Programs that Impact the Pathways Measures of Success

Abriendo Puertas is one of the largest programs in the nation working with Hispanic parents of preschool-aged children to foster children’s learning and development, parent leadership, and advocacy. Abriendo Puertas has been shown to significantly improve core parenting behaviors associated with academic success, including:[i]

• Education activities by parents at home, including reviewing the letters of the alphabet and reading to children more frequently
• Employing a research-informed reading approach, including stopping from time to time to talk about the story with the child, and reading with an expressive and enthusiastic voice
• Using the library to take books home
• Understanding the importance of child care providers reading with children every day
• Making time to respond to children’s behavior
• Becoming mindful of how their behaviors as parents influence their young children[ii]

[i] Abriendo Puertas: Opening Doors Parenting Program, Child Trends, June 2014, p. 3 http://www.childtrends.org/wp-content/uploads/2014/06/Abriendo-Puertas-Report-8-18-141.pdf

[ii] Abriendo Puertas, op cit., p. 6

Attachment Bio-Behavioral Catch-up is an evidence-based infant-parent intervention developed to treat infants ages six to 24 months who have experienced early adversity. Over ten sessions, parents are coached in a set of skills and videotaped to help them reflect on their behaviors. Traumatized infants whose parents completed the ABC sessions had more normalized stress responses.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. (2016). Attachment and Biobehavioral Catch-up (ABC). Retrieved from http://www.cebc4cw.org/program/attachment-and-biobehavioral-catch-up/detailed

The Baby Love Program is North Carolina’s Medicaid program for pregnant women. The program provides childbirth education, health and behavior intervention and medical home visits.[i] Healthy Start Baby Love Plus is a Forsyth County initiative with a primary focus on reducing infant mortality and promoting women and children’s health.[ii]

[i] North Carolina Health and Human Services. (2017). Women’s Health Branch: Baby Love Program. Retrieved from http://whb.ncpublichealth.com/services.htm

[ii] Forsyth County, North Carolina. (n.d.). Healthy Start / Baby Love Plus. Retrieved April 1, 2017 from http://www.co.forsyth.nc.us/publichealth/baby_love_plus.aspx

BELL is a six-week program aimed at improving academic achievement, parent involvement, and self-esteem for children in low-income, urban communities. In a randomized control trial study of over 1,000 children, the BELL participants showed statistically significant gains of one month of reading skills compared to their control group counterparts. BELL parents were more likely to encourage reading.[i] Implementation of this program in some locations may no longer follow the structure and practices evaluated in the randomized control study, which could change children’s outcomes.[ii]

[i] Chaplin, D. and Capizzano, J. (2006). Impacts of a Summer Learning Program: A Random Assignment Study of Building Educated Leaders for Life (BELL). http://files.eric.ed.gov/fulltext/ED493056.pdf

[ii] Personal communication, Munro Richardson, Read Charlotte. June 2017

CCDF provides federal child care support for low-income working families. State compliance with broad federal guidelines is required, including setting income eligibility limits at or below 85 percent of state median income (SMI) and the maximum age for children at or below 12 years. The maximum age may be extended to 18 years if children have special needs. Federal guidelines also broadly define activities that qualify for assistance, usually work, education and training. Within the broad federal guidelines, however, states may use discretion in administering the program.[i]

In 2014, the U.S. Congress passed the first reauthorization of CCDF since 1996. The reauthorization requires that state CCDF policies be “more family friendly,” result in increased quality of child care (including health and safety of children) and improve the transparency of provider information for parents.[ii] It also provides more options for parents in selecting child care services.

Under the 2014 reauthorization, each state was required to submit a new CCDF plan. The North Carolina plan received conditional approval from the federal Office of Child Care in June 2016.[iii] The federal review identified a couple of concerns, chief among them that North Carolina child care subsidy rates may not allow families receiving subsidies to access child care at a level of quality comparable to that accessible to families not receiving subsidies, as required by law. The federal Office of Child Care will review these rates as a priority item in upcoming implementation monitoring visits.[iv]

Child care subsidy rates were raised during the 2017 NC legislative session.

