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Sign 'em Up: Strategies to Enroll Eligible Children in DC Healthy Families
Author: Susan Rogers
Editors: Vince Hutchins, M.D., Mark Rom, Ph.D., Donna R. Morrison, Ph.D.
The large number of uninsured children in this country is hardly a new issue, since health insurance has long been considered a powerful indicator of children's degree of access to and use of primary health care services. In order to decrease the number of uninsured children and the problems that arise from their lack of insurance, in 1997 Congress created the State Children's Health Insurance Program (SCHIP). SCHIP is the largest single expansion of health insurance coverage for children since the cre-ation of Medicaid in 1965. SCHIP allocates $24 billion to states over a 5-year period to help them expand the availability of health insurance to uninsured children ages 18 and under. The District of Columbia's SCHIP program, DC Healthy Families, has targeted over 16,000 people for enrollment. While the program has successfully enrolled thousands of children and eligible adult family members, thousands more eligible children have not been identified and enrolled. (Eligible adults include preg-nant women, parents, and relatives who are caretakers of eligible children.) It is reasonable to assume that the children already enrolled were easier for the program to identify and target.
This report begins with a description of SCHIP and a brief overview of DC Healthy Families. Next it discusses some of the barriers to identifying and enrolling children in DC Healthy Families and looks at several successful methods of expanding enrollment, including the use of community-based organiza-tions (CBOs), school activities, and health care provider initiatives.
Reconnecting DC Families: Involving Low-Income Families in the Lives of Their Children
Author: Kristine Kelty
Editors: Leslie Gordon, M.P.P., Vince Hutchins, M.D., Mark Rom, Ph.D., Donna R. Morrison, Ph.D.
Over the past two decades, the number of U.S. children growing up in households in which a father does not reside has increased by 56 percent.1 Approximately 24.7 million U.S. children (36.3 percent) do not live with their biological father.2 Although it is certainly not always the case that fathers who live apart from their children are uninvolved fathers, father absence does have clear negative economic and psychological consequences for children and is costly for society. Children whose fathers do not live with them are more likely to (1) perform poorly in school, (2) have low self-esteem, (3) initiate sexual activity early, (4) be economically deprived, (5) abuse drugs or alcohol, and (6) have health and emotional problems.3 While at one time fathers were thought of mainly as providers for their families, their involvement with their children is now considered essential to family health and well-being.4 Through the establishment of fatherhood programs and work force policies, and by providing addi-tional funding and more welfare and child support flexibility, federal, local, and state governments have attempted to encourage and promote father involvement by helping fathers with low incomes become financial providers and nurturers.
Researchers and practitioners may disagree on which approach most effectively promotes father presence, but all agree that father involvement matters and that programs must aid in reconnecting dead broke dads and their children. This briefing report (1) reviews the consequences of father absence and the benefits of father presence for children; (2) examines the policy environment affecting fathers with low incomes; and (3) highlights creative local and national models promoting father involvement.
Do School-Based Mental Health Services Make Sense?
Author: Susan Rogers
Editors: Leslie Gordon, M.P.P., Vince Hutchins, M.D., Mark Rom, Ph.D., Donna R. Morrison, Ph.D.
Mental health problems affect one in every five children and adolescents at any given time in the United States.1 Children with mental illness often have difficulty learning, develop behavioral and emo-tional problems, and participate in activities that endanger themselves and others. While a high per-centage of these children are genetically predisposed to mental illness, children in poverty face a greater risk of developing mental health problems, and are less likely to receive treatment. The prevalence of and lack of treatment for mentally ill children has noteworthy consequences for the children, their fam-ilies, and their communities. In light of this, families and communities are seeking new strategies with which to better diagnose and treat mentally ill children. Providing services through school-based health centers and SBMHCs is one option that is gaining attention. A 1998 study concludes that Òschool-based health centers are particularly successful in improving access to and treatment for mental health prob-lems and substance abuse.Ó2 This background report examines the prevalence of children's mental ill-ness and the problems associated with it; looks at the benefits and practical considerations of inte-grating mental health care into the schools; and highlights creative local and national models.
