The prenatal period and the first three years after birth help set the foundation for the health and well-being of children. During this critical time of brain and body development, pre- and postnatal care as well as quality early childhood care and education are key building blocks to ensure that children can thrive early on and get set on a healthy life trajectory. Comprehensive services after pregnancy are also needed to promote the well-being of the mother and support positive health outcomes for the mother-infant dyad.
States can deploy American Rescue Plan Act (ARPA) and other COVID-related federal funds and policy options to improve the health and well-being outcomes of infants, toddlers and their families impacted by the public health emergency. But there is a narrow window of opportunity for states to strategically use these time-limited funds and policy options, including effectively aligning them with other supports to enhance health care delivery, early childhood programs, and family services. These efforts are especially crucial for families earning low incomes and families of color that have been disproportionally impacted by the pandemic and often face stark health disparities.
Aligning Early Childhood and Medicaid: Maximizing the Impact of Federal Funding Opportunities, a learning community led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, worked with cross-agency state teams from Alaska, Illinois, Nevada, North Dakota, and Oklahoma. The initiative aimed to foster opportunities to align Medicaid and early childhood policies, funding mechanisms, and program implementation strategies that can drive strategic investments of COVID-19 fiscal relief funds. These efforts can help increase the capacity and quality of programs provided to families, improve linkages and coordination across programs, and create new family-focused services to address unmet needs. This initiative also focused on early intervention and early childhood mental health; maternal substance use disorder supports and home visiting programs; and expanded care teams that include community health workers, doulas, and early relational health staff.
To support state success and foster shared learning, the learning community provided:
- Peer-to-peer exchange to foster cross-pollination of innovative implementation, financing, and quality improvement strategies;
- Technical assistance from nationally recognized subject matter experts to assist with cross-sector alignment planning and provide policy and implementation guidance; and
- Community engagement supports to ensure that impacted families earning low-incomes and families of color are informing alignment efforts.
The initiative was guided by an advisory group of national experts, including:
- Emily Blanford, Program Principal, Health Program, National Conference of State Legislatures
- Elisabeth Burak, Senior Fellow, Georgetown University Health Policy Institute, Center for Children and Families
- Beth Dworetzky, Associate Director of Programs, Family Voices
- Gretchen Hammer, Executive Director, Public Leadership Group
- Karen Seaver Hill, Director of Leadership Development, National Association of Medicaid Directors
- Daniela Lewy, National Director, Social Determinants of Health Consulting
- Kimberly Martini-Carvell, Executive Director, Help Me Grow
- Aza Nedhari, Executive Director, Mamatoto Village
- Vanessa Rodriguez, Project Coordinator, Family Voices
- Loraine Swanson, Senior Project Director, National Institute for Children’s Health Quality
- Kima Joy Taylor, Founder and Managing Principal, Anka Consulting
- Lindsay Usry, Director of Infant and Early Childhood Mental Health, ZERO TO THREE
This initiative built on lessons from Aligning Early Childhood and Medicaid, an earlier CHCS-led project supported by the Robert Wood Johnson Foundation, that sought to enhance alignment across Medicaid and state agencies responsible for early childhood programs with the goal of improving the health and social outcomes of infants and young children in low-income families.