Common Interests Cement E.D.-H.H.S. Ties
Last September, when a draft of the Clinton Administration's health-care-reform bill was circulated, it implied that the plan would not include health services currently provided by a popular program for children with disabilities.
The Early Periodic Screenings, Diagnosis, and Treatment program, which has been funded under the Medicaid program since 1986, is seen by educators as a source of federal funds to help pay for the health needs of special-education students and an important vehicle for detecting health problems in such children at an early age. (See Education Week, Nov. 24, 1993.)
When the final version of the Clinton proposal was released later in the fall, it contained new "place holder'' provisions that essentially promise continuation of E.P.S.D.T. services.
Education and health lobbyists, as well as officials in the Education and Health and Human Services departments, credit Secretary of Education Richard W. Riley with convincing H.H.S. Secretary Donna E. Shalala that the services were necessary to insure the health and education of disabled children.
And, observers say, the incident illustrates an unusually high level of collaboration between the two departments, which have over the past several months worked together on such issues as welfare reform and Head Start reauthorization.
"Clearly, they're working much more together'' than in the early days of the Administration and than they did during the Bush Administration, said Allan Bergman, the director of state and federal relations for the United Cerebral Palsy Associations. "It's that kind of attitude that we're in this together, none of us has any silver bullets.''
William A. Galston, a deputy domestic-policy adviser to the President, said the collaboration is related to the "reinventing government'' effort that the Administration embarked on last fall.
"The American people at this point see the federal government as a whole that is less than the sum of its parts,'' he said, and collaboration "speaks to the public sense that the federal government has to use resources more effectively.''
Moreover, Mr. Galston said, it is important for the federal government to set an example for state and local governments, which are being asked by the Administration to seek ways to more efficiently provide social services.
To highlight the cooperation between their agencies, Mr. Riley and Ms. Shalala earlier this month declared in a "Joint Statement on School Health'' that "health and education are joined in fundamental ways with each other and with the destinies of the nation's children.''
They also established an Interagency Committee on School Health, in which Thomas W. Payzant, the assistant secretary for elementary and secondary education, and Dr. Philip R. Lee, the assistant secretary for health, will bring together representatives of several agencies to coordinate health and education policy. It is an outgrowth of efforts begun during the Bush Administration to develop an interagency committee on school health.
The secretaries have also created a National Coordinating Committee on School Health to include representatives of major health and education organizations.
"They may have done a better job in health and human services collaborating with education than the advocates have,'' noted Lucy Hackney, the acting director of the health division of the Children's Defense Fund.
In another highly visible example, Mr. Riley and Ms. Shalala shared the dais at last week's Carnegie Corporation of New York conference on the health and well-being of infants and toddlers. (See related story, page 7.)
Meanwhile, Elaine Holland, the Education Department's liaison on health-care reform, and Dr. Bob St. Peter, H.H.S.'s coordinator of children and school programs, served on a panel at a conference sponsored by the Association for the Advancement of Health Education.
While welcoming the dialogue between the agencies, some observers say they are still looking for tangible evidence of new linkages.
"There does seem to be more interagency meetings, perhaps, but it's hard to say what that means; it's hard to quantify it,'' said Barbara Willer, the director of public affairs for the National Association for the Education of Young Children.
"It may be a rhetoric-versus-reality thing, and there may be nothing to it,'' said Allyson Tucker, the manager of the Heritage Foundation's Center for Educational Law and Policy. "I don't know.''
However, conservative observers such as Ms. Tucker are concerned about the potential implications of collaboration between education and social-service bureaucracies.
"It's all about providing social services in the schools, and they seem to think that's a good thing,'' she said. "I'm not so sure it is.''
Other observers say the Administration's effort has already produced positive results.
"You always have to be skeptical until you see something that's solid, but we have seen some solid accomplishments,'' said Margaret Dunkle, the director of the Institute for Educational Leadership's "policy exchange,'' which is promoting cross-agency collaboration.
Education and H.H.S. officials cite several examples of policies or actions that were influenced or spurred by interagency efforts:
- A provision in the Administration's proposal for reauthorizing the Elementary and Secondary Education Act that would require schools to conduct two health screenings each year of Chapter 1 students.
- Requirements in the E.S.E.A. proposal and the Goals 2000 program--which was enacted last month--that states and school districts consult with health officials in developing school-reform plans.
- Inclusion of several Education Department officials on a panel that drafted the Administration's Head Start reauthorization plan.
- Provisions in the Clinton health-care proposal that would provide federal funds for health-education programs and school-based health services.
- Joint planning of a school-health conference scheduled for June and a youth-violence conference set for August, which also involves the Justice Department.
Administration officials also argue that their visible collaboration sends an important message to providers of social services, and that the effort is a long-term project that will bear more fruit in the future.
"What we're doing is promoting collaboration on the federal level so it's not just empty rhetoric when we say, 'You've got to work together,''' Ms. Holland said.