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Inclusion of Health Grant in New Family Agency Criticized

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Washington--A coalition of health groups has urged Secretary of Health and Human Services Louis W. Sullivan to reconsider his decision to place the Maternal and Child Health Block Grant under the control of a new umbrella agency overseeing children and family programs.

Dr. Sullivan announced last month that he was reorganizing the Department of Health and Human Services to focus greater attention on the needs of children and families. (See Education Week, April 24, 1991.)

The new Administration for Children and Families includes such key programs for low-income families as Head Start, Aid to Families with Dependent Children, and Job Opportunities and Basic Skills, as well as programs focused on child support, child care, and foster care.

At a hearing on the reorganization held last week by the Senate Subcommittee on Children, Families, Drugs, and Alcoholism, the proposal was generally well received by panel members and state and local officials who testified.

The new H.H.S. agency "has before it a rare opportunity to foster true coordination among programs and to help make a reality of a concept that has been discussed for years," said Senator Christopher J. Dodd, the Connecticut Democrat who chairs the panel.

He and others at the hearing voiced optimism that the plan would help weave a "seamless garment" of support to serve families more comprehensively.

But some questioned whether the Maternal and Child Health Block Grant should be part of an agency geared toward social services.

Dr. Antoinette P. Eaton, president of the American Academy of Pediatrics, argued that removing the grant program from the Public Health Service would sever its links with other agencies addressing the health needs of children and families and limit its influence on health programs "it was intended to complement."

"This potential disruption becomes even more evident at the state level," she said, where maternal- and child-health services are administered by health departments with disparate goals and regulations from those of state social-welfare agencies.

Ms. Eaton also argued that making the grant "a relatively small health component in a larger social/are administration" would limit its ''visibility and clout."

Alternative Suggested

Jackie Noyes, head of the A.A.P.'s Washington office, also said in an interview that it would be a "disservice" to give the block grant a "welfare connotation," since its focus is broader than just low-income families.

In an April 24 letter to Dr. Sullivan, 15 groups, including the A.A.P., also argued that separating the block grant from other health programs is "inconsistent with the President's emphasis on increased immunizations, substance abuse prevention, and infant mortality."

As an alternative, Ms. Eaton suggested that Public Health Service staff members be designated "to function as liaisons" to the new agency.

In testimony before the panel, however, Jo Anne B. Barnhart, assistant secretary of the new agency, said including the block grant was intended to foster collaboration between health and social services by creating a "vital link rather than just a liaison."

Ms. Barnhart also outlined plans to use the new agency to better coordinate services to children and families eligible for several forms of aid, from child support to job training.

Panel members and witnesses warned, however, that sufficient resources must be committed to ensure the reorganization does more than "move boxes around" on charts.

Also last week, the Senate Labor and Human Resouces Committee held a hearing to highlight model programs offering "one-stop shopping" services combining health, education, and social services for children, youth, and families.

Senator Edward M. Kennedy, who chairs the panel, is expected to introduce legislation to support such initiatives later this year.

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