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Applied &vcloplnenhl Science1999, Vol. 3, No. 4,213-216 Copyright $31999 byLawrcncc ErlbaumAssociates, Inc,

Creating Partnerships With Governm ent, Comm unities, andUniversities to Achieve Results for ChiIdrenLinda S . Thompson

Special Secretary, Governor's O fic e for Children, Youth, and FumiliesSiate of M arylandIn recent years, a strate gy ofpar tnership and c ollabora tion between government andcommunities hm star fed o emerge as policy makers and service providers c allfo r amore res pom ives yslem to addr ess the health and well-being of children, yourh, and

. families. The trend toward a com prehensive,holistic slrategy isdriven in part by con-. cern overrhe effectivena s of apatc hwo rksyste m of categorical heallh and human ser-vices designed to solve one problem at a time. At issue also is the movement " devolv -ing'' more responsibilityfor child and family well-bein gfiom the state to localgovernments and the challenge this change represents to communities. This articleproposecr a comprehensive,community-basedstrategy/or refonn ofl~ealthnd humanservice r and examines the approach of ones tate that may be usefil or other stater in-terested in reform:In tbc United States today, state governments arcstruggling to reform their system of health and hum anservices for children. Indeed, a new philosophy iscmerging about how children and familics who needhelp are scrved. The realities o f federal block grantfunding and a call for grcater ef ki en ey in this areahave forced many sta ks 10examine their top-down ap-proach to health and human service delivery and createa system more responsive to community needs(Hutchins, 1998). How ever, crcating such a system has

proved a daunting task as states find they arc hamperedby inadequate information about the ability of localcommunitics to rcspond to thcse chan ges aud measureeffectiveness.Aslrategy ofp&ershipdevelopmcnt betwcen gov-ernmen t, conununitics, and acadcm ic institutions is anemerging a pproach that holds promise forhelpixlgco m-munities de vclop sustained capacity for improving out-come s fo r children and families (PooIe, f997; Taylor,Bcanc, &Genec, 1998).Thektlowledgeandlearningrc-sources o f acade mic institutions are particularly criticalto the developm ent of lhis new model, largely becauscof rlic,ability o test approache s, collcct and disseminatedata, expand know ledge, and conduct research.This ar-tick examines the current status of cluld policy ap-proaches as weH as limits to these politics. It thendescribes the method ofonc stateto rcfon n its system of. health aud human services with rccommcndations onways academic ccnters can assis tRqucsts for rcprints should bescnl to Linda S. Tl~ompson,pe-

cial Smrchy. Govcmor's Oflice TorChildren,Youth, and Families,30 1 W. Prcston Strcel. Suite 1502. Ilallimort,MD 21201.

Today , w e are experiencing a period of widespreadprosperity resulting in a h ealthy economy and unprcce-dented progress on many fionls. At the same timc,there is apprchension and concern about the ovcrall'well-bcing o f childrcn and the ability of the nation to@cat beir problcms. More childrcn today nre growingup in singIe-pnrent homes with limited or no co ntactwith thcir biological fathcrs, which results in h e i r in-creased likelihood of living below or at the povertylevel. Incidents of child abuse and ncglect are rising asfamilies struggle to confiont thc daily challenges ofsurvival. G reatcr numbers of children arc experiencingpoor mental health as a rcsult of repeated exposure toviolence within thcir communities and media. Toomany childrcn are cxpcriencing inadequate health careStahls becausc of problems at birth, limited access tohealth care services, or exposurc to physical or en vi-ronmcntal injuries (Starfield, 1992).Because these problems 2irc colnplex andmultifactorial, policy m akers and child advocatcs haveargued for a shift in categorical programming (Schorr,1997). Onc approach suggested was to recognize andbuild on the social and economic strengths of the corn-munity (Krerzmann & McZG~ight,1993). It is in thiscontcxt that a generation ofcomprchensive focal initia-tives emcrgcd that focused on m eeting thc varied needsof children, youth, and families in a way that is h olisticand prevention oriented. Largely supported by founda-lions or tllrougli parh ership s with statc and local com-muni ties , b e omprehcnsivc in it ia tives seek tocreate synergy among health and human services,comm unity revitalization, and economic developmen tstrategies to build communitics bat support b i l y ifc(Chaskh & Garg, 1997).

