Emerging State and Community Strategies to Improve Infant and Toddler Services

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Emerging State and CommunityStrategies to Improve Infant and

Toddler ServicesBy Rachel Herzfeldt-Kamprath and Katie Hamm June 2015


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Emerging State andCommunity Strategiesto Improve Infant andToddler Services

By Rachel Herzfeldt-Kamprath and Katie Hamm June 2015


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1 Introduction and summary

3 Background

6 Promising strategies to improve access and

provide continuity

8 Financing infant and toddler programs

16 Targeting infant and toddler services

22 Assuring continuity for infants and toddlers

26 Federal policy can support infant and toddler alignmen

30 Conclusion

32 Appendix: Federal funding sources for infant and

toddler services

38 Endnotes

Contents


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1 Center for American Progress | Emerging State and Community Strategies to Improve Infant and Toddler Services

Introduction and summary

Decades o research on brain developmen and oucomes rom early learning

inervenions have clearly demonsraed ha children hrive when hey have

consisen access o high-qualiy early childhood programs saring a birh or

even beore and coninuing unil hey ener kindergaren. Ye oo ofen, programs

ha arge young children provide services in isolaion, are underunded, and ail

o mee he needs o all eligible amilies. Creaing a coninuum o services ha are

inenionally aligned o reach children or as long as possible can help ensure ha

early childhood services and programs effecively suppor all aspecs o youngchildren’s healhy developmen.

Saes and communiies are increasingly recognizing he imporance o creaing

a coordinaed sysem o services ha suppors all aspecs o inan and oddler

developmen rom birh o age 5. Since young children’s developmenal needs are

uniquely inerwined, i is criical ha inans and oddlers have access o qualiy

healh care, nuriious ood, and simulaing and sae environmens in order o

achieve posiive oucomes laer in lie. ereore, programs across he specrum o

public services or young children and heir amilies mus be readily accessible or

all who need hem. While many saes and communiies offer a variey o services

o suppor young children and heir amilies, significan barriers keep many ami-

lies rom accessing he resources hey need.

e curren mix o programs and services ha provide early care and educaional

opporuniies or inans and oddlers are underunded across he counry, and

many amilies who qualiy are unable o access he services ha hey need. When

programs are underunded, geting he righ services o he righ amilies can

become a significan challenge. Similarly, where services are provided, hey are

ofen offered in isolaion. For example, amilies who receive benefis hrough heSpecial Supplemenal Nuriion Program or Women, Inans, and Children, or

WIChe ederally unded healh and nuriion program or women and heir

childrenmay no know ha hey also qualiy or home visiing services, mean-

ing ha hese amilies miss ou on an imporan opporuniy.


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Forunaely, saes and communiies across he counry are implemening effors

o beter coordinae heir inan and oddler services o suppor healhy develop-

men and successul ransiions rom one program or educaion seting o anoher

during early childhood. ese effors can be suppored urher by ederal policy

acions o incen and ensure ha low-income children and amilies receive he

suppor ha hey need o hrive.

Communiies across he counry are working o align inan and oddler services

by increasing access o available programs and resources, creaing cenralized

inake sysems, and argeing inervenions o specific populaions. Similarly, saes

are developing saewide plans o deliver a coninuum o suppor or children

rom birh o age 3 and ideniying sandards and developmenal guidelines or

programs ha serve young children.

As saes and communiies coninue o make progress o reach more inans and

oddlers hroughou he firs hree years o lie, ederal policy should suppor hem by increasing invesmens and providing long-erm and coninuous unding; mak-

ing unding sources more flexible o suppor service alignmen effors; coninuing

o build momenum or privae-secor invesmens; providing guidance or weav-

ing ogeher disparae unding; sreamlining gran applicaions and reporing;

and iniiaing a permanen cross-agency office a he ederal level ha would ocus

specifically on inans and oddlers.


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Background

Enriching environmens and nururing relaionships promoe healhy child

developmen and can se young children on he pah o posiive oucomes laer

in lie. Research shows ha healhy brain developmen, especially in he firs

hree years o a child’s lie, is criical or producing posiive oucomes over his or

her lieime.1 Ye many amilies are no able o provide he enriching conex ha

young children need o hrive, meaning ha some children sar ou a a disadvan-

age. e direc negaive effecs o povery creae a significan gap in healh and

developmen oucomes beween children living in povery and heir wealhy peerseven beore hey begin school.2 As early as 18 monhs o age, children rom lower-

income households are developmenally behind children rom higher-income

households in early language developmen and processing skills.3

FIGURE 1

Poverty rates for U.S. children between birth and age 3

Percent of infants and toddlers living in extreme poverty, poverty, and low-income

households, 2013

Below 50 percentof the poverty line

Below 100 percent

of the poverty line

Below 200 percent

of the poverty line

46%

23%

11%

Source: Authors' calculations based on data from Bureau of the Census, Community Population Survey (U.S. Department of Commerce,2014), available at http://www.census.gov/cps/data/cpstablecreator.html.


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According o daa rom he Bureau o he Census, in 2013, nearly hal o inans

and oddlers in he Unied Saes lived in low-income households. More han one

in five inans and oddlers lived in households wih incomes below he ederal

povery linewhich defines povery as $24,250 or a amily o our in 2015and

more han 1 in 10 lived in deep povery, or below 50 percen o he povery line.

(see Figure 1) e povery raes are disproporionaely high or children o color, wih 45 percen o Arican American, 48 percen o American Indian/Alaska

Naive, and 35 percen o Hispanic children younger han age 3 living in povery.

By comparison, only 15 percen o whie inans and oddlers live in povery.4

e increasing diversiy o he counry’s child populaion underscores he need

or policymakers o address hese inequaliies. For he firs ime in U.S. recorded

hisory, he cohor o children born in 2011 was majoriy children o color.5 is

demographic rend has coninued, and he U.S. inan and oddler populaion is

projeced o become even more diverse, wih children rom Hispanic and mulira-

cial backgrounds expeced o increase he ases over ime. (see Figure 2) Addingo his rend, nearly one in every our children younger han age 3 comes rom a

household where one or more paren is oreign born, and abou one-hird o chil-

dren rom immigran amilies are in households below he povery line.6

2012

White alone Black alone Other

Nonwhite and

white Hispanic

Asian aloneTwo or

more races

2015

2020

2030

2060

FIGURE 2

The infant and toddler population is projected to become more

diverse over time

Racial/ethnic distribution of the child population younger than age 3, 2012 projections

Source: Authors' calculations based on data from Bureau of the Census, 2012 National Population Projections:Downloadable Files (U.S. Department of Commerce, 2012), available a t http://www.census.gov/population/projections/-

data/national/2012/downloadablefiles.html.


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Because children rom diverse and immigran backgrounds are disproporionaely

more likely o live in households experiencing povery, he inersecing rends o

child povery and changing demographicsespecially among he inan and od-

dler age groupsmean ha a growing proporion o he American populaion may

be growing up in households ha lack he resources needed o suppor healhy

child developmen. Children living in households below he povery line are morelikely o have healh problems, ace ood insecuriy, grow up in unsae neighbor-

hoods, and have parens who repor being sressed by parening.7 All o hese ac-

ors can conribue o he oxic sress ha inhibis healhy brain developmen.8

In order o ensure ha inans and oddlersespecially hose a risk o growing

up in poveryare able o hrive as aduls, policy soluions mus suppor devel-

opmen and acively address he growing dispariies in child oucomes. Many

programs exis o address developmenal needs, bu hey are ofen underunded,

ail o mee demand, and can be inconsisen in heir qualiy or amilies in need.

ese ypes o inconsisencies during he pivoal years o a child’s developmencan lead o school readiness and suden achievemen gaps laer in lie.