This seminar, the 23rd in a series sponsored by the DC Family Policy Seminar at Georgetown University, seeks to air a variety of ideas and to discuss the advantages and challenges associated with school-based mental health services. The organizers hope to encourage increased collaboration among community, government, and nonprofit organizations to ensure the improved quality and increased quantity of mental health services for children and youth in the District. The seminar will also high-light several successful programs that may assist District of Columbia officials and service providers if they choose to create more school-based programs.
Out-of-School Time Activities: Can Programs Help Families and Can Families Help Program?
Author: Katherine Shoemaker
Editors: Leslie Gordon, M.P.P., Vince Hutchins, M.D., Mark Rom, Ph.D., Donna R. Morrison, Ph.D.
As the number of working parents in the United States continues to grow, so does the need for quality out-of-school time activities 1 for school-age children. When children between 7 and 21 are left unsupervised, they are at greater risk for engaging in risky social behavior and are not as likely to do well in school (NIOST, 1998).
One strong element of many national and local models is the involvement of families. Involving families in out-of-school time activities may seem counterintuitive, since many of the children who attend these programs have parents who are at work. However, organizations and families have collaborated creatively to develop roles for families that allow for variation in the level of involvement and extent of the time commitment.
This seminar, the 22nd in a series sponsored by the DC Family Policy Seminars at Georgetown University, seeks to bring different ideas to light and to discuss alternatives that District out-of-school time organizations can incorporate to encourage family involvement. The seminar will also examine the management and organizational implications of involving families.
Quality Housing for All: Family and Community-Led Initiatives
Author: Susan Rogers
Editors: Leslie Gordon, M.P.P., Vince Hutchins, M.D., and Mark Rom, Ph.D.
The troubled condition of public and low-income housing in the District of Columbia (DC) is well docu-mented, yet many residents still live in substandard housing. Quality housing is of particular importance to families because a decent, safe place to live is essential if families are to focus on other key issues like educa-tion, health, and employment. Recently, government agencies, community-based nonprofits, and residents have begun implementing a more holistic approach to improving the housing situation. This approach views housing solutions as interrelated with the overall quality of neighborhoods, schools, health, and economic growth. Such a holistic approach requires resident involvement and input in prioritizing the needs of the families and individual residents, as they are the most knowledgeable about their own communities.
Resident involvement in improving housing elevates the self-esteem of the residents, fosters a sense of ownership of the neighborhood, and creates a sense of hope for families and communities. The process also creates role models for children and adolescents who witness the adults taking responsibility and effecting change for themselves. The successes of improved housing give residents the confidence to address other issues essential to the well-being of their families and neighbors. This briefing report will examine the impor-tance and benefits of resident initiatives and involvement in improving their communities and homes.
This seminar, the 21st in a series sponsored by the DC Family Policy Seminars at Georgetown University, seeks to bring different ideas to light and to discuss alternatives that DC low-income housing providers and residents can adopt to encourage change. The seminar will also examine the current trend toward using non-profit community-based organizations, community development corporations, and resident management cor-porations to improve the quality of housing and neighborhoods for families.
Education with Peers: Others Do - Should You?
Author: Katherine Shoemaker
Editors: Mark Rom, PhD; Leslie Gordon, MPP; and Vince Hutchins, MD, MPH
The children and families of the District of Columbia face many social concerns and challenges. Substance abuse, youth violence, access to and information about health care, AIDS and HIV head the list of issues that national and local government, non-profits, service providers and schools try to address each day. Though a number of potential interventions exist, many organizations have turned to peer education programs as a partial solution to these social issues.
As the number of peer education programs in the District grows, it is important to examine the strengths and weaknesses of this approach and its use among different populations. This briefing report will examine the theoretical basis of peer education, review the research, and highlight peer education's use in specific local and national models.
