The Commonwealth Fund Improving Childrens Healthy Development Through Federal Child Health Policy Respondent Co-sponsored by Voices for Americas Children, the National Academy for State Health Policy, and First Focus Alan Weil, Director, National Academy for State Health Policy

State Response to an Expended Federal Role for Improving Childrens Healthy Development (I) State interest is high, as evidenced by –Existing Medicaid and SCHIP standards –Participation and interest in programs like ABCD –Comprehensive approaches that operate outside traditional health delivery system boundaries

State Response to an Expended Federal Role for Improving Childrens Healthy Development (II) States face limitations in –Resources to define high quality outcomes –Provider and managed care payment levels –Primacy of medical model as funding source –Lack of focus by other payers

State Response to an Expended Federal Role for Improving Childrens Healthy Development (III) States worry when –Federal standards come without resources –Federal standards fail to mesh with existing state efforts –Federal reporting is a substitute for real interest