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Promising strategies to improve

access and provide continuity

is repor considers wo iner-relaed problems acing saes and communi-

ies rying o improve services or inans and oddlers: financing and providing

coninuiy during he firs hree years o lie. Funding is a major barrier o expand-

ing services or inans and oddlers. In general, services or inans and oddlers

are underdeveloped and underunded compared wih programs or preschool-age

children and especially compared wih older children in K-12 educaion. For

example, Early Head Sar is he gold sandard or high-qualiy programming

or inans and oddlers, bu he program serves less han 4 percen o eligiblechildren.9 Likewise, he evidence-based Maernal, Inan, and Early Childhood

Home Visiing, or MIECHV, program is so minimally unded ha only one-hird

o high-need U.S. counies receive is ederally unded services.10 Programs ha

reach larger populaionssuch as WIC, which serves more han 4 million young

children annuallyhave no been well inegraed hisorically wih early care and

educaion programs.11

e second issue addressed by his repor is he lack o coninuiy o services

or inans and oddlers. Given he inerdependency o a child’s developmenal

needs during he firs hree years o lie, effors o ensure ha young children

have coninuous access o healh care, amily services, child care, adequae amily

income, and nuriion is a challenge. Saes and communiies also mus accoun

or he ac ha unlike children who have access o kindergaren or he ormal

educaion sysem, inans and oddlers develop in myriad setings where access o

developmenal suppor can vary rom nonexisen o very high qualiy. is means

ha children ener kindergaren wih varying skillses and a differen sages o

developmen. (see Figure 3) For his reason, ideniying effecive sraegies ha

increase unding or and access o high-qualiy inervenions and ha provide con-

inuiy hrough he inan and oddler years can help close he school readinessgap and achievemen gap and se children on he righ pah or uure success.


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A scan o saes, ciies, counies, and school disrics produced a number o emerg-

ing sraegies o address boh unding and coninuiy or inans and oddlers.

Promising sraegies and approaches o bring ogeher he various resources andservices ha promoe healhy developmen include: creaive financing; commu-

niy ocal poins or service delivery; and coninuiy in programs and sandards.

Examples o hese approaches are discussed in he ollowing secions.

FIGURE 3

Primary care arrangements vary for young children

Preschool children younger than age 5 with employed mothers, 2011

Source: Lynda Laughlin, "Who’s Minding the Kids? Child Care Arrangements: Spring 2011" (Washington: Bureau of the Census, 2013),

available at http://www.census.gov/content/dam/Census/library/publications/2013/demo/p70-135.pdf.

22%

26.6%

25.2%

12.9%

13.2%

Parent

Other relative

Other

Center-based program

In-home care by nonrelative


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Financing infant and

toddler programs

One o he criical barriers o ensuring coninuiy and access o inan and oddler

services is insufficien unding resources. As a consequence, many communi-

ies draw upon muliple unding sources o suppor inan and oddler services.

While his approach has helped saes bolser heir capaciy o provide services,

he pachwork sysem o unding sources is no ideal. e adminisraive burden

o remaining accounable o he various requiremens o each unding source can

be a significan challenge. While he end goals may be similar, he array o unding

sreams can vary and even conflic wihin he populaions hey arge or he man-daed reporing and evaluaion mechanisms, qualiy and insrucion sandards,

and/or ime rame or reporing. Similarly, since many o he unding sources are

in he orm o gran programs or philanhropic conribuions, he susainabiliy o

resources is no guaraneed, which can inhibi long-erm planning a he sae and

local adminisraive levels.

Developing a beter and more comprehensive approach o unding inan and od-

dler services would ensure ha exising programs are adequaely unded o serve

he enire eligible populaion o children and amilies. However, he curren pach-

work sysem ails o und enough slos in any given program o mee 100 percen

o need. In he absence o sufficien unding, some communiies have blended

unding sources by cenralizing heir program delivery and creaing processes and

relaionships ha esablish early childhood sysems ha can leverage he various

unding opporuniies. Communiies ha have had success wih his approach

ypically offer a mix o servicessuch as healh care, child care, and home visi-

ingha work collaboraively o suppor children across programs over ime.

Communiies are aking advanage o ederal unding sources, sae unding

sources, and philanhropic and privae parnerships in order o suppor he con-

inuum o inan and oddler services o expand access o high-qualiy programs.


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Federal funding sources

ere are several ederal unding sources o suppor inan and oddler services.

Funding opporuniies are available hrough many differen ederal agencies o

suppor key aspecs o child developmen, including he Deparmen o Healh

and Human Services, he Deparmen o Educaion, and he Deparmen o Agriculure. (see able 1) Alhough each unding source aims o address a specific

issue or se o issues, he inervenions ha suppor healhy developmen ofen

produce a variey o oucomes in a person’s lie ha achieve he goals o muliple

unding sreams. For example, home visiing services have been proven o suppor

school readiness, decrease child abuse and neglec, improve maernal and child

healh, reduce crime and domesic violence, and improve amily economic sabil-

iy.12 For his reason, communiies across he counry are using a variey o und-

ing sources o suppor home visiing iniiaives and inrasrucure, including unds

specifically designed o suppor home visiing, such as he MIECHV program;

dedicaed sae appropriaions; philanhropic suppor; and oher sources ha aimo produce he same oucomes such as Early Head Sar; he Race o he op –

Early Learning Challenge; emporary Assisance or Needy Families, or ANF;

Medicaid; he Child Healh Insurance Program, or CHIP; and he Maernal and

Child Healh Block Gran, or MCH.13 A lis o prominen ederal unding sreams

ha have been leveraged o suppor inans and oddlers is presened in able 1.

While many o he unding sreams ocus on supporing a specific ype o iner-

venionsuch as Early Head Sar or he Supplemenal Nuriion Assisance

Program, or SNAP, ormerly known as ood sampsa number o he ederal

grans also provide unding more broadly or alignmen and sysems develop-

men. For insance, while MIECHV primarily unds home visiing, one o he

argeed oucomes o he gran program is o improve coordinaion wih and reer-

rals o oher communiy resources and suppors.14 Similarly, he ile V Maernal

and Child Healh Services Block Gran Program provides a airly flexible unding

sream ha suppors posiive healh oucomes or young children and moh-

ers.15 While ile V unds ocus on child and maernal healh oucomes, here is a

significan amoun o flexibiliy buil ino wha services can be suppored by he

gran. Saes have leveraged hese unds o suppor cross-secor sysems building

and home visiing services and o provide and improve healh sandards and qual-iy o child care or young children.


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TABLE 1

Federal funding sources available to support infant and toddler services

Funding stream

Number of states

receiving funding Amount of funding

Explicitly

supports

service

alignment Type of funding

U.S. Department of Health and Human Services

Maternal, Infant, and Early Childhood

Home Visiting, or MIECHV

Every state, including territories

and tribal communities

$386 mil lion awarded in 2015 Yes Discretionary, formula an

competitive grants

Medicaid/Children’s Health

Insurance Program, or CHIP

Every state Not applicable Yes Mandatory, funded through a

mula and in partnership with s

Title V Maternal and Child Health Every state and nine juristictions About $6 billion per year with

state matching funds

Yes Discretionar y, grant based w


Early Childhood Comprehensive

Systems, or ECCS

47 states and the District of

Columbia; Guam; Northern

Mariana Islands; Puerto Rico;

Republic of Palau; and the

U.S. Virgin Islands.

$7.1 mill ion awarded in 2014 Yes Discretionary, grant base

Healthy Start 33 states $65 million awarded in 2014 Yes Discretionary, grant based

Healthy Tomorrows 47 states, District of Columbia,

Puerto Rico, and Guam

Funded eight five-year awards total-

ing $377,000 in fiscal year 2014

Yes Discretionary, grant based

Project LAUNCH 35 states and 20 cities, counties,

or tribal communities since 2008

$3.4 mill ion anticipated in 2015 Yes Discretionary, grant based

Temporary Assistance for

Needy Families, or TANF

Every state $31.7 billion in federal and state

maintenance of effort, or MOE,

funds awarded in FY 2013

No Discretionar y, grant based w


Community-Based Child Abuse

Prevention, or CBCAP

Every state $41 million for 2015 Yes Discretionary, grant based

Head Start and Early Head Start Every state $8.6 billion in 2014 Yes Discretionary, grant based

Early Head Start-Child Care,

or EHS-CC, Partnerships

Specific communities

in every state

$500 million awarded by

March 2015


U.S. Department of Education

Child Care and Development Block

Grant, or CCDBG

Every state $109 million awarded in 2014,

targeted to infants and toddlers

Yes Discretionary, grant based w


Elementary and Secondary

Education Act, or ESEA, Title I

Every state About $14 billion per year. For

Title I, states typically use less than

5 percent for preschool.