[i] Minton, s., Stevens, K. & Blatt, L. (2016). Implications of Child Care and Development Block Grant Reauthorization for State Policies: Changes to Requirements for Legally Unregulated Child Care Providers. Retrieved from http://www.urban.org/research/publication/implications-child-care-and-development-block-grant-reauthorization-state-policies-changes-requirements-legally-unregulated-child-care-providers

[ii] Minton et al, Implication of Child Care and Development Block Grant Reauthorization, op cit.

[iii] Office of Child Care. (2016). North Carolina Child Care Development Fund (CCDF) Plan with Conditional Approval Letter for FY 2016-2018. (p. 1). 

[iv] Office of Child Care, North Carolina CCDF Plan with Conditional Approval Letter for FY 2016-2018., op cit., p. 3

Child First is an evidence-based program that works to decrease the incidence of emotional and behavioral disturbance, developmental and learning problems, and abuse and neglect among high-risk young children and families. Child First serves pregnant women and families with children birth through age five. Research shows that Child First stabilizes families and improves the health and well-being of both parents and children. A mental health/developmental clinician and care coordinator work as a team to provide services that include a comprehensive assessment of child and family needs, observation and consultation in early care and education settings, a family and child plan of care, a parent-child mental health intervention, and care coordination. The program typically lasts six to 12 months, depending on a family’s needs. During the first month, the clinician and care coordinator conduct joint home visits twice per week, and thereafter visits occur either separately or jointly and at least weekly.[i] The intervention currently sites in Connecticut, Florida and North Carolina.[ii]

[i] Child First. (2011). (p. 1). Home Visiting Evidence of Effectiveness. Retrieved from https://homvee.acf.hhs.gov/effectiveness/Child%20First/In%20Brief

[ii] Child First. (n.d.). Child First Network: North Carolina. Retrieved from http://www.childfirst.org/our-network/state-affiliates/nc

This promising program is a short-term, strength-based therapy program for children ages 3-17 and their parents or caregivers in families who have been substantiated for physical abuse, those who have had multiple unsubstantiated referrals, or those who fear they may lose control with their child. The program aims to help children heal from the trauma of physical abuse, empower and motivate parents to control their emotions and use effective parenting strategies, and strengthen parent-child relationships.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/combined-parent-child-cognitive-behavioral-therapy-cpc-cbt/

This promising program is a home-based, parent-child therapy program for children under age seven with significant behavior and/or emotional problems including trauma. It was designed specifically for a diverse population of very young children who come from families living in poverty, most of whom meet criteria for a psychiatric diagnosis. EPP clinicians model effective strategies to strengthen a child’s positive behaviors and reduce challenging ones and provide feedback and coaching to parents as they try the strategies. Families are visited weekly for an average of 8-12 weeks with sessions added as needed.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/early-pathways-program/

Family Connects is a voluntary, universal nurse home visiting program in several counties in North Carolina. Family Connects is the first replication of the evidence-based program Durham Connects. The home visit is a “gateway” to community referrals and resources to enhance overall family well-being. Working through local health departments and community leaders, the program identifies and supports family needs in one to three home visits within 12 weeks of a baby’s birth. There is no charge to families for this service.[i]

Family Connects partners include The Duke University Center for Child & Family Health, local health departments, the North Carolina Partnership for Children, Inc. (Smart Start), the North Carolina Division of Public Health, and the National Implementation Research Network (NIRN). Each county delivering Family Connects has its own local leadership team that includes representatives from among health providers, schools, churches, human service agencies, childcare organizations, and other community-based partners.[ii] 

[i] Family Connects. (n.d.). Retrieved from https://familyconnects.org/family-connects-model/family-connects-sites/

[ii] Family Connects Nurse Home Visits. (n.d.). Retrieved March 2021 from https://www.ccfhnc.org/programs/family-connects-durham/

Freedom School Partners in Charlotte, North Carolina employs the Children’s Defense Fund Freedom Schools® program to serve 1,200 K-12 students, many from lower-income families. The morning program includes breakfast, a pep rally and literacy-focused classes. These classes are led by college students who employ a social action, conflict resolution and problem-solving curriculum. In the afternoons, activities include STEAM (Science, Technology, Engineering, Arts and Math) projects. Outcome evaluations find that more than 90 percent of children who spend their summers in Freedom School maintain or improve their reading levels, often gaining nearly a year of progress. (Note: The evaluation was a pre- and post- design without a control group.[i] However, national research shows that low income children on average tend to lose 2-3 months of progress over the summer.[ii]) In 2013, the program was awarded one of three national best in class awards from the National Summer Learning Association.[iii]

