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Division of Child, Adolescent and Family Health

The work of all Maternal and Child Health Bureau divisions, programs, and staff is in support of the Bureau’s Strategic Plan (2003-2007) for meeting the needs of the maternal and child health populations of the United States and its Jurisdictions. The Bureau focuses—through leadership, performance, and accountability—on accomplishment of five over-arching goals: 1) Provide National Leadership for Maternal and Child Health; 2) Promote an Environment that Supports Maternal and Child Health; 3) Eliminate Health Barriers and Disparities; 4) Improve the Health Infrastructure and Systems of Care, and 5) Assure Quality of Care. The Bureau’s progress—or accountability—toward goal achievement is reported annually.

The Division of Child, Adolescent and Family Health (DCAFH) is one of five divisions in the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB). It is the national focal point for improving health care for America’s children and adolescents. Strategies include encouraging medical homes for all children, focusing on a coherent support system for early childhood health and development, and promoting national campaigns on safety and violence prevention that have proven effective in reducing illness, injury, and death among children and adolescents. The Division takes a lead role in encouraging comprehensive, community-based health care that combines public and private resources and promotes environments where healthy behaviors can develop.

Infant and Child Health

State Early Childhood Comprehensive Systems (ECCS)

This program was launched in 2003 to assist States and Territories in planning, developing and implementing collaborations and partnerships to support families and communities to assure that their children are physically, socially and emotionally healthy and ready to learn at school entry.  The ECCS program provides opportunities for State Maternal and Child Health other State and local child and family serving agencies to develop a coherent approach to meeting child and family concerns in the following areas: access to health care through a medical home; mental health and social/emotional development; early care and education; parenting education; and, family support.  This program evolved from the Division’s earlier initiative in health and safety in child care settings.

Health and Safety in Child Care Settings

Since the mid-1980s DCAFH has supported the development of national health and safety standards in childcare and programs and community-based networks to improve and maintain the health of infants, children, and families who use child care programs. Specific activities have included: The Healthy Child Care America Campaign, a partnership between MCHB and the Administration for Children and Families. (ACF) Child Care Bureau that creates links between providers and the child care community; the Health Systems Development in Child Care Grants Program to promote system development; and the Partnership to Develop and Implement a Child Care Health Consultant Program, which trains child care providers in health and safety. The Division’s National Resource Center for Health and Safety in Child Care Settings provides information dissemination on health and safety standards.

Sudden Infant Death Syndrome/Infant Death (SIDS/ID) Programs  

This program supports States in their efforts to reduce deaths due to SIDS and to support families who have suffered a sudden unexpected infant death of any sort. A collaborative effort of DCAFH and the National Institute of Child Health and Human Development (NICHD) supports the national Back to Sleep Campaign to reduce SIDS deaths. The program also supports individual State SIDS prevention programs and four resource centers that offer information and technical assistance to professionals and the public: the National SIDS Resource Center; the National SIDS/ID Program Support Center; Project Impact; and the National Center for Cultural Competence.

Adolescent Health/Office of Adolescent Health

The Office of Adolescent Health provides national leadership in promoting the health, development, safety, and social and emotional well-being of all school-aged children, adolescents, and young adults in the United States, and their families. Its adolescent health activities are structured around the four goals of the National Initiative to Improve Adolescent Health, which DCAFH co-facilitates with the Centers for Disease Control and Prevention’s Division of Adolescent and School Health. The summarized goals include: 1) Elevate national, State and community focus on, and commitment to, the health, safety and well-being of adolescents and their families; 2) Increase adolescents’ and young adults’ access to quality health care; 3) Improve health and safety outcomes for adolescents and young adults; and 4) Eliminate health disparities among adolescents and young adults. Within this framework, programs focus on national professional membership associations (Partners in Program Planning for Adolescent Health), disseminate resources and information to a variety of audiences (National Adolescent Health Information Center); analyze the effects of policies and programs (Public Policy Analysis and Education Center for Middle Childhood, Adolescent and Young Adult Health); and assist states in developing and strengthening their adolescent health programs (State Adolescent Health Resource Center for Maternal and Child Health Personnel, Partnership to Promote Adolescent Health in States).

The Office of Adolescent Health also supports several programs that promote the mental health of young people and augment the ability of school programs to address the general and mental health needs of students. Mental health programs take place at state (State Agency Partnerships for Promoting Child and Adolescent Mental Health) and community (Integrated Health and Behavioral Health Care for Children, Adolescents and their Families) levels. The Office of Adolescent Health also provides assistance to schools and educational systems attempting to address the mental health of their students (School Mental Health Program and Policy Analysis Centers) and to school health programs providing primary care services to students (National Center on School-Based Health Care). The National Coordinating Committee on School Health and Safety, composed of approximately 75 organizations from the education, health and nutrition sectors, facilitates communication and collaboration among its organizational members and disseminates policy and program information on effective school health programs.

Cross-Population Initiatives

Oral Health

MCHB funds a variety of oral health grants that support the infrastructure of State and/or local oral health programs: “Improving Perinatal Oral Health” with the American Academy of Pediatric Dentists expands availability of perinatal oral health care and the adoption of the age one dental visit and dental home policies by pediatric and general dentists; “Partnership for State Leadership in Oral Health” cooperative agreement with the Association of State and Territorial Dental Directors supports partnerships within State dental public health communities and among Medicaid and private sector providers to increase access to early intervention, preventive, and restorative oral health services for mothers and children; Healthy Tomorrows Partnership for Children Program grants  support the development of family-centered, community-based initiatives that plan and implement innovative and cost-effective approaches for focusing resources to promote community defined preventive oral health objectives for vulnerable children and their families, especially those with limited access to quality health services; State Oral Health Collaborative Systems grants are awarded to States and Jurisdictions to help stabilize State oral health program infrastructure and integrate State oral health activities with State MCH programs.  Currently over 40 States and Territories participate.

Injury and Violence Prevention

DCAFH promotes child and adolescent health and safety through education and training, technical assistance, and support for state MCH personnel and other related professional organizations through a system of resource centers.  The major focus is on improving and enhancing the skills and abilities of MCH staff to address identified injury and violence-related issues, as well as integrating injury and violence prevention into existing MCH programs and services. Improving safety programming through injury data analyses which include recommendations from State Infant, Child, Adolescent, Maternal and Domestic Violence Mortality reviews is emphasized.   Health and Safety Guidelines and Standards related to child care and schools and unique and successful methods of involving youth, adults, families and non traditional partners with safety education and promotion and injury and violence prevention are stressed.  

Emergency Medical Services for Children (EMSC)

The EMSC grant program is administered by the Maternal and Child Health Bureau (MCHB) in partnership with the National Highway Traffic Safety Administration.  This Federal initiative evolved out of a growing recognition that children have unique needs in emergency situations -- needs that often vary from those of adults due to physiological, developmental and psychological differences.  Legislation passed by Congress in 1984 authorized the use of Federal funds to expand and improve emergency medical services for children in each State.  Since 1984, 50 States, 5 territories and the District of Columbia, have been active program participants.  The goal of the EMSC program is to reduce child and youth morbidity and mortality resulting from severe illness or injury.  The EMSC program does not intend to promote the development of a separate EMS system for children, but rather to enhance the pediatric capability of EMS systems originally designed primarily for adults.  “EMS” is here understood broadly to include the following components: prevention, prehospital EMS care, hospital based care, rehabilitation and reentry of the child into the community.

For more information, contact DCAFH at 301-443-2250.

Maternal and Child Health Bureau

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