Individuals with Disabilities

Education Act, or IDEA, Part C

Every state, District of Columbia,

and Puerto Rico

$438 million in 2014 No Discretionary, grant based

IDEA Part B Every state, District of Columbia,

and Puerto Rico

$353 million in 2014 No Discretionary, grant based

Race to the Top – Early Learning

Challenge, or RTT-ELC

20 specific states picked for

grants in 3 rounds

$1 billion over three rounds

in 2011, 2012, and 2013.

Yes Discret ionary, competit ive g


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Ohio, or example, uses several unding sources o suppor inan and oddler

services hrough he Help Me Grow program, which is designed o ensure ha allOhio children have a healhy birh and access o he amily resources hey need o

achieve a healhy and srong sar o lie.16 e iniiaive includes boh home visiing

and early inervenion. e home visiing services include our key componens:

• Research-inormed parening curriculum

• Ongoing screenings and assessmens

• Family need-based reerral and resource linkages

• ransiion o a developmen enhancing program and early care and

educaion cener17

Since is incepion, he Help Me Grow program has drawn on ederal unding

hrough MIECHV; ANF; and he Individuals wih Disabiliies Educaion Ac,

or IDEA, Par C, unds, as well as sae general revenue unds.18 Ohio also recenly

received auhorizaion o bill aspecs o is home visiing program o Medicaid.

Besides Help Me Grow, he Ohio Office o Healh Improvemen and Wellnessoversees addiional iniiaives ha inersec wih early childhoodsuch as he

Projec Linking Acions or Unme Needs in Children’s Healh, or LAUNCH,

Funding stream

Number of states

receiving funding Amount of funding

Explicitly

supports

service

alignment Type of funding

U.S. Department of Agriculture

Supplemental Nutrition Assistance

Program, or SNAP

Every state $74 billion in 2014 No Mandatory

Special Supplemental Nutriton Porgram

for Women, Infants, and Children, or WIC

Every state $6 billion in 2014 No Discretionary, grant based

Child and Adult Care Food

Program , or CACFP

Every state $3 billion in 2014 No Discretionary, grant based

Note: The funding for Head Start and Early Head Start includes that for EHS-CC partnerships

Source: See appendix.


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gran; Paien Cenered Medical Homes; Ohio’s MCH Block Gran; and WIC.

Similarly, Ohio’s Division o Family and Communiy Healh Services works

closely wih oher agenciessuch as Ohio’s Medicaid office, Deparmen o

Educaion, and Deparmen o Job and Family Serviceso provide a more com-

prehensive sysem o early childhood services.19

State and local funding

In addiion o ederal unding, saes and communiies use sae- and local-level

unding o suppor inan and oddler services. Saes use boh general sae appro-

priaions and dedicaed revenue sources. In recen years, he naional atenion

o high-qualiy early learning programs has led many governors o highligh he

issue in heir budge proposals. Legislaors in Kansas, or example, allocaed sae

unds wihin heir budge o esablish he Kansas Early Childhood Block Gran,

or ECBG, o be adminisered by he Kansas Children’s Cabine and rus Fund.20 e ECBG includes a se-aside or inan and oddler services ha requires a leas

30 percen o unds o suppor programs ha serve children rom birh o age 3.21

Saes also direc specific revenue sources oward early childhood services. A num-

ber o saes suppor heir home visiing inrasrucure wih sae obacco setle-

men unds. In Caliornia, a 1998 ballo iniiaive esablished a ax on cigaretes

and obacco producs.22 Revenue rom he axes goes direcly o suppor early

learning opporuniies and healhy child developmen or children and amilies

during he firs five years o heir lives hrough he Firs 5 Caliornia program.23

In Palm Beach County, voters established the Children’s Services Council of Palm

Beach County, or CSCPBC, which is supported with dedicated funding from a county

property tax that provides 77 percent of the council’s budget.24 Services provided or

supported by the CSCPBC serve families during pregnancy, for children from birth to

age 6, and during out-of-school time for older children.25 The CSCPBC also provides

targeted services in at-risk neighborhoods to coordinate community services, includ-

ing home visiting, child care, parenting, and mental health support.26 The CSCPBC,

Palm Beach County, Florida

County property tax funds the Children’s Services Council

of Palm Beach County


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Legislaors in Caliornia have made recen atemps o pass legislaion ha would

esablish a comprehensive and ully unded sysem o early learning or children

rom birh o age 5. In February 2014, sae Sen. Carol Liu (D) inroduced he

Srong Families, Srong Children Ac, which ulimaely ailed o pass he sae

legislaure.29 e bill was designed o provide unding ha would expand access o

high-qualiy early learning and parenal suppor services or low-income amilies

wih inans and oddlers. e bill aimed o align services o suppor young chil-dren by ransorming he general child care services or inans and oddlers ino a

new program named Caliornia Srong Sar, which would have provided children

wih he ollowing services rom birh o age 3 lised in he bill:

• Paren engagemen and suppor services ha promoe posiive

paren-child relaionships

• Full-day early learning and care services

• Par-day early learning and care services

• Volunary home visiaion services

• Nuriion services; and

• Reerral o services such as healh and denal care, child abuse prevenion,

housing and early childhood menal healh30

While he iniiaive received enough suppor o be considered hrough muliplerounds o commitee reerrals, concerns abou he financial viabiliy o he policy

prevened he passage o he bill.31 Similarly, provisions ha would have alered

he mandaed child-o-eacher raios raised significan concern, especially relaed

o he effec i would have on providers’ financial abiliy o mainain services wih-

ou seeing an increase in service raes.32

an innovative model that contracts with community partners through a competitive

bid process, relies on research and data to identify which community needs it should

fund. The CSCPBC also closely monitors funded programs to ensure that target child

outcomes are achieved.27 In the 2014–2015 funded program, allocations ranged

from $35,192 to $15,260,768.28


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Philanthropic and private partnerships

Many saes and communiies also are drawing upon privae and philanhropic sup-

por o creae and susain an inegraed sysem o services or inans and oddlers.

e Buffet Early Childhood Insiue a he Universiy o Nebraska was esablishedhrough he financial suppor o philanhropis Susan Buffet and he resources o

he Universiy o Nebraska. e Buffet Early Childhood Insiue parners wih 11

school disrics in he Omaha area o adop a birh-hrough-hird-grade approach

o early childhood programming.33 welve schools in six disrics are piloing an

inensive model hrough which schools serve as hubs or comprehensive educaion

and suppor services or young childrenrom birh hrough hird gradeand

heir amilies, including birh hrough age 3 home visiing programs.34

In addiion, L.B. 1256 esablished he Nebraska Early Childhood Educaion Cash

Fund, also known as Sixpence, in 2006 o bring ogeher sae agencies and privaephilanhropy and o increase high-qualiy early developmenal experiences or

Nebraska’s inans and oddlers a risk o ailure in school.35 Sixpence suppors

high-qualiy, cener-based, and amily engagemen programsincluding birh

hrough age 3 home visiing programsacross he sae. A number o he parici-

paing birh hrough age 3 home visiing programs are atached o schools in an

effor o beter align hese suppors wih children’s ongoing early educaion.36

In he sae o Washingon, he legislaure esablished a Home Visiing Services

Accoun, or HVSA, which leverages public maching unds o bolser public

financing o expand evidence-based home visiing services. e legislaion cre-

aes a public-privae parnership beween he Deparmen o Early Learning and

rive by Five Washingon, he nonprofi organizaion ha adminisers he unds

and raises he philanhropic mach.37 e HVSA is designed o suppor evaluaion

o home visiing services, he provision o echnical assisance and raining, and

he inegraion o home visiing wihin he sae’s broader birh o age 3 plan.38

Recen ederal engagemen on early childhood issues hrough he Inves In US

campaign has garnered significan financial commimens rom philanhropic

parners and he privae secor o suppor early childhood programs and services.For example, e Caliornia-based Heising-Simons Foundaion commited $6.6

million beween 2015 and 2018 o mach ederal invesmens in early child-

hood programs, specifically seting aside $2 million o suppor he implemena-

ion o ederal invesmens, such as he Child Care Developmen Block Gran,


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or CCDBG, and MIECHV.39 Similarly, in ulsa, Oklahoma, he George Kaiser

Family Foundaion commited $25 million over five years o scale up a paren

engagemen iniiaive designed o connec amilies wih parening resources and

lieracy aciviies hrough communiywide engagemen. e invesmen aims o

provide services o an addiional 20,000 children who are eligible or bu currenly

no receiving services.40


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Targeting infant and

toddler services

One approach o maximizing scarce financial resources and providing coninu-

iy or inans and oddlers is o concenrae services in geographic areas wih he

mos a-risk amilies or o ideniy amilies ha mos need services hrough a single

poin o enry. Wih geographic argeing, saes deliver comprehensive services

wihin regions where here are high concenraions o specific risk acorssuch

as povery, crime, high maernal or inan healh problems, or low school peror-

mance. Alernaely, some saes atemp o ideniy vulnerable amilies and connec

hem wih a broad array o services hrough a single enry poin. Coordinaingaccess o services hrough communiy ocal poins encourages more efficien and

collaboraive operaions while ocusing on comprehensive service delivery. e

ypes o services ofen involved can include healh services, nuriion services,

amily economic and employmen suppors, educaion, and home visiing.

