attract and retain qualified staff. The pandemic has created many hurdles to this goal. The percentage of HS staff who speak languages other than English is similar to last year, but is down from 5 years ago. The percentage of teaching staff in HS last year who were ESL was 5%, whereas the percentage of children is 10% with the 9 out of this subset of children 10 speaking Spanish as their primary language. In EHS the percentage of staff who speak another language is 17.6%, whereas the percentage of children is 5%; approximately 75% of the children who speak another language speak Spanish. It is possible that HS has a greater challenge in hiring teachers who are qualified (i.e., degreed) and speak Spanish, whereas EHS does not require a degree to be fully qualified, and thus the market may favor EHS in this endeavor. Those who speak Spanish and who also hold more education are going to be more easily hired and command a higher salary in many sectors, making it challenging to meet the salary and benefits offered in private, for-profit organizations. The pandemic has resulted in more staff turnover than is typical, and replacing those staff is proving difficult due to the tight market and the lack of childcare in the private childcare sector. Our program has not been fully staffed for all classrooms in well over a year, despite interviewing and hiring constantly.

Services In CARD Areas

Relevant Opinions of Community Needs
A summary of the overall responses of the communities to the survey regarding needs and strengths follows:
There are many resources to help children and families in need, such as food banks/pantries and churches that feed the community; it is thought that these exist because of the lack of grocery stores especially in small, rural areas.
The sense of community is huge in the small towns. Community members are willing to cooperate and collaborate to address the needs of the community by attending town hall meetings and organizing community group meetings, etc.
The greatest challenges still remain- public transportation, awareness and availability of, and access to resources.
Families have struggled with isolation. This is an ongoing challenge due to the Pandemic.
Transportation is a greater challenge currently because of the cost of gas and inflation. Mass transit is really not available in rural areas, and even in the towns like Claremore and Broken Arrow, the transit available will not meet a family’s needs for getting to work or school.
Our families report that housing is a challenge. There are few Section 8 possibilities. In some communities, families are being forced out as rent rises. This is meaning a change in schools for some, and this is generally not advantageous for children.
If and when new resources do become available, community members say there are not enough ways for them to find out about them, and there should be more collaboration between programs and agencies to make sure the community is well informed about new AND existing resources.
Families have expressed frustration that some services needed are only available at times that do not work for working parents.
training staff.

Services In CARD Areas

Implications for Future Planning and Programming:
With new Medicaid expansion, support for families in the community may be needed. As the state and this area have high rates of uninsured adults, assisting families in accessing and navigating their health coverage is a beneficial goal.
As immunizations have rolled out for all ages, education of staff and parents will be an ongoing endeavor.
Data would suggest that families need full year, full day high quality childcare, and that the need is significant in all areas. It would appear that the greatest needs are for younger children, and in areas where childcare centers have recently closed the businesses: Pryor, Wagoner, Broken Arrow, Bartlesville have all recently experienced childcare center closures. This will be a challenge due to funding and staffing during COVID19.
Salaries and benefits need to increase, but there needs to be stabile funding to accomplish this.
There are few family visiting programs now in Washington and Nowata counties. Further investigation might indicate if there is sufficient need in those counties.
The high ACE scores point to continued need for mental health services for 0-5 years, an under-sourced area of expertise.
The pandemic has heightened the need for mental health services for adults and children.
High rates of child abuse/neglect and minimal opportunities for families to engage in research- and evidence-based parent education programming, as well as activities to build relationships with other parents and gain parental support lead towards programming for parent education and parent engagement activities.
Additional and on-going training for staff on trauma, aces, social emotional support and development, etc. are supported.
High rates of obesity, and a general lack of health in Oklahomans and in these counties support additional programming and targeted services for families on health and wellness.
Low educational attainment for Oklahomans could mean opportunities to grow educational capacity for adult Oklahomans in partnership with vocational technical schools, high schools, and colleges.
Student challenges at grades 4 and 8 also support the program emphasis on literacy and math, following foundational work in social and emotional development and support, of course.
When considering disparity, inclusion, and inequality, program outreach efforts should be purposeful and mindful in regards to recruitment, and is an area of opportunity for training staff;

Program and availability	Mayes	Nowata	Rogers	Tulsa	Wagoner	Wash-ington
Children First Home Visiting	X		X	X	X
Cherokee Parents Home Visiting	X
Cherokee Nation HS/EHS	X	X	X	X	X
Child Guidance			X	X
Circle of Parents			X	X
Parents as Teachers Home Visiting				X	X
Sooner Start Part C Early Intervention						X
Sooner Success	X	X	X	X	X	X
WIC Plus			X	X