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Journal Issue: Caring for Infants and Toddlers Volume 11 Number 1 Spring/Summer 2001

Reports from the Field: Starting Points: State and Community Partnerships for Young Children
Michael H. Levine Susan V. Smith

State and Community Partnerships for Young Children

In selected states and cities, the Starting Points Initiative sought to turn research and public awareness into action by building state and city leadership networks for program and policy improvements. In 1996, Carnegie Corporation launched a program of competitive grants called the Starting Points State and Community Partnerships for Young Children. Initial funding supported alliances in 10 states and 6 cities that sought to implement the reforms called for in Starting Points. In 1998, seven of those states and four cities received grants to continue their work for two more years.

The initiative was designed to be catalytic, so the grants it provided were modest in size. A total of approximately $10 million in private funding was allocated over the four years, from Carnegie Corporation and local funding partners. Local foundation, business, media, university, and community leaders joined policymakers, parents, and professionals in attempting to design and sustain useful innovations and chart progress toward meeting the needs of families and young children. (See Table 1 for an overview of the major components of each project.) A forthcoming study by the National Center for Children in Poverty highlights the progress in the sites and the major challenges to sustaining meaningful reforms.6

The accomplishments and the challenges that define this work are illustrated here in the work of two sites: Rhode Island and West Virginia. The Rhode Island effort illustrates how comprehensive legislation can create a framework for improving early childhood programs and policies statewide, while West Virginia's effort has created and expanded community-level programs for families with young children.

Rhode Island

Rhode Island's Starting Points project brings together an unusual public-private partnership involving the Governor's Office; the Rhode Island Departments of Health, Human Services, and Elementary and Secondary Education; the Rhode Island Foundation; the United Way of Southeastern New England; and Rhode Island KIDS COUNT, a statewide children's policy and advocacy organization. This leadership group came together in 1996, when comprehensive reforms in child care and health care for young children and families were being crafted by the Governor's Office and state legislative leaders.

Strengthening Child Care for Low-Income Families

In 1997, Rhode Island passed the Family Independence Program, model welfare reform legislation that emphasized the need for child care for parents returning to work by establishing entitlements to child care subsidies for low-income families. To improve the availability of good child care, the state also sought to increase the professionalism of the entire child care workforce. The legislation turned a spotlight on the critical role that family child care providers play in Rhode Island, as they do elsewhere, recognizing that child care providers constitute a significant subgroup within the ranks of the working poor. In response, Rhode Island became the first state in the nation to provide health care coverage to licensed family child care providers and their children.

Building on that beginning, in 1998, the state legislature passed comprehensive legislation that promoted the availability and affordability of high-quality child care. The program, Starting RIght, expanded the eligibility guidelines for child care subsidies to include families earning up to 225% of the federal poverty level and established child care networks to provide high-quality child care, health, mental health, and other social services to low-income children. To strengthen the child care system overall, Starting RIght extended health insurance coverage to staff working in child care centers, raised the rate the state pays to child care providers, and expanded funding for child care career development activities.

Broader Policy Reforms

These investments to improve child care were one aspect of broader efforts to use federal Medicaid and welfare funding in innovative ways. For instance, Rhode Island's health care program, RIte Care, significantly increased the number of children receiving health insurance. RIte Care produced rapid positive health results, including increased access to prenatal care, a decrease in smoking during pregnancy, and increased birth intervals.7,8

Rhode Island has emerged as a national leader in the development of public policies that serve low-income families with young children.9 A key factor is the potent combination of people who worked on the reforms, including the skillful advocates at Rhode Island KIDS COUNT, leaders from the foundation sector and United Way, and insiders at all levels of state government.

Challenges Ahead

As Starting RIght and RIte Care are being implemented statewide and enrollments grow, the state must find financing streams to sustain these initiatives, even when an economic downturn hits. Governor Lincoln Almond, the legislature, and other groups are working to ensure that the state's increased investments in early care and education will continue. With the new investments has come an increased commitment to measuring results, particularly with regard to school readiness. Rhode Island is developing reliable indicators to track child and family outcomes. The consensus built by leaders in the state brightens hopes that they can sustain the progress they have made in advancing a comprehensive early childhood initiative.

West Virginia

West Virginia has been a pioneer in developing cost-effective, innovative programs for children over the past decade. Its Governor's Cabinet on Children and Families, the first in the nation when it was established by former Governor Gaston Caperton in 1990, was created to reduce program fragmentation through a new system of family supports capable of responding flexibly to community priorities. In 1991, the cabinet established Family Resource Networks, which are local hubs that promote the planning, coordination, and improvement of comprehensive health, education, and social services. In 1996, with support from foundations and federal and state agencies, these networks began to provide expanded programs and services from the prenatal period through school entry through Starting Points Centers.

Starting Points Centers

Comprehensive centers were established within the Family Resource Networks in 18 of West Virginia's most isolated communities, where families often travel long distances to access basic health and education services. Reflecting the Starting Points report's recommendation that communities mobilize to create neighborhood family and child supports, the Starting Points Centers offer health screening and care, parent and preschool education, information and referral services, employment counseling, home visiting outreach programs, and developmental screening. Preliminary evaluation data show strong participation by low-income families; improvements in child health insurance coverage, immunization rates, and parenting skills; and increased use of nutrition and other community services.10

In July 1997, West Virginia's Starting Points Centers received a National Governors' Association award for outstanding design and innovation. Governor Cecil Underwood, a Republican who assumed office in 1997, championed the establishment of centers in each of the state's 55 counties, gaining funding from the state legislature for an initiative that began under a Democratic administration. With the skillful leadership of entrepreneurial staff members and support from the legislature and community and parent groups, the governor's cabinet is developing innovative financing strategies to sustain and expand the centers.

Challenges Ahead

In West Virginia, a rural state with a very modest tax base and widespread intensive need for parenting and income supports, it will not be easy to secure the long-term viability of the Starting Points Centers. Challenges include finding resources to establish centers to reach all of West Virginia's counties, while improving the quality of the services provided at the centers. Tough choices must be made to keep the momentum for early childhood program and policy reforms moving forward, especially given the election of a new governor in 2000 and turnover among supportive state legislators who face term limits. As in Rhode Island, legislators have demanded information on the effects of their early childhood investments on young children, yet little reliable outcome data exists.

The West Virginia team must also provide local program leaders with dependable information and guidance about programs that work, while paying attention to the need for local decision making and innovation. This tension between state and local control is not unique to West Virginia; rather it is a balancing act that states and communities, that are engaged in early childhood program and policy planning, confront on a daily basis.