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Overview: Growing up healthy in a stable and supportive family environment is central to enabling children to live happy and successful lives. The Department of Health and Human Services (HHS) takes a multifaceted approach to promote the positive development of our young people, especially disadvantaged children. Healthy development is the foundation for a healthy life from infancy through adolescence. Children and adolescents need social and community supports to navigate a safe and healthy passage throughout their formative years. HHS programs help to meet the diverse health, social and educational needs of children.

HHS supports major programs to enhance and protect the welfare of children and to ensure quality, appropriate health care services. The President's welfare reform proposal places a particular focus on the well-being of children and families while other HHS social service programs support family preservation, adoption, foster care, mentoring, responsible fatherhood and other vital services. HHS is increasing its investment in children's health research through the National Institutes of Health (NIH) and continues to expand the number of children who have health care coverage through the State Children's Health Insurance Program.

President Bush's fiscal year 2003 budget proposal invests significant additional resources in children's health care and social services, including an estimated $81.7 billion in HHS programs serving children - nearly $4.2 billion more than the current year's budget. Consistent with the President's overall budget, the HHS budget meets the nation's priority needs while being responsible with the taxpayers' money.

NEW HHS INVESTMENTS FOR CHILDREN UNDER WELFARE REFORM

The 1996 welfare reform legislation that created the Temporary Assistance for Needy Families (TANF) program also included a number of provisions to improve the well-being of children and families. That legislation is up for reauthorization in 2002, and the President's reauthorization proposal strengthens and builds upon welfare reform's commitment to children. Highlights of specific welfare reform proposals include:

Establishing the well-being of children as the overarching purpose of the TANF program. The administration's welfare reform proposal will formally establish as the overall purpose of TANF improving the well-being of children. The change is based on the recognition that the goals of the program are important core strategies for improving overall child well being.

Maintaining a high level of commitment to child care. The administration's welfare reform proposal maintains the historic levels of child care funding currently available to states. Under the proposal, entitlement child care funding will be continued at $2.7 billion in fiscal year 2003 and $2.1 billion has been requested in discretionary spending. States can transfer up to 30 percent of TANF funds to the Child Care and Development Fund or spend TANF funds directly for child care.

Encouraging the formation of strong families and healthy marriages. Research finds that children raised in households headed by continuously married parents on average fare better than children growing up in any other family structures. Children growing up without a married mother and father are more likely to experience school failure, to suffer from emotional disturbance or depression and to abuse drugs. The administration's welfare reform proposal would provide $100 million to support research and technical assistance for innovative strategies primarily directed towards maintaining and building strong families and healthy marriages. The administration's proposal also includes a $100 million grant program available to a limited number of states, territories and tribal organizations to develop innovative approaches to promote healthy marriages and reduce out-of-wedlock pregnancies.

Enhancing child support enforcement. Child support enforcement is essential to help promote family self-sufficiency, both for TANF recipients and those who do not receive cash assistance. The 1996 welfare reform law included the most extensive child support reforms ever enacted, and the administration's reauthorization proposal makes additional advancements. The proposal includes federal matching funds to encourage states to pass more child support collected for current and former TANF recipients directly to the families, instead of retaining it to repay the state for the cost of TANF assistance. The administration also proposes lowering the threshold for denying a passport to a person delinquent in paying child support from the current level of $5,000 in past-due support to $2,500. The department's fiscal year 2003 budget includes $3.5 billion to support state child support enforcement programs.

Encouraging abstinence and preventing teen pregnancy. Out-of-wedlock births are associated with higher rates of poverty and lower rates of achievement, both for the unwed parents and for their children. The administration's welfare reform proposal reauthorizes the $50 million abstinence education program created in 1996 to enable states to establish programs to promote abstinence education for adolescents. In addition, HHS' fiscal year 2003 budget includes $73 million - a $33 million increase - for community-based abstinence education grants under a program administered by HHS' Health Resources and Services Administration.

Information on the administration's overall welfare reform proposal is available at www.whitehouse.gov/news/releases/2002/02/welfare-reform-announcement-book.html.

ADDITIONAL HHS INVESTMENTS IN CHILDREN'S WELL-BEING

In addition to investments in children's well-being under welfare reform, HHS supports a number of social service programs to strengthen families and help at-risk children. Highlights include:

Promoting Safe and Stable Families. This program is designed to assist states in coordinating services related to child abuse prevention and family preservation and to provide community-based family support, time-limited family reunification and adoption promotion and support services. The program provides grants to states to keep children with their biological families, if safe and appropriate, or to place children with adoptive families. The budget includes $505 million for the program in fiscal year 2003, an increase of $130 million above the current year's funding level.

