The neglected family : recommendations of the State 4C Committee, dealing with the problems and needs of Arizona's children, youth, and their families

              Copy 2
EGLECTED FAMILY
I
of" · ',A8
The Governor's . tY . Arizona~
Coordinated Child Care Committee ;. ,., . .
"
,; "
Laura Almquist,
Chairperson
Tucson
Martha Ahearn
Yuma
Phyllis Antone
Phoenix
Ronald S. Barber
Tucson
Ted Baum, M.D.
Tempe
Arthur Bevilockway
Phoenix 0
Buel Bowlan, Ph.D.
Page·
Roger. Hodges,
Chief,
Social Services Bureau
Department of
Economic Security
Milo Blecha, Ph.D.
Chairman
Pima Council on
Children's Services
Carol Kamin, Ph.D.,
4-C Executive
Director
4-C Committee MembersG& Staff
. Haskell Cannon, Ph.D .. Janet Marcotte,
Flagstaff Tucson .
'Cruz Davis
Parker
Arthur W. Elrey
Tucson
Eleanor Flake,Ed.D.
Mesa
Gregg Goggin
Tucson .
Bobbie Hannah
Tucson
Thomas Jordan, Ph.D.
Tucson
Senator Betty Morrison
Phoenix .
Jacque Steiner,
Co-Chairperson
. Phoenix
Mildred Perkins
Phoenix
Colonel John W. Rice
Tucson
Barbara Rock
Tucson
Stephen D. Wise
Phoenix
Ex-Officio.Members
. Ray Dugan,'
Contact Person
Local 4~C,
Maricopa County
Flora Hyde,
Chairperson,
Yuma County 4-C
Ann Devoll
4-C
Program Specialist
Florence Karlstrom,
President . /
Coconino County
.Council· for
Children
Pat Sauser
4-C.
Secretary
Staff
June Patton
4-C
Intern
©1976 4-C
\
G v ~. c1J),.2. ! N3 l,?,
COp! ~
. THE NEGLECTED FAMILY·
Recommendations of
the State4C Committee,.
dealiI!g with the problems
and needs ~. . ( .. "....--'"""f
of Arizona's children, ( L . youth, ~"LYJI
and their families.
Prepared in conjunction with URSA Institute
Profound changes are
. taking place in the lives
of Arizona's Chi Id rene .
The . institution at the
center of these changes,
which itself is under- > ..
going the \ most rapid.
and radicaltransfor­mation,
is the family.
Many families are able
to cope with these chan-ges,
but some are not.
In January 1974, Governor Jack Williams
established the Community Coordinated Child
Care Committee _.. the Arizona State 4C Program
- to serve as a mechanism for the coordination
. and promotion of quality comprehensive services
to children and their families.· I n that year over
1200 people attended hearings sponsored by the
committee and expressed their concern that
decision-makers, both state and local, re-assess
the priorities and services throughout the state. -I n
1975, the 4CCommittee published a series of
reports that dealt with the. problems facing
Arizona's children: day care, child abuse, foster
. care, adoption, health care, services to the han­dicapped,.
and the special problems facing
minority children. The findings and recom­mendations
in these reports are of great im­portance
to our state's children and certainly merit
action. In 1976, Governor Raul Castro reaffirmed
the mission of the Arizona State 4C Committee as
he appointed new members and reappointed
members.
The longer the Committee has studied the
problems of children, the more obvious it. has
. becorne that the central focus for the resolution of
many problems affecting vulnerable children in
our state must be the family setting.
3
----------------:---------,---
That the family is the prirnary and most fun­damental
influence in the young child's develop­ment
is generally accepted in -American society.
The kind and quality of care and guidance the
young child receives in his/herfamily is critical to-'
successful development and determines to a
major extent ultimate capabilities and
achievements. If our socio~legal-economic
systems put undue pressure upon families,_
thereby undermining them and making it difficult
for them to discharge their essential functions,
then an indispensable and irreplaceable force for
rearing healthy children will be severely damaged.
THE NEGLECfED FAMILY
Dhe family of today differs
significantly from the
family of twenty-five
years ago; there have been over­whelming
changes in and
pressures on the family in this'
decade alone. Almost one-half of
4
all mothers are employed outside
the home; one 'in' every three
mothers with children under six is
employed outside the home. As '
the number of mothers leaving
ho~e for outside work has in­creased,
the number of other
adults in the'householdwho could
care for the child has markedly
'decreased. For example, fifty years
ago half of the households in
Massachusetts included at least
one adult besides the parents;
today the figure is only 4 per cent.
In the past decade the num­berof
single-parent households in­creased
10 times more than two­parent
families. This translates
into a .national situation in which
'"
one in every six children is raised
in a family in which one parent,
because of' death, divorce, deser­tion,
or separation, is absent. Most
of these families .. are headed by
women, and over' half of these
families fall below .the.poverty
line.
The 4C Committee finds that,
- despite the realities such as
those outlined above. and despite
the pervasive political rhetoric
about the importance of the family'
- there is a gross inadequacy in
the programs, policies and laws
meant to assist families and to
provide them with essential sup-'
port services. There is much in our
state laws, regulations and prac­tices
that threatens the viability of
the family.
Only the most inadequate
support is granted to a needy child
living in his/her own home; most
fiscal resources are directed
'toward more generous support of
the child once he/she has been
removed from the natural home in
order to live with 'strangers.
Arizona statute and policy, under
the rubric of maintaining the sanc­tity
of the family, has refused to
assist until family breakdown is
complete .. When help finally is
. provided, too often it is in the
form of crisis services, emergency
wards, police and the courts. How
many neglected, dependent,
delinquent or handicapped
children who have been taken
away from their homes might have
been able to remain with their
families or in their communities if
effective and adequate supportive
services had been available to the
family? This absence of preven­tative,
supportive services to
strengthen the family so that a
child need not be. removed from
his/her own home illustrates the.
emptiness and folly of official
rhetoric about, and lack of, due
provision for, the importance of
the family.
In fact, the costs of keeping
the family intact - when that
alternative is considered
beneficial to the child- are lower
than or about the same as the cost
of removing the child from home,
even if the cost of in-home services
are added to the total. It has been
estimated, for example, that foster
home care costs amount to three
to five times as much as it would
cost or to enable an intact family
on a low budget to help and raise
the same child.
the area of family support
services is extremely sensitive and
fraught with controversy. Some
feel such services are an intrusion
into private life. Others fear the
undermining of. ~ultural ethnic
traditions and mores. These cer­tainly
are legitimate concerns.
