Children’s Cabinets in Minnesota and Iowa Share Successes and Challenges

March 21, 2022 | Paris Harper-Hardy

In winter 2021, ASTHO and CDC developed and conducted a series of interviews exploring successful state policies and practices to impact the health and development of children through early care and education. In Minnesota and Iowa, discussions specifically explored the experience of working with state Children’s Cabinets—boards, commissions, or councils that generally work to improve child and family health—and their efforts to address early childhood health and development. This report discusses the findings of those two case studies and the success and challenges of a state Children’s Cabinet.

Many states have established children’s cabinets or similar entities to coordinate all children’s services and to serve as policy advisors on children’s issues. Children’s Cabinets in states are typically comprised of leaders of agencies with child and youth serving programs, but the structure and responsibilities of Cabinets can vary from state to state.

Differing State Approaches Yield Positive Results

Minnesota’s Children’s Cabinet is composed of members from 22 different state departments, including the Departments of Health, Human Services, and Education. The Cabinet members are mostly commissioners, division directors, and other senior leadership. Minnesotan interviewees pointed out that their Cabinet was well supported by “recognition from the administration that kids’ long-term health and wellbeing starts early.” Their administration also has bipartisan support for reducing health disparities, and the Cabinet’s ability to provide data linking their initiatives to reduction in disparities is extremely helpful.

Instead of a cabinet, Iowa uses two collaborative state boards focusing on early care and education, and developmental health. The Boards are composed of agency director-level staff and some healthcare provider and other citizen members. Iowa is aligning the Boards’ activities to reduce duplication of efforts and clarify the points of intersection. The two Boards are mostly comprised of members from the Departments of Human Services, Education, and Public Health, as well as the Medicaid and Child Welfare programs.

Both states agree that active support from state leadership is indispensable. And interviewees from both states applauded Children’s Cabinets/Boards for driving collaboration, facilitating a holistic view of how different agencies contribute to early childhood development, and preventing siloed efforts.

Cabinets/Boards in both states are highly engaged in advocacy work within their governments, promoting the early children development agenda in various ways.

Minnesota

• Increasing early learning scholarships, including a preschool development grant, by successfully advocating with legislature members.
• Building funding for maternal mortality review.
• Advocating for more community involvement in the Title V needs assessment to inform government decision-making.

Iowa

• Promoting universal screening for developmental delays program for children.
• Advancing best practice initiatives, such as early intervention, children’s mental health and children’s behavioral health.
• Developing a credentialling system for home visiting programs to meet evidence-based- or a promising practice standard.
• Implementing and promoting a culturally congruent community-based doula program.
• Increasing childcare nurse consultation services by building a strong structure in the state.
• Starting to develop an integrated data system for early childhood indicators.

Siloes and Miscommunication Remain Challenges

Although inter-agency collaboration was touted as a benefit and a facilitator for Children’s Cabinets in both states, “siloed” programs and interagency miscommunication persist as common barriers.

For example, one interview participant described how Minnesota’s data sharing laws prevent the WIC program from sharing data with the Medicaid program without individual consent, making cross-program strategies challenging.

In Iowa, participants described how workgroups and agencies had knowledge gaps on other workgroups specific focus and goals. As one participant described, the authority to determine children’s services has never been identified in Iowa state code:

“…There was never…language in code about where children's services sat within our departmental structure [in Behavioral Health]. There were adult services…but there was never a real focus and funding for children's services in the state.”

In Iowa, interviewees also described the challenge of gaining support through different levels of governance. As one participant described, the Early Childhood Board initiatives don’t always receive buy-in from local level stakeholders:

“The boards are director-led and have citizen- or provider-type members. So sometimes there's that disconnect between the state agency perspective [and the] public’s understanding or expertise…. The people may say this is really what we need in the public system, but then the political will at the state level is not the same.”

Recommendations for States Considering a Children’s Cabinet

Based on their experiences, interviewees offered advice to other states considering establishing their own Children’s Cabinets.

• Build effective communications channels with your governor’s office.
• Anticipate challenges cause by changes in administration. An interagency leadership team doesn’t change as often as other positions. Take advantage of cross-department relationships at lower levels because they are more stable.
• Identify a funding source that you can implement and sustain.
• Clearly define the roles of Cabinet and/or Council members, and their scope of work.
• Identify the functions of your cabinet and workgroups in relation to other groups that might have similar areas of interest. Establish communication between the different state activities that support the same population of focus.
• Set evaluation and performance goals at the beginning.
• Explore diverse partnerships. For example, Iowa engaged workforce development and economic development agencies to promote the economic benefits of investing in quality childcare.

Summary

For Minnesota’s Children’s Cabinet and Iowa’s two Childhood Boards, the main priorities and the core functions are the same. A key group of high-level government staff from different agencies coming together to facilitate collaboration and drive the agenda for early childhood development policy in a way that would be difficult for any department to accomplish alone. In both states, the Cabinets are facilitated by a supportive legislative agenda.

However, while the primary role of these groups is to drive collaboration, they are frustrated by the same sorts of siloed activities they are trying to eliminate. This was especially true for the Iowa group, because their work is split between two Childhood boards, however, they also described an ongoing process of aligning the activities of the Boards to address this very issue.

Other states considering developing Children’s Cabinets will likely see unique barriers and challenges to overcome. However, the benefits and priorities of a group empowered to drive early childhood development policy through inter-agency collaboration and capacity-building are likely to remain consistent and warrant further exploration.