This seminar, the 20th in a series sponsored by the DC Family Policy Seminars at Georgetown University, will focus on national and local peer education models and specific program evaluations. The goal is to bring different ideas to light and to discuss alternatives that District service providers, agencies, and citizens can use to encourage change. The policy objectives of this seminar are to (1) recognize the wide variety of uses of peer education in different populations and for different purposes; (2) review research and evaluations of peer education programs in the District, the nation and other countries; (3) bring together key District participants to strengthen a coordinated response; and (4) provide policymakers with knowledge that allows them to make informed decisions.
Saving Our Schools: Would Vouchers Create New Solutions or New Problems?
Author: Antoinette Laudencia
Editors: Hilary Kao, Donna Ruane Morrison, PhD; and Mark Rom, PhD
The District of Columbia's troubled public education system has been the target of a number of education reform initiatives in recent years. Few disagree with the need for education reform; however, the methods of bringing about change are subject to debate. Among the suggested approaches (and perhaps the most controversial) is the proposed implementation of a publicly funded voucher initiative.
Recent legislation introduced in Congress seeks to provide publicly subsidized education vouchers for use in both public and private area schools. Entitled The District of Columbia Student Opportunity Scholarship Act, the bill would provide subsidies of up to $3,200 to approximately 2,000 children from low-income families and also provide tutoring assistance to an additional 2,000 children. The proposed legislation has inspired fierce debate and raised substantive questions about whether such a system of vouchers could accomplish the desired result&emdash;an improved education system for all District children.
This seminar, the 19th in a series sponsored by the DC Family Policy Seminars at Georgetown University, will focus on national and local initiatives aimed at improving the quality of the public school system in the District. The goal is to bring different ideas to light and to discuss alternatives that District service providers, agencies, and citizens can use to address this problem. The policy objectives of this seminar are to (1) recognize the crisis in education and examine the effect that it may have on children in public school systems, (2) review research data and the impact of public voucher systems in other localities, (3) bring together key District participants to strengthen a coordinated response, and (4) provide policymakers with knowledge that allows them to make informed decisions. If the District of Columbia is successful in its approach, the quality of education for all District children will be greatly improved.
Finding Families: DC's Foster Family Deficit
Author: Katherine Shoemaker
Editors: Mark Rom, PhD and Hilary Kao
The child welfare system in the District of Columbia faces several major challenges. More children need foster care than the system can currently handle. Much of the care provided does not best serve the needs of children. In addition, since 1991 the District's child welfare system has been in receivership as the United States District Court for the District of Columbia found that the system "was operated in violation of federal law, District law and the United States Constitution" (Hogan, 1995).
The Receiver, Child and Family Services, and others in the District are now taking steps to address these problems. This seminar, the 18th in a series sponsored by the DC Family Policy Seminars, is a joint collaboration between Georgetown University and the National Center for Education in Maternal and Child Health. This seminar will focus on the foster care problems the District faces, the local initiatives aimed at resolving these problems, and initiatives being implemented in other parts of the country to address similar problems. The purpose is to bring different ideas to light and to discuss alternatives that District service providers, agencies, and citizens can use to address the problems. The policy objectives of this seminar are to address (1) the state of child welfare in the District and the nation, and (2) ways that the child welfare system can be improved, specifically through the recruitment of foster parents.
We hope that this seminar will provide members of the District's policy community with new insights concerning child welfare. If the District of Columbia can improve its child welfare system, the health and well-being of countless children can be enriched.
Building the Future: Strategies to Serve Immigrant Families in the District
Author: Antoinette Laudencia
Editors: Hilary Kao; Donna Ruane Morrison, PhD; and Mark Rom, PhD
Recent public policy debates have focused largely on the negative effects of immigration on society and particularly on the use of public benefits by immigrant families. While the debate remains open concerning immigrants' contribution to society and their relative use of public benefits, the laws affecting immigrants have changed substantially over the past year. In 1996, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act. Despite the restoration of Supplemental Security Income (SSI) and Medicaid benefits for legal immigrants (through the Balanced Budget Act of 1997), many immigrant families remain vulnerable to the effects of reform.
