increase in the number of mothers working outside the
home and (2) the increase in the number of single-parent
families. Today, 65 percent of mothers with school age
children work outside the home. The figure for moth-
ers ofpreschool children is 60 percent. Amongwomen
with children less than 1 year old, 54 percent work
outside the home. Moreover, the Department of Labor
estimates that, by the year 2010, labor shortages will draw
even more mothers into the work force. Today more
than 25 percent of all American children and 50 per-
cent ofblackchildren grow up in single-parent families.
  Research 011 the impact of daycare on children,
Dr. Zigler noted, has shown that good dayare is good
for children and bad daycare is bad for children. M'e
know how to provide good care, but we don't want to
pay what it costs. "The general state of childcare as
experienced by children in this counts is abysmal," he
stated. "This country is getting what it pays for." The
average annual turnover in childcare facilities is about
40 percent. As many as 90 percent of daycare centers in
the U.S. are completely unregulated. No national
standards exist, and there is wide variation among
States. Even where standards exist, they are too lax to be
of much use. Based on studies recently completed in
California, Dr. Zigler estimated that about one-third of
centers in this counts are so poorlv managed and the
qualit) ofcare is so low that children are being "serioush
compromised." He went on to say, "We cannot treat
children the way we are currently treating them in the
childcare setting in America and expect this to be a
great nation."

  &Uthough the 1990 Childcare Block Grant has
been hailed by many as a victon for childcare reform,
Dr. Zigler expressed doubt that it will have any signifi-
cant positive effect. Seventy-five percent of the funds
allocated to the Block Grant are earmarked for poor or
nearly poor families. The middle class, which is equall)
in need of good childcare, will see almost no benefit,
and Dr. Zigler expressed his fear that this situation ma)
lead to backlash against the grant and against childcare
reforms in general. He stressed the relationship of
good daycare to achieving the President's six National
Education Goals. "Five lousy years of childcare will

126 Parents Speak Out for America's Children

guarantee that the\- [children] tvill show up at school
guarantee that the\- [children] tvill show up at school
not ready to learn."
not ready to learn."
  In Dr. Zigler's opinion, the system as it currently
  In Dr. Zigler's opinion, the system as it currently
esists does not lvork and cannot he made to work.
esists does not lvork and cannot he made to work.
Instead of tt7ing to retrofit the current system, he
Instead of tt7ing to retrofit the current system, he
proposes a whole new system that he calls the School of
proposes a whole new system that he calls the School of
the Tlventy-First (:entur\.. The program, as Dr. Zigler
the Tlventy-First (:entur\.. The program, as Dr. Zigler
envisions it, will incorporate the following key features:
envisions it, will incorporate the following key features:

*

*

*

Two systems will exist: first, the formal, Y-month,
8:00 am to 300 pm school, and second, the 12-
month. 7:OO am to 9:00 pm school.

Children will enter the system at the age of three
for full-day. developmentally appropriate school.
In commmlities that already have Head Start
programs, Head Start could simply be blended
into the system; parents with earnings above the
poverty line will pay an enrollment fee.

Before- and after-school childcare will be pro-
vided for children aged 6 to 12.


Each family will be assigned a home visitor who
lvill conduct developmental screening. offer sup-
port to parents, etc.

All family daycare programs will be tied in to the
school, which will offer support and periodic
training sessions for childcare providers.

The school will contain a comprehensive informa-
tion and refer-al system that can direct families to
appropriate health and social senices agencies (such
as immunization clinics or night care providers).

  Successful pilot programs to build Schools of the
T\vent\-First Centun. alreadr. exist in several States,
including Missouri, C:onnecticut. Colorado. \l'\oming,
Texas, Kansas. Idaho, Arkansas. and Mississippi.

  .-\nother proposal Dr. Zigler is attempting to
present to Congress is the "(:hildren's Allowance for

America."  This plan would allow a new parent to
\\-ithdraw up to S.?,OOO from his or her o\vn Social
Security account to allow the parcwt to stay home or to
help pay for good childcare.

Nancy Van Doren
President, Tmveh:r Companies Fouwlntion
Director, ~V~tionnl and Community .-lffir~ LXvisio,7
Thp Trcwe1cr.r Cornponies

Ms. Van Doren spoke on behalf of the Travelers Com-
panies Foundation about the role that businesses and
private organizations can play in securing good care for
children and pregnant women.  The Travelers are
headquartered in Hartford, Connecticut-one of the
poorest cities in the country, located in one of the
richest states.  Disproportionately large numbers of
children in Hartford are born to teenage mothers, are
underimmunized, and have asthma, attention deficit
disorders, or learning disabilities. All of these condi-
tions are usually preventable.  As one of the
organization's social responsibility commitments, the
Travelers are working to improve the health ofchildren
and the prenatal care of mothers in the greater Hart-
ford area.