[i] Center for Adolescent Literacies, University of North Carolina at Charlotte. (2015). Freedom School Partners Children’s Defense Fund Freedom Schools® Program Evaluation Report. Retrieved July 16, 2017 from http://literacy.uncc.edu/sites/literacy.uncc.edu/files/media/docs/2015%20FSP%20UNCC%20Evaluation%20Report%20Final%20Final.pdf

[ii] Annie E. Casey Foundation. (2010). Early Warning! Why Reading by the End of Third Grade Matters, op. cit.

[iii] National Summer Learning Association, National Summer Learning Association Announces Winners of 2013 New York Life Excellence in Summer Learning Awards, op cit.

Healthy Families is an evidence-based program that improves the health and well-being of children and families by providing intensive home visitation services. The program has been shown to reduce the risk of low weight births,[i] improve positive parenting practices and reduce child maltreatment rates.[ii] Two North Carolina evaluation studies have found significant positive change in parenting behaviors and children’s social-emotional competence as well as in a reduction of rapid rebirth and teen rebirth rates.[iii] Healthy Families operates in 585 sites nationally,[iv] including in five sites across North Carolina through the federal Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV).[v]

[i] Lee, E., Mitchell-Herzfeld, S. D., Lowenfels, A. A., Greene, R., Dorabawila, V., & DuMont, K. A. (2009). Reducing low birthweight through home visitation: a randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154-160. DOI: 10.1016/j.amepre.2008.09.029. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19135906

[ii] Home Visiting Evidence of Effectiveness. (2017). Healthy Families America. Retrieved from https://homvee.acf.hhs.gov/effectiveness/Healthy%20Families%20America%20%28HFA%29%C2%AE/In%20Brief

[iii] Healthy Families America. (n.d.). Evaluations of Healthy Families America by State. Retrieved March 2020 from https://www.healthyfamiliesamerica.org/our-impact/state-evalutations/

[iv] Healthy Families America. (n.d.). Great childhoods begin at home. Retrieved October 31, 2017 from http://www.healthyfamiliesamerica.org/

[v] WCH: Maternal, Infant, and Early Childhood Home Visiting Program. (2015). North Carolina Department of Health and Human Services. Retrieved from https://publichealth.nc.gov/wch/aboutus/ebhv.htm

Healthy Start aims to reduce infant mortality and improve maternal and infant health in at-risk communities. Programs offer a suite of health and social services for pregnant women and infants and include community engagement and outreach strategies, needs assessments, and ongoing evaluation.[i]

[i] Promising Practices Network. (n.d.). Heathy Start. Retrieved March 2021 from: https://cdc.thehcn.net/promisepractice/index/view?pid=138

Homebuilders is an evidence-based home- and community-based intensive family preservation services treatment program that aims to reduce child abuse and neglect, family conflict and child behavior issues, and teach families the skills they need to prevent placement in foster care or successfully reunify with their children. The program is designed to avoid unnecessary placement of children and youth into foster care, group care, psychiatric hospitals, or juvenile justice facilities. The model engages families by working with the home, at times when the family is most receptive to learning, and by enlisting family members as partners in assessment, goal setting, and treatment planning.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/homebuilders/

Incredible Years is a promising program for parents, teachers, and children designed to promote social-emotional competence and prevent, reduce, and treat children’s emotional and aggression problems.[i] In North Carolina, the program has been evaluated through randomized control group studies. Results include a reduction in parental depression and in the use of harsh criticism, as well as increases in positive family communication, problem solving and parental involvement with teachers and classrooms.[ii]

[i] Prevent Child Abuse North Carolina. (n.d.). The Incredible Years. This program is online at —  www.incredibleyears.com

[ii] Prevent Child Abuse North Carolina. (n.d.). The Incredible Years. Retrieved from https://www.preventchildabusenc.org/services/implementation-support/the-incredible-years

Motheread is an international child literacy training and curriculum development program that works to build knowledge and skills in support of early reading.[i] Motheread has been shown to increase parental knowledge of emergent literacy and improve children’s expressive language.[ii] There are Motheread programs in North Carolina.

