This is the sixth and final blog in a blog series on Children’s Cabinets and integrated supports and services for children.
By Maria Echaveste and Chiara Parisi
In this blog series, we have discussed how Children’s Cabinets, governmental bodies that coordinate various child-serving agencies, offer a way to support the integration of supports and services for children. Through the integration of services, children can better access the support they need for their physical, mental, and social needs, allowing them to thrive academically and improve their life outcomes. Over 25 states currently have a Children’s Cabinet and participate in the Forum for Youth Investment’s State Children’s Cabinet Network. Notably missing from the list, however, is California.
Though various more narrow efforts have been made in California to integrate supports and services, there has yet to be a comprehensive state level effort to coordinate the state’s many child serving entities and initiatives. For example, the California Child Welfare Council coordinates services, but only for children in the welfare system. Similarly, the California Interagency Coordinating Council on Early Intervention just focuses on students with disabilities. AB 2083 established legislative expectations that services at the local level be coordinated among multiple agencies for children in foster care. California’s Multi-Tiered System of Support (MTSS) provides a broad continuum of services and programs within the school. SB-75 created a competitive grant program to fund partnerships between county mental or behavioral health departments and K-12 schools. And California recently made a historic $3 billion investment in the California Community Schools Partnership Program, promoting integrated supports and services, as well as a large investment in the Children and Youth Behavioral Health Initiative, fostering relationships with schools and mental health providers.
This is all in addition to the many efforts sprouting from the local level. The Los Angeles County Office of Education, for example, is leading a pilot in 15 high schools that involves partnering with over a dozen Los Angeles county agencies to provide a range of services—including counseling, mental health education, enrollment support and case management of social services, parent workshops, after-school programming, and field trips. In Redwood City, a collaboration that started in the 1990s now includes the Redwood City School District, Kaiser Permanente, San Mateo County Health System, San Mateo County Human Services Agency, and Sequoia Healthcare District. The Forum for Youth Investment’s Local Children’s Cabinet Network includes Oakland, Los Angeles, Sacramento, San Francisco, Stockton, and Lost Hills.
And yet, despite the many efforts to integrate services in California, we still fall short of providing the ideal kind of comprehensive care a child needs. Parents continue to struggle with navigating complex and disconnected systems on their own. No entity has the necessary authority to braid or blend funding to make the most efficient use of the state’s resources. A PACE report indicates that less than 5 percent of California’s Medi-Cal-eligible children receive the mental health services they are entitled to. A lack of shared goals and accountability across agencies leads to fragmentation, duplication, and gaps in services. And an absence of connectivity between data systems and the burdens of creating data sharing agreements prevent the fluid sharing of information between agencies. Last, legislative and regulatory barriers are seldom addressed by existing coordinating bodies.
A state level Children’s Cabinet could offer a possible solution to the persistent barriers to service integration. Unlike existing California coordinating entities, this Cabinet would need the necessary authority and capacity to address the full scope of integrated supports and services. The structure could take various forms and be housed in the Governor's office, like the Maryland Children’s Cabinet, or in the judiciary, like the Commission on Improving the Status of Children in Indiana. Or instead of a Children’s Cabinet, we may want to create a Children’s Secretary. Alternatively, the effort could involve expanding the role of one of California's existing coordinating bodies. And the state level entity might want to coordinate with county level cabinets throughout the state. What matters is that the charge of the Cabinet or Secretary be broad, rather than the narrow and local initiatives that California has created so far. With the creation of a new Cabinet, California could also consolidate many of the integration initiatives listed above.
Some are justifiably skeptical that a Children’s Cabinet can get the job done in California. Cabinets run the risk of just meeting quarterly to discuss issues in a manner that ends up being more performative than productive. But, as we have shown in this blog series, at their best, Children’s Cabinets can also make improvements in access to supports and services for children in need. With the necessary staffing, funding, and authority, Children’s Cabinets have the potential to make a true impact. By focusing on the alignment of data, people, evidence, and money, a Children’s Cabinet could offer a possible solution to California’s fragmented services and supports for children.