  M71en a new children's hospital was proposed for
Hartford, the Travelers commissioned an independent

analyst to conduct an evaluation of Harti&-d's health cart
delivevneeds. The consultant found that,while Harttijrd
would indeed benefit from haling another- hospital, it was
even more important to increase availabilip of priman
and preventive health care for children and expectant
mothers. Ms. \`an Doren said that it has been a challenge
to persuade contributors and decisionmakers to redirect
their limited resources fi-om "glamorous." high-lisibilih
projects such as new hospitals to more mundane (but
effectivy) applications such as prenatal and perinatal
health clinics for low-income mothers.

   11s. \7an Doren said that she is motivated in her
efforts b!. a mixture of rage and shame that people in
her communit\. are unable to have even their most basic
needs met. She urged the audience to let their rage and
shame move them to act and to search for opportunities
to push for the redirection of resources to the places
\vhere theI. can do the most good. Hartford has been
successful $0 far in its drive to reallocate resources from
prisons to scl~oola, and from neonatal intensive care
units to preventive care. Ms. \`an Doren emphasized
the importance of prel,enting health crises rather than
remedving them.

CHILDREN WITH SPECIAL HEALTH CARE NEEDS:
LESSONS LEARNED

This panel offered wluable insights about setting up
systems that address the problems of children with
special health care needs. The speakers offer three
perspectives-all key to successful programs: (1) par-
ent empowerment, (2) program-level development,
and (3) State-lel,el involvement. The panel uxs moder-
ated by Rear Admiral~Julia R. Plotnick, M.P.H., R.S.(:.,
who holds the rank ofAssistant Surgeon General and is
the Associate Director. Division of Senices for (:hildren
with Special Health (;arr Needs. at the \f;irtTIld a11d

(1hiltl Health Kureau.


Ms. Robinson se17w as a parent/child advocate at the
Robert Ta!4or (:otni-ntulit!.-kno~vn to he the largest
public housing divisiott in the I_`nited States-w+et-e
she has resided for more than 20 >`ears. Her video
presentation highlighted the dail!. struggles of a com-
munity with high& concentrated and severe povert)
and its associated problems: extreme overcrowding,
extremely high infant mortality and morbidity rates,
high incidents of low birth iveight, high percentage of
teenage tnothers, and high rates of violence. The
commrmi~ is further crippled b!, threatened famih
unity; psychological and phvsical absence of fathers;
anger, depression, and despair: and social isolation.

  11s. Robinson`s determination to help herself and
fellow community members led to her advocacy work on
the Beethoven Project at the Center for Successful Clhild
De\,elopment. The (:entet- protides cot~irntuni~.-based
senices that address the health, education, and social
needs of the coniniuni~. The (;entet-`4 philosoph\. is
based on two beliefs: that each individual has the abilip.
toachie~-eandbrindepende~ttanctin controlofhisot.ht,l-
life, and that strong fLnily relationships are important.
Set-r-ices are tailored to the needs ofindi\idual titmilies. in
a n.pe of holistic set3icr plan.

  Instead of' focusing on the barriers to itnprwing
communin. life. said 11s. Rohittson. the <:rnter builds on
community strengths to deal lvith the problems. From her
experience at the CIenter, 11s. Robinson shared t~vo basic
problems and approaches to sohing them. ( 1 ) Economic
entrapment and iwlation leads to a nlolltll-ttr~llo~ltll
sttxtggle to meet basic needs. To address this problem. the
(23iter offers ongoing employment training, coutwling.
and I-efcr-t-als. The Center also provides other tools to
make lift- rasirr and help people to help themselves.
Project staff at-e empathetic rather than y-mpathetic, and
support groups abound. (2) Educational opportuni?. is
lacking in the communit\: Project staff help parents to
become better persons as well as better parents. The
Center recognizes that parents who feel powerless and/or
inadequate as parents don't read to children. Staff

tn~nnhet-s stress the importance of reading to their
children and other approaches parents can use to
foster school success.  The staff encourage strong
parent-child relationships and emphasize taking pride
in the child's academic achievement.

  Finally, parents are taught to become accountable
and take an active role in their children's lives and in
their community. Said Ms. Robinson, "Healthy parents
read\, to learn will provide LB with healthy children
ready to learn."

