COMMISSION ON
CHILDREN
Service Integration: Building Systems of Support for Children, Families, and Communities
The Connecticut Commission on Children
With
Support From
The Travelers Foundation and
Connecticut Public
Television
INTRODUCTION
Who’s Who
Presenters
U.S. Senator Christopher Dodd
U.S. Representative Nancy Johnson
Martha Burt
Urban Institute
Sally Vogler
Policy Advisor
Office of
Colorado Gov. Roy Romer
Kay Reiss
Coordinator, School-Based Youth
Services Program
New Jersey Department of Human Services
Mary Willoughby
Senior Planner and Chief
Financial Strategist
Youth Futures Authority
Savannah,
Georgia
Maria Casey
President, Urban Strategies Council
Oakland, California
Dwayne Crompton
Executive Director, KCMC Child
Development Corporation
Kansas City, Missouri
Cynthia Guerreri
Coordinator, Family Support and
Resource Center
Manchester, Connecticut
Connecticut Commission on Children
Elaine Zimmerman
Executive Director
Laura Lee Simon
Chair, Kids Count
__________________________________________________________________________________
Connecticut has entered a period of rapid and profound transformation in the services and systems supporting our state’s children. Congress has begun a restructuring of the federal budget with new methods of financing human services. States will have more flexibility in program delivery, but fewer dollars. Local control will increase. Service models will vary from state to state and region to region. Some standards and accountability factors will diminish. These trends necessitate an in-depth assessment of the policies, values, priorities, and programmatic options facing children. Service integration, long touted as beneficial to families, is surfacing as one model approach for local communities and their children.
Service integration refers to coordinated programs that offer comprehensive service delivery in a consumer-friendly way. Children’s services are often fragmented, with program orientation defined by the funding source rather than consumer need. Frameworks and values are sometimes rooted in institutions instead of neighborhoods. "Multiple agencies responding to the same family created confusion, and fiscal inefficiency", commented teleconference moderator Elaine Zimmerman. With both devolution of dollars and fewer dollars, states are looking to move beyond barriers of turf and funding stream to more holistic approaches to the child, family, and neighborhood.
Most states and municipalities are not waiting for federal action to respond to national trends toward streamlining, coordination, and decategorization. At the state and local levels, a number of models of service integration are already in place, demonstrating the efficacy and efficiency of linking staff, training, and resources in innovative ways. Other strategies for service integration are just beginning to emerge as federal agencies promote the "one-stop" concept for service delivery and shift decision-making responsibilities to state and local governments. Connecticut is widely recognized as a pioneer in the creation of family resource centers, but the state can learn from the exemplary service integration initiatives that are producing positive results elsewhere in the nation.
_________________________________________________________________________
Background
Prior to the teleconference, the Commission on Children joined with state and regional business leaders, educators, elected officials, and other children’s advocates to sponsor a series of strategy sessions focusing on federal budget and policy trends. More than 250 Connecticut residents participated in these regional efforts to plan for devolution, budget cuts, and the possibility of block grants. The values articulated and emphasized by participants from all parts of the state included: fairness; prevention; equal access; accountability; parent responsibility/leadership; citizen involvement; and efficiency.
Further groundwork for the teleconference was set at a March 7 planning session. More than 150 parents, providers, teachers, business leaders, and policy makers came together to discuss the benefits, challenges, and urgency of integrated approaches to service delivery. Participants worked in teams to explore possibilities for linking or weaving services in Connecticut's communities. All of the individuals who participated in these deliberations were invited to share their ideas at the subsequent teleconference.
______________________________________________________________________________________
To explore the potential of service integration and acquaint Connecticut residents with models that have proven successful, the Connecticut Commission on Children held a teleconference, Building Partnerships for Children in a New Era, on March 25, 1996. The broadcast, which was made possible by a grant from the Travelers Foundation, originated in Hartford. Participants at five additional cities around the state--New Haven, New London, Norwalk, Storrs, and Waterbury--were linked electronically to the proceedings. More than 600 people participated, providing strong evidence of the depth of constituent interest in this critical policy issue.