Single points of entry

Several communiies are developing cenralized inake sysems, designed o help

amilies access muliple programs hrough a single enry poin. is policy is gain-

ing racion, resuling in par rom an influx o ederal home visiing unds hrough

he Maernal, Inan, and Early Childhood Home Visiing program. Several saes

and communiies developed cenralized inake sysems o improve access o he

coninuum o services available o a-risk children and amilies.

While cenralized inake sysems can vary in heir scope and mehodology, hey

ypically cenralize core asks ha are common o mos social services, such as

oureach and idenificaion o amilies, screening or assessmen during inake,

idenificaion o needed services, and reerral o services and programs. Somecenralized inake sysems iniiaed hrough MIECHV unding are limied o

home visiing services and aim o connec amilies o he home visiing model ha

will bes mee heir needs.41 Oher cenralized inake sysems offer much broader

reerrals o services wihin he various social domains ha suppor young children

and heir amiliesincluding healh, educaion, and nuriion.42


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Many emerging cenral inake sysems sem rom or are closely conneced o

healh sysems and expand o reach across a variey o programssuch as early

learning, social services, and nuriionha serve children and amilies. Healh

care sysems are well posiioned o ideniy pregnan women who ace risk acors

and who could benefi rom addiional services. In Delaware, or example, resuls

rom developmenal screenings are provided o he sae’s cenralized inakesysems or reerral o ollow-up services. Since he process is iniiaed wihin he

healh care sysem, Medicaid unding suppors he process.43

In New Jersey, he cenral inake model has evolved rom is iniial ocus on

linking inans and pregnan women o he sae’s home visiing programs o is

curren expansion o inake hubs in all 21 counies o he sae ha provide link-

ages o resource and reerral services designed o assis amilies o young children

beyond pregnancy and birh.44 Led by he New Jersey Deparmen o Healh and

wih unding suppor rom he sae Deparmen o Educaion and he Race o he

op – Early Learning Challenge gran, he hubs help amilies access appropriaeand needed services, including home visiing; prenaal care; pediaric and adul

primary healh care; amily suppor and social services; Head Sar and Early

Head Sar; and oher early learning opporuniies, such as high-qualiy child care

ceners.45 Similar o New Jersey’s implemenaion o he MIECHV gran, cenral

inake is an ineragency collaboraion ha benefis rom he inpu o sae parners

across our sae deparmensHealh, Children and Families, Human Services,

and Educaionworking o implemen a comprehensive pregnancy o age 8 early

learning plan or he sae.46 New Jersey’s cenral inake design suppors sysems

inegraion and closely aligns wih naional sysems-building iniiaives ha

include Early Childhood Comprehensive Sysems, or ECCS; Help Me Grow; and

Projec LAUNCH.47

Capitalizing on the success of federally funded home-visiting services has pro-

vided states a unique opportunity to concentrate their efforts on aligning servicesfor infants and toddlers. MIECHV program is a federal grant initiative to fund the

expansion of evidence-based home visiting programs. It aims to improve health and

developmental outcomes by connecting families with home visitors who provide

guidance and support to parents through regular and voluntary home visits.48 Addi-

tionally, MIECHV provides resources for states and communities to improve the coor-

Serving infants and toddlers with comprehensiveservices through MIECHV


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Geographic targeting of services

Services delivered wihin a argeed geographic region, someimes called hubs or

zones, offer saes and communiies an opporuniy o consolidae adminisra-

ive aciviies, share financial resources, ideniy common goals, align aciviies

and sandards, and build working relaionships across agencies while providing

a coninuum o services o a key populaion. Geographic argeing cus down

on duplicaive effors across secors and rees up resources o increase service

capaciy, ulimaely reaching more amilies and children in need. For insance,

in Washingon, D.C., he Division o Early Learning in he Office o he Sae

Superinenden o Educaion is using an Early Head Sar-Child Care Parnerships

gran o und neighborhood-based qualiy improvemen hubs o provide compre-

hensive services and an evidence-based model o inan and oddler care ha is

consisen wih he high-qualiy early learning sandards oulined in Early Head

Sar.51

ree hubs, which are in high-need wards o Washingon, will supporchild care ceners in raising heir qualiy o mee Early Head Sar sandards and

provide raining and proessional developmen opporuniiesall while parner-

ing wih oher healh, social service, and home visiing agencies o ensure ha

amilies have access o available social suppors hrough child care ceners.52

dination of services targeting infants and toddlers.49 Many states are working toward

this goal by implementing centralized intake systems. MIECHV-funded centralized in-

take in some states focuses on providing a single entry point to access home visiting

services in the state. In other states, administrators use MIECHV to connect program

intake, screening, and referral across multiple early childhood programs.50

While MIECHV supports a variety of home visiting models, many of these mod-

els place significant emphasis on developing early cognitive skills to ensure that

children are ready for preschool, kindergarten, and beyond. To achieve the goals of

healthy early development and school readiness, many home visiting curricula build

in transition support and planning. That is to say, as home visitors become trusted

advisors for parents, they often fulfill the role of facilitators and help families with the

logistics of selecting and moving into child care and early education settings, as well

as with building and supporting their child’s school-readiness skills. For this reason,

home visiting is an important part of the continuum of services to support young

children, especially those from high-need households.


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Oregon is working to integrate its early childhood services by developing regional

hubs across the state that will coordinate services to the communities within the

region. This strategy was authorized by legislation in 2013 that directed the state’s

Early Learning Council to create 16 regional hubs covering the entire state.53 While

each regional hub has the flexibility to identify strategies that meet the needs of

their particular communities, the legislation mandates that each hub must work

toward the goals of aligning and coordinating an early learning system that is family

centered; fostering universal kindergarten readiness; and focusing on healthy, stable,

and attached families.

Each hub will bring together the early learning, health and human services, public

health, education, and private sectors to develop a collective vision and strategy for

achieving the overarching goals. The hubs also are charged with engaging parents

and families, coordinating services, developing shared data collection and evaluationprocesses, and measuring the impact of collective efforts by identifying and tracking

shared metrics.54 In Oregon, hubs are supported by educational organizations and a

variety of other community organizations working within the target sectors, includ-

ing the United Way from the nonprofit sector, community colleges, and coordinated

care organizations, or CCOs—umbrella organizations that aim to centralize the deliv-

ery and administration of health care services, including mental health and addiction

services, physical health care, and maternal and child health services.55

Funding for Oregon’s hubs is predominantly derived from state allocations in the

budget, but some hubs have been able to leverage additional financial support

from philanthropic sources, federal grant programs such as Race to the Top, or otherstate grant programs.56 Hubs also are working to align their services with the CCOs

that are being established in the state.57 In one hub region, the local CCO provided

the hub with additional financing to provide parent education and support to

families and children.58

Oregon early learning hubs

In order o address specifically he challenges aced by high-need communiies

or neighborhoods, inensive suppor provided wihin esablished zones bringsogeher a variey o services ha can include educaion, healh, nuriion, and

economic suppors. In recen years, saes have used Race o he op – Early

Learning Challenge, or RT-ELC, grans o ideniy arge communiies and

implemen zone sraegies. In is wo-year progress repor on RT-ELC imple-


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menaion, he Deparmen o Educaion noed ha 10 o he 20 granee saes are

specifically argeing high-need communiies, many o which are developing inno-

vaion zones.59 Since hen, oher communiies have adoped he model as well.

e ollowing ex box, describes a number o curren iniiaives implemening

his sraegy. While RT-ELC has provided saes wih a unique opporuniy and

he financial resources o implemen and pilo zone sraegies, gran unding wasonly provided or hree years and was no coninued in he mos recen appropria-

ions process, meaning ha hese iniiaives could lose unding.60

Georgia: Early Education Empowerment Zones, or E3Zs

Georgia used RTT-ELC funds to identify and create four E3Zs, with the goals of ex-

panding access to quality early education to children with high needs and aligning

supportive services, activities, and resources. Working with the state departments

of Economic Development, Community Affairs, and Education, the Georgia Depart-

ment of Early Care and Learning is applying a data-driven approach to identifying

the geographic areas with the highest proportion of need.61 Within these identified

high-need zones, Georgia is implementing tiered family copays in its child care

subsidy system based on the provider’s quality level.62 Families that choose higher-

quality care will pay less out of pocket.63 These grants provide funding for additional

slots in programs, which will allow providers to recruit and serve more high-risk

young children.64 Georgia also is planning to use its E3Zs to expand its Great StartGeorgia initiative—an effort to establish a coordinated system of services for ex-

pectant parents and children from birth to age 5—by creating home visiting hubs

in each zone.