Polly Arango

Ms. .It-ango introduced her audience to Sew Mexico
from the \-ielvpoint of Sew .\lexico's parents of children
\vith special health care needs lvho have been working
to impt-o\e the State's medical and educational systems.
\Vhilc Sew Llvsico i\ a State ofgreat physical beau? and
diwrGt~-. it also faws many challenges:

It Ont'of'sc\en Sew Slesicochildt-en lil,esin paver?.

Ir Stv Slesico ranks .`ilst in the Sation in the per-
ccntagr of \vomen rect%ing prenatal care.

+ The State's tern suicide t-ate is dismal.

  Thet-rfot-c. Sew Mexico's families have arranged
to makt~ the lives 01.1 heir children better, one famil!,and
oiie issne at a time.

  11s. .\rango became involved as an advocate j\hen
she and her family learned that their youngest son,
Sick. has cerebral palsy and developmental delays. As
Ivith many middle-class families, the .-\rangos discov-
ered that fe\j- avenues existed to assist them as thev

stt-uggled to pay Sick's medical and preschool bills. For
example, although Nick was adopted, his adoption
occurred before the emergence of adoption subsidies.
Sick is an LXnierican Indian, but his birth parents chose
not to enroll hitn in the tribe, a decision honored by
Nick's adoptive farnil!,. & a result, Nick is not eligible
for services through Indian Health Service or the Bu-
reau of Indian Mfairs. Because they were decided])

128  Parents Speak Out for America's Children


middle class, the Xrangos could not meet income guide-
lines for the State's crippled children program.

  To deal with her frustration. Ms. Arango joined
with other parents to found a statewide organization
called Parents Reaching Out (PRO) for any and all
families with children who have chronic conditions.
disabilities, or illnesses of any kind. Twelw years later.
PRO has 500 members ~vho at-e from e\w?. pat-t of the
State and every ethnic background and ~vho have chil-
dren with many challenges. Man!. of' PRO's membet-r
are the professionals, friends. and relations of families
\vho ha\,e children with special health needs.

  PRO began as an organization to provide peer
support and information to families. and this fitnction
continues to he the heart and SOLII of its ef'fot-t5 to&t\.
Holye\-et-. PRO's parent\ soott tackled Ijiggct. ihsttca
such as \\riting rhc lcgi&ttiott that created a (;omptx-
hensive High Risk Insut-ancc Pool for Sew Nrsico. The
list of issues they have addressed goes on and on. The
following elements have contributed to their success in
changing the s\xtem:

* Ordinal parents have united to form a common
bond.

* They have forged strong partnerships\vith health.
education, and other professionals.

* One parent usualI!- has risen to the forefront as a
symbol of the movement.

* Public and private agencies have supported the
  2
campaigns Mith technical assistance and in-kind
contributionsasawayofenlighteningandeducat-
ing the public.

+ At least one policymaker who is willing to "bleed
and die" for the issue has become involved.

* The highly visible work and people are supported
by a broad-based grass-roots community of fami-
lies and professionals who voluntec~r at hotne.

Sr Evenone remembers the bottom line: improving
the health of children and ensuring that their fami-
lies can raise them with dignin., rrspwt. and lo\r.

\Ihen 11s. McConnell's child required an osygtw tank.
she had to learn about health cat-e svstems and ho~v IO
make thetn\vork. Because ofherexperience, ILlc(~ot~ttcll
~vas hired b\. the Michigan Department of Public Hwltlt
to work on a peer level lvith "weigh?," issues for a ttrwl\
creatrd parent participation program. The program,
horn out of` decentralization at the State level, nccdtd
more parent involvement at the local level.  Ms.

\lc(Ionnell dexribed the initial ambivalence of` one
sup~r~~iso~~ who did not understand the need for parent
in\ oh t' mrnt at the State le\.el. Holvever, as the program
gained \vide acceptance, she gained this pet-son's
full wppo1-t.

  \Is. \lc(:onnell's job was to build relationships;
create task forces; make appro\.als: and set policies for
hospitals. physicians, L md home health senices. She is
proud of the f:nct that all hospitals in her State now tired
pal-en t ad\-isot-y committees and parent staff. She stressed
the benefits gained from building relationships among
parents, communi~. and Cgoverntnent: the establishment
of enormous power bases that took action when funding
cuts 1vet.e threatened. They influenced senators so that

"Families have both an immediate
vested interest to get things changed
and the freedom to act. . . ."


l);trcttt~ receij-ed needed appropriations. The!, helped
est;thlish boilerplate in law that required that t`atnilies and
conseqttences to them be considered before pt-OgtTttllS
are changed or funds are Gthdt-awl. In effect. the legislsladon
mandated State government to work with bnilies.