Presenters at the teleconference included U.S. Senator Christopher Dodd, U.S. Representative Nancy Johnson, key staff from service integration initiatives in six states, and a prominent national researcher. Each presenter described a specific approach to service integration, with particular emphasis on what was integrated--staff? training? programs? facilities? funding? and other resources? Expert commentary and probing questions were offered by a panel of respondents, members of which included: Dennis King of Governor Rowland's staff; Joyce Thomas, Connecticut's Commissioner of Human Services; State Representative Jack Thompson; Ellen Galinsky of the Families and Work Institute; and Jule Sugarman of the Center for Effective Services for Children.
Why Service Integration is the Right Thing To Do
"We have awakened to the reality that the requirements of children don’t fall into neat parcels. A child’s health, early care and education, safety, and learning needs are inter-connected and must be dealt with comprehensively for the best results."
Laura Lee Simon
Chair, Kids Count
"Let’s be clear about what service integration means. Integration is not just a fancy word for budget cuts. Integrating programs should not be confused with slashing their funding. If integration allows communities to do more with less, so much the better for everybody. Integration is the right thing to do for children. It means looking at all a child needs and streamlining the delivery of services to meet those needs. It means looking at the child as a member of the family and the community."
U.S. Senator Christopher Dodd
"We have to rethink from the ground up: What’s the problem? What’s the need? How do we pull in services at the time of need? How do we make them powerful in people’s lives? As you rethink from the bottom up, you begin to see falling away the old barriers that we’ve put between programs, artificial lines that we’ve put up over the years, administrative categories that no longer make sense, procedures, all kinds of things."
U.S. Representative Nancy Johnson
"Internally, there has to be a culture change within state government. . .You have to listen to the local community, and you have to involve your agencies. . . We’re learning that we cannot empower the community by telling them what to do."
Dennis King
Gov. Rowland’s Office
______________________________________________________________________________________
THE MEANING AND CONTEXT OF SERVICE INTEGRATION: WHAT IT IS AND WHAT IT ISN'T
Offering a context for the teleconference deliberations, Dr. Martha Burt of the Urban Institute encouraged participants to think about service integration in terms of what they want to accomplish. She identified three common reasons for service integration:
Dr. Burt elaborated on the issue of appropriateness, emphasizing the need to focus resources on prevention instead of costly remedial efforts to "fix" a child or family. She encouraged providers and policy makers to use resources rather than services or programs to direct their efforts.
Dr. Burt told the teleconference audience that service integration, at the simplest level, is about improving the way information, clients, and money flows among agencies. She described optimal service integration as a single stream of funding that can be used for whatever children and families need.
Cautioning against the notion that service integration will yield significant cost savings, Dr. Burt suggested an emphasis on improved outcomes--for children, families, and neighborhoods. She identified two critical ingredients of service integration initiatives: 1) active involvement of agency staff at levels in planning as well as implementation and 2) relaxation of regulations governing information flow and categorical funding streams.
The presenters who followed Dr. Burt provided operational examples of ways to translate service integration theory into practice. They spoke of the critical need to replace discrete, compartmentalized policies and programs with a holistic system of services and supports that are coherent, culturally competent, and focused on the unique assets that each individual contributes to a family and the community as a whole. Endorsing the trend toward greater integration of funding, programs, and staff, each speaker described efforts to build a community in which service delivery is unfettered by turf boundaries, obsolete regulations, and contradictory policies.
_____________________________________________________________________________________
"Collaboration is crucial and solves many problems, but alone it will not improve outcomes. It must be seen as a means, not an end. It is futile to put together services that are of mediocre quality, that are rendered grudgingly, that are rendered by professionals who do not know how to work collaboratively with families and are unable to respond to the unique characteristics of a particular community. It is a disservice to act as though whatever is out there is all that is needed--and as though all that needs doing is to link together what is."
Lisbeth Schorr
"Community Support for Student
Success"
_____________________________________________________________________________________
COLORADO: A MULTI-FACETED APPROACH TO SERVICE INTEGRATION
Although Governor Roy Romer is perhaps best known in national circles for his work on welfare reform for the National Governor’s Association and his leadership of the National Education Goals Panel, one of his goals as governor has been to make Colorado the best state in the nation in which to be born and grow to adulthood. Sally Vogler, Governor Romer’s policy director for families, children, and human services has been at the center of the state’s ground-breaking efforts to integrate services for children and their families. She described several of these efforts to the teleconference audience and cautioned that it is sometimes difficult to maintain a focus on service integration as players and visions change.
