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State of the States’ ECCS Initiatives
Short Take No. 5

Authors: Kay Johnson and Suzanne Theberge
Publication Date: July 2007

Updated November, 2007

The Issue

The primary purpose of the federal Maternal and Child Health Bureau, Health Resources and Services Administration’s (MCHB-HRSA) State Maternal and Child Health Early Childhood Comprehensive Systems (ECCS) grants is to assist states and territories in their efforts to build and implement comprehensive statewide systems of care that support family and community approaches to promote positive early development and early school success for young children. These grants originated with a MCHB-HRSA Strategic Plan for Early Childhood that called on State Title V MCH programs to use their leadership and convening powers to foster the development of cross-agency early childhood systems development planning. 1

Building a more comprehensive early childhood system requires intentional efforts to bridge the gaps created by multiple, discrete funding streams for early childhood services to create a deliberate framework to foster integrated early childhood service systems at the federal, state, and community levels. 2 This Project THRIVE Short Take summarizes the results of Project THRIVE’s review and analysis of state ECCS plans, reports, and other related documents related to early childhood systems.

Analysis of State ECCS Initiative Efforts

Analytic Framework and Methods

To study the status of state ECCS initiatives, Project THRIVE developed an analytic framework based on systems development theory and experience. We concluded that building a system of systems to promote early childhood health, growth, and development requires: (1) strategies to promote systems integration and (2) governance and structural mechanisms to support and sustain systems integration.

We identified a set of criteria related to each of these factors and, for each state ECCS initiative, used the criteria to systematically review key documents, including: Fiscal Year (FY) 2006 and 2007 progress reports, FY 2007 continuation proposals (as sent to MCHB-HRSA), and ECCS plans as they were made available. 3 Many states shared additional documents and publications that were also analyzed. Two individuals conducted the review using qualitative research methods with both machine and hand notation.

The resulting data were sent to states (in table format) for vetting and confirmation. Between December 2006 and October 2007, more than two-thirds of states shared updates and edits, with relevant documentation. The database was updated to reflect these changes, as appropriate. The complete state-by-state results and variable definitions can be found on our web site.


Overall Status of ECCS Initiatives

States with completed ECCS plan and in implementation phase in FY07

Figure 1: States with completed ECCS plan and in implementation phase in FY07

  • For FY 2007, 47 states and the District of Columbia received ECCS grants. Mississippi, Pennsylvania, and South Dakota do not have current year grants.
  • By January 2007, 42 of 48 grantees had moved from the planning phase of the state ECCS program to the implementation phase.

Systems Integration

Characteristics of high performing early childhood systems

Figure 2: Characteristics of high performing early childhood systems

The work of ECCS requires efforts to bring together many existing separate programs, systems, and funding streams and create structures that meld them into integrated early childhood service systems. 4 Thus, a “system-of-systems” approach is essential to creating a comprehensive and well-integrated early childhood system. This analysis reveals that while 41 states report using a system-of-systems approach, less than half of all states (22) have evidence of such an approach in their ECCS proposals, reports, and plans. Moreover, only 30 states have developed memoranda of understanding (MOU) or similar administrative mechanisms to formalize interagency and cross-system plans. (See Figure 2.)

The charge to state ECCS initiatives was to address five core early childhood service components in their plans, and in 44 states, ECCS documents indicate parallel emphasis across sectors (health, mental health, early care and education, parent education, and family support). This tally includes states where ECCS efforts focus more on one component but the overall plan indicates how other core components would be addressed. For example, a state ECCS initiative may be focused on linking child care and health professionals, while other state projects are working on child care quality rating systems, early childhood mental health, and so forth.

All of the 48 state ECCS initiatives analyzed have at least a birth to age 5 focus, and all have conducted crosssector program planning as required by their grant from MCHB-HRSA. Fewer (16) states had undertaken crosssector fiscal planning or children’s budget analyses by January 2007. (See Project THRIVE Short Take No. 3.)

Governance and Structural Mechanisms

Stages for building early childhood systems

Figure 3: Stages for building early childhood systems

Each stage of systems building (planning, implementation, and management) requires somewhat different skills, talents, and individuals but also may require different governance or structural mechanisms. 5 (See Figure 3.) As would be expected, state ECCS governance approaches are varied and have evolved from their early planning stages to their current implementation. Generally, grantees have developed or built on existing collaborative structures, including stakeholder agencies across a broad array of services, with governing structures and formal work groups to guide and carry out their activities.

In 36 states, governors or cabinet-level officials are involved in early childhood systems development. While in some cases, such senior state leaders may be focused primarily on one area (such as early care and education), having the early childhood systems discussion at the highest levels of state government increases the potential for improvement across all core components. With early childhood and school readiness issues in the limelight, state staff and family advocates can emphasize the importance of health, mental health, family support, and cross-system concerns.

One of the stated purposes of the MCHB-HRSA in offering state ECCS grants was to support state MCH programs in the “use of leadership and convening powers to foster the development of early childhood systems.” State documents reveal progress in developing leadership and convening a broad array of partnerships. Virtually all (46) states report having a formally established, crosssector stakeholder group involved in early childhood systems development.

Private sector partners engaged in state ECCS initiative leadership

Figure 4: Private sector partners engaged in state ECCS initiative leadership

Engaging private sector and civic leaders is equally important. 6 Figure 4 illustrates the array of private sector partners involved in state ECCS Initiatives. Overall, nearly half of the states (24) report having a formally established public-private entity that has responsibility for improving early childhood systems. Some of these are incorporated and have substantial funding (for example, Washington State Early Learning Foundation, Michigan Great Beginnings), and others are quasi-public entities created by a governor (for example, Vermont Building Bright Futures). Engaging families in the leadership of early childhood system efforts is particularly important. While many states conduct focus groups with families, and most have designed family support activities, only 33 states report involving parents in leadership roles for ECCS.