,Any program of aid to families
must, therefore, clearly demon­strate
its aim as being supportive
of' parents in achieving more ef­fectively
their own goals for their
children.
The goal of state-supported
family and children's service
programs, as defined by this com­mittee,
must be to strengthen the
cohesiveness. of the family and to
foster its . independence and
adequacy in child rearing. The
overriding need is' for consistent
policies and programs that 'will
strengthen the family. Thus, one
of the purposes of this report is to
expose policies and laws that have
a destructive impact on Arizona's
families and to indicate how
statutes, policies and programs
might be altered for the benefit of
those families.
Although, for the sake of con­venience
and clarity, issues are
discussed separately, it is essential
to recognize that these issues are
interdependent, having common
important elements. The con­stellation
of problems discussed
here bears most heavily on
families who are poor, which
usually means young parents with
young children. But many of the
issues also strongly affect middle
class families of all ages. Public
policy remedies are necessary for
the' sake of all of Arizona's
children.
Therefore, the
Arizona State 4C Com­mittee
strongly urges that
prompt and serious con­sidera
tion be given to the
fo lIowi ng recomm en
dations:
5
TITLE XX 10
Recommendation 3: Concerning the Full Utilization of
Title XX Funds
TEENAGE PARENTS 12
Recommendation 4: Concerning Education
for Parenthood
HEALTH CARE 13
Recommendation 5: Concerning Health Care for
Children
DAY CARE 16
6
Recommendation 6: Concerning the Use of Federal
Funds for Day Care Services
FOSTER CARE 19
Recom~e~dation. 7: Concerning the .Provision
of In:. Home and Family
Rehabilitation Services
Recommenda tion 8: Concerning the· Permanent
Placement of Children
Recommendation 9: Concerning Expansion of the Per­manent
Placement Unit
Recommendation 10: Concerning a Foster Parent
Recruitment Program
Recommendation. 11: Concerning Recruitment of
. Adoptive Homes
Recommendation 12: Concerning Foster Care
Payments to Relatives
Recommendation 13: Concerning Increased Ap~
propriations for Foster Care
COORDINATING MECHANISMS FOR SERVICES ·TO
CHILDREN, YOUTH, AND
FAMILIES
Recommendation 14: Concerning the Arizona State 4C
Committee
Recommendation 15:. Concerning the Creation of the
Family Services Commission
23
7.
RECOMMENDATION 1: ConcerningtheAFDC Program
ThatJhe Legislature, acting on a valid assessment of. need by the
Department of Economic Security, increase appropriations to
the Department such that AFDC payments will be. adequate to
maintain the integrity of the family unit in need. The assessment
conducted by the Departmont should include. development of a
Standard of Need, and befundt:d at that level.
lit ore than 50,000 Arizona
children now receive
. . assistance through the
Aid to Families with Dependent
Children (AFDC) Program; over
half of these children are under
eight years of age. In order to com­pute
household budgets and
8Flsistancepayments, our state
uses the 1971 "Staridard of Need,"
and stipulates that the total
. minimum . living needs of one
parent and three children is $282
a month. However, due to in­sufficient
appropriations to the
Department of Economic Security,
the agency responsible for the
program, such a family actually
receives only 70% of this figure, or
$198. In addition, the Consumer
Price Index, the primary factor in
computing the Standard of Need,
has risen 40% since 1971; in other
words, the amount a family of four
receives, $198, is only 43% ot the
federally established poverty level
of $459. puring 1975, Arizona's
level of support for needy parents
and their children ranked 42nd
among the 53 states and
possessions, based on. maximum
AFDC as a percent of median
family income for the state.
8
Beca use of these grossly
inadequate assistance payments
and the lack of supportive ser­vices,
most of. the families
receiving AFDCpayments in
Arizona are forced to. live in a
state of continual crisis which of­ten
results in family disin­tegration.
Additionally, eince
these assistance payments cannot
. . . Aid To Families With
be made available to households
with an employable male present,
it is common knowledge that
unemployed fathers are forced to
desert their families in order that
their wives and children can
become eligible for AFDC
payments.
Thus, a ,substantial per­centage
of Arizona's children, in­cluding
those yet to be born; are
potential long-term charges upon
the taxpayer . throughout their
lifetimes. The known con­sequences
of poverty are
malnutrition,mental retardation,
poor health, school dropouts, in-
'stability, delinquency and crime.
Department of Economic Security
records indicate that ap­proximately
one-fourth of the sub­stantiated
child abuse and neglect
cases occur in AFDC families. It
has been estimated that 30% of
all the people in penal institutions
are former AFDC children.
This expensive
and illogical manner in which
AFDC is funded in Arizona is best
exemplified by the following:
Arizona pays $1.40 .. a day to a
child in his/her own home through
AFDC. However, once the child is
removed from that family into
foster care, the .support expense
jumps from $3.64 to $5.00 a day
plus the cost of comprehensive
medical and dental care. Finally,
if the child becomes severely
emotionally distrubed - not
unusual for some children after
spending years in oft-changed
foster homes - the state will and
often must pay up to $40.00 a day"
for a child care.institution. The
dissolution of the family; forced
desertion of the fa ther,
malnutrition, mental retardation,
and chronic illness - all these.are
indisputable evidence of .the
results of a fiscally short-. sighted
public assistance program: Cer-
. tainly there can be" no. compar­isonbetween
the incalculable
price paid by th.e AFDC recipi~nts
and the "fiscal economy" which
the Legislature has mandated "by
failing to respond to the budgetary
request of the Department of
Economic Security for an ap
propriation sufficient to meet
the needs of AFDC families.
"RECOMMENDATION 2: Concerning theAFDC-UP Program
Th'af/the Aid to Families with Dependent Children - Unemployed
Parent' Program be reactiva.ted" with,' sufficient appropriations
and workable, realistic regulations, such as to insure ac­cessibility
for qualified families.
Dependent Children
hat ,the State has the
responsibility to protect
and assist its citizens,
as dividuals and as mem­bers
of a family, is amuch spoken
but little acted on principle. In
1965, after ,years of ,advocacy by
concerned citizen groups, the
Ariz~na Legislature enacted the
Aid to Families with Dependent
Children - Unemployed Parent
(AFDC UP) Program,
recognizing and mandating the
responsibility of the State, to
provide material assistance to in­tact
families and households in
which the father" or t~e head of
householdis present but unable to
secure employment ,and, therefore,
the necessary income for the basic
living needs of the family.