[i] Motheread National and State. (n.d.). Motheread, Inc.. Retrieved February 4, 2017 http://www.motheread.org/supporting-national-programs/

[ii] Motheread Research. (n.d.). Motherread, Inc. Retrieved on June 29, 2017 http://www.motheread.org/research-and-public-information/

MST-CAN is an evidence-based program that aims to reduce abuse or neglect and placement in foster care, improve parenting, improve parent and child mental health functioning, and increase the family’s social support. It is used for families with serious clinical needs who have come to the attention of child protective services (CPS) due to physical abuse and/or neglect. Clinicians work on a team of 3 therapists, a crisis caseworker, a part-time psychiatrist who can treat children and adults, and a full-time supervisor. Treatment is provided to all adults and children in the family in the family’s home or other convenient places.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/multisystemic-therapy-for-child-abuse-and-neglect/

NIDCAP trains hospital staff in neonatal intensive care units and special care nurseries on specialized infant care. NIDCAP helps to improve the cognitive and physical growth and overall health of pre-term and high-risk newborns through the an individualized, family-centered approach.[i]

[i] Newborn Individualized Developmental Care and Assessment Program Federation International. (n.d.). NIDCAP Training. Retrieved October 31, 2016 from http://nidcap.org/en/programs-and-certifications/nidcap-training/overview-2/

Nurse-Family Partnership (NFP) is an evidence-based, voluntary home visiting program designed to promote healthy behaviors and improve parenting for first-time, low-income mothers and their children. Through ongoing consultations in the mother’s home, registered nurses work to improve pregnancy outcomes, improve child health and development, and increase the economic self-sufficiency of the family, beginning early in pregnancy and continuing until the child’s second birthday. The intervention promotes supporting relationships and improves prenatal health and outcomes, child health and development, and families’ economic self-sufficiency and/or maternal life course development.[i] NFP serves 17 high-risk North Carolina counties.

[i] Nurse Family Partnership. (2016). Home Visiting Evidence of Effectiveness (HOMVEE). Retrieved October 31, 2017 from https://homvee.acf.hhs.gov/effectiveness/Nurse-Family%20Partnership%20%28NFP%29%C2%AE/In%20Brief

Parents as Teachers is an evidence-based[i] early childhood parent education program focused on positive child development. The program focuses on early detection of children’s developmental delays and health concerns, and on parents’ knowledge of early childhood development, parenting practices, and school readiness. The program is delivered in monthly home visits and group meetings. Trained parent educators work with expectant families and families with very young children (not yet in school) through the kindergarten year. It has been implemented with families with low incomes, teen parents, first-time parents, immigrant families, families with substance abuse or mental health issues, and families of diverse cultures and ethnicities. PAT may be modified to be culturally responsive to special populations, or offered in conjunction with other early care and education programs.[ii] There are Parents as Teachers programs in North Carolina.

[i] Parents as Teachers, HOMVEE, July 2013 https://homvee.acf.hhs.gov/implementation/Parents%20as%20Teachers%20%28PAT%29%C2%AE/Model%20overview

[ii] Parents as Teachers, op cit., pp. 57-59

Parent-Child Interaction Therapy is an evidence-based parent-child intervention in which specially trained coaches work with parents of children ages two to seven years old with disruptive behaviors. Parents are coached to develop communication, positive discipline, and child management skills. Weekly coaching is provided. Research shows improvements in parental skills and positive behaviors toward their children and reductions in children’s negative behaviors.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/parent-child-interaction-therapy/

Triple P – Positive Parenting Program – is an evidence-based parenting and family support system designed to prevent and treat behavioral and emotional problems in children. Triple P draws on social learning, cognitive behavioral and developmental theory as well as research into risk factors associated with the development of social and behavioral problems in children. It aims to equip parents with the skills and confidence they need to be self-sufficient and to be able to manage family issues without ongoing support. Triple P is delivered to parents of children up to 12 years. There are also specialist programs – for parents of children with a disability (Stepping Stones), for parents going through separation or divorce (Family Transitions), for parents of children who are overweight (Lifestyle) and for Indigenous parents (Indigenous).

