RETHINKING THE ORGANIZATION OF CHILDRENS PROGRAMS - LESSONS FROM THE ELDERLY

The U.S. system of care for children is a collection of activities and funding mechanisms that create a complex, fragmented patchwork of ser vices and programs. In contrast, the elderly enjoy universal entitleme nt to national health insurance through Medicare, a uniform level of i ncome security, and an organized system of community-based services. T he provisions of the Older Americans Act (OAA) are compared with the c urrent program of maternal and child health services. Basic features o f the national policy-and the core program and administrative infrastr ucture of the OAA-may serve as a model to meet the special challenges of child and family services. The tools for building the coordinated, comprehensive service system that. was devised the elderly are also av ailable to improve the lives of children. Federal legislation is neede d to create the special protections that are basic to the organization and delivery of services and to the assurance of a permanent national policy focus for children and families.