First Impressions, the early childhood initiative launched during the Governor’s first term, has been a catalyst for change for a decade. Created to focus attention on the needs of the state’s youngest residents, this initiative brought together policy makers and child advocates to form a new infrastructure of support and assistance for children and their families. Components of this infrastructure include efforts to integrate state agency responsibilities, policies, programs, funding, and service delivery mechanisms. The resulting children’s agenda provides evidence of the state’s commitments along with the flexibility and support communities need to develop a vision and plan for implementation.
Bright Beginnings, a public action and awareness campaign, seeks to ensure that every child born in Colorado will be welcomed, not only by parents but by the neighborhood, the community, and the state. Led by Brad Butler, former Chairman of Proctor & Gamble, this initiative is based on the belief that government alone cannot solve all of the problems that families face. The business community, the media, senior citizens groups, churches, legislators, and child advocates are among the key constituents who are helping to develop and implement Bright Beginnings. At the heart of this initiative is the concept that everyone must take responsibility for helping families raise healthy children--and the recognition that communities are the best avenue of help for families.
First Impressions and Bright Beginnings are among the most visible of Colorado’s many efforts to transform the ways in which the state meets and anticipates the needs of children and their families. In 1991, a state management team was formed to improve collaboration among departments, maximize available resources for children and families, improve service delivery, and improve outcomes for children. The recommendations put forward by this team included establishment of measurable goals for child well-being and creation of a performance accountability system for evaluating outcomes, development of a collaborative budget planning process, and increased involvement of consumers in decision-making and priority-setting.
______________________________________________________________________________________
Integrating Services for Children and Families in Colorado
______________________________________________________________________________________
NEW JERSEY: LESSONS LEARNED FROM THE FIRST STATE EFFORT TO LINK COMPREHENSIVE SERVICES TO SECONDARY SCHOOLS
New Jersey’s School-Based Youth Services Program (SBYSP), initiated in 1988 under Governor Thomas Kean, links education and human services by eliminating the boundaries that divide them. The program, which is administered by the New Jersey Department of Human Services, offers teenagers a comprehensive set of services on a one-stop shopping basis. Kay Reiss, coordinator of the SBYSP, described how she and her colleagues put into place this statewide effort that provides "integrated resources to attack the integrated problems that students bring to the community and to schools."
The goals of the SBYSP are to provide adolescents with opportunities to complete high school, to obtain the skills needed to enter employment or further education, and to lead healthy, drug-free lives. New Jersey communities compete for SBYSP funds through an application process that encourages them to build on and link existing resources in innovative ways. Although the exact mix of services available at each SBYSP site is driven by local needs, all funded programs offer health care, mental health and family counseling, employment training, substance abuse counseling, recreational opportunities, and referral services. Some sites also offer teen parenting education, transportation, day care, tutoring, family planning, and hotlines.
With at least one site per county, the SBYSP now operates in 30 urban, rural, and suburban school districts. Although the programs are located in or near secondary schools, not all of them are managed by local educational agencies. The programs operate before, during, and after school as well as during the summer months. In some sites, services are also available on weekends.
Ms. Reiss attributed the effectiveness and credibility of the SBYSP to its longevity. Rather than a temporary grant or demonstration program, the SBYSP is a line item in the state’s human service budget. This continuity of funding is important because it gives local program operators the flexibility to modify their mix of services as needs and circumstances change. According to Ms. Reiss, "a stable funding stream is a recognition that service integration is a continuous process, not a one-time task."
______________________________________________________________________________________
New Jersey’s SBYSP Emphasizes Local Design and Flexibility
Communities that receive state funding to support a school-based youth services program (SBYSP) design a mix of services that builds on existing resources and anticipates local needs. The statewide program is administered by the department of human resources, but communities are able to designate the local grant recipient and establish their own service delivery design. Local staff from all parts of the state meet regularly for peer support and technical assistance.
The results of this flexible, locally driven approach to service integration demonstrate the value of a comprehensive or holistic approach. In 1992, program sites served one out of three eligible teenagers—more than 20,000 students. Services ranged from counseling related to peer problems, adolescent suicide, and pregnancy to assistance in obtaining job skills and employment. Service integration is critical to program success because young people may not know what kinds of help they need when they make their initial visits to an SBYSP site.