With the passage of this
program," a "limited appropriation
was made and policies were draf­ted.
These policies were so restric­tive
as to disqualify or dissuade
all but 25 families in the entire
state from securing the benefits of
the program. Following this, there
were year-end surplus funds in the
program; these were regarded by
the Legislature as an indication of
the lack of need for the program.
'Thus, there have been no, further
appropriations by the Legislature,
despite recent. efforts by the
Department of ECQnomic Security
to reactivate the program .
. The unfunded AFDC - UP
program contradicts any
protestations on the part of the
Legislature as to th~ value and
significance it places on the in­tegral
family. Except for
inadequate emergency assistance
funding, Arizona continues to
deny assistance to ,a family or
household in which either \ the
father or an employable male is
present, regardless of the
documented inability of that in­dividual
to secure employment.
Unemployment compensation, in a
majority of cases, is not a viable
alternative, primarily due either
to the expiration of entitlements
after long unemployment, or to
the failure to have previously
satisfied the requirement of the
minimum quarters of regular em­ployment.
The consequences of the
State's failure to fund this
program are grave; the father or
head of the household is often
compelled to desert the family in
order that the children and
mother may qualify for AFDC.
Thus the integrity of the family,
a'nd the love and reassuring
presence of the father is denied to
the children simply because the
Legislature, based on an ill­conceived
effort years ago, has
failed to refund a program.
9
lIIilhons of dollars were
, ava. ilable to Arizona from
. 1970 through 1975, and
were lost because of the State's
10
failure to take advantage of finan·
cial assistance from the federa:!
government. Through several
amendments to the federal Social
Security Act, dollars were
available to the State on a mat·
ching basis; the match, in most in·
stances, would have been provided
by local governments and agen·
cies, and organizations in the
voluntary sector. Title XX of the
Social Security Act was begun to
be utilized in 1976, making funds
available for such services as day
care, protective services for
children and foster care. However,
Arizona has still failed to utilize
its full potential in these funds -
$24~million for Fiscal Year 1977.
. The federal intent of Title
XX (and the other amendments)
to the Social Security Act is to
assist states to develop and
strengthen social services
programs. Aimed principally at
low income and handicapped per·
sons, and families and individuals
under stress, Title· XX expresses
Congressional intent in the
provision of social se.rvice
programs in areas and to persons
previously unserved, as well as the'
extension and upgrading of
existing social programs. In effect,
the intent and hope of the
Congress is to impact and to deal
more effectively than 'in the past
with those problems and needs of
families and individuals which
Title XX
impair their self·sufficiency, and
which create and perpetuate their
dependency on governmental
assistance. Many of the service
programs, either innovative or
ameliorative which are proposed
in this report will in volve consid. '
erable costs;
Title XX could be a ready source
of the funding needed. What is
required and indicated is prompt,
efficient action on ,the part of
the State through the' Depart.
ment of Economic Security.
The Department has the design·
ated responsibility to gear up the
machinery and processes for a full
utilization of the Title XX funds.
The Councils of Governments
and other parties in the state have
subm,itted plans documenting
priority needs and proposing
programs responsive to those
needs which could be funded by
Title XX; It is encouraging to note
the readiness of many local
governments .and elements in the
voluntary sector, including United
Way organizations, which have
volunteered to put up the local
matching funds required, thereby
effecting. a partnership with the
state and federal government in a
long overdue strengthening and
extension of the social services
system.
It is critically important in
the use of Title XX funds by the
state that nothing be done to sub·
vert the intent of the Congress.
Title XX funds must not be
used simply to replace State or
other funds in or der. to refinance
"old" services. This will merely
maintain .the status' quo. The'
short· term savings of taxes and
other funds would, in the last anal·
ysis, be counter·productive in
every sense of the word. Social
problems will continue. to worsen
and will ine~itably result in an
increased, ~ontinueddependency
requiring more' and more costly
services. Title XX is one major
opportunity' to effect changes; in a
human services. system which is
manifestly inadequate; Arizona
cannot afford to misuse this. opp.
ortunity.
RECOMMENDATION 3: Concerning the Full Utilization of Title XX Funds
That the Legislature .and the Department of Economic Security act im-
. mediately to develop and implement a process for the full
utilization of federal funds through Title XX, and act im­mediately
to take advantage of all solicitations of aid from local
agencies and o~ganizations which will assist in this utilization.
\ 11
RECOMMENDATION 4: Concerning Education for Parenthood
That education-for:-parenthood courses be offered for every child and
youth in every junior and senior h.igh~chool in. the. sta,e, ~nd
that these courses include information In at least .th.e. ~ollow Ing
areas: child development, parentallega I responsibilities, . and
causes }ind results.of child a bu se and neg lec t. Furtner explor­ationof
the needs of teenage parents and prospective parents
should be conducted)bY·the appropriateagenc les.
Teenage Parents
en percent of all 17 -year­old
women in this coun­are
mothers and 16%
women already have at
least two children. In Arizona
20% of. the children born.in 1975
were born to mothers 18 years old.
and under; this percentage is
rapidly rising. In Maricopa
County, 11.4% of all births in
1973 were to young single
mothers. In Pinal County, almost
one-third of the mothers in 1974
were teenagers. Adolescents from
ten to fourteen are the only group
of women for whom the birth rate
is rising rather than declining. Ex- .
cept in the major population cen­ters
of Phoenix and Tucson the
support services essential toassist,
these young people to cope with
pregnancy, birth and the com­plexity
and significance of their
role as parents are few and
fragmented.
Of the 160,395 secondary
school students in Arizona, only
about 4% are enrolled in some.
kind of elective family life or child
care course. If high school girls
become pregnant, despite the. fact
that the rural areas have the
highest rates. of birth to teenage
mothers, most of the special
programs designed to assist them
IHe in the metropolitan high
school districts For
teenage parents who have dropped
out of school or who do not live in
12
these few districts, programs to
assist them are practically inac­cessible.
The critical need for
education for parenthood and sup- "'
port systems for the teenage
parent should be. obvious. Most
teenagers, through lack of
preparation for parenthood,. are
not familiar with what to expect
in a child's development and lack
knowledge of how to care for their
babies properly. Many young
parents of today are physically or
socially isolated from their
parents, gran<1parents, uncles and
aunts who at one time provided
the necessary information and
support. Since these young parents
usually are economically disad­vantaged
in terms of occupation,
income and assets, they often must
bear alone the heavy personal,
legal, social and psychological
responsibilities for raising their
children. Due to the lack of
knowledge about their baby's
development, increasing numbers
of ·teenagers tend to have
unrealistic expectations leading
often to harsh punishment, abuse
and neglect of their children. Fur­ther
evidence of the lack of
preparation for family living and.
parenthood is seen in the fact that
nearly half of all teenage
marriages break up within five
years and teenage marriages
resulting from pregnancy are three
,times more likely to dissolve.