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THOMPSON

Cu rren t Policy Environment forChildrenThe appeal of comprehensive, community-basedapproaches is driven by the recognition of the limitedability of narrowly dched, categorical strategies toimprove child and f m il y well-being. Indeed, govern-ment has been criticized over the years for its bureau-cratic approach to providing effective services tochildrcn and families who need them (Hutchins, 1998).Currently, states in conjunction with local govem-ments largely fund services to children and youththrough a patchwork system of categorical, discreetservices that are administered through num erous agen-cies and programs. These agencies divide responsibiii-ties for serving childrcn and families into s'ectors such

as health, education, and social services; there is hr-ther d ivision into sections for scrvices to specific popu-lations such as infants and young children, teenagers,the developmentally disabled, and juvenile offenders.A separate and uncoordinated h c w o r k usually ex-ists for each of these sectors with discrete findingstreams, regulations, and political and professionalpeople of influence.The result of these forces is an uneven systemwhere som e programs arc generously funded, whereasothers are chronically underfunded; some are mea-sured for effectiveness, whereas othcrs becomeentitlements; and some become demonstration projectsthat disappear when funding runs out. Unfortunately,individual child and family needs rarely fit into a pre-scribed h e w o r k of uncoordmatcd programs andspecific services. Yet this system is often perpetuatedbecause o f the professional orientation of myriad ser-vice prov iders-p hysicia ns and health professionals,attorneys, and socia l workers-whose approach tomecting clicnt need varies. These divisions furthercomplicate and influence policy making for childrenand family issues. Indeed, flaws in public policies forchildren oftcn force the 5ag ncntz tion of servicc dcliv-ery into categories that artificially block off aspects ofa child's condition and permit the delivery of servicesfor only discrete periods of time and only for specificmanifesting conditions and then h i 1 to provide fortransition of thc child fiom one srage to another(Hcrrington, 1992).

, La ck of AccountabilityAggrava ting the problems associated w ith categori-zation of services to childrcn is the lack of data systemsto track children and families in need o r to determinewhethcr conditions have improved. Services are de-signed toward a crisis-oricnted model that lacks a sys-tem of accountability. Without adequate data, serviceprovidcm are hampered from providing greater coordi-

nation and integration of services to children and h i -lies. Furthermore, inconsistent or inadequate data andthe lack of accou ntability for results provides limitedfeedback to policymakers to fin d and support the mosteffective programs and services. In the current system,services are responsive to children whose problemshave become acute and been allowed to persist overrime. Thus, a preventable problem m y have deterio-rated to the point where remcdiation may no longer bepossible or may be costly to achieve. A prevcn-tion-oriented approach would allow a remedy thatcould be administered efficiently at the communitylevel. The most graphic example of this isunderhding of relatively inexpensive commu-nity-based prenatal programs and provision of ex-tremcly expensive neonatal intensive care'units intertiary care hospitals (Herrington, 1992).Today, the public wants government to becomemore cost efficient and effective, focus on customerservice, providc more choices, and be more inclusivein planning and implementing programs that servechildren and fam ilies. The current system of central-ized, categorical approaches to so cial change and ser-vice provision are seen as hilure s, prompting the needfor more coordinated and responsive models forlong-term, sustainable change. Promoting socialchange through local gov m an ce is an attractive modelbecause it is inclusive and recognizes the concerns,needs, and priorities of the individuals and families af-fected by the development of p r o m nd policies .As federal and statc governments assignmore respon-sibility for child and fam ily well-bcing to local juris-dictions, this approach holds promise because itengages citizens in the proccss of planning and imple-mentation, cmpowering them to have some controlover policies and programs that will have an affect ontheir lives. Incorporating citizen participation in policymaking and pro pam development promotes policiesthat are more connected, directed, and appreciated. In-deed, programs that aremorc closely aligned to citizennccds and priorities prcduce better programm ing andpolicy making and improve public confidence in theseefforts (Chaskin & Garg, 1997).

A State-Level StrategyIn onc midatlantic statc, Matyland, reform o f healthand hum'm services was approached through the de-velopment of a statewide network of comprchensive,locally drivcn initiatives ad ministered by a local gov-erning board representative of the community. To cn-surc accountability, the state embraced a set ofmeasurable indicators and outcomcs for children,youth, and families. These indicaton were developed

in opcn, local for u~ ns nvolving all membcrs o f thecommunity. The road to consen sus on methods of rc-

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CREATING PARTNERSHIPSform was riddled with problems and obstacles. Formany nonbelievers, the reform of systems that pro-vided health and human service delivery to chiIdrcn,youth, and fam ilies was doomed to fail, cvcn if fundingwas aIlocated and legislation was enacted to encouragelocal participation.

An interagency planning and policy process involv-ing cabinct m embers of the child-serving agencies o fthe state and lcd by top levels of government suc-ceeded in engaging statc and local elccted officials,community and business leaders, and citizens in re-form. A task force was formcd with a mission to en-gage the cntirc commu~lityn this effort After a Zye arpericd of community engagement, every jurisdictionin thc state embraced the vision of local governance byappointing local managemeut boards. T hese .boardswill eventually ovcrsee all local efforts to improvechild wcll-being.