______________________________________________________________________________________
SAVANNAH, GEORGIA: EXPANDING OUTWARD FROM A NARROW FOCUS
The Youth Futures Authority (YFA) of Savannah/Chatham County is a prevention-oriented, family-focused systemic reform initiative. Services, staff, and funding are all integrated under the aegis of the YFA. Mary Willoughby, senior planner and chief financial strategist for the YFA, described her community’s journey from programming for at-risk youth to a continuum of supports for children from birth to young adulthood.
The Savannah/Chatham County YFA was created by the Georgia legislature in 1992 to manage the state, county, local and foundation resources assembled as a result of the city’s New Futures grant from the Annie E. Casey Foundation. Empowered by state statute as a planning body, the YFA’s initial goals were significant reductions in youth unemployment, teen pregnancy, the dropout rate, and the percentage of students scoring in the lowest quartile on achievement tests. A comprehensive plan developed by the YFA led to a series of contracts with various agencies to provide direct services and conduct programs in four middle schools and four high schools. Implementation began without broad inter-agency agreements in place, so the YFA service offerings were largely add-ons to existing structures. By 1990, the YFA could point to numerous individual success stories, but little or no school-wide impact despite annual expenditures of $5.5 million.
The YFA’s recognition that middle school was too late to start serving young people was prompted by tracking data that showed children started failing as early as the first grade. Instead of working top-down, as city leaders and agency directors had been forced to do in the rush to implement the first phase of programming, the second phase of Savannah’s Casey initiative featured a bottom-up planning process that tapped the expertise of agency line workers, schools principals, and the boards of member institutions. The new blueprint that resulted emphasized community-building, prevention--and the need to "fix" systems, not individual children.
Services now available through or coordinated by the YFA include: child care; full-day Head Start; summer camp; evening meals; health care; after school care and tutoring; enrollment in the Women, Infant, and Children (WIC) nutritional support program; food stamp, Medicaid, and Aid to Families with Dependent Children (AFDC) eligibility certification and benefits; youth development programs; and mental health counseling. A family resource center that was opened in 1994 provides a home for many YFA services and opens new possibilities for coordination cooperation, and integration. For example, planning for the family resource center encompassed common intake forms, a shared management information system, and inter-agency agreements regarding the flow of confidential information.
Goal setting, planning, and management decisions for the YFA are handled by a 25-member board of directors, the composition of which is partially determined by state statute. Since 1992, the board has emphasized program monitoring and evaluation. During that time period, the Savannah/Chatham County area has demonstrated an increase in the number of women receiving pre-natal care, a significant decrease in the infant mortality rate, decreases in school suspensions and the number of elementary children overage for their grades, and an increase in school attendance. The success of the YFA as a catalyst and vehicle for service integration led to state legislation authorizing the creation of ten similar community partnerships in FY1995-96.
______________________________________________________________________________________
Charting Savannah’s Journey to Service Integration
"Over the past several years, our journey has taken us from a focus on the child and the child’s at-riskness to a realization that the child comes in a package with a family that lives in a neighborhood--a neighborhood in which a number of families share a common set of problems."
Mary Willoughby
Savannah/Chatham County Youth
Futures Authority
______________________________________________________________________________________
KANSAS CITY, MISSOURI: THE ‘SHOW ME’ STATE SHOWS HOW TO EXPAND COMPREHENSIVE EARLY CARE
Despite overwhelming evidence of Head Start’s effectiveness, few states or communities have demonstrated the political will needed to offer comprehensive early care and services to all children. In Kansas City, Missouri, the KCMC Child Development Corporation devised a cost-effective way to expand Head Start while enhancing the quality of the community’s existing early care and education programs. Dwayne Crompton, director of the KCMC Child Development Corporation, encouraged teleconference participants to use Head Start funds to leverage other resources and create a seamless service delivery system that is not restricted to children and families who are eligible for Head Start.
______________________________________________________________________________________
"It’s extremely important that we keep the vision of children and families before us because in keeping that vision, all things become possible."
Dwayne Crompton
Director, KCMC Child Development
Corporation
______________________________________________________________________________________
An outgrowth of a needs assessment conducted to plan for Head Start expansion, KCMC’s Full Start is a partnership between Head Start and three urban child care centers. When the needs assessment survey revealed that as many as 70% of the children enrolled in child care in certain Kansas City neighborhoods were Head Start eligible but were not receiving any Head Start services, KCMC staff decided to use their expansion grant to help existing child care centers enhance their programming to meet the nutrition, health, and learning needs of young children.