The mortality for babies of
school age mothers is nearly three
times as high as for. infants of
women 20-24 years of age and in­cidence
of. low birth weight is
greatest among teenage mothers.
Low birth weight decreases the
chances. for the baby's survival
during the first year .and has an
adverse affect on the child's later
development. Girls in their teens
have a greater· probability of
serious health problems during
pregnancy and delivery than any
group except women over .40. Yet
pr.egnancy is • the major known
cause of female school dropouts in
the U.S.
"Education for parenthood"
has caused confusion in some
districts because of a ruling by the
State Board of Education, which
removed health education as a
requirement for graduation. This
action has been interpreted
erroneously to mean that paren­thood
education is not allowed; in
point of fact, the Board has not
acted on this matter.
A variety of programs need to
be available statewide to help
parents and prospective parents
understand better the develop­mental
needs of young children,
and the complexity and
significance of their· role as
parents. Without such programs,
many of Arizona's teenagers will
continue to marry with unreal­istic
expectations, will continue
to parent unwanted and unheal­thy
babies, and will continue to
abuse and neglect their children.
Health Care
dequate nutritional,
educational, pre-natal,
and pediatric care are es­sen
to the promotion of health
and prevention of disease and can
significantly determine a person's
ability to finish school, find· a job
and make a contribution to
society. As, a child grows from
birth to maturity, he/she is depen­dent
upon the critically-timed
acquisition of preventative and
therapeutic health care in order to
develop optimally. Beyond any
doubt, lack of such care at the
proper time will have permanent
negative effects on a child's
health. The rate of physical
growth. is most rapid at birth and
is at a continuous rate of
deceleration from birth until
adolescence. Consequently, en­vironmental
factors have their
greatest effects on growth early in
life.
The tremendous inequities in
our health system which results in
great suffering and enormous state
expense in'terms of rehabilitative
care are obvious. The biggest
health problem for families is
poverty, according to the recent
pUblication of the National,coun­cil
of Organizations for Children
and . Youth entitled, America's
Children, 1976. Not only is a poor
family less able to find and pay for
health care, but poverty itself
creates conditions that lead to a
cycle of ill health and continuous
poverty. As this pUblication cites:
• The effects of poverty on the
child begin before birth. Ten
to fifteen percent of babies
born to lowest income
families have low birth
weights; for all families this
figure is only 8%. Physically
and mentally crippling birth
defects are three times as
likely among low weight
babies.
• A major cause of low birth
weight babies is malnutrition
of the mother starting in her
own youth. One-half (urban
white) to two-thirds (urban
black, rural white)' of
pregnant women in poverty
are· malnourished.
13
14
• Most disabling physical and
mental conditions that do not
begin before birth originate in
infancy and the pre-school
years1 Lack of health care can
cause permanent damage. In
1970, 50% of low income
children under 18 saw a
physician; the figure for high
income children was 73% .
• The average health ex­penditure
for children who
had some treatment in 1970
was $86 for children of the
poor and $161 for children of
the higher income families.
,Because racial discrimination
affects health service delivery, and
because minority, children are
more often living in poor families,
they are generally less healthy
than other children:
• Minority children die at a
substantially higher rate than
white children; 70% higher at
age' one to four, 40% higher at
age 'five through nine.
• Non-white mothers have low
birth-weight babies at twice
the rate of whites.
• The death rate among Native
American children from heart
disease, influenza, pneum­onia,
and suicide is more
than double the rate for other
children.
Where' children live strongly
affects their chance for good
health:
• Urban areas have 48% of the
population and 86% of the
doctors.
• Seven of Arizona's fourteen
counties do not offer public
programs for pre-natal. care.
• Three quarters of the nation's
1,700,000 mentally retarded
children live in slums.
Medicaid, established by Title
XIX of the Social Security Act,
was started ten years ago by' the
federal government to provide
matching funds to the states to
pay for the medical expenses of
both those on' welfare and those
who would be forced onto welfare
by trying to pay their own medical
costs.
Arizon'a was the ,last state to
enact Medicaid; Arizona is' the
only state which has failed to fund
Medicaid. '
By current estimates, 104,000
needy Arizona children would be
eligible for Medicaid, representing
69% of. all Medicaid eligible in­dividuals.
These children would
be eligible for early and periodic
screening diagnosis' and treatme~t
(EPSDT). The, purpose of the ,EP­SDT
Program is to discover
problems at an early age and
provide early treatment which
should result" in a lower death
rate, reduced~erious illness and
reduced institutionalization. For
the~ajority of the 104,000 eligible,
children, Medicaid would
represent the first introduction to
preventative medical services and
needed diagnostic and ,treatment
services.
Although Medicaid is not
meeting the entire health needs of
eligible families in other states "
throughout the country, and there
are enormous:,' difficulties in
program administration and
monitoring, the loss of more than
200 million federal Medicaid
dollars ,that would have come to
Arizona, plus the inadequate and
inequitable county system which
presently exists,' certainly makes
Medicaid a significant if partial
solution, to the indefensible, plight
of Arizona's needy families.
N()t only would Medicaid
provide the EPSDT Program, but
also eye care, dental care, and
transportation needed to obtain
medical services. Medicaid would
~stablish a uniform eligibility
standard" statewide, establish Ii
new uniform group of health care
services statewide, promote the
end of the present dual health
RECOMMENDATION 5 :Conceming Health Care "for Children
That the Legislature appropriate~ either through its own funds or
through the development of. appropriate local funds, sufficient
monies to make the Medicaid program or similar services a
reality for Arizona families.
care system by helping to make
county facilities self·supporting for
reimbursement, and expand
health services available to needy
Arizonans.
Without Medicaid, counties
.. will continue to have to bear the
cost alone. for the increase in
medical services and th.e" increase
in the number of/indigent in·
dividuals. Tax rates will have t~
;ise o~ health care services and
eligibility will have to be exen fur!
ther restricted.
Costs of curative health care
for families continue to skyrocket.