Independent Living Program. The department's fiscal year 2003 budget includes $60 million to expand the Independent Living Program to provide at least 12,000 vouchers of up to $5,000 for college tuition or vocational training to foster children and young adults, ages 16 to 21, who "age out" of the foster care system. The program is designed to help these young people increase their prospects for becoming self-sufficient and living independently. Overall, the budget includes almost $6.7 billion to support state foster care, independent living and adoption assistance programs. On average, the programs serve about 600,000 children per month.

The Early Childhood Initiative and Head Start. In April 2002, President Bush announced the Early Childhood Initiative to improve the state of early childhood education, in which too many children come to school unprepared to learn. The initiative includes steps to improve Head Start, an early childhood development program run by HHS to give a boost to children's education and helping strengthen the skills of parents to better nurture and provide for their children. The initiative directs HHS to implement a new accountability system to ensure that every Head Start center assesses standards of learning in early literacy, language and numeracy skills. In addition, HHS will implement a national training project with the goal of training all of the nearly 50,000 Head Start teachers this year in the best pre-reading and language teaching techniques for young children. Under the President's budget proposal, Head Start funding would increase by $130 million to $6.7 billion in fiscal year 2003, while giving it a clear mission to prepare the nation's most disadvantaged children to learn as soon as they enter school. Head Start will serve about 915,000 children next year. More information on the President's initiative is available at www.whitehouse.gov/infocus/earlychildhood/. Information on Head Start is available at www2.acf.dhhs.gov/programs/hsb/.

Mentoring children of prisoners. The imprisonment of a parent can result in traumatic separations for children, often followed by erratic shifts from one caregiver to another. HHS' budget proposes $25 million to states to fund activities to assist children while their parents are in prison and to support family reunification when in the child's best interest. Faith-based and community organizations could compete for the grants.

Maternity group homes. Young women who become pregnant or have children can be vulnerable to abuse and neglect and often end up living in poverty and on the streets. HHS' budget proposes $10 million for the maternity group homes program to help young mothers and pregnant women who cannot live with their own families due to abuse, neglect or other circumstances. The program will fund about 80 community-based, adult-supervised group homes or apartment clusters to provide shelter and support to these women, including child care, education, job training and counseling.

Promoting responsible fatherhood. HHS' budget proposal includes $20 million to promote responsible fatherhood. Most of the money would be awarded in competitive grants to faith-based and community organizations for skill-based marriage and parenting education, job training and other services that help fathers provide emotional and financial support to their children.

HHS INVESTMENTS IN CHILDREN'S HEALTH

The President's fiscal year 2003 budget increases net resources for HHS' children's health programs, including larger investments in medical research, children's environmental health, children's health coverage, and childhood immunizations and vaccines. Highlights include:

Increasing medical research. The HHS budget proposes a record $3.7 billion increase for NIH research, including a $224 million - or 8 percent - increase for child health research. Under the proposal, the NIH would spend an estimated $3.1 billion on child health research in fiscal year 2003. Planned initiatives include improving early literacy skills; reducing pregnancy complications; reducing disparities in reproductive health outcomes; increasing our understanding of the brain's neural development during adolescence; improving treatments for asthma; and initiating clinical trials for the primary prevention of type 2 diabetes in children. Information from NIH's National Institute of Child Health and Human Development is available at www.nichd.nih.gov.

State Children's Health Insurance Program (SCHIP). Today, about 8.6 million American children are uninsured. In the Balanced Budget Act of 1997, Congress created SCHIP to help states expand health insurance coverage to uninsured children below 19 years of age with family incomes of up to 200 percent of the poverty level. SCHIP was designed to reach children who come from families with incomes too high to qualify for Medicaid but who do not have private health insurance. There were 4.6 million children enrolled in SCHIP programs in fiscal year 2001. HHS' 2003 budget proposal extends the availability of $3.2 billion in expiring SCHIP funds to enable more states to maintain their current coverage levels as well as provide additional health coverage to more uninsured Americans. Information on SCHIP is available at cms.hhs.gov/ and at www.insurekidsnow.gov.

Medicaid. Medicaid, a federal-state partnership to provide health insurance to low-income families, provides coverage to an estimated 20 million children nationally. For fiscal year 2003, HHS anticipates about $35 billion in mandatory federal expenditures on Medicaid coverage for children. The department's 2003 budget includes $350 million for transitional medical assistance to provide health insurance to former welfare recipients after they enter the workforce. The program allows families to remain eligible for Medicaid for up to 12 months after they are no longer eligible for welfare due to earnings from work.

Immunization and vaccines for children. HHS efforts to promote and provide childhood immunization have helped to increase immunization rates among children, with 90 percent or more of America's toddlers receiving the most critical doses of vaccines for children by age 2. The proposed budget provides federal spending on vaccines and immunization programs of $824 million for the Vaccines for Children Program and $631 million for immunization activities. Immunization information is available at www.cdc.gov/nip.

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