The North Carolina Division of Public Health, in partnership with Triple P America, implemented Triple P in 19 northeastern North Carolina counties, including the Transformation Zone counties.  North Carolina Triple P State Learning Collaborative offers parents and caregivers Triple P – Positive Parenting Program for no or low cost. Triple P is currently used in 25 countries and has been shown to work across cultures, socio-economic groups, and in all kinds of family structures. [i]

[i] See data on Triple P in the following compendia of evidence-based programs:

The Smart Start Resource Guide of Evidence-Based and Evidence-Informed Programs and Practices: A Summary of the Evidence. (2015). p. 53-54. Retrieved from http://www.smartstart.org/wp-content/uploads/2015/05/SmartStartEBEI_Guide_052615.pdf; Home Visiting Evidence of Effectiveness. (2014). Implementing Triple P – Positive Parenting Program – Home Visiting (Triple P-Home Visiting). Retrieved from https://homvee.acf.hhs.gov/implementation/Triple%20P%20-%20Positive%20Parenting%20Program%C2%AE-Variants%20suitable%20for%20home%20visiting/More%20information%20about%20the%20model; SAMSA’s National Registry of Evidence-based Programs and Practices. (2015). Literature Review: Parent-Training Programs. Retrieved January 3, 2017 from http://www.nrepp.samhsa.gov/Docs/Literatures/NREPP%20Learning%20Center%20Lit%20Review_Parent%20Training%20Programs.pdf (The NREPP is no longer available online as of March 2021)

A medical home is when a patient is connected with a primary care provider who coordinates his or her health care. North Carolina Pregnancy Medical Homes provide comprehensive prenatal care for pregnant women enrolled in Medicaid through public-private partnership and coordinated service delivery. Pregnant women at high risk for preterm birth are assigned trained social workers or nurses who work to:

• Facilitate transportation
• Access benefits, including mental and behavioral health services
• Discuss concerns

Recent studies indicate the program is associated with lower rates of preterm and low birthweight births.[i]

[i] Community Care of North Carolina. (2013). CCNC Pregnancy Home Risk Screening Form. Retrieved from https://www.communitycarenc.org/sites/default/files/2019-06/pregnancy_risk_screening_form_english.pdf

Project Connect is a promising program that aims to maintain children safely in their homes and reunite families when children have been placed in foster care. The program works with high-risk families who are affected by parental substance abuse and are involved in the child welfare system. The program offers home-based counseling, substance abuse monitoring, nursing, referrals for other services, home-based parent education, parenting groups, and an ongoing support group for mothers in recovery.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/project-connect/

Promoting First Relationships is a promising program that aims to improve parent-child interactions and build positive and mutually reinforcing relationships between parents and their children (birth to three years old), educate parents about children’s social-emotional needs and increase their capacity to understand children’s cues, and build trust, competence, confidence and emotion regulation in both parents and children. The program helps parents understand and learn how to address challenging infant and toddler behaviors.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from: http://www.cebc4cw.org/program/promoting-first-relationships/

Reach Out and Read (ROR) is an evidence-based program used in doctor’s offices to promote early literacy. During children’s well-child visits, pediatricians encourage parents to read to their children, volunteers model shared book reading, and each child receives a new book appropriate to his or her age. Research reveals that participation in the program by low-income parents makes families more focused on reading, results in higher vocabulary scores among older children, and increases the amount the family members read each week. There are Reach Out and Read programs in North Carolina.

SBCT is a community engagement and systems change promising practice, focused on improving how the courts, child welfare agencies, and related child-serving organizations work together to improve and expedite services for young children who are under court supervision. The SBCT is designed to protect babies from further harm, address the damage already done, and correct structural issues in the child welfare system.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from:  http://www.cebc4cw.org/program/safe-babies-court-teams-project/

SEEK is an evidence-based program that uses pediatric primary care as an opportunity to help prevent child maltreatment in families who may have risk factors for child maltreatment. The frequency of well-child visits and generally good relationship between health professionals and parents offer an opportunity to identify and help address issues. SEEK aims to also help strengthen families, support parents and parenting, and promote children’s health, development, and safety.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved March 2021 from https://www.cebc4cw.org/program/safe-environment-for-every-kid-seek-model/

WIC is a federal nutritional program to improve the health of low-income women and their young children. It provides better nutrition and nutrition education (including breastfeeding support) and referrals to needed health and social services.[i] Available in all 50 states, WIC benefits generally are provided through electronic vouchers or paper checks for the purchase of food.[ii]