The recent changes in the immigration laws are both substantial and complex. Immigration proponents argue that these changes have had a chilling effect on immigrant families seeking care from social services agencies. The result, they argue, is that families have turned increasingly to nonprofit organizations to serve their needs. This in turn has placed a great strain upon the ability of nonprofit agencies to provide effective service.
Diverting Children from Crime: Family-Centered, Community-Based Strategies for Prevention
Author: Antoinette Laudencia
Editors: Shelley Stark and Donna Ruane Morrison, PhD
The traditional approach to addressing juvenile crime has focused largely on punitive measures imposed by the juvenile justice system and law enforcement. Critics argue that this approach is reactive, however, and fails to stem the tide of violence in the community. They believe, instead, that efforts should focus on prevention and should address the social, economic, and health issues affecting the child. While prevention experts do not recommend abandoning punitive intervention methods once a youth commits a crime, they do suggest supplementing these measures with a holistic approach that also addresses the environmental factors that lead to delinquent behavior. A key strategy is to address delinquency from a family-centered perspective, in which the goal is to bolster existing support systems by involving parents, siblings, and caregivers. As this family-based, holistic approach takes hold in the District of Columbia, we see a movement growing toward a coordinated response from every sector of the community, including mental health, public health, education, and criminal justice components.
The Child Care Crisis in the District of Columbia: Can (or should) Businesses fill the Gap?
Author: Helena Wallin
Editors: Donna Ruane Morrison, PhD and Shelley Stark
As increasing numbers of women with young children have entered the workforce, pragmatic problems associated with the management of both work and family lives have gained more visibility. Progressive businesses have started "work and family" policies to help their employees cope with these stresses and have begun to reap the returns of higher productivity, lower absenteeism and turnover, and greater company loyalty. Many businesses are also enhancing their traditional benefits packages of health insurance and expanded family and medical leave policies by offering on-site child care, child care referral lines, and "savings accounts" for child care expenses to relieve the burden facing some of their employees.
In the District of Columbia, where 60 percent of children under the age of six have a parent in the workforce, finding affordable and quality child care can be an enormous challenge to working parents. Moreover, the recent loss of subsidized child care slots and the closing of many family child care homes&emdash;at the same time that welfare to work policies will be pushing more mothers into the workforce&emdash;further exacerbates the child care dilemma. Businesses are in a strong position to take leadership in addressing the current child care crisis. Doing so not only meets civic responsibility, but is also directly tied to the corporate "bottom line."
Feeding our Families: Community Food Security in the District of Columbia
Author: Antoinette Laudencia
Editors: Donna Ruane Morrison, PhD and Shelley Stark
As a direct consequence of increasing poverty and reductions in food assistance programs, the number of American families who go hungry is rising. Although hunger is a chronic problem, it is symptomatic of a broader based problem involving a community's limited access to food. Steps to eradicate hunger should thus focus on providing families with long term "security" in obtaining an adequate food supply.
Food security is defined as the access, at all times, through normal channels to enough nutritionally adequate food to live a healthy, productive life. It encompasses how communities provide food and how community members gain access to that food. Strategies include providing sustainable agriculture, initiating community gardening projects, building affordable and easily accessible grocery stores in low-income neighborhoods, and exploring the efficacy of food and cash benefits. Because of the government's limited role in adequately addressing the problem of inadequate food supply, it is important to discuss ways in which communities can secure food for themselves.
Keeping our Kids Safe: Preventing Injury in DC Public Schools
Author: Helena K. Wallin
Injuries occurring to young people (ages 0-19) are an important, and often overlooked, problem. Injuries claim the lives of over 20,000 children each year and send countless more to the emergency room for treatment. Many injuries occur in the school setting, where faulty playground equipment, deteriorating structures, and unsafe surroundings are "accidents waiting to happen."