So many health problems of
children can be traced to poor con·
ditions in early childhood that it
makes undisputable sense, as well
as good economics, to improve the,
conditions that would prevent the
llroblemsfrom occurring. Accor'
ding to a 20 year study conducted
by the federal government, A.riz·
ona r,anks last in the nation in
term s of per capita expend it ures
,for medical care.
Arizona must change from
treating its children solely on a
crisis basis which results in many
of them reaching school age - for
those fortunate e~ough to survive
- without medical care and im·
munizations. When compared to
the costs in human suffering and
potential, the expenses of
rehabilitative care and the loss to
?
the community of useful members,
expenditures for prevention are by
far the least expensive of the alter·
, natives' available to the State.
15
16
pay Care
he' demand for day care
nationally and statewide
is enormous and in­creasmg
rapidly. Between 1950
and 1970 the. participation of
women in the labor force in­creased
fro~ 33% to 43%. During
that same period, however, the.
participation of mothers in the
labor force alm08t doubled -
from 22% in 1950 to 42% in 1970.
Presently, one out of three
mothers of pre-school children is
in the labor force and almost half
the mothers' of children under 18
are working. By 1980, working'
mothers of pre-school age children
alone are expected to increase by
over 1.5 million. This rise in the
number of working women is not a
temporary phenomenon and. is
economically significant. In
families with working wives,
women now' account for 26% of
the family income. Additionally,
in the years 1960 to 1974 thenum­ber
of children being raised in
families solely supported by
women has more than doubled
and their numbers are rapidly
rising. Statistics indicate that one
out of seven children, is being
raised by~a single parent and 30%
of these children are under six.
Specific reliable statistics
regarding Arizona's working
mothers are difficult to obtain.
However, there is every reason to
believe that the Arizona figures
are comparable to national figures
which would mean that 30% of
Arizona mothers of children under
six are in the labor force.
Nationally, even though the
number' of places in licensed day
care facilities has risen rapidly in
the past five years - from 250,000
to 700,000 - the total picture has
not improved. While. the 450,000
places were added, the number of
children under age six whose
mothers are working increased by
800,000. In Maricopa County, the
1970 census found that there were
22,409 working mothers with
children under' six. Yet, as of.
April, 1974 there were only 203
.licensed day care facilities having
a total capacity of 12,938 children
to serve these 22,409 working
mothers.
The number of day care
places is an important factor; a
more important one is the quality
of service. It has been
unquestionably demonstrated that
the years from birth to age six are
the most crucial in terms ~f life
,time patterns and later develop-ment.
These are the formative
years during which thousands of
Arizona's young children are spen­ding
up to nine and ten hours
daily in day care s,ettings. The
state of, Arizona licenses only
group day care centers; there is. no
licensure of family day care homes
in which 90% of the children of
RECOMMENDATION 6: Concerning the Use of Federal Funds for Day Care Services
That the Department of Economic Security, Social Services Bureau,
establish an equitable sliding fee schedule for daycare services
which would eliminate any sharp cutoffs of service for any
population covered, and that the Department utilize ad­justn:-
ents in this fee schedule in order to offset any changes in
the required federal ratio.
working mothers are placed. A
1976 legislative revision to the
day care licensing law should
strengthen ,the Department of,
Health's ability to regulate those
licensed centers that. are
detrimental to the well-being of
children; However, little is known
about either the estimated 10 per
cent of centers that are unlicensed
or the thousands of family day
\. 'care homes for which no state
licensing procedure is required.
Although the demand for day
care cuts across social and
economic lines, one of the largest
users of day care are families
whose-.incomes place them slightly
above poverty level
traditionally the blue collar or
low-middle income bra~kets.
These families· must have two in­comes
to get by, and day care for
their pre-school and· school age
children is a matter of economic
necessity. These are the families
that are not qualified for public
assistance, yet certainly have in­comes
inadequate to pay $80 to
$110 a month for day care ser­vices.
The principle dilemma that
these parents face is not the choice
of whether to enroll the child ih
group care, arrange for family day
care, or kee-p the child at home,
but the necessity to find some
form of substitute care in the
reality situation in which
relatively few resources are
available. A national survey con­ducted
in 1975 on "Child Care
Arrangements of Working
Mothers in the United States"
revealed that .46% of children un~
der 14 covered by the survey were
cared .for in their own homes while
the mothers worked. Of these, 8% ,
or more than half a million, were
cared for by another child under
16. Of all children of working
. mothers, 13% (1.6 million) were
cared for by the mother at the
place of work. Care outside the
child's home accounted for only
10% of the children of working
mothers, 7% in family day care
settings and 3% in group care,
notably the rares~ of all
arrangements.
There' are many individuals
and groups around the country
who sincerely believe that the day
care cure is worse than the
disease, that providing day care
for children of working mothers is
actually destructive to families
and children. Specifically, they are
convinced that such measures will
only weaken the mother/child
relationship, and thereby un­dermine
the child's emotional
security and subsequent per­sonality
development. In answer
to such concern, experts and
researchers such as Urie Bron­fenbrennerhave
pointed out that
studies have failed to show any
difference in performance between
children raised by their own L
purents· at home versus children
exposed to good substitute care for
extended periods; also, research
clearly shows that day care
children do exhibit strong mater­nal
attachments. It is the lack of
good, stable day care situations
which often is the cause of family
breakdown. A recent Mass­achusetts
study of children in
foster care indicates that 29% of
the natural mothers questioned
stated that the. availability of day
care may have prevented the
placement of their children in
other homes.
This all points to the
followinl{ conclusion: The demand
for quality day care in Arizona far
outstrips the supply. The result is
that the great majority of children
are being cared for in informal
arrangements in their own home,
or in arrangements in an unlicen­sed
.day care home. While some of
these situations may be excellent
and suit the family and child's
needs very well, experience has
shown that many of them are at
best custodial and at worst
destructive. '
With the availability of Title
XX social service funds in
Arizona, day care services are now
available to a much greater
population of low-income families.
Furthermore, mandated minimum
17
standards of care are greater for
this population-at-risk. The State
of Arizona 'and the Department of
'Economic Security are to be com­mended
for having taken great
strides in meeting this serious
problem.
18
A serious' drawback. in the
low-income day care service
provided in Arizona since' the ad­vent
of Title XX, however, is the
absence of a sliding scale of fees
allowing parents to pay a . portion
of the cost based on ability to pay.
Currently, a family of four with
both parents working or a single
parent family of four earning $870
per. month is eligible to receive
free day care. The same family
earning $871 per month would be
ineligible, and required to pay the
full cost of $80 to $110 per month
themselves. Yet, as pointed out
above, these are the very families
for which there is an economic
necessity in day care and for
whom this full cost creates a true
economic burden, even with both
parents working.