Illinois: Early Childhood Innovation Zones

Illinois established seven Innovation Zones in high-need communities that are

committed to improving the quality of and access to early education services

for at-risk children. Each innovation zone tests different strategies to increase

participation in early education programs in targeted communities. Local collabo-

rations lead these efforts, and the most effective strategies will be considered for

statewide implementation.65

Selected zone initiatives to improve infant andtoddler services through RTT-ELC


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Maryland: Community Hubs

Using RTT-ELC grant funds, the Maryland Department of Education will establish two

Community Hubs in under-resourced communities in Baltimore to provide and coor-

dinate existing services for children and families with children from birth to age 5.66

Minnesota: Transformation Zones

Minnesota is using RTT-ELC grant funds to target services toward high-need com-

munities. Currently, four areas that have high concentrations of childhood poverty

have been identified as Transformation Zones: White Earth Reservation, Itasca

County, Saint Paul Promise Neighborhood, and Northside Achievement Zone in

Minneapolis. Each zone has the flexibility to create goals and design programs to fit

the specific needs of the community.67

North Carolina: Transformation Zone

North Carolina’s Transformation Zone selected 4 counties—out of 17 eligible coun-

ties—that are committed to providing adequate early learning services to children

in poor communities to ensure that they are well equipped for kindergarten. Ap-

plying implementation science methods, the goal of the Transformation Zone is to

identify effective strategies for creating systems of services to better support young

children’s healthy development. Each community has representatives from various

early childhood agencies and a local implementation coach to ensure that the grant

and services are being used effectively.68

New Mexico: Investment Zones

The Children, Youth and Families Department launched a task force to gather infor-

mation on the condition of the state’s communities and school districts. According

to the task force’s findings, a significant amount of areas in New Mexico lacked

development; these communities are considered Investment Zones. These zones

should identify and eradicate socioeconomic and academic factors that prevent

young children from being prepared for preschool and kindergarten. 69

Pennsylvania: Community Innovation Zones

At risk elementary schools with an innovative idea apply for the competitive EarlyChildhood Education Community Innovation Zone Grant of as much as $75,000 that

is offered to 50 schools and neighborhoods. The goal of the initiative is to identify

best practices that can be elevated at a broader state level. Grants will support

developmental screening, Kindergarten Entry Inventory implementation, alignment

of early care providers and school districts, and improved family engagement. 70


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Assuring continuity for infants

and toddlers

No all saes are aking a geographic approach when i comes o coordinaing

inan and oddler services and have insead sough o creae a broader culure o

coninuiy by developing saewide plans and policies. Ofen, saewide plans

iniiaed as a resul o sae legislaion specifically calling or more inegraion and

coordinaion among services or prescribed by coaliion groups, such as children’s

cabines, councils, or oher inerdeparmenal oversigh bodiesypically aim o

inves in broader access o high-qualiy early childhood services and o address

concerns relaed o coninuiy o care across a argeed age range.

Developing a statewide plan

Minnesota

In Minnesoa, he Children’s Cabineconsising o he commissioners o he

deparmens o Educaion, Healh, and Human Servicescharged he sae

Deparmen o Healh wih developing a saewide prenaal o age 3 policy

ramework ha would guide is work o build a srong early learning sysem.71

e resuling ramework ocuses on oucomes or children and amilies in five key

areas: prenaal healh, general healh, educaion, and well-being, as well as service-

area coordinaion or children rom beore birh o age 3.72

During phase 1 o he prenaal o age 3 planning process, he Minnesoa

Deparmen o Healh convened a working group o ideniy desired oucomes in

he key areas and merics o deermine success.73 Phase 2 included building par-

nerships wih a broad eam o sakeholders o ideniy policy recommendaions opromoe healhy developmen and early learning success among young children

and heir amilies and o raise he public profile o he imporance o inan and


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oddler developmen.74 Now in phase 3, he work aims o build communiy capac-

iy or innovaion in reducing healh inequiies and promoing sae, sable, and

nururing relaionships and environmens, as well as social and economic securiy

or pregnan and parening amilies wih very young children.75

Washington

e sae o Washingon developed a comprehensive plan o align services or

inans and oddlers rom birh hrough high school graduaion. In 2010, he sae

legislaure passed a bill ha required he Deparmen o Early Learning o develop

a Comprehensive Birh o 3 Plan.76 is approach aims o connec programs

ha serve children boh across ages and wihin age groups. Specifically, he plan

provides he ollowing: universal developmenal screening services ha are linked

across our sae agencies; a porolio o evidence-based home visiing services; ser-

vices o connec amilies wih primary medical care providers; suppor or amily,riend, and neighbor child care providers; increased child care choice, access, and

coninuiy by increasing capaciy hrough child care subsidies; and he creaion o a

saewide srucure o coordinae he birh o age 3 programs and services.77

In addiion, he plan offers key recommendaions o urher exising work and

represens boh shor- and long-erm invesmens in he birh o age 3 services,

such as creaing a susainable sae unding sream or inan and oddler services,

increasing unding or home visiing, providing unding or inan and oddler

child care consulaion, and creaing a sanding birh-o-age 3 subcommitee o

he Early Learning Advisory Council.78

Aligning standards, quality, and educational practices

Saes are working o improve he coninuiy o early learning programs by

aligning sandards and educaional pracices during he inan and oddler years

and beyond. Aligning sandards and educaion creaes a coninuous pahway o

learning and developmen ha reduces gaps or unnecessary redundancies in early

learning and difficul adjusmens or children moving rom one level o anoher.Similarly, i can suppor a uniorm learning ramework ha is consisen or an

enire communiy, helping ensure ha all children achieve he same developmen-

al benchmarks beore hey ener preschool or kindergarenno mater where

hey spend he firs years o heir lives.


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Since access o high-qualiy care and parens’ abiliy o provide a nururing learn-

ing environmen can vary significanly during he firs ew years o children’s lie,

children ofen ener kindergaren wih vasly differen levels o experience and

readiness o learn. Correcing or his imbalance by ensuring ha qualiy sandards

are aligned across setings and conneced wih he K-12 sysem are imporan

goals o inan and oddler alignmen. Communiies are approaching sandardsalignmen by replicaing effecive sandards and regulaions rom exising high-

qualiy programs; iniiaing effors o improve he qualiy o available setings,

including inormal care received rom amily, riends, and neighbors; and ideniy-

ing developmenal benchmarks ha children should achieve rom birh hrough

heir ormal educaion.

Georgia uses is Race o he op – Early Learning Challenge unding o incen-

ivize higher qualiy along he specrum o inan and oddler care providers.