Childhood injuries are of particular importance since they are easily preventable by setting in place various measures to guard against hazards. While the District of Columbia faces a number of unique challenges with respect to funding and management issues, a number of opportunities exist for creating awareness and collaborations to prevent an unnecessary injuries in our schools.
Fundraising for Family-Centered Organizations in the District
Co-Authors: Tobi Printz and Helena K. Wallin
Securing funding for social service programs and organizations has always been a difficult task. Today, in an era of shrinking federal and private dollars, programs are increasingly pressed by funders not only to demonstrate need but also to provide measures of accountability and to prove program effectiveness when applying for funds. Organizations must maximize the outcomes of their fundraising and grant-seeking operations to effectively compete for these scarce resources and ensure the survival of their organization.
The purpose of this seminar is to identify proven and successful practices for local nonprofit organizations to access funds from public and private sources. Guest presenters will discuss: the role of federal agencies in providing funding for family-centered initiatives; fundraising strategies and recent trends; diversification of funding streams; the corporate role in nonprofit fundraising; the shrinking level of federal support and its implications for programs or agencies; ways to encourage collaboration to coordinate service delivery; and economic development at the grassroots level.
Strengthening Families: Parenting Programs and Policies in the District
Co-Authors: Helena K. Wallin and Donna Ruane Morrison, PhD
A child is born into this world with a great many needs&emdash;physical, emotional, and intellectual. Parents bear the primary responsibility for providing their children with basic material necessities, affection, and attention. When parents are unable to perform their parental responsibilities effectively their children are less likely to achieve their full potential. As has always been the case, in order for today's parents to fulfill their functions well, they need the support and cooperation of other institutions and their communities.
The transformation of the U.S. economy in recent decades and changing social and demographic realities of family life have increased the stress that families face and reduced the level of support traditionally available to them. While individual needs and circumstances differ, all parents need information and support, whether it is advice on child rearing issues, emergency assistance to cope with a crisis, or simply the camaraderie of other parents. Society benefits by supporting parents in their child rearing roles and enabling them to fulfill their obligations to their children.
Transitioning from Welfare-to-Work in the District: A Family-Centered Perspective
Author: Helena K. Wallin under the direction of Laurie Bassi, PhD
Public support programs, such as Aid to Families with Dependent Children (AFDC) have been criticized for many years. Though the intention of AFDC is to provide temporary support to low-income families with children, many are unable to transition successfully to self-sufficiency in the job market.
As the 104th Congress and the President debate how to curb the costs of entitlement programs and decide how to "end welfare as we know it," program directors, health and human service agencies and advocates are looking for ways to help mostly welfare dependent mothers get into the job market and become self-sufficient. At the core of this effort are four components: education and training, child care, health care, and case management. The focus of this seminar will be to consider some of the opportunities and challenges to providing the aforementioned services in the District from the perspectives of both research and practice.
Helping Families and Schools Get it Done: Mentoring Interventions in the District
Co-Authors: Jens Ludwig, PhD and Helena K. Wallin
This background report summarizes the essentials on several topics related to adolescent mentoring interventions in the District of Columbia aimed at supplementing family and school life-skills and academic training. It provides an introduction to the purpose and importance of the adolescent years, reviews federal funding for adolescent prevention programs, shows current structures of mentoring programs, and examines common benefits and challenges of current mentoring interventions.
Families that Play Together: Recreation and Leisure in the District
Authors: Kerry Whitacre with Mark Rom, PhD
This background report summarizes the essentials on several topics related to recreation and leisure activities for families. First, it provides an introduction to what is meant by recreation and leisure. Next, it briefly describes the programs that provide recreation, details the benefits of recreation to families and communities, and outlines the challenges communities face in providing family-centered recreation during times of fiscal constraints. An annotated list of recreation and leisure activities for children and families in the District of Columbia is included in the report.