Role of Higher Education InstitutionsThe state embarked on an'open, inclusive processfor engaging the community in structuring i& reformeffort, yet participation by the academic sector waslimited. Although academic institutions are oflen lo-cated in c o k u n it ic s of gc atest need, tradit ionallydley are not tapped as partners in efforts to advancechange and improvc results. Partnmhipu bctwccncommunitics and academic institutions, particularlyteaching universities with staff resources and h o w l -cdgc, can m ake a direct contribution to the lives of in-dividuals and familics and promotc greater

collaboratioii as a strategy for long-term, sustainablechange (Lerner & Simon, 1998).In the age of reform (education, welfare, heaftbcare), this new approach to governing is more im por-tant than cvcr. Collaborativc, comprehensive effortscan b ring togethcr the myriad of local agencies, legis-lators, citizens, local policymakers, and reprcsenta-tivcs fiom the nonprofit and business co~nm unity omake reform work. Local collaborations at the com-munity and neighborhood level may achieve greaterresults because of their close proximity to dm problem sfacing the comm unity and an ability to engage sbke -holders w ho are affected and will benefit directly h m

improved conditions (Hutchins, 1998). Although col-laborations that work through local nctworks may bcmore responsive, thcy are also morc challenging bc-caus e thcir potential impact is unclear. Thereforc, theneed for academic involveme~its increased because oftheir expertise in recording effectivcness and efficacy.The increased need for teehnical assistance and afocus on rcsults suggcst the need for increased inv olv ement and partnership with the academic community.Such a relationship is beneficial both to thc acadc micinstitution and the community. Partnerships at the uni-

versity level can provide a mcans for the community tohavc access to the scho larly resources of the universityand scrve as avehicle through which the unjversity canbc accountable to thc comm unity. Rclationships withacadcmic institutions in particular can play a crucialrole in supp orting communities as hcy respond to dc-volution of responsibility for child and familywell-being fiom state government to local govm-m cn k and com munitics (Taylor et al., 1998).Academic institutions can play a key role in sup-porting the vision of providing comprehensive, inte-grated services to children and thcir families andcomm unities through activities such as technical assis-tance, evaluation,assessment, and program design andimplementation. Univcrsitics are in thc business o f c r oating and applying knowledge; thcrcfore, thcy areuniquely suited to makc a difference in the livcs ofchildren and familics by using the ir knowledg e to eol-laboratc within communities. By becoming invohedwith comm unities, universities can offer resources andservices, collaborate with scho ols, government, busi-ncss, and comm unity organizations as well as expandthe knowledg e about the challenges to child and familywell-being and what can be done to improve the qual-ity of life in communities.

ConclusionsIf thc United States is to retain its position a s an eco-nomic and social force in the future, it must focus moreattenlion on the wcll-being of c hildrcn. Indeed, if chil-dren, fa mif es, and communities are to prosper into the

ncxt century, all childrcn must be given an opportu~utyto grow up in a _caring,nurturing, and safe environ-ment; be educated; and have a sense of hope for abright futurc.To ac hieve this goal all sectors of our comm unitiesmust work togethcr, including government, commu-nity-based organizations, and acadcmic institutions.Communitiesare the bcst placcs to ens ure that childrengrow up healihy, are educated; and becomeself-sufficient adults. Universities can assist govern-ment and com munitics inachieving this vision by doingwhat they do b a t, creating and applying knowledge forthe benefit of the community.

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bohd-basedini l ial ives. UrbanAfluirsRevlew. 32.63 1-66t.Hcnington. C. D. (1992.March). S~atcaridchlkdren: elaringpolicy,pructice. andfinance at rhc slate Icvel. Paperprcscntcd at IheAmerican Educnlion FinanceAssociation Confacnce. New Or-l a m . lAHutchins. J. (1 998). Coming logethcrfir chiIdren and amilie$: A re-portfiom theFamily ltnp acf Sembrar.Washinglon,UC: amily

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Krctzmann. I. P.. & McKnight. J. L 1993). Bullding communitiesfiom the h i d e out: A path lowordjlm iing and mobilizhg acommuniry s me &. Chicago: ACTA

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Scborr,L 3, 1997). Common purpose: Strengrhening milles andnelghborhoodr to rebuild America. New Yo*: Doublcday.

Slarficld,B. 1992).Childandadolesccntht3lthstalusmeasures. 17reF u ~f v e f G i l &e ~ Z(2). 25-39.Taylor, I.R, Bune, E G., & Genee, C. L. (1998). The MichiganPublicH d f h Institule:A model foruniversity,gavem cnt andcommunity research and practice partnership.aciery of Re-search ddmlnicfrarors, 30(1). 17-23.

Received ,Uarch 24, 1999Accepted March 24,1999