KCMC’s infusion of Head Start funds enabled these centers to enroll additional children and provide a comprehensive array of services to all enrolled children and their families. The Head Start expansion grant helped these centers upgrade their services to meet Head Start quality standards and allowed them to designate current pupils as the beneficiaries of Head Start funds. This made it possible for the centers to reallocate existing funds from other sources to serve additional children.
Unlike traditional Head Start programs that operate on a part-day, part-year basis, KCMC’s Full Start initiative recognizes that many families need full-time child care in order for parents to work or attend school or job training. Pooling multiple funding streams enables Full Start to offer comprehensive early care services on a full-day/full-year basis.
Mr. Crompton acknowledged that KCMC initially found itself caught in a situation in which funding seemed to dictate program possibilities and credited the business community for recognition of the need to identify the optimal program and service mix before putting together a funding package. He attributed part of the success and sustainability of Full Start to partnership commitments that keep all funders together because of the savings achieved through collaboration and integration. Looking to the future, Mr. Crompton asserted that KCMC and other child advocates need to expand their thinking to focus on what’s going to be missing rather than what’s going to be available.
______________________________________________________________________________________
Making a Good Thing Better!
Kansas City, Missouri’s KCMC Child Development Corporation uses Head Start expansion funds to transform neighborhood child care centers into comprehensive providers of services for all young children and their families. As a result, these child care centers, which must demonstrate the capacity to meet federal performance guidelines for Head Start, are able to offer:
______________________________________________________________________________________
OAKLAND, CALIFORNIA: A LOCAL INTERMEDIARY STIMULATES AN INTEGRATED SERVICE MODEL FOR YOUNG CHILDREN
Oakland’s Urban Strategies Council is a non-profit agency focused on the reduction of persistent poverty. The council acts as an intermediary organization, helping agencies and institutions create systems change. Typically, the Urban Strategies Council convenes the full spectrum of players with interest in/responsibility for a given issue and provides a place for candid discussion as well as staffing, resources, and technical support. The emphasis is always on services--how they are currently used and delivered and how resources could be invested more effectively to stimulate widespread improvements in the lives of low-income children and families. The Urban Strategies Council has helped Oakland develop models for early childhood development, school reform, and community building. Maria Campbell Casey, president of the Urban Strategies Council, shared with the teleconference audience her organization’s experiences in the development and implementation of Oakland’s Birth-to-School project.
The Birth-to-School project is based on a vision that all children will grow into competent, caring, conscientious, healthy adults. This initiative, which is patterned after Chicago’s Beethoven project, seeks to integrate critically needed services in ways that help children develop to their full potential and assures their readiness for school.
Most families participate in the Birth-to-School project for five years. Pregnant women receive assistance in obtaining and participating in comprehensive perinatal services. After delivery, they get help in finding and using pediatric services, and their infants are enrolled in an on-site child development center. At two and one-half years of age, the children are enrolled in the on-site Head Start center, where they remain until they enter kindergarten. Throughout this five-year period, mothers and other family members are eligible for services ranging from parenting education and family planning to job training.
The Birth-to-School project integrates funding as well as programs and delivery mechanisms, tapping existing public, private, and community resources to help families access necessary services. By reducing the effects of various risk factors associated with poverty and providing multiple services in a single, convenient site, the project: 1) helps families move toward self-sufficiency and 2) enables them to assist their children in becoming ready to succeed in school. The Urban Strategies Council is now working to expand the Birth-to-School project at its current location (the Thurgood Marshall Family Resource Center) and to move this model of service integration into other Oakland neighborhoods.
______________________________________________________________________________________
Oakland Documents the Multiple Service Needs of Children and Their Families
The Urban Strategies Council’s research confirms that students and families who use one type of social service are more likely to use other kinds of services as well. The Council analyzed use of particular types of services--housing, income, probation, health maintenance, health crisis, employment and training, special education, mental health, and child welfare. This analysis documented multiple service needs as well as the relationships among specific service needs:
______________________________________________________________________________________
MANCHESTER, CONNECTICUT: A HOME-GROWN MODEL OF SERVICE INTEGRATION
"Parenting by Design," which offers a range of free and low-cost services, is the innovative centerpiece of Manchester Memorial Hospital’s Family Support and Resource Center (FS&RC). Originally developed in response to a tremendous volume of requests for assistance with general parenting issues, Manchester’s FS&RC has now integrated 13 different service components into a seamless delivery system. With services available at a community hospital and two elementary schools, Manchester Memorial sponsors the only FS&RC in the nation that is both hospital- and school-based. Speaking at the teleconference, Cynthia Guerreri, coordinator of the Manchester FS&RC, attributed the success and growth of the project to collaboration and integration on three levels --hospital, community, and funding.