Substance Abuse Prevention and Treatment Programs: A Family Approach
Co-Authors: Kerry Whitacre; Mark Rom, PhD; and Amy Scott
This background report summarizes the essentials on several topics related to the role of the family in the prevention and treatment of substance abuse. First, it provides an introduction to the role of the family in substance abuse. Next, it briefly describes the key issues involved in community and family-oriented prevention and treatment strategies for substance abuse. An annotated list of prevention and treatment programs and organizations completes the report.
Caring for our Children: Meeting the Needs of Low-Income, Working Families in the District
Author: Kerry Whitacre with William Gormley, PhD
This background report summarizes the essentials on child care for low-income, working families in the District. It provides an introduction to the demographics of low-income, working families and addresses issues such as the current federal child care programs and current political environment, child development, availability, affordability, quality, family-friendly work policies, and the impending changes in the federal child care system.
HIV/AIDS: Helping Families Cope
Co-Authors: Mark Rom, PhD and Kerry Whitacre
This briefing report focuses on the compelling needs of families with children in which one or more persons are infected with the Human Immunodeficiency Virus (HIV). First, it provides an introduction to the impact of HIV/AIDS on the family. Next, it briefly describes key issues involved in family-centered comprehensive care for families with HIV/AIDS infection. An annotated list of medical and social service programs aimed at helping families with HIV/AIDS is included in the report as well as a list of important telephone numbers.
Family-Friendly Welfare Reform: Using Welfare Policies to Strengthen the Family
Author: Mark Rom, PhD
The seminar focuses most directly on the role of the father in the welfare family, and considers such issues as paternity establishment, child support, training and work programs, and barriers to marriage. This background report summarizes the essentials on several topics. First, it provides an introduction to the topic of family friendly welfare reform. The following sections briefly describe the key issues involving welfare and marriage, paternity establishment, and economic support. A directory of some programs within the District that focus on family welfare concludes the report.
Co-Authors: Mark Rom, PhD and Amy Scott
This background report summarizes the essentials on several topics. First, some of the core facts and principles concerning family violence are described. Second, some elements of promising programs for preventing family violence are outlined. The third section provides a directory of programs within the District that focus on family violence. An annotated guide to selected references and a list of upcoming seminars on preventing family violence conclude the report.
Preventing Adolescent Violence in the District of Columbia
Co-Authors: Mark Rom, PhD and Amy Scott
This background report focuses on adolescent violence. First, some of the core facts and principles concerning adolescent violence are described. Second, some elements of successful violence prevention programs will be presented. The third section provides a directory of violence prevention programs within the District. An annotated guide to selected references and a list of upcoming seminars on preventing violence conclude the report.
Integrating Services for Preventing Teen Pregnancies
Co-Authors: Mark Rom, PhD and Jeanne Ponessa
Human problems are often complex, and are not usually solved by doing just one thing. This appears especially true for teen pregnancy, which is not due just to teen sexuality, but also to such diverse factors as poverty, unemployment, educational failure, social isolation, low self-esteem, community standards, and lack of hope for the future.
Governmental programs, in contrast, are commonly designed to provide one particular service. Agencies may specialize in providing specialized economic, educational, physical health, mental health, or other social services. The logic behind service integration is that the specialized service programs must work together if human problems are actually to be solved. Integrating services for teen pregnancy prevention implies that the educational, economic, and social needs of adolescents will be addressed through comprehensive programs.
The District of Columbia, as well as numerous other state and local governments, is now working to better integrate its services so that human problems may be more effectively treated or prevented. The District's "Turning Points" program is an example of one comprehensive program intending to enhance youth opportunities and thus reduce teen pregnancy.
This background report summarizes the essentials on four topics. First, some of the core facts and principles concerning teen pregnancy will be described. Second, some elements of successful teen pregnancy programs will be presented, together with some examples of promising programs. Third, the main concepts of service integration are outlined. Finally, the District's efforts to integrate services will be discussed.