A second consequence of these
eligibility levels is under­utilization
of federal dollars for
a~sistance recipients. During the
summer of 1976, utilization of day
care services by AFDC recipients
dipped to 27% of the total
program. Federal regulations
require that 50% of the federal"
share be expended on assistance
recipients (for.day-care, this would
require a 37.5% AFDC .utilization
as federal share equals 75% of the
total program costs). State' of­ficials,
. consequently, are con­sidering
a reduction in the
eligibility level from $870 per
month. '
Although consideration. was
originally, given to a sliding fee
schedule for day ~are services un;
derTitle XX, it was decided not
to initiate one due to the ad­ministrative
problems this would
incur. Consideration should 'be
given, however, to establishing a
sliding scale of parent fees. If the
. federal' expenditure rate required
adjustment in the, eligibility level,
the result would not be total'
elimination of segments of the
low-income. population from
eligibility, as is presently the case,
but'rather, aslighdncrease in the
rate they would pay.
RECOMMENDATION 7: Concerning the Provision of In-Home and
Family Rehabilitation Services
That the Department of Economic Security, and the Legislature' if
necessary, give greater priority to the provision of in-home and
family rehabilitation services and develop a mechanism to per­mit
services .to be rendered to families without the necessity of
having the child adjudicated dependent or incorrigible.
"FosterCare
of Arizona has
assumed the primary
responsibility for ap-
3000 children ,under
18 years of age. These children
live. in state-sponsored foster, care,
including foster family hom~s,
group ho~es and child welfare in­stitutions.
For a large number of
these children, i the state has
assumed responsibility because no
one else is available. Some are or­phans;
others have been volun­tarily
relinquished by a family no
longer willing' or. able to care for
them; and still others are placed
in foster care because the state has
seen fit to intervepe and to remove
the child from parental custody.
Some 40% of the childrenin foster
care ill Arizona are there due to
abuse and neglect by their natural
parents.
Foster care is traditionally
seen as short term care, a "way
station" either to adoption or
eventual return to the natural
parents. The actual facts' are to
the contrary: only a negligible
number. of children in foster care
are ever adopted, and well over.
half the children remain in long
term foster care. The average
length of stay in foster care.for a
child in Maricopa County ac­cording
to a 1974 DES study, was
three and one half years. Ac- .
i 'cording to a recent Child Welfare
League publication, the major
exodus. from foster care occurs
during the first year after entry,
when three out of ten children
leave. There is also a rapid decline
during the ~ext two years so that
at the end of three years it has
become only a modest outflow and
most of. the children then in care
tend to be destined to spend the
remaining years of their childhood
as foster children.
What happens to the .children
while they are waiting? This in­limbo
status is one of the most
destructive results of foster care;
the longer children stay in un­planned
and unsupe~vised ,foster __
care, the more likely. they are to
show signs of severe emotional
disturbance. Few relationships are
stable for foster children. Natural
parents are often not seen on a
regular basis; case workers and
social workers come and go with
frightening regularity. Foster
parents must give up the child
when they need to move out of
town, because of their own ill~
health, or due to their inability to
cope with the child's problems and
needs. Children institutionalized
through the foster care program
are traumatized. further by high
rates of turnover in both the in­stitution's
staff and its foster child
population. '
In spite of widespread
statements about the integrity of
the family, the foster care
situation in this state refutes that
as a true concern. The' -crurent
program more often than not
splits up families by placing
children in foster care without
first exhausting all available
resources . to hold the' family
together. Often, it is only after the
child has gone through the court
system and is adjudicated a ward
of the court that services become
available to assist his/her troubled
family. In a recent Massachusetts
study of children in foster care,
almost one-third of th;-natural
parents contacted felt that the
provision of some needed services
would have made foster care
placement unnecessa~y.
Once the child is placed in
foster care, "family", often
becomes a slogan. The hope of
reuniting a child with his/her
family is clung to even when .this
is often unrealistic, such as when
parents have never established. a
home or when neither parent has
positive ties to the child. In only
48% of the cases reviewed in the
1974 DES study, when adoption
was the plan and the parents
whereabouts unknown were
petitions filed .requesting ter­mination
of parental rights. And
in cases where a possibility exists
for rehabilitating the family, the
19
RECOMMENDATION. 8: Concerning the.Permanent PlacementoL Children".
- --~ ---- -- --- --
That the Legislature amend the present severance statute in order to
provide additional grounds for the termination of the parent:­child
relationship for. the purpose of affording children who
have no reasonable probability of permanent reunion with the
natural parents the opportunity, for placement in adoptive.
homes, and that the Department of Economic Security, in cases,
where restoration of the child to the ,natural family is not
possible or appropriate, I either. work rapidly to sever the child
and place him/her as soon as possible in an adoptive home,
or arrange appropriate long~term foster care.
delicate job of patching up brokan
families is often not .even begun
due to a number of factors in­cluding
large worker caseloads,
rapid turnover rates among
caseworkers, lack of expertise and
resource knowledge.
Most child weifare experts
agree that children who have
already suffered physical
separation from their own parents
should be spared further un­necessary'
moves while living un­der
substitute care; they need' con­tinuity
of environment and ,con­tinuity
of relationships with other
significant individuals. All recent
Arizona studies and reports
dealing with foster care point
directly to the inadequate number
of qualified foster' homes, Plu­ticularly
for children with special
needs. There are many reasons
why the situation could not lie
otherwise.
The formal recruiting-.
screening and training of foster,
parents is minimal. Only 1% of
the Maricopa County parents
studied in the 1974 DES study haS"'"
been recruited through formal
recruitment means.
, The 1974 DES study revealed
that in Maricopa County 40% of
the changes in foster home
placements occurred due to the
inability of the previous foster
families to meet the"children's
20
n'eeds. Due to inadequate training
and overloaded ,caseworkers, there
is little support available for
foster families when problems
arise ,with the child. A foster
family that is unable to secure
requested DES support often sim­ply
demands that the state remove
the child. Due. to the pressure for
expediency in placing emergency
foster care cases and the dearth of
emergency foster home facilities, a
foster family that might be able to
care for one foster child
adequately often finds itself called
upon to care for two, three, or
more. Eventually,' upon receiving.
no casework support,' the home in­variably
collapses.
