The Institute for Child Success (ICS) is pleased to submit comments on the Draft Policy Statement on Family Engagement, From the Early Years to the Early Grades, jointly developed by the U.S. Departments of Education (ED) and Health and Human Services (HHS). Headquartered in Greenville, South Carolina, the Institute for Child Success (ICS) is an independent, nonpartisan, nonprofit research and policy organization dedicated to the success of all young children. ICS recognizes that the most effective way to improve the success of children is not one child at a time – but by improving the systems that foster the health and education of our children. We supports service providers and advocates focused on early childhood development, healthcare, and education – all to coordinate, enhance, and improve those efforts for the maximum effect in the lives of young people. Given our focus on systems-based change for children, we are particularly heartened to see the policy statement jointly released by ED and HHS and recommendations across settings in which young children are served.
Health care settings provide an invaluable resource for connecting families and professionals, and serve as the major point of contact with families before children enter formal care and education settings. The draft statement highlights the importance of family engagement strategies to improve referrals to community health services, but health care settings themselves are an opportunity to expand meaningful family engagement.
ICS has highlighted the opportunity to integrate traditional home-visiting programs with patient-centered medical homes (PCMH) to utilize existing relationships and improve care:
“By bringing together the [family-centered medical homes] and the community, through [home-visiting] programs, personal and population approaches to health and health care delivery will become integrated. This allows health care to become more about optimizing each child’s and family’s life course trajectory, improving outcomes and reducing costs than the current system allows.25 The benefits found in the utilization of PCMHs are only amplified by coordinating the medical home with home visiting models….Two of the leading pediatric associations in the United States, the AAP and the American Pediatric Association (APA), have endorsed collaboration between home visitors and primary care providers as a unique opportunity to integrate and improve services provided to children and families.”
ICS has published a case study of the Carolinas Health Centers in Greenwood, South Carolina to demonstrate the benefits and practicalities such an integration. PCMHs are an important community resource, extending coordination beyond families to include the early care and education sectors. Dr. Dave Willis, of the Division of Home Visiting and Early Childhood systems within HHS, has underscored the importance of integrating home-visiting with family medical homes, noting that the health care system is the primary engine to reach families with children ages 0 to 3.
Given the fourth principle of family engagement in the statement – prioritize engagement around children’s social emotional and behavioral health – partnership with health care settings could have a clear benefit for families and care end education settings. Comprehensive strategies for family engagement in multiple sectors can mean great things for social-emotional development, as we’ve written: “figuring out how best to serve children and their parents, together, is a core opportunity if we want to strengthen executive function and self-regulation skills of each.”
Particularly given the importance of two-generation approaches, we were also heartened by the definition used in this report: “The term ‘family’ is used to include all the people who play a role in a child’s life and interact with a child’s early childhood program or school. This may include fathers, mothers, grandparents, foster parents, formal and informal guardians, and siblings, among others.” While this definition appears only as an explanatory footnote in the statement, we encourage the Departments to go further in addressing the differences in family engagement for particular family members. As programs working with families try to increase meaningful engagement, how can they provide outreach that includes each of these family members? How can entities like child care programs and health practices respectfully engage informal guardians while respecting privacy laws? This vision of family engagement beyond the nuclear family is crucial but can prove difficult to providers navigating family dynamics. Additional guidance and case studies of best practices could provide assistance.