Funder Investments in Early Relational Health Policy

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Early relational health (ERH) is an emerging term that means, at its core, that healthy and positive child development emerges best in the context of nurturing, warm, and responsive early parent/caregiver child relationships, when children are surrounded by safe communities with strong trust and social connectedness (CSSP Center for the Study of ERH).

With many lens and entry points for supporting healthy and positive child development, there is no one policy that supports early relational health.  Medicaid, the Child Care Development Block Grant, and the Maternal, Infant, and Early Childhood Home Visiting program are all examples of policies that have intersections with early relational health – supporting children’s health development, and providing supports for the adults in their lives to help their children thrive.

There are many strategic levers that need to work in tandem to effectively defend and advance policies that support children and policies. Specific ways philanthropy can support ERH policies include:

  • Supporting innovation and quality improvement initiatives to transform health care systems and community services;
  • Supporting research to demonstrate the impact of interventions;
  • Supporting strategies to move public financing and resources for broader scale change;
  • Supporting communications for narrative change to elevate the importance and impact of early relational health on young children.

In March 2022, ECFC hosted a discussion exploring three examples of how funders are supporting ERH policy in their states.  Katie Beckmann, Program Officer for The David & Lucile Packard Foundation, opened our discussion with an overview of how Packard views early relational health, and some of the ways they support ERH policy, including:

  • Responsive advocacy networks to address challenges and take advantages of opportunities –through grassroots, state, federal advocacy as well as through the interplay between all three;
  • Research and policy analysis that highlights the impact of policy decisions on state and federal budgets as well as child and family outcomes;
  • Communications to support narrative change and to educate the public in policy levers; and,
  • Litigation to ensure public programs are implemented as intended under the law.

Deb Kong, Program Officer, The David & Lucile Packard Foundation (CA) shared a specific example of an inside/outside approach Packard used to support a Medicaid dyadic care benefit that resulted in a state-led strategy for health care services, that will improve the health of children and families, including many elements to improve ERH. Learn more about the strategy: Medi-Cal’s Strategy to Support Health and Opportunity for Children and Families. This webinar archive from Manatt Health, Strengthening Children’s Social and Emotional Health: Key Lessons From California, also explores innovative strategies and options California can use to leverage Medi-Cal, the state’s Medicaid program, for creating an equitable and advanced healthcare system that addresses the full array of factors that drive children’s health.

Another example of how Packard and Einhorn Collaborative are supporting ERH is Pediatrics Supporting Parents, which is reimagining pediatric well-child visits to include proven, scalable resources that empower and guide parents – and provide them with additional support when needed to strengthen the parent-child bond and create lasting change that helps children succeed. Learn more their Blueprint for Leveraging Medicaid and CHIP to Finance Change:  Fostering Social and Emotional Health through Pediatric Primary Care.

Becca Graves, Executive Director, Perigee Fund, shared two examples of their work in Washington state that to support and elevate ERH, including support for a legislative children’s group in the state (which previously had no early childhood focus), and resourcing a consultant to build a subcommittee focused on infant and EC mental health. Another example of resources Perigee has supported, specific to early mental health at the state level: PRiSM: Promoting Research-informed State Infant-Early Childhood Mental Health Policies and Scaled Initiatives.

Atiya Weiss, Executive Director, The Burke Foundation, shared their investment in Mount Sinai’s early childhood development curriculum, a training program for pediatric residents around early childhood, and early relational health, resulting in a statewide training program for all pediatric residents (and expanding to family medicine residents) through the NJ American Academy of Pediatrics.  The investment is supporting integration of ERH resources into pediatric practice in a systematic way with a goal of standardization, policy and reimbursement linked to inclusion of ERH program in primary care.

Watch the recording of our March 2022 webinar to learn more about policy intersections with ERH.

Related resources on ERH policy intersections:


Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health, a statement from the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health, the Section on Developmental and Behavioral Pediatrics and the Council on Early Childhood

Guide to Leveraging Opportunities Between Title V and Medicaid for Promoting Social-Emotional Development, Center for the Study of Social Policy guide designed to support state-level planning, action, and innovation aligned with the goals of the Pediatrics Supporting Parents initiative, using a framework that stretches from promotion to screening to prevention to early intervention and treatment. Find the accompanying matrix for the report here. 

Medicaid Opportunities for Supporting Early Relational Health, an ECFC Early Relational Health Workgroup call archive featuring resources and examples of supporting early relational health through Medicaid and EPSDT.

Supporting Parent and Caregiver Mental Health and Emotional Well-Being, an ECFC webinar featuring four examples from Perigee Fund, The Burke Foundation, Irving Harris Foundation, and ZOMA Foundation illustrating different, yet complimentary pathways into supporting maternal and caregiver mental wellbeing that create the conditions for positive child outcomes.

Photo credit: Photo by Jonathan Borba on Unsplash

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