Adminisraors overseeing he implemenaion o Georgia’s RT-ELC unds are

using heir grans o provide subsidy grans o high-qualiy programs ha servechildren rom birh o age 3.79 o obain one o hese grans, providers mus

mee higher sandards or qualiy and be in an area where Georgia pre-kinder-

garen programs are available o ensure coninuiy as children age ou o inan

and oddler care.80

Meanwhile, Washingon, D.C., uses he Common Core as an opporuniy o

connec is educaional sandards or he K-12 sysem wih he early learning

sysem, including indicaors or children rom birh o preschool.81 e Disric

o Columbia esablished a se o Common Core Early Learning Sandards ha

include guidelines and expecaions or developmen wihin domains ha span

approaches o learning; logic and reasoning; communicaion and language;

lieracy; mahemaics; scienific inquiry; social sudies; he ars; social-emoional

developmen; and physical developmen, healh, and saey. Indicaors or prog-

ress wihin each area o child developmen are idenified or inans, oddlers,

2-year-olds, preschool-age children, and expecaions or preschool exi.82


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The Quality Rating and Improvement System, or QRIS, is another policy lever that

can be used to align standards and address transitions for infant and toddler devel-

opment to ensure a continuum of early learning.

Illinois has established quality guidelines in its QRIS for infant and toddler child care

settings and to address transitions. The QRIS includes child care standards related to

the learning experience, instructional quality, child screening, environmental rating,

family and community engagement, program administration, and continuous im-

provement. Illinois requires programs to demonstrate high-quality in all classrooms

to ensure that programs cannot receive a high rating if their quality of infant and

toddler classrooms and services is poor.83 Specific infant and toddler quality rating

standards include but are not limited to the following:

• To achieve a gold rating, a program must implement parent-teacher conferences;

plan specific communications with parents; plan for family involvement; and have

strategies in place for connecting families with other social, health, education, and

medical services as needed.84

• To achieve a silver rating or above, settings must implement curricula that align

with the Illinois Early Learning Guidelines for Children Birth to Age 3 Years, or IELG,

and the Illinois Early Learning and Development Standards, or IELDS, for preschool

3 years old to kindergarten enrollment age.

• To achieve a silver rating, a program must have a policy and procedure to ensurethat all children, including infants and toddlers, are screened annually for special

needs and referred to other community supports as needed.

• Any child assessment tools used by a setting to evaluate a child’s developmental

progress must align with the state’s IELG and IELDS in order for a program to qualify

as a sliver rated program.

• To achieve a bronze rating, at least one administrator or teacher must have re-

ceived training on a curriculum aligned with the IELG and IELDS.

Leveraging the Quality Rating and ImprovementSystem in Illinois to align infant and toddler standards


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Federal policy can support infant

and toddler alignment

While sae and local communiies are aking he lead o implemen promising

approaches o expanding services o inans and oddlers, he ederal governmen

can and mus do more o susain hese effors and ensure ha inan and oddler

programs and services are more broadly available across he Unied Saes. Key

policy acions aken a he ederal level could bolser inan and oddler services

ha are already occurring in some saes and communiies.

Specifically, Congress mus:

• Increase unding or inan and oddler services o mee demand and

improve qualiy

• Ensure ha exising ederal unding sreams provide more long-erm and con-

inuous invesmens

• Make sure ha unding sources are flexible enough o suppor coninuiy

o services

For is par, he Obama adminisraion and uure adminisraions should:

• Coninue o build momenum or invesmens in early childhood iniiaives

• Ensure ha he deparmens overseeing he various ederal unding sources

leveraged o suppor inans and oddlers provide guidance or blending ederal

unding sreams

• Iniiae a permanen cross-agency office ocused on aligning inan andoddler services

• Sreamline gran applicaions and reporing


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Increase funding for infant and toddler programs at the

federal level

Since he majoriy o programs providing services or low-income children and

amilies canno mee he needs o all who are eligible, increasing invesmens o

expand services is a criical firs sep o suppor coninuiy or inans and od-dlers. Ensuring ha all eligible children receive services will beter posiion saes

and communiies o provide a coninuous pipeline o services so ha more disad-

vanaged children ener school ready o learn and a he same developmenal sage

as heir more affluen peers. Increasing unding or inan and oddler programs

will allow hem o increase capaciy and serve more children and heir amilies. All

signs poin o a difficul appropriaions process in 2016, wih he hrea o cus o

many imporan programs. o preven disruping progress a he sae and local

levels, Congress should ensure ha early childhood programs are proeced rom

unding cus.

Make funding streams permanent

While here are many differen ederal unding opporuniies ha suppor young

children and heir amilies, he majoriy o unding sreams are discreionary

unds or gran based, which makes hem less dependable. Gran-based unds,

paricularly hose ha are compeiively disribued, are no guaraneed beyond

he erms o he gran. Moreover, while compeiive gran programs can be an

effecive ool or incening beter qualiy and oucomes, hey should be comple-

mened by ormula unds ha provide a oundaion o financial suppor o build a

base level o inrasrucure.

Similarly, discreionary unding sreams ha are subjec o he annual appropria-

ions process also can be reduced or eliminaed depending on he prioriies o

Congress. is is a paricular challenge or inan and oddler services, which are

already underunded and ofen underdeveloped, unable o mee he needs o all

eligible amilies, and primarily unded a he ederal level hrough discreionary

gran programs. Uncerainy abou uure unding can inhibi long-erm plan-

ning a he sae and local levels. In recen years, parisan ension in Congress ledo sequesraion, a governmen shudown, and shor-erm exensions o criical

programs serving inans and oddlers, including MIECHV.


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Program exensions and delayed appropriaions decisions produce a grea amoun

o uncerainy or sae and local adminisraors. When adminisraors lack assur-

ance ha unding will be susained, hey may be relucan or unable o hire or

reain saff; o expand services or scale up successul effors; or o inves in qualiy

improvemen, raining, and echnical assisance. Funding uncerainy also can

mean ha ime and resources are spen on coningency planning raher han service delivery and program developmen.

Ensure flexibility within funding sources

Since he developmenal needs o young children are inherenly inerwined,

unding sources ha suppor he myriad domains o developmen should be su-

ficienly flexible o suppor iniiaives ha align communiy-level resources and

services. While some unding sreams are available o suppor broad alignmen

and sysems building effors, many programs and inervenions sill operae inisolaion. Legislaive language should promoe collaboraion and alignmen and

allow or a broader use o unds.

Continue to create momentum for investments in early

childhood initiatives

e Obama adminisraion’s spoligh on he imporance o early childhood

inervenions has leveraged he philanhropic communiy and privae secor in

meaningul ways, generaing more han $340 million in unding commimens.85

e curren adminisraion, as well as uure adminisraions, should coninue o

prioriize early childhood and inan and oddler alignmen as a key sraegy or

improving he oucomes o low-income children and amilies and developing a

uure workorce ha is compeiive on an inernaional scale.

Provide guidance on blending different sources of federal funding

Federal agencies ha adminiser he various unding sreams or inans andoddlers should provide more guidance o sae and local adminisraors on how

unds can be used o suppor sysems building and he developmen o a conin-

uum o services. Guidance should ideniy successul sraegies and demonsrae


32/45


how hese sraegies can be replicaed while also addressing issues o conflic-

ing requiremens. Likewise, ederal agencies ha adminiser financial suppor

should esablish high-qualiy sandards ha are aligned across he various unding

sreams and are atainable or sae and local implemening agencies.

Federal agencies also should provide echnical assisance and resources o helpsae and local agencies manage he adminisraive burden o applying or and

reporing on muliple unding sreams, including how o creae daa sysems ha

can efficienly rack merics across various programs.

Consider ways to streamline grant applications and reporting for

initiatives that blend funding streams

Beyond providing guidance, he ederal governmen should consider developing

a cenralized process or applying or and reporing on grans and oher ederalunding sreams. Since he curren programs and services ha arge inans and

oddlers are adminisered across many differen ederal agencies, being accoun-

able or he various oucomes can be a significan adminisraive burden or sae

and local agencies.

Establish a permanent federal cross-agency office focused on

infant and toddler ser vices

o provide beter oversigh and suppor or inan and oddler alignmen effors,

a cross-agency office should be esablished a he ederal level o ocus on deliver-

ing he coninuum o services or young children. Such an office would mirror

sraegies currenly implemened a he sae level o provide more inenional

oversigh and adminisraion o inan and oddler services. is office would

develop and provide guidance and assisance o sae and local agencies ha apply

or and implemen grans argeing inan and oddler services. Similarly, he office

would coordinae wih he various ederal agencies ha oversee inan and oddler

programs wih he goal o sreamlining reporing processes, daa collecion, and

qualiy improvemen effors.


