By Charles Bruner, Director of the Child and Family Policy Center, Des Moines, Iowa
By now, the call for more integrated, comprehensive, and community-based services and supports for children and their families has become common. Doug Nelson, Director of the Annie E. Casey Foundation (one of the pioneering foundations in supporting more integrated services) puts it this way:
"There is widespread agreement that adequately meeting the needs of disadvantaged children and their families will require services that are flexible, family focused, and comprehensive. ... Despite good intentions, autonomous agencies with differing perspectives, mandates, and missions frequently offer uncoordinated, incomplete, and even contradictory help to disadvantaged children and their families who need assistance."
Advocates, policymakers, administrators, and staff have called for more collaboration, coordination, and integration of these "fragmented" services in order to provide a better match between what children and families need and what current systems offer them.
With respect to early childhood services, however, "service integration" is the answer only if "service fragmentation" is the problem. It may appear that early care and education services for children in the preschool years (0-6) and their families are fragmented. In almost every community in the country, public efforts have been made to develop child care centers and other child care arrangements, preschool programs, and services to help families meet their young children's health and developmental needs. Increasingly, governments (local, state, and federal) are establishing and financing discrete new programs and services for families with young children.
Still, it is important to recognize that a proliferation of programs and program settings does not itself constitute a "fragmentation" of services. Such a proliferation of programs may simply fill broad service gaps and not result in a real overlap or duplication of services.
Service "fragmentation" implies much more than the existence of multiple, independently operating programs and services from which consumers may chose. In the context of developing more integrated public responses to children and families, "fragmentation" implies a segregation of responses (or interventions) into discrete and independent programs (or units of service). It implies that many families are eligible for and are receiving two or more services. Finally, it implies that these services would themselves be more effective if provided in a comprehensive manner, rather than separately.
Under the broad rubric of early care and education services, there are at least three different rationales for providing public resources that might lend themselves to development of a "fragmented" service system:
Clearly, the configuration of federal, state, and local financing of early childhood services includes examples in each of these areas. As a society, however, we have yet to reach a consensus on which of these areas (if any) represents a true public responsibility, either for families universally or for those experiencing disadvantage. Much of the funding provided through public systems is on a small-scale demonstration or grant basis, and no categories of families are truly entitled to early childhood services.
For this reason, most public responses in the early childhood arena have fallen far short of serving the broad range of families that might benefit from services. In practice, few families can obtain publicly supported child care, child development, and parenting support services from three different service settings ("fragmentation"), and many more families cannot obtain any early childhood services ("service gap").
This distinction is important in developing a more integrated, comprehensive, and community-based system of services and supports for young children and their families. Specifically, if the fundamental need is for more services, integration of existing services through pooled funding streams, regulatory policies, or collaborative mandates (the tools often used to support service integration) will do little to fill this need.
Rather, we first must seek to define much more specifically society's responsibility for financing and providing child care, child development, and parenting support services. We must define which families are entitled to receive services and toward what minimum ends. Parents have the fundamental responsibility for ensuring that their children start school "ready to learn," but society also has a responsibility to support those children when parental support alone will not achieve some minimum developmental end. These ends need to be clearly defined.
Second, we must ensure that sufficient public resources are provided to achieve these ends. We must identify the services that already are being provided and identify the service gap in each of the three above-mentioned service areas in order to define society's new responsibility. We must remember that not all families need all types of support. Some families need only high-quality, full-day child care; others need only a part-day, developmentally appropriate preschool experience; still others need only family support and guidance in the nurturing of their newborn children.
Third, we must meet early childhood service needs with the consumers in mind. In many instances, setting this goal will lead to comprehensive and integrated services and supports, providing all services within the same program. We do not want to construct an artificially "fragmented" system of services for families with young children packaged into separate programs. At the same time, we want a system through which families can receive what they want and need without receiving more than they need, which will not always involve a comprehensive service package. To be effective and efficient, the service system must be flexible to respond to individual family needs.
It is important that "service integration" not be posed as the only solution to meeting the needs of families with young children. "Service integration" is the answer only if "service fragmentation" is the problem. While we do need better coordination, collaboration, and integration of early childhood services, fragmentation is not the most pressing problem.
Our main concern should be establishing a public commitment to meeting minimum family needs for early childhood services that can help us attain the first educational goal. This commitment will require more comprehensive and integrated services for families with young children, but primarily it will require more services.
Posted on March 23, 1995
URL: http://www.ncrel.org/sdrs/areas/issues/envrnmnt/go/93-3gc2.htm