Notably, not all ECCS projects operate as autonomous entities. Some have been absorbed into larger national initiatives. 7 For example, in Illinois, Minnesota, Michigan, and Washington State, the ECCS grantee is integrated into the work of the Build Initiative—a multistate, multiyear initiative, supported by a number of foundations through the Early Childhood Funders’ Collaborative. In Colorado and Oklahoma, ECCS has become inextricably linked with Smart Start projects. For other states, ECCS is a source of funding and planning support for a larger, umbrella effort guided at the cabinet level (for example, Kentucky, Ohio, and Vermont).

A smaller number of states have created a new unit of government to focus on early childhood systems. A few examples illustrate the range and variation of these efforts to consolidate governmental responsibility for early childhood systems. In Washington State, Governor Gregoire has made early learning and education one of her top priorities, and, as a result, she created a new Department of Early Care and Learning in 2006. In 2007, Maine created a Division of Early Childhood in the reorganization of its Department of Health and Human Services, based in part on recommendations from a Children’s Services Reform workgroup. In Vermont, the Child Development Division was formed five years ago as part of a reorganization of the Agency of Human Services. Vermont’s Child Development Division brings together programs and projects related to child care, Head Start, home visiting, early childhood mental health, and early intervention, as well as the Building Bright Futures and ECCS functions, to improve overall integration and coordination.

To change the way that early childhood systems operate requires action at the state level; however, early childhood systems integration also requires ownership and leadership at the local or community level where direct services are delivered to families. A majority of states (37) have or are developing structures to support local systems integration. Some states are providing technical assistance to local communities, while others have established efforts with formal structures for planning, building, and reporting on local systems development. A few states provide funding for local community systems development. Major efforts include: Arizona’s First Things First Initiative; Iowa’s Community Empowerment county programs; Illinois’ All Our Kids (AOK) Early Childhood Networks; Michigan’s local Great Start Collaboratives; Smart Start in Colorado, North Carolina, and Oklahoma; Vermont’s Building Bright Futures regional affiliates; and Washington State’s Making Connections project. (The next Project THRIVE Short Take will focus on how states are supporting local system development.)

Drawing Conclusions

Much progress has been made toward creating comprehensive systems of early childhood services. For the future, state ECCS leaders face several challenges.

First, states need to give more equal emphasis to all of the components of the system. State Early Childhood Comprehensive System grants support state MCH programs and their partner organizations in their efforts to build early childhood service systems that address the five core components: (1) access to health care and medical homes; (2) social-emotional development and mental health; (3) early care and education; (4) parenting education; and (5) family support. Today, the focus tends to be more on state early care and learning policies and programs. Most states need to give more importance to strategies that promote health, mental health, and family support. Best practices exist in each area that could be advanced by state ECCS leaders.

Second, while a majority of states have or are planning for support to local systems, most of these are fledgling efforts that will require ongoing guidance, technical assistance, and financing. In some cases, this will take the form of grants to local entities, and in other states the work will be through requirements for common planning and performance monitoring. What we know is that states play a critical role in providing flexibility and technical assistance for local programs and providers.

States with children's budgets or cross-system fiscal analysis planned or underway in FY07

Figure 5: States with children's budgets or cross-system fiscal analysis planned or underway in FY07

Finally, as states move beyond planning into the implementation and management stages of their systems development work, new governance and structural mechanisms will be required. New interagency agreements, staff configurations, and fiscal arrangements will be essential for supporting more integrated systems. This will require leadership at all levels of government and partnerships with a variety of private stakeholders. This is the critical work of the next stage of ECCS initiatives.


1. Halfon, N.; Uyeda, K.; Inkelas, M.; & Rice, T. (2004). Building bridges: A comprehensive system for healthy development and school readiness (Building State Early Childhood Comprehensive Systems Series No. 1). Los Angeles, CA: National Center for Infant and Early Childhood Health Policy, University of California at Los Angeles. Retrieved January 10, 2006, from <>.

2. National Governors Association Task Force on School Readiness. (2005). Building the foundation for bright futures: Final report of the NGA Task Force on School Readiness. Washington, DC: National Governors Association. Retrieved October 3, 2006, from <>.

3. A list of state ECCS plans can be found at <>.

4. Hayes, C. (2003). Thinking broadly: Finance strategies for comprehensive child and family initiatives. Washington, DC: The Finance Project. Retrieved May 31, 2007 from <>

Hayes, C. (2002). Sustaining comprehensive community initiatives: Key element for success. Washington, DC: The Finance Project. Retrieved May 31, 2007 from <>.

5. Bruner, C.; Wright, M. S.; Gebhard, B.; & Hibbard, S. (2004). Building an early learning system: The ABCs of planning and governance structures (State Early Childhood Policy Technical Assistance Network Resource Brief ). Des Moines, IA: State Early Childhood Policy Technical Assistance Network (SECPTAN) and Build Initiative, c/o Child and Family Policy Center <>.

6. Chrislip, D. D. & Larson, C. E. (1994). Collaborative leadership: How citizens and civic leaders can make a difference. San Francisco: Jossey-Bass, Inc.

7. Floyd, S. & Child and Family Policy Center (CFPC) staff. (2004). Up and running: A compendium of multi-state early childhood initiatives, 2nd ed. Des Moines, IA: State Early Childhood Policy Technical Assistance Network (SECPTAN), c/o Child and Family Policy Center. Retrieved June 27, 2007 from: <>.