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Conclusion

Saes and local communiies across he counry are bringing ogeher resources

and experise o creae sysems o suppor around our younges and mos vulner-

able ciizens. While innovaion is happening on he ground locally and a he sae

level, he ederal governmen can and mus play a significan supporing role by

ampliying and expanding promising approaches o inan and oddler services

alignmen. Coninuing and increasing unding or programs ha caalyze he

healhy developmen o inans and oddlers is no only a smar invesmen bu

also a necessary one.

Families o color coninue o disproporionaely ace economic and social chal-

lenges in he Unied Saes, even as hey come o represen a larger share o he

overall populaion. ereore, policymakers mus inves in proven soluions ha

preven poor oucomes or he younges and mos vulnerable among us. Many o

hese soluions already exis bu lack he unding needed o be effecive. Aligning

services and sysems o care or inans and oddlers will allow saes and com-

muniies o more efficienly use limied resources, while building on successul

programs ha suppor he healhy developmen o our uure generaions.


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About the authors

Rachel Herzfeldt-Kamprath is a Policy Analys wih he Early Childhood Policy

eam a he Cener or American Progress, where her research and analysis con-

ribues o policy developmen ha suppors he healhy developmen o young

children. Previously, she worked on sae-level policy research, advocacy, andcommuniy organizing in Minnesoa, where her work ranged rom issues relaed

o child care and early educaion unding, o abuse and neglec, human rafficking,

and povery and affordable housing.

Katie Hamm is he Direcor o Early Childhood Policy a he Cener. Prior o

joining he Cener, Hamm worked as a program examiner a he U.S. Office o

Managemen and Budge, or OMB, on ederal child care and early educaion

programs, including he Race o he op – Early Learning Challenge, he Child

Care and Developmen Fund, and he Head Sar program. Her work ocused on

developing budge proposals o srenghen he qualiy o and access o early child-hood programs. She also worked on inernaional issues in early childhood while

on deail o he Organisaion or Economic Co-operaion and Developmen.

Earlier in her career, Hamm worked a he Cener or Law and Social Policy and

he Insiue or Women’s Policy Research on child care and early educaion issues.

Acknowledgements

e auhors would o hank he sae adminisraors who reviewed inorma-

ion abou sraegies hey are currenly working o implemen. Addiionally, he

auhors would like o hank Miriam Calderon, early childhood educaion con-

sulan, and Mimi Howard, a policy advisor or School Readiness Consuling, or

heir research suppor on his projec.


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Appendix: Federal funding sources

for infant and toddler services

Maternal, Infant, and Early Childhood Home Visiting

e MIECHV gran program suppors he expansion o evidence-based home

visiing services or high-risk children and amilies in saes, erriories, and ribal

communiies. Various home visiing models suppored by MIECHV provide

services or young children and parens rom beore birh o preschool.86

Medicaid and the Children’s Health Insurance Program

Medicaid, CHIP, provide healh insurance coverage or low-income inans and

oddlers and heir amilies. Medicaid allows eligible children o access he Early

Periodic Screening, Diagnosis, and reamen program, and CHIP provides

highly flexible unds ha can suppor comprehensive healh and developmen

benefis, as well as healh insurance coverage. Saes also have been successul in

billing aspecs o maernal and inan home visiing services o Medicaid.87

Title V Maternal and Child Health Services Block Grant Program

ile V Maernal and Child Healh program unds are provided o saes hrough

an annual ormula gran o provide a oundaion o ensure he healh and well-

being o women and young children. Specifically, ile V unds aim o ensure

access o high-qualiy care, reduce maernal and inan moraliy, provide compre-

hensive prenaal and posnaal care, increase child healh assessmens and rea-

men, provide access o prevenive care, suppor communiy- and amily-based

sysems o care, and provide oll-ree holines.88


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Early Childhood Comprehensive Systems

e ECCS gran program direcs unds oward srenghening sae sysems o pro-

moe early childhood developmen. e goals o he program include increasing

access o healh care, ideniying developmenal issues, improving early care and

educaion, educaing parens, and supporing amilies. In 2013, he mos recengran period, he program reocused o beter suppor early childhood iniiaives,

including MIECHV programs.89

Healthy Start

Healhy Sar is a gran program ha aims o reduce inan moraliy by ideniy-

ing new mohers in communiies wih he highes inan moraliy raes. e goal

o he program is o improve maernal healh and o help parens care or heir

young children unil hey are 2 years old. Gran unds go direcly o healh andsocial service organizaions o help reduce racial and ehnic dispariies and o

improve healh oucomes or mohers and children.90

Healthy Tomorrows Partnership for Children Program, or HTPCP

e HPCP aims o improve access o maernal and child healh care. Projecs

unded by he gran mus arge high-need communiies, represen a new iniiaive

wihin a communiy, and serve as a demonsraion ha will undergo an evalua-

ion. Inervenions can address many differen issues, including early childhood

developmen; school readiness; care coordinaion and case managemen; nuri-

ion; and physical, menal, and behavioral healh.91

Project LAUNCH

e Projec Linking Acions or Unme Needs in Children’s Healh aims o

promoe he healh and well-being o children rom birh o age 8 by supporing

heir physical, social, emoional, cogniive, and behavioral developmen. Graneescan mee hese goals by using gran unds o improve sysems coordinaion, build

inrasrucure, increase screening and reerrals, and increase access o evidence-

based prevenion and wellness promoion services or children and heir amilies.92


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Temporar y Assistance for Needy Fami lies

e ANF program awards saes block grans o provide income suppor o low-

income amilies wih children. Saes receiving hese ederal grans also conrib-

ue addiional unds oward he programs. ANF unds are inended o suppor

amilies in caring or heir children; o reduce dependency on social services byincreasing job raining, work, and marriage; o preven ou-o-marriage pregnan-

cies; and o increase wo-paren homes. ANF unds are relaively flexible, and

saes can use gran unds o mee he goals as hey see fi. For insance, a signifi-

can porion o ANF unds are spen on providing child care, and recenly, saes

have used ANF unds o suppor heir home visiing iniiaives.93

Community-Based Grants for the Prevention of Child Abuse and

Neglect, or CBCAP

e CBCAP program was designed o suppor communiy-based effors o preven

child abuse and neglec by coordinaing resources and aciviies o srenghen and

suppor amilies. o receive unds, saes mus ideniy a plan o blend ederal, sae,

and privae unds; o promoe paren leadership; o oser ineragency coordinaion;

o increase heir use o evidence-based programs and inervenions; and o evaluae

he effeciveness o heir programs. ese goals can be achieved by implemening

services such as home visiing and communiy and amily resource ceners.94

Head Start and Early Head Start

Boh he Head Sar and Early Head Sar programs suppor he menal, social,

and emoional developmen o children rom birh o age 5 by providing educa-

ion, healh, nuriion, social, and oher services. Head Sar promoes he role o

parens as a child’s firs and mos imporan eachers and works wih amilies o

suppor posiive paren-child relaionships, amily well-being, and connecions

o peers and communiies. Head Sar began as a program or preschoolers, and

he majoriy o children served are ages 3 o 4. Early Head Sar serves pregnan

women, inans, and oddlers hrough programs ha are available unil childrenurn 3 years old and ransiion ino Head Sar or oher preschool programs. Early

Head Sar suppors amilies hrough early, coninuous, inensive, and compre-

hensive services.95


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Early Head Start-Child Care, or EHS-CC, Partnerships

EHS-CC Parnerships grans enable new or exising Early Head Sar programs o

collaborae wih local child care ceners and high qualiy home-based amily child

care providers ha serve low-income inans and oddlers o provide ull-day,

ull-year programs or working amilies. ese parnerships will also exend hecomprehensive services provided by Early Head Sar, including higher healh,

saey, and nuriion sandards; comprehensive screenings; proessional develop-

men or eachers; and paren engagemen.96

Child Care and Development Block Grant, or CCDBG

e 2014 reauhorizaion o he CCDBG requires saes o spend a minimum o 3

percen o heir CCDBG unds o improve he qualiy and increase he quaniy o

care or inans and oddlers. Aciviies ha can be unded hrough his se-asideinclude esablishing and expanding high-qualiy communiy or neighborhood

amily and child developmen ceners; improving access o provider raining, ech-

nical assisance, and proessional developmen; incorporaing inan and oddler

componens ino he sae’s Qualiy Raing and Improvemen Sysem; helping

parens access high-qualiy child care programs; and oher aciviies ha suppor

he healhy developmen o inans and oddlers.97

Elementary and Secondary Education Act, or ESEA, Title I

ile I o he ESEA idenifies preschools as an allowable use or unds. ese unds

can suppor programs designed o improve he cogniive, healh, and social-

emoional oucomes or eligible children rom birh o he age a which ree public

elemenary educaion is provided. Children who live in areas wih lower achieve-

men raes could be eligible o paricipae in ile I-unded preschool programs.