From 2009 through 2016, participation in the North Carolina WIC program declined, from just under 270,000 to just over 241,000. Benefits of participation in the North Carolina WIC program documented over time by the North Carolina Department of Health and Human Services include:

• An increase in the number of women receiving adequate prenatal care, and a decrease in infant mortality by at least 25% and in low birthweight and preterm births by just over three%.
• A decrease in the rate of child anemia, improvements in children’s diets, a higher rate of immunizations, and better vocabularies than comparable children who do not participate in WIC.
• A reduction of $744 in Medicaid costs per enrolled baby during the first 50 days of life, which was $3.90 in savings per WIC dollar invested.[iii]

[i] U.S. Department of Agriculture. (n.d.).  The Special Supplemental Nutrition Program for Women, Infants and Children: WIC Program.  (p. 1). Retrieved from https://www.ers.usda.gov/topics/food-nutrition-assistance/wic-program/

[ii] U.S. Department of Agriculture, The Special Supplemental Nutrition Program, op cit., p. 2

[iii] Research Proves WIC Makes a Difference. (2017). Retrieved from https://www.nutritionnc.com/wic/

The Strengthening Families Program (SFP) is rated as an evidence-based program by SAMHSA and as effective for addressing child maltreatment by the California Evidence-Based Clearinghouse for Child Welfare. It is not yet rated as evidence-based by CEBCCW. The Strengthening Families Program is a family skills training program designed to increase resilience and reduce risk factors for behavioral, emotional, academic, and social problems in children three to 16 years old. SFP comprises three life-skills courses delivered in 14 weekly, two-hour sessions.

The Parenting Skills sessions are designed to help parents learn to increase desired behaviors in children by using attention and rewards, clear communication, effective discipline, substance-use education, problem solving, and limit setting. The Children’s Life Skills sessions are designed to help children learn effective communication, understand their feelings, improve social and problem-solving skills, resist peer pressure, understand the consequences of substance use, and comply with parental rules. In the Family Life Skills sessions, families engage in structured family activities, practice therapeutic child play, conduct family meetings, learn communication skills, practice effective discipline, reinforce positive behaviors in each other, and plan family activities together. Participation in ongoing family support groups and booster sessions is encouraged to increase generalization and the use of skills learned.[i]

The North Carolina Strengthening Families program focuses on increasing child resilience and reducing risk factors for abuse, aggression, and school failure. It targets children ages six to 11 years old. Evaluation of the program shows increases in children’s pro-social skills, improvements in parenting skills, and decreases in parental drug use, the use of corporal punishment as a disciplinary practice, and family conflict.[ii]

[i] SAMHSA’s National Registry of Evidence-based Programs and Practices. (2014). Strengthening Families Program. Retrieved from https://www.vfhy.org/sites/default/files/pdf/SFP_611_NREPP.pdf (The NREPP is no longer available online as of March 2021.)

[ii] Prevent Child Abuse North Carolina. (n.d.). Strengthening Families Program 6-11. Retrieved from https://www.preventchildabusenc.org/services/implementation-support/strengthening-families-program-6-11

Nationally, the federal SNAP reaches over 44 million people in almost 22 million households each month. Three out of four SNAP households include a child, senior, or disabled individual. SNAP also provides employment services to help recipients increase their earnings and reduce their need for assistance.[i]

Studies have shown that SNAP benefits support families to eat healthier.[ii] A 2013 Food and Nutrition Service study found that participating in SNAP for six months resulted in a five to ten percentage point decrease in food insecurity. In 2015, SNAP is reported to have raised 4.6 million individuals out of poverty.[iii] 

In federal fiscal year 2015, North Carolina SNAP served 1.65 million individuals monthly, representing just over 800,000 households. North Carolina was ranked ninth in the nation in the number of participants and 34^th in the amount of monthly payments: $122 for individuals or $248 per household.[iv] Electronic Benefit Transfer cards (EBT cards) are used to distribute SNAP benefits in North Carolina.[v]

[i] U.S. Department of Agriculture. (2017). Supplemental Nutrition Assistance Program (SNAP). Retrieved February 27, 2017 https://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap

[ii] Conway, K.M. (2015). Past, Present and Future of SNAP: Hearing Series Findings, 114^th Congress

[iii] Conway, Past, Present and Future of SNAP, op cit.

