Financing Strategies

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• Financing Strategies
• Jane Knitzer, Ed.D

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Assumptions Governing NCCP Fiscal Analyses

• Funding needs to address three levels of
  intervention prevention/promotion, early
  intervention,and treatment
• Funding needs to support caregivers who work
  directly with young children and families (e.g.
  pediatricians, child care providers,
  home-visitors, child health consultants)
• Strategic fiscal planning to build systems is as
  important as programmatic planning must involve
  a cross-program perspective

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NCCP Fiscal Resources

• Making Dollars Follow Sense Financing ECMH
  Services (lessons from 4 states and 2 local
  sites action steps) 2002
• Spending Smarter A Technical Guide for
  Policymakers (October 2005)
• Project THRIVE Issue Brief 1Spending Smarter
  Using Federal Programs and Policies to Promote
  Healthy Social and Emotional Development Among
  Our Most Vulnerable Young Children (November
  2005)

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The Spending Smarter Framework

• Focus has been primarily on social and emotional
  health and school readiness
• Help states mix and match through strategic
  fiscal planning
• Maximize the impact of every federal and state
  program to build a seamless system
• Recognize the most difficult supports and
  services to fund are for at-risk young children
  two generational strategies consultation
  strategies
• Medicaid, no infrastructure or training, but
  Title V can support infrastructure and training

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Spending Smarter Analyses Each Program Potential
To

• Improve screening and diagnostic evaluation.
• Increase outreach and monitoring for high-risk.
• Improve access to appropriate services.
• Develop clear, functional eligibility
  definitions.
• Enhance professional training and capacity.
• Overcome fiscal, administrative and policy
  barriers.

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Using Title V MCH Block Grant

• Use SECCS project grants
• Use for infrastructure support
• Include children with developmental, behavioral,
  or emotional challenges explicitly in state
  definition of special needs (CSHCN)
• Spend on services and supports not covered by
  Medicaid
• Professional training
• Maternal depression programs
• Other two-generational approaches
• Include social-emotional services in the state
  concept of medical home

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Using Child Care

• Blend child care quality funds to finance early
  childhood mental health consultation (e.g.,
  quality set aside)
• Use CCDF to support training on social-emotional
  and school readiness
• Ensure highest risk get high-quality child care

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Top Ten things you could do now

• Convene a group to review current funding.
• Support strategies with interagency plans and
  written agreements.
• Adopt a statewide definition of risk factors and
  mobilize resources to serve at-risk.
• Blend dollars for cross-training professionals.
  
• Pay for services where children and families are.
  
• Clarify eligibility and payment mechanisms
  between Medicaids EPSDT, Part C, Title V, and
  mental health, etc.
• Adopt policies and billing mechanisms to support
  child developmental and behavioral
  relationships-based services.
• Target high-risk populations start with one
  group.
• Finance two-generation strategies and
  parent-child interventions.
• Monitor (track) children at-risk not yet eligible
  for entitlements.

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Beyond Financing

• Use administrative levers interagency
  partnerships
• Maximize entitlement and flexible grant dollars
• Boost provider capacity (grow your own)
• Use outcome data to make the case

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For more questions, information, or suggestions
about Project THRIVE contact Thrive_at_nccp.org Kay
Johnson, MPHProject DirectorJohnsonGCI_at_aol.com L
eslie Davidson, MDSenior Health
AdvisorLLD1_at_columbia.edu Jane Knitzer,
EdDExecutive DirectorNational Center for
Children in Povertyknitzer_at_nccp.org