The more homes that a child
has failed in - and that have
failed a child - the more difficult
it is to place the child in. yet
another foster family and the
. more . expensive the care costs.
Eventually the only placement
alternative left is expen~ive in­stitutional
ciue at an' average cost
of $600 per month. In recent years,
in Ari~ona, there has been a
marked increase in the number of
children, many of whom by then
are teenagers, who h.av'e ex­perienced
many foster home
placements which culminated in
institutional placements.
The increased use of in­stitutional
placement is also due
to sheer numbers. While the num­ber
of foster. children in the state
under ten years of age decreased,
over the past six years, the num­ber
of teenagers in care has in­creased
over the same period by
, 20%. Most of these children .find
themselves in institutional care.
Many of these teenagers might
have succeeded in family foster
homes if well trained and ap­propriately
paid foster parents
had been available. .
Foster care costs about three
to four times as much as it would
cost an intact. family on;a low
budget to raise the" same child:
Clearly ,the cost of keeping a
family intact by providing
necessary services to achieve per­manence
for the child is lower
than or about the same as the cost
of foster care. Where out-of-home
placementis.the only option, and'
it must be recognized, that for
many children foster care is the
only choice, the ultimate savings
to the State of . having well
screened, . trained and paid" foster
parents could be significant.
These criticisms of Arizona's
foster care program are not meant
to be a blanket indictment of'
foster care as a type of care., The,
damage to children in foster. care
is a function of the low quality of
that care and the .largely un­planned
nature of the service.
RECOM'MENDATION9: Concerning Expansion of· the. Permanent Placement Unit
. That the Department of Economic Security expand the permanent
. placement unit in Maricopa County to the entire state (in order
,to assure every foster child in placement the attention of a
specialized worker whose sole function is to work with the
child, the natural parents, the foster parents and, if appropriate,
: potential adoptive parents.
Both conditions exist because of
the continued indifference of both
the public and the State to the fate
of thousands of Arizona's
children. Even six years ago,
. authorities in the child welfare
field in Arizona were signalling at­tention
to the dangers of un­planned
long term foster care.
Over the past few years there has
been growing public and State
concern with respect to the cost of
foster 'care and the children who
seem fated to spend all of their
childhood in· foster care.
The Department of Economic
Security recently singled out foster
care as a number one priority. A
permanent placement project in
Maricopa County presently con­sisting
of six' workers and one
supervisor has, over the past three
years, been demonstrating the ef­fectiveness
of caseworkers having
small specialized caseloads
working intensively with foster i
children' and their families; This
tiny unit has successfully shown its
effectiveness in moving children
out of foster care back into their
own families or to' adoptive place­ments.
If these children had
remained in care through age
18, the additional cost to the
state would have been $3-million.
In addition, the Department of
Economic Security, in the latter
part of1976, embarked on It foster
care project which utilizes federal
seed money. The purposes of the
project are two-fold: (a) to begin
to develop a program of foster
parent recruitment and training,
and (b) to expedite either the re­union
of fostp.r children with
their natural families or their
severance for adoption by reorg­anizing
caseload management int~
team approach lines.
The State 4-C Committee, at
the request of the Director of the
Department of Economic. Security,
has appointed a statewide Task
Force on Institutionaland Family
Foster Care of Children to develop
an assessment of the state's foster
care program and to recommend
solutions to any problems
disclosed .. The TaskForce Sub­committees
involve over 125
Arizona citizens which include
representation from all state agen­ciesconcerned
with foster
children, the state ,legislature,
juvenile court judges, foster parent
groups, and concerned citizen
groups.
While these efforts should do
much to set a favorable climate
for change, the real action and un­derstanding
into the needs of
foster children must come at both
the grassroots and policy making
levels. For change to occur for
foster children, attitudes' must
shift to the point where those who
'. are not directly injured become as
indignant as those who are.'
21
RECOMMENDATION 10: Concerning a Foster Parent Recruitment Program,
That the Department ot Economic Security or an appropriate con­tracting
agency design and implement a workable statewide
program of recruiting, screening and training foster parents,
including special training and compensation to those foster
parents capable of caring for children with special needs,
and that the training of foster parents bea mandatory
requisite prior to placement of childr.en ina foster home.
RECOMMENDATION. 11: Concerning Recruitment. of Adoptive Homes
That .the Department of Economic Security or an appropriate con­tracting
agency design and implement a . program for
recruiting adoptive homes, particularly for older children and
children with special needs.' .
RECOMMENDATION 12: Concerning Foster Care Payments to Relatives
!
That the Legislature amend Arizona RevisedStafute8-501 to
change the definition of "foster home" so that a relative of a
foster child may be 'permitted to' care for sucha child and to
receive foster care payments.
RECOMMENDATION 13: Concerning Increased Appropriations for Foster Care,
22
, ,I '( That the Legislature appropriate funds sufficient to hire enough
caseworkers in the Department of Economic Security to
handle Arizona's foster children in an equitable and humane
fashion, 'rather than by the present practice' of overloading'
workers which results in the institutional neglect of children.
'. '
Coordinating Mechanisms
'~for Services toChlldren,
Youth, and Families
hen the State of Arizona
deals with a child, that
child is potentially
;mong at least four dif-ferent
state agencies, a myriad or
private. agencies and up to several
county agencies. The keystone to
supporting and maintaining the
integrity of the family - as em­phasized
repeatedly throughout
this report - is ensuring the
delivery of efficient, cost-effective,
, quality services to those who are
in need of them.
We have a diverse, ex­penseive,
multiple-agency deliyery,
system which is chaotic. 'It is a
potpourri of different outlooks,
goals and objectives, articulated
from and by many different sour­ces:
Geographic areas, or localities
with the greatest concentration of
resources tend to provide more
services for their children, while
other remote or impoverished
localities are neglected.
Categorical programs limit ser­vices
to certain economic, ethnic
or special-category groups to the
exclusion of others with equally
pressing problems.
The greatest barrier to better
services which is usually men­tioned
is money, and there is no
question that a greater portion of
our state's resources could and
should be channel~d into services
for families.Y et ~ even if we
received all the money which we
feel we need, many, if not most, of
the basic problems and inequities
in our system would remain. This
is principally because of the
\, fragmentation of services and
because of our inability as a com­munity
to deal rationally with the
delivery of services to people who
need them.
There are four prima'ry
elements which go into making
any delivery system work. They
are:
Planning:
This involves laying out
strategies for attaining
the objective!> which
reflect identified goals.