[iv] U.S. Department of Agriculture. (2016). The Supplemental Nutrition Assistance Program:  State Activity Report, FFY 2015. Retrieved from https://www.fns.usda.gov/sites/default/files/snap/2015-State-Activity-Report.pdf

[v] North Carolina Department of Health and Human Services. (n.d.). Food and Nutrition Services. Retrieved January 18, 2017 from http://www.ncdhhs.gov/assistance/low-income-services/food-nutrition-services-food-stamps

TANF was created by the U.S. Congress as part of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act. TANF replaced Aid to Families with Dependent Children, a federal program providing cash assistance poor families with children since 1935.[i] TANF was last reauthorized in 2010. In July of 2015, the U.S. House of Representatives’ Committee on Ways and Means (Subcommittee on Human Resources) introduced a draft bill to reauthorize TANF for the period 2016-2020. It was not enacted. The EMPOWER Act of 2016 was introduced in the Senate in June 2016 to reauthorize TANF through fiscal year 2021. No action has been taken since its introduction.[ii] There will likely be statutory changes in TANF and other means-tested family support programs at the federal level in the coming years.[iii] Cuts to this program would impact child and family supports.

In North Carolina, TANF is called Work First. It offers short-term training and other services to create increased employment opportunities for low-income parents.[iv] In 2014, the maximum monthly income for initial TANF eligibility for a single-parent family of three was $680, and the maximum allowable family economic asset level was $3,000. The maximum monthly case benefit was $280, and TANF benefits cannot be claimed for more than a cumulative total of 60 months.[v] In North Carolina in 2013-2014, fewer than one in ten poor families with children received TANF.[vi]

In October 2015, CLASP issued a report outlining a set of four policies through which TANF could better support mothers and very young children.^[vii] These include:

• Creating adequate income supports
• Recognizing time-related challenges of contemporary work and assuring mothers have time with babies to develop attachments
• Assuring access for working parents to quality, affordable child care
• Improving connections between families and needed benefit programs and services.

[i] Center on Budget Policy and Priorities. (2015). Policy Basics: An Introduction to TANF. Retrieved from, http://www.cbpp.org/research/policy-basics-an-introduction-to-tanf

[ii] CLASP. (n.d.). TANF Reauthorization. Retrieved March 2021 from https://www.clasp.org/publications/report/brief/goals-tanf-reauthorization

[iii] On the Issues. (n.d.). Paul Ryan on Welfare and Poverty. Retrieved January 18, 2017 http://www.ontheissues.org/House/Paul_Ryan_Welfare_+_Poverty.htm

[iv] North Carolina Health and Human Services. (n.d.). Work First Cash Assistance. Retrieved January 18, 2017 from http://www.ncdhhs.gov/assistance/low-income-services/work-first-cash-assistance

[v] National Center for Children in Poverty. (n.d.). 50 State Policy Tracker, TANF North Carolina. Retrieved January 20, 2017 from http://www.nccp.org/tools/policy/

[vi] Center on Budget Policy and Priorities. (2016). Chart Book: TANF at 20. Retrieved from http://www.cbpp.org/research/family-income-support/chart-book-tanf-at-20

[vii] Lower-Basch, E. & Schmidt, S.. (2015). TANF in the First Year of Life. Retrieved from http://www.clasp.org/resources-and-publications/body/TANF-and-the-First-Year-of-Life_Making-a-Difference-at-a-Pivotal-Moment.pdf

Thirty Million Words® is designed to use parents’ language to help build their children’s brains. The curriculum combines education and technology in a multimedia platform. The education component presents accessible and easy-to-understand concepts about language and reading, animated as part of a video of parent-child interaction. On the technology side, a word tracker records parents’ conversations with their children weekly so that parents can monitor the amount and type of language that their children are hearing.[i] Parents receiving the intervention have been shown to significantly increase their talk and interaction with their children.[ii]

[i] Thirty Million Words: What is TMW?, Thirty Million Words, undated. Retrieved January 16, 2017  http://thirtymillionwords.org/tmw-initiative/

[ii] Thirty Million Words: Our Research, op cit.