ile I unds also aim o promoe paren engagemen, suppor he ransiion o

young children ino kindergaren, and coordinae wih oher ederal programs ha

benefi young children.98


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Individuals with Disabilities Education Act Part C

Par C o IDEA is a sae-adminisered program o serve inans and oddlers

wih developmenal delays or diagnosed physical or menal condiions rom birh

hrough age 2. Is purpose is o provide ree access o public educaion or all

young children wih disabiliies, ensure heir righs, and assis saes and local eni-ies in beter serving hem.99

IDEA Part B

Secion 619 o Par B o IDEA offers saes grans o provide preschool o children

wih disabiliies rom age 3 o age 5 and, a he saes’ discreion, o 2-year-olds

wih disabiliies who will urn 3 years old during he school year.100

Race to the Top – Early Learning Challenge

e RT-ELC is a compeiive gran iniiaive ocused on improving early learning

and developmen programs or young children. Grans go direcly o saes ha

are working o increase he number or percenage o low-income and disadvan-

aged inans, oddlers, and preschoolers who are enrolled in high-qualiy early

learning programs. e grans also can suppor effors o design and implemen

sysems inegraion iniiaives and o improve he qualiy o assessmens in early

childhood programs. Grans were awarded in 2011, 2012, and 2013 bu were no

unded beyond hese years.101

Supplemental Nutrition Assistance Program

SNAP provides individuals and amilies wih nuriion assisance. Individuals who

qualiy based on income, resources, deducions, immigraion requiremens, employ-

men, and disabiliy can apply or SNAP benefis hrough local SNAP offices. 102


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Special Supplemental Nutrition Program for Women, Infants,

and Children

WIC provides ederal grans o he saes or supplemenal oods, healh care

reerrals, and nuriion educaion or low-income pregnan, breaseeding, and

non-breaseeding posparum women, as well as or inans and children hroughage 5 who are ound o be a nuriional risk.103

Child and Adult Care Food Program, or CACFP

CACFP provides nuriious meals and snacks o inans and children who are

enrolled in a variey o child care seting, including: public and privae nonprofi

child care ceners, Head Sar programs, care ceners serving children ouside o

school hours, oher licensed or approved day care providers, and some or-profi

ceners serving lower income children. CACFP reimburses paricipaing cenersor he eligible meals and snacks served o enrolled children, specifically argeing

hose children mos in need.104


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Endnotes

1 Harvard University Center on the Developing Child,“InBrief: The Science of Early Childhood Development”(2007), available at http://developingchild.harvard.edu/index.php/resources/briefs/inbrief_series/inbrief_the_science_of_ecd/.

2 Julia B. Isaacs, “Starting School at a Disadvantage: The School Readiness of Poor Children” (Washington:Center on Children and Families at Brookings, 2012),available at http://www.brookings.edu/~/media/re-search/files/papers/2012/3/19%20school%20disadvan-tage%20isaacs/0319_school_disadvantage_isaacs.pdf .

3 Bjorn Carey, “Learning gap between rich and poorchildren begins in infancy, Stanford psychologistsfind,” Stanford Report, September 25, 2013, availableat http://news.stanford.edu/news/2013/september/toddler-language-gap-091213.html.

4 David Murphey, Mae Cooper, and Nicole Forry, “TheYoungest Americans: A Statistical Portrait of Infants and

Toddlers in the United States” (Chicago and Bethesda,MD: Robert R. McCormick Foundation and Child Trends,2013), available at http://www.childtrends.org/wp-content/uploads/2013/11/MCCORMICK-FINAL.pdf .

5 Bureau of the Census, “Most Children Younger Than Age1 are Minorities, Census Bureau Reports,” Press release,May 17, 2012, available at https://www.census.gov/newsroom/releases/archives/population/cb12-90.html.

6 Murphey, Cooper, and Forry, “The Youngest Americans.”

7 Ibid.

8 Harvard University Center on the Developing Child,“Key Concepts: Toxic Stress,” available at http://devel-opingchild.harvard.edu/key_concepts/toxic_stress_re-sponse/ (last accessed May 2015).

9 Maryam Adamu and others, “Aligning and Investingin Infant and Toddler Services” (Washington: Centerfor American Progress, 2014), available at https://cdn.americanprogress.org/wp-content/uploads/2014/10/InfantToddler-report.pdf .

10 Health Resources and Services Administration, The Ma-ternal, Infant, and Early Childhood Home Visiting ProgramPartnering with Parents to Help Children Succeed (U.S.Department of Health and Human Services, 2015),available at http://mchb.hrsa.gov/programs/homevisit-ing/programbrief.pdf.

11 Based on authors’ calculations from Food and NutritionService, “WIC Program,” available at http://www.fns.usda.gov/pd/wic-program (last accessed May 2015).

12 Stephanie Schmidt, Christina Walker, and RachelHerzfeldt-Kamprath, “An Investment in Our Future:How Federal Home Visiting Funding Provides CriticalSupport for Parents and Children” (Washington: Centerfor Law and Social Policy and Center for American Prog-ress, 2015), available at https://www.americanprogress.org/issues/early-childhood/report/2015/02/11/106406/

an-investment-in-our-future/.

13 Ibid.

14 Health Resources and Services Administration, The Ma-ternal, Infant, and Early Childhood Home Visiting ProgramPartnering with Parents to Help Children Succeed .

15 Health Resources and Services Administration, “TitleV Maternal and Child Health S ervices Block GrantProgram,” available at http://mchb.hrsa.gov/programs/titlevgrants/ (last accessed May 2015).

16 Ohio Department of Health, “Ohio Help Me Grow,” avail-able at http://www.helpmegrow.ohio.gov/en/aboutus/abouthelpmegrow.aspx (last accessed May 2015).

17 Ground Work Ohio, “Ohio’s Help Me Grow Pro-gram: Serving Ohio’s Vulnerable Infants and Toddlers”(2014), available at http://groundworkohio.org/wp-content/uploads/2014/07/Help-Me-Grow-0409.pdf .

18 Ibid.

19 Ohio Department of Health, “Maternal and Child HealthPrograms,” available at https://www.odh.ohio.gov/land-ing/phs_access/family.aspx (last accessed May 2015).

20 Zero to Three, “Resource Details Kansas Early ChildhoodBlock Grant,” available at http://policy.db.zerotothree.org/policyp/view.aspx?InitiativeID=595&origin=results&QS=%27&union=AND&viewby=50&startrec=1&tbl_Public_InitiativeYMGHFREStateTerritoryTribe=KS&tbl_Public_InitiativeYMGHFREDescription=&top_par-ent=164 (last accessed May 2015).

21 Ibid.

22 First 5 California, “Welcome to First 5 California,” avail-able at http://www.first5california.com/ (last accessedMay 2015).

23 Ibid.

24 Children’s Services Council Palm Beach County, “HowWe’re Funded,” available at http://www.cscpbc.org/howfunded (last accessed May 2015).

25 Ibid.

26 Children’s Services Council Palm Beach County, “2014- 2015 Funded Programs,” available at http://www.cscpbc.org/funded-programs (last accessed May 2015).

27 Children’s Services Council Palm Beach County, “CSCBids (RFP/RFQ),” available at http://www.cscpbc.org/openprop (last accessed May 2015).

28 Children’s Services Council Palm Beach County, “2014 -2015 Funded Programs.”

29 Child Care and Development Services Bill , California S.B.No. 1123 (February 19, 2014), available at http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1123.

30 California Legislative Information, “SB-1123 Child careand development services: Bill Analysis,” availableathttp://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1123 (last accessed May2015).

31 Child Care and Development Services Bill .

32 California Legislative Information, “SB-1123 Child careand development services: Bill Analysis.”

Documents

Emerging State and Community Strategies to Improve Infant and Toddler Services