The goals are expressed
through the political
process, in both the
legislative and executive
branches. This is an im­p~
rtant responsibility of
both branches of govern­ment
and involves
defining the structure for
addressing social
problems, concerns and
needs.
Coordination: This insures that
all services complement
23
RECOMMENDATION 14: Concerning the Arizona State.4C Committee,
Thatthe Governor, through executive order; or:the Legislature,
through legislation, place the staff of )the Arizona State 4C ..
Committee in a position in the State government which win per­mit
it sufficient autonomy .andlatitudeto carry out its respon­sibilities,
and provide that committee,with sufficient authority
a:nd support to enable it to truly act In the interests of'the
children, youth and families of Arizona.
each other as they move
toward the same goals
with a minimum of
overlap and duplicating
impacting. Coordinating
involves responding to
perceived gaps in service,
to fragmentation and to
other failures of the.
delivery system. This, too,
is an important respon-
, sibility of both branches
of government.
Evaluation: This is the check on
the system: are services
matching up with iden­tified
needs; are services
working toward defined.
objectives. This, too, is a
responsibility of both
branches and asks the
question, how well is the
whole system working?
Access: A delivery system is not a
static form; it shifts. and
changes as needs change,
as goals are re-defined, as
programs do not meet ex­pectations.
Public process
has two functions: to
keep a check on the
system and to provide the
system with accurate
reflections of what is
currently needed. The
public - citizens, con­sumers,
clients '- must
24
have access ,into the
system to insure that,
ultimately, the services
provided are reaching the
people who need them in
a form which·' reflects
society's goals. In order
for this to .beeffective,
responsibility for access
must be separated
enough from' the direct
control of the . decision­makers.
to insure that ser­vices
are indeed meeting
community . expectations.
Traditionally, access has
been largely controlle'd by·
the' agencies responsible
for delivering services.
This creates an inherent
contradiction of interests
and promotes public
disaffection with the ac­cess
process and,
ultimately, with the
delivery system itself.
All' four of these elements are
presently at work now, but in very
fuzzy, unclear, form. The. result is
that the delivery system itself gets
out of hand;. attempts to clean-up
the system· by "moving around the
boxes," generally results in added
confusion, lowering of efficiency
and frustration for both providers
and recipients of service.
In order to deal in a more
sane fashion with these parts of
our present delivery system and to
attempt to make that system more
flexible and responsive • to . the
needs and goals of the community,
the State 4C Committee strongly
. urges that serious consideration be
given to the creation of a coor­dinating
mechanism which would
address these elements.
The 4CCommittee, as it is
presently constituted, in­stitutionalizes
the' access element
within the public realm, providing
access and input into the delivery
system. However, in addition to
maintaining the 4C Committee in
its present form, it is equally im­portant
that a Family Services
Commission be established, which
would institutionalize the plan­ning;
coordination and evaluation
elements described above in the
legislative and .executive branch~s
of Arizona's state government.
The Family Services Com­,
mission - created by either
legislation or executive order -'
would have the responsibility for
',. assessing the needs. of. children,
youth, and families, evaluating
the efficacy of existing services for
meeting legislatively defined ob-·
jectives, developing coordinated
strategies to increase results
within resource constraints,and to '
RECOMMENDATION 15: Concerning the Creation of the Family Services Commission
,~That the Governor, through executive order, or the Legislature,
through appropriate legislation, create and establish the Family
Services Commission which will have the duties and respon­sibilities
outlined in this report, and which will be represen­tative
of executive, legislative and provider agency points of
view.
create overall plans for the
delivery of services to children,
I youth and families. The Com.
mission must be representative of
executive, legislative and provider
agency points of view; it must also
have political authority and
flexibility. Planning coordination
and evaluation need considerable
administrative authority. It is a
full·time responsibility and should
be treated as fuch by the creation
of a commission separate from the
delivery system.
The Commission would make
recommendations, based on its
findings and reviews, to the
Legislature, the Governor, and the
Directors of the Departments of
Health, Economic Security,
Corrections, and Education. All
recommendations will, in turn, be
reviewed by the. State 4C Com·
~ittee to insure public awareness
and input. The Commission
should have its own staff, which it
wilL hire and fire. The staff will
maintain liaison with all of the
departments and agencies in the
state whose activities impact
children, youth, and families. The
purpose of this liaison is to insure
that sufficient' information is
provided to the Commission so
that it can adequately plan and
coordinate the provision of ser·
vices to children. All agencies
which conduct programs im·
pacting on children and youth will
b,e required to cooperate with the
Commission by making available
information which is needed for
the Commission to perform its
mission.
The State 4C Committee
should continue to provide a con·
duit for information flowing bet·
ween, on one hand, the
Legislature, the Executive and the
Commission and, on the other, the
community at large, including
consumers and interest groups. Its
function is that of communicator,
facilitator, not of lobbyist. It
should .continue to organize and
provide access for constituencies
who are supportive of programs
for, children, youth and their
I families; it should continue to
. educate the public about
problems, opportunities and
programs; . it should continue to
provide a forum so that concerned
citizens can have access into the
planning, coordination,
evaluation, and, ultim:ately, the
delivery processes; it should con·
tinue .to work to protect children,
youth and their' families.
The 4C Committee,as stated,
should maintain its present struc·
ture and staffing, and should con·
tinue to encourage the develop·
ment and establishment of local
4C organizations. However, it is
essential that the 4C Committee
be placed in the State government
in such a manner as to provide it
with sufficient visibility and
autonomy so that it can carry out
its functions to the highest degree
possible.
Both bodies - the Com·
mission and the Committee -
should be staffed sufficiently to
carry out their responsibilities
without having to rely on
borrowing additional staff from
the service delivery agencie~.
Borrowing staff, unfortunately, of·
ten means borrowing a specific
point of view as well.
Delivery systems set up within
state or local agencies or by
narrow·purpose public and private
groups, by and large, deliver only
those services in which the per·
sonnel in that particular agency or
group have .specialized training or
services which fit the com·
paratively narrow purpose of the
group. Ways such, as we have
described must be found to
develop delivery systems which
are designed to provide a broad or
comprehensive set of services to
meet the multiple needs of young
children and their families.
Although the specific ways in
which planning, coordination,
evaluation and access may change
25
and vary with experience. it is im­portant
to keep out front the basic
. concept of balancing the power of
the various components of the
system and providing public input
into the system. Whatever form
these ultimately take, they must
be clearly delineated so that the
delivery system as a whole· can
meet the expectations of all those
concerned.
26
,.'", 'I"~ 'a...