TF-CBT is an evidence-based child and parent model for children who are experiencing significant emotional and behavioral difficulties related to traumatic life events. TF-CBT aims to improve child post-traumatic stress disorder (PTSD), depressive and anxiety symptoms; improve child behavior problems; improve parenting skills and parental support of the child and reducing parental distress; enhance parent-child communication, attachment, and ability to maintain safety; improve child’s adaptive functioning; and reduce shame and embarrassment related to the traumatic experiences.[i]

[i] The California Evidence-Based Clearinghouse for Child Welfare. Retrieved December 2018 from:  http://www.cebc4cw.org/program/trauma-focused-cognitive-behavioral-therapy/

Trauma Informed Child-Parent Psychotherapy is an evidence-based treatment for children ages birth through six who have experienced traumatic events, and their parents. The treatment guides parents through a process of repairing parent-child “relationship breaches” resulting from traumatic events. This intervention, disseminated through National Child Traumatic Stress Network, has been implemented 143 sites.[i] CPP is also one of the few empirically-validated interventions that is “routinely conducted with ethnic minorities.”[ii]

[i] SAMHSA’s National Registry of Evidence-based Programs and Practices. (2017). Child-Parent Psychotherapy (CPP). Retrieved from http://legacy.nreppadmin.net/ViewIntervention.aspx?id=194 (The NREPP is no longer available online as of March 2021.)

[ii] The National Child Traumatic Stress Network. (2012). CPP: Child-Parent Psychotherapy. Retrieved February 18, 2017 from http://nctsn.org/sites/default/files/assets/pdfs/cpp_general.pdf

The federal Workforce Innovation and Opportunity Act (WIOA), unanimously passed by the U.S. Congress in July 2014, replaces the Workforce Investment Act and requires states to:

• Place a greater emphasis on local and regional collaboration among workforce, education, and industry partners
• Improve services offered to employers, including work-based training programs
• Increase both the amount of funding devoted to helping out-of-school youth and the maximum age at which youth can receive services
• Reinforce connections with registered apprenticeship programs
• Promote strong Workforce Development Boards
• Use career pathways to ensure job seekers are receiving credentials for in-demand jobs
• Ensure that accountability measures are data driven[i]

Established in 2014, NC Works manages a partnership between North Carolina’s workforce and education agencies, health and human services, commerce, and the community college system. The goal is to create stronger connections with local employers. NC Works’ Career Centers conduct staff training to promote higher levels of responsiveness to the needs of both job seekers and employers, while the NC Works Commission approves the criteria for NC Works Career Pathways. Local NC Works partners have also met with 1,000 employers to gain insights on how the workforce system can be designed to better meet their needs.[ii]

The North Carolina Workforce Innovation and Opportunity Act (WIOA) Unified State Plan was submitted in 2016 and is available online.[iii] This plan guides how NC Works links employers and certain groups of job seekers, including dislocated workers and disconnected youth. WIOA focuses on skill development in areas such as adult education, literacy, and vocational rehabilitation.[iv] There are opportunities for state policy makers and agency administrators to determine how the North Carolina WIOA and CCDF plans can build coordinated and integrated services that meet both the workforce and child care needs of eligible families.

For example, the CCDF plan will coordinate with the North Carolina Division of Social Services to streamline access to supports for families—when the subsidized child-care program is moved into NC FAST, families will no longer need to apply separately for TANF assistance and subsidized child care. In addition, an integrated case management model will be used. With implementation of the NC FAST eligibility system, client information stored in NC FAST will be generated when clients apply for child care subsidies. This streamlining benefits both the clients and the state by reducing double reporting.[v]

[i] NC Works, Workforce Innovation and Opportunity Act, op cit.

[ii] North Carolina Department of Commerce. (n.d.). Workforce Innovation and Opportunity Act. Retrieved March 17, 2017 from https://www.nccommerce.com/ncworks

[iii] North Carolina Workforce Innovation and Opportunity Act Unified State Plan, August 30, 2016 

[iv] NC Works. (n.d.). Workforce Innovation and Opportunity Act, Unified Plan.  Retrieved January 20, 2017 https://www.nccommerce.com/wf/workforce-professionals/workforce-innovation-and-opportunity-act

[v] NC Works, Workforce Innovation and Opportunity Act, op cit., p. 28