Policy
Excel by Eight Foundations
The brain develops faster from birth to age three than at any period in life, building the foundation for future learning, behavior, and health. Parents play a lead role in healthy development, but many are stretched in the earliest months and years of their child’s life. Whether providing direct support or through a community-based network of organizations and programs, government has a role to play in helping parents access needed services. With this early support, infants can grow into healthy kids who are confident, empathetic, and ready for school and life—and our communities, workforce, and economy become stronger and more productive as a result.
Prenatal to Age Three is Critical for Brain Development
A child’s experiences in the first three years are the bricks and mortar of brain development, with more than one million new neural connections forming in an infant’s brain every second. As research from the Center on the Developing Child at Harvard University shows, responsive relationships and positive experiences build a sturdy brain architecture that becomes the foundation for core social emotional intelligence, early executive functioning and self-regulation, and literacy—skills that are all critical for later health and success. Experiences begin at home but can also be provided through effective programs and policies.
Early Investment Works
It’s not only infants, toddlers, and families who benefit when we start early—it’s entire communities. When we invest in the first three years of a child’s life, we can reduce the need for more expensive interventions later. Research from Professor James Heckman at the University of Chicago found investments in high-quality programs that support young children starting at birth deliver a 13% annual return—significantly higher than the return delivered by preschool alone.
Our Policy Agenda
The Excel by Eight Foundations Collaborative has developed a policy agenda that builds on existing knowledge of how to best support families with young children. We want children to have healthy beginnings and for families to feel supported and have access to high-quality child care and early learning experiences.
E8 Foundations has four focus areas:
Healthy Beginnings
A healthy beginning starts before birth. Expectant mothers need access to comprehensive prenatal and postnatal care, screenings and services to ensure infants are born safely and continue to thrive. Once born, infants need access to ongoing well-child visits, developmental screenings, and any needed therapy services and social supports identified by those screens.
Supported Families
For healthy development, infants and toddlers need quality health care, stimulating learning opportunities, and nurturing, responsive relationships. A system of support should be in place at or before birth to ensure every parent and child receives the needed information, assessments and referrals for a strong start. Home visiting programs are a key strategy for providing these resources.
High Quality Child Care and Early Learning
High-quality child care must be accessible and affordable. Whether it’s in a center or through a home-based program, stimulating learning opportunities and nurturing, responsive relationships are crucial to healthy brain development. High-quality child care also gives parents the peace of mind, so they can focus on work.
Maternal Health
Ensuring adequate maternal health care before, during, and after pregnancy is crucial for the healthy development of a child and can reduce the risk of complications during birth. Access to regular prenatal care, appropriate medical interventions, and support during labor and delivery can help prevent fatalities and serious health issues for mothers and babies across Arkansas.
Goals and Recommendations
The Excel by Eight Foundations Collaborative engaged in a yearlong planning process in 2023 to review and update our policy agenda. We kicked off our planning process in November 2022 with a daylong summit that convened members of the Excel by Eight Foundations Collaborative, the group that helps us develop and implement our policy agenda to improve health and education outcomes for infants and toddlers.
In February 2023, we began the nine-month stakeholder input process that involved more than two dozen one-on-one interviews followed by four surveys, 10 virtual focus groups, and seven in-person focus groups.
The feedback from more than 500 parents, child care providers, home visitors, HealthySteps pediatricians and specialists, as well as doulas and other birth workers shaped the goals and recommendations developed by our four working groups – Early Childhood Education, Healthy Beginnings, Maternal Health, and Supported Families/Home Visiting.
The following goals and recommendations will inform the Excel by Eight Foundations Collaborative’s priorities for the next several years. Download a PDF of our goals and recommendations.
Goal 1: All women are able to receive complete, high-quality preconception, prenatal, and postpartum care.
Recommendations
- Expand postpartum Medicaid coverage for a full year.
- Provide Medicaid and private insurance coverage to include doulas on the birthing team.
- Increase the number of group prenatal care sites, such as Centering Pregnancy, by exploring payer strategies to incentivize practices to adopt such strategies.
Cross cutting: Implement communications strategy to educate providers about how women feel unheard during preconception, prenatal, and postpartum care, including issues related to maternal mental health.
Goal 2: All expecting and current parents are able to receive parenting supports that address comprehensive health, wellbeing, and development topics and are tailored to individual family needs.
Recommendations
- Expand evidence-based targeted and universal home visiting strategies.
- Implement Maternal Life360 for pregnant women and new mothers at birthing hospitals.
- Increase pay for home visitors and improve service delivery by braiding existing funding sources.
Goal 3: Every family of infants and toddlers is able to receive social, developmental, and behavioral screening and referrals to needed health care and community supports.
Recommendations
- Complete the regulatory process to implement evidence-based pediatric primary care models for early childhood, such as HealthySteps, and communicate changes to health care providers.
- Expand evidence-based pediatric primary care models, such as HealthySteps, to more practices, including family physician offices and rural sites.
- Seek funding to implement process-improvement strategies to educate providers about how to ensure parents feel valued and heard in health care settings.
Cross Cutting: Implement communications strategy to educate providers about how to ensure parents feel valued and heard in health care settings.
Goal 4: Quality child care is affordable and accessible for all families.
Recommendations
- Make child care more affordable for middle income families through tax credits directly to families and employer tax policies to be developed in collaboration with the business community.
- Develop a more family-friendly system to help families learn about/access/apply for early childhood education programs (vouchers, ABC, Head Start, EIDT, etc.).
- Ensure providers, including family child care homes, are financially viable:
- Determine if reimbursement rates are covering the cost of quality care, and increase rates if needed.
- Address state and local policies, regulations, zoning, permitting, and other structural barriers that prevent access to high-quality child care.
- Pay vouchers in 12-month contracts based on enrollment vs. attendance.
- Develop shared services for providers that address HR, accounting, insurance, etc.
Goal 5: All early childhood educators are well-prepared for the complexity of child development and receive commensurate compensation and benefits.
Recommendations
- Improve wages and benefits for early childhood educators:
- Maintain T.E.A.C.H. and WAGE$ when ARPA funding expires.
- Adopt the Unifying Framework for the Early Childhood Education profession.
- Pay early childhood educators on par with public school teachers.
- Include early childhood educators who work for public schools in the teacher retirement system.