Early Intervention and Prevention Initiatives for Kids Cut, Despite Potential for GoodChild Abuse & Neglect Early Childhood Federal Budget Health Nutrition Poverty & Family Economics
Evidence clearly demonstrates that early intervention and prevention services improve outcomes for children and families that have lasting impacts on their lives, and the health and economic well-being of their communities and our nation. These programs that improve prenatal health, birth outcomes, early learning and development, and economic self-sufficiency of young children and their parents are far more likely to be effective and less costly because they address problems before they begin, rather than mitigating complex health, development and social problems after they have occurred.
Despite the anticipated return on investment, these intervention services and prevention services for children have been cut and those cuts will likely continue in the coming years. First Focus recently reviewed an array of federal discretionary programs that impact children from birth until age five in the areas of child abuse and neglect, early childhood, health, learning and development, and economic stability. Looking at fiscal years (FY) 2010 through 2015 and adjusting for inflation, we found that these initiatives had been cut by about $1 billion.
During the time period 2010-2015, both economic stimulus to counter the impact of the economic recession and sequestration de-stabilized spending patterns for these programs, which were already underfunded. Enacted in early 2009, the American Recovery and Reinvestment Act (ARRA) provided increased funding for several children’s programs, with the bulk of the money allocated in FYs 2009, 2010, and 2011. In 2013 and 2014, little of the original allocation was left, leaving many areas with an “ARRA cliff” – a steep drop in funding. Adding to that cliff, Congress passed legislation that enforced spending limits through sequestration or “across the board cuts” for FY 2013, exempting certain federal programs. A bipartisan deal in 2013 provided some sequestration relief for FYs 2014 and 2015, essentially providing a bump to some of these programs.
Still funded below 2010
Now that ARRA is over, and cuts remain in effect, several early intervention and prevention programs for children are still below where they were in 2010. In most cases, programs faced greater need with fewer resources. Here are some examples:
The Special Supplemental Program for Women, Infants and Children (WIC) that provides nutritious foods and nutrition education to 8.9 million women, infants and children has seen a ten percent cut, despite a bump from ARRA. According to USDA, thirteen million children and youth do not have enough to eat, 49.1 million people, including 16.7 million children, experienced food insecurity (limited availability to safe and nutritionally adequate foods).
CDC’s National Center on Birth Defects, Developmental Disabilities, Disability and Health at the Centers for Disease Control and Prevention has seen reductions in recent years further complicating efforts to address birth defects. More than 5,000 infants die each year from birth defects and about 15% of children over 2 have at least one developmental disability.
Programs aimed at children who are victims of neglect and abuse remain below 2010 funding levels. This includes the Child Abuse Prevention and Treatment Act (CAPTA) Programs, Stephanie Tubbs Jones Child Welfare Services program, Child Welfare Training, and Promoting Safe and Stable Families discretionary grants.
Other programs that have not regained their 2010 funding level include:
- Abandoned Infants Assistance
- Adoption and Legal Guardianship Incentive Payments Program
- Community Services Block Grants
- Child Care Access Means Parents in Schools
- IDEA B – Preschool Grants
- Healthy Start
- Childhood Lead Poisoning Prevention Program
- Part C Early Intervention Services component of the Ryan White HIV/AIDS Program Universal Newborn Hearing Screening and Early Intervention
- EPA’s Children’s Health Protection
- Teen Pregnancy Prevention Discretionary Grants
- National Asthma Control Program
- WIC – Special Supplemental Program for Women, Infants and Children
Programs Flat funded since 2010 – a cut by another name
While some early intervention and prevention programs have been set back, others have spent five years climbing to get back to where they were in 2010. A flat funding level is essentially a cut when adjusted for inflation, as the cost of living has gone up.
Individuals with Disabilities Education Act (IDEA) Part C, which serves children with disabilities aged birth through 2 and their families, saw cuts in 2013, reversing ARRA gains, and is now back to 2010 funding levels. IDEA Part B preschool grants have been reduced by five percent or $20 million.
The Autism and Developmental Disorders Initiative and USDA’s Children, Youth and Families at Risk program have also been practically flat-funded. The Autism Initiative support intervention activities for a disease that is on the rise nationally, and USDA’s program helps families and youth at risk to ensure that basic needs are met, including healthy births and developmental supports for young children.
Programs Consistently Underfunded
Few early intervention and prevention programs have rebounded and received additional funding since 2010. Those that have still struggle to meet growing needs of vulnerable children.
Head Start has seen an 18 percent funding increase, following attention to the 57,000 slots lost in the program as a result of sequestration. The initiative mitigates the K-12 “achievement gap,” by helping the nation’s most disadvantaged children enter school ready to learn. Celebrating its 50th year anniversary, the uptick in resources for Head Start still falls far short of need. Even with added resources, Head Start currently serves less than half of eligible children. Early Head Start, which provides comprehensive health and educational assistance to infants and toddlers age 0-3 serves less than 5 percent of children and families eligible for and in need of its services.
Similarly, the Child Care Development Block Grant (CCDBG), which makes child care affordable for millions of low-income working families, also saw a 14 percent funding increase since 2010. But even at higher funding levels, CCDBG helps only 18 percent of the families eligible to receive assistance. Over 2.6 million children and families are still in need of assistance. Moreover, although Congress reauthorized this program last year with overwhelming bipartisan support, significant funding increases are necessary for states to implement the safety and quality provisions of the new law. Without significantly increased funding, the net impact is that more children and families will go without quality childcare, causing them to either stop working or seek unregulated, less-quality child care settings.
Adoption Opportunities grants have seen a 48 percent increase for projects designed to eliminate barriers to adoption and help find permanent families for children awaiting adoption, particularly children with special needs. Likewise, CDC’s Safe Motherhood and Infant Health Program received an insignificant bump towards their efforts to monitor trends in maternal health and mortality, infertility, and sudden unexpected infant death. In 2012, preterm birth affected more than 450,000 babies—that’s 1 of every 9 infants born in the U.S.
A Better Approach
Not all early intervention and prevention programs are subject to the annual appropriations debate. The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) enjoys bipartisan support, and provides evidence-based coaching and support for at-risk parents and their young children. First Focus advocated for its continued funding this year. MIECHV’s services to families are voluntary, but its funding is “mandatory,” meaning funding is not subject to the shifting winds of annual congressional budget and appropriations debates. By contrast to other early intervention and prevention initiatives, MIECHV now has two years of stable funding, permitting states to budget and plan for efficient, effective supports for kids and families. Despite enjoying stable funding, MIECHV also serves a fraction of the children and families eligible and in need of its services.
Decisions about discretionary funding levels for FY 2016 will be a major hurdle for Congress this fall. According to OMB, in the absence of congressional action in FY 2016, both defense and non-defense discretionary spending will be at the lowest levels in a decade, adjusted for inflation. And it appears that there is no resolution in sight with the Republican budget agreement that includes $496 billion in cuts to non-defense discretionary programs and Senate Democrats and President Obama are united in opposing appropriations legislation that adheres to spending levels set by sequestration. To that end, annually funded early intervention and prevention services are in danger of further spending cuts and putting our nation’s children in further jeopardy.