Manchester Memorial’s service mix includes short-term clinical counseling and case management, parent/child play groups, an educational home visiting program, positive youth development for children in grades four through six, support for family day care providers, crisis counseling and intervention, child care referral, and mentoring for teen parents. One of the FS&RC is most effective components, the Healthy Families program, is an abuse and neglect prevention effort modeled after the highly successful Healthy Start Hawaii initiative. The Healthy Families philosophy is to reach out to parents early, before the birth of their first child, and provide support until the child reaches the age of five.
Despite its impressive growth and expansion, the Manchester Memorial FS&RC is confronting the funding instability that plagues many successful service integration efforts. Ms. Guerreri warned of the dangers of the three-year funding syndrome-- ‘creating wonderful programs, giving them the time necessary to start up, and then walking way at the end of that three-year period." Even though the Manchester FS&RC has successfully integrated a number of funding streams, questions remain as to how to replace the grant funds that currently support the general operating costs of specific service components.
______________________________________________________________________________________
Ambitious Goals Drive Service Integration in Manchester, Connecticut
One of 28 Family Resource Centers now operating in Connecticut, the Manchester site integrates more than a dozen services to achieve four goals:
______________________________________________________________________________________
BARRIERS TO CHANGE: WHY ITS HARD TO DO THE RIGHT THINGS
The service integration strategies described by the teleconference presenters and panelists represent only a minuscule fraction of the efforts that are underway in states and communities across the nation. The possibilities for innovation and variation are literally limitless. The need for collaboration, cooperation, and integration will accelerate as Congress and state governments honor local decision making and more flexible use of existing resources. Nonetheless, these integration efforts will have to demonstrate that they can surmount a number of barriers if they are to be sustainable and drive lasting change in service delivery at the local level.
As Connecticut moves forward to create new, family-friendly combinations of services, the state must factor in obstacles to systems reform and plan thoughtfully to surmount them. Teleconference presenters cited a high resistance to change resulting from turf protection and differences in work styles. Some pointed to fears of job loss. Presenters identified categorical grants, state and federal laws that prohibit the pooling of dollars, and confidentiality regulations as barriers to certain forms of service integration. Others noted that staff turnover and changes in political leadership can diminish commitment to once-shared visions.
Martha Burt stressed that service integration bolsters community resources and improves service delivery, but does not make up for budget deficits. Jule Sugarman poignantly warned that waiting too long for local service integration, regardless of obstacles, increases the risk of losing a generation of youth.
______________________________________________________________________________________
Implications for Systems Change
Lisbeth Schorr
"Successful Programs and
Bureaucratic Dilemmas: Current Deliberations"
______________________________________________________________________________________
SUMMARY: AN ACTION AGENDA FOR CONNECTICUT
Elaine Zimmerman, executive director of Connecticut’s Commission on Children and moderator of the teleconference, concluded the March 25 policy deliberation with a summary of key points made by presenters and panelists. A common theme of the presenters, she noted, was the need for broad stroke, bold policies, and decisive actions. Small pilot programs and "tinkering" with regulatory or funding policy cannot drive the magnitude of systems change that is needed.
Contrasting innovative service integration strategies with a status quo that is often "too little, too late," Ms. Zimmerman observed that prevention is paramount. She also imparted a sense of urgency, calling upon the teleconference audience to seize the moment and use the current political support for decategorization and local decision-making to serve a generation of children that is already at risk of losing its sense of hope and expectation.
______________________________________________________________________________________
"Helping parents work and children thrive is of paramount importance. Family and work policy is not just a social service issue. It is an economic and value-driven issue of importance to those who care for families and those who seek a healthier economy. Yet, there are clear obstacles to change. Despite growing public concern over these issues, public policies that comprehensively address the growth of both the child and the economy are few and far between."
Elaine Zimmerman
Executive Director
Connecticut Commission on Children
______________________________________________________________________________________