
The Healthy Families America (HFA) vision is that one day all new parents will receive the education and support they need at the time of birth and in the months and years thereafter. To achieve this vision, the HFA approach represents a dramatic change in the manner in which we design and implement programs, conceptualize and deliver primary prevention efforts and define social responsibility for the welfare and nurturance of children. In each domain, the HFA initiative challenges both public and private policy makers to adjust their thinking in how child health and welfare issues are defined and addressed.
By all estimates, the current fragmented, crisis oriented approach to working with overburdened parents and troubled children has failed. Little or no progress has been recorded in the number of children born to single mothers, immunization rates, child abuse and neglect reporting rates and school completion rates. In fact, a three-year study of young American children released by the Carnegie Corporation revealed that "millions of infants and toddlers are so deprived of medical care, loving supervision and intellectual stimulation that their growth into healthy and responsible adults is threatened." Achieving measurable gains in these and other areas requires more than simply offering more programs. It requires new thinking, new partnerships, and new systemic configurations that will endure over the long term.
While there are a vast number of community-based family support programs trying to protect children, their impact has been limited due to small and unstable funding streams, inflexibility, lack of coordination with related programs, and standards that are not grounded in research. To augment their effectiveness, we need to refocus our efforts so that programs are accessible to all families in need and exist within a coordinated, continuous system of care. As a reflection of this type of public policy, HFA is designed to incorporate and build upon available service resources rather than proscribe a defined curricula that undercuts existing efforts. Recognizing that no single intervention can address the entire range of families needs, the HFA approach encourages collaboration across systems so that families are linked to the services that meet their specific needs. HFA further calls upon program planners to engage state level administrators and policy makers in their planning process to lay the foundation for a sustained effort. This is particularly important in light of recent federal efforts to allow states greater autonomy. In addition, federal initiatives have called upon states to play a greater leadership role in developing partnerships with communities to initiate positive change for children and families.
In a country founded on the principle of equal opportunity, all children should have access to a set of health, education and supportive services so that they can develop to their fullest potential. While many parents in this country can and will access these services on their own, there are far too many others who are either unable or unwilling to meet these responsibilities. For these families, society must make every effort to assist parents. Recognition of the need to support parents, quite often through home visitation, has long been an integral feature of the maternal and child health care programs of most industrialized countries. The HFA initiative makes it incumbent upon each state to take responsibility for the welfare of all their children, not through the establishment of short term, limited demonstration programs, but by creating a permanent infrastructure that will support all children.
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