  Ms. McConnell noted that parents are willing to take
t-i&s to support the continuance of needed sen-ices.
"Even if they are not sure the steps at-e right," she said,
"[parents] are \%illing to follow their instincts."  Ms.
McConnell introduced four strategies to help families
meet children's special health care needs. (1) Support.
State agencies should nurture and facilitate the develop
tnent of statelzide coalitions of and support groups for
persons with disabled children. State agencies should
encourage refer]-dls to these groups. Financial sttpport is
also vet-y important. Parent consultants must get reim-
bursed for their time and expenses. ,~wther t\pe of
support involves helping parents acquit-e a \vealth of
knokvledge. They need information, for example, about
who in the communi~ has had a bad experience lvith
clinics, etc. (2) Dissemination of Infi)rmation.  State
agencies must establish effective, routine mechanisms for
receiving information from parents and parent support
groups and for disseminating information to them (Ltm-
il! support nenvorks). .%gencies must pt-o\idc families
with clear written information describing programs. ser-
\-ices. and mechanisms foracces\ittg those senicrs. .+tt-
ties must prwide read\ access fi)r parents to unhiaaed attd
complete information from their child's records.  (3)
(:ollabordtion. Fatnilies that participate across the State
must represent the culn~ral and economic di\.et-sit\. of the
State. They must participate fully Ivith professionals in
polic! development, program itnplementatiott. coot-di-
nation of senices. and e\.aluation of programs. State
agencies must financially support parents involved in
these activities.  (4) Integration (the ultitnate goal of
senicrs). State agencies must have a written poliq that
reflects the pivotal role offamilies. Integration recognizes
the concept of fdmil>,<entered senices. Howe\,er, parent
inptttis needed toensure thatsenicesarefdmil\centered.
Therefore, tnechanisms for parent and professional col-
labordtion should be used routinely at a11 le\,els and in all

program areas.

  In closing, Ms. McConnell shared the following
"lessons learned" frotn her experience: (1) Families
have both an immediate vested interest to get things
changed and the freedom to act (they haye no boss in
this endeavor, nothing to lose, and everything to gain).
(2) Concepts trickle down to benefit health care for
children in general, not just for those with special
needs. (3) Financial support and encouragement are
Lital. (4) Xdvocacy can result from one-on-one relation-
ships, either parent to parent or parent to professional.
(3) None of the panelists are specialistsin special health
needs. In other words, parents should be recruited on
the basis of their commitment. not educational de-
grees. (6) Gaining new territory is worth the risk.

PARENTING: THE CRITICAL ROLE

.\s she introduced the speakers on this panel, Modera-
[or Bat-hat-a Hriser of` the La Lechr League stressed the
importance of parent inwl\,etnent in children's lives
both at home and at school. Xs children's main support
s\.strtu, first teachers, and caretakers, parents exert a
lifelong influence on their children's development.

Ann G. Cagigas, R.N., I.B.C.L.C.
Lnrtntio)~ Cn~~srllln~~t

For this panel's opening presentation. Mrs. Cagigas
shared some of her experiences as the mother of three
childrett. t\voofwhom had severe sleep apneaaschildren.
;\s infants, all of her children had to be constantl!
monitored lest the!, suddenly stop breathing.  Mrs.
(:agigas, a former emrrgencyrootn/trauma nurse, found
herself wholly devoted to a new, 2+hour, acute care
detail at home. Hereldestdaughter, who is now 1 Syears
old, has fought se\,eral tnedical problems, including
thyroid f:nilure and Tourette's Syndrome. Mrs. Cagigas
said she beliel,es that the commitment she and her

husband made to their children and their determination

130  Parents Speak Out for America's Children


to stay activy in their roles as parents carried them
through some difficult times.  She also stated that
breastfeeding her children as infants helped her to feel
connected to them later in life and kept the maternal
bond strong even driritig \~n. stressfiil pet-iods.

Mildred M. Winter, M.Ed.
bkQCWtillQ Dim-for
PCl,-QlltS (1.5 ~QfldlQV\ .\\rtiOHfl/ (,htfV
i'rri71Qr:sit~ ~~[.\lic.tou~i St. I.orris

Ms. \Viiitcrs presettted the tiiethodolo~gy and histot? of
Missouri's Parents as Teachers program. (~l~iltlrrtt are
hot-n learning. she said. "hut the~~doti't cotiir~vith itistt-uc-
tions." .& children'\ first attd most itifliitwtial teachers.
parents should help theit- children Itw-n all the! GUI. Tht
P;1rents as Teachers program help\ parents xi\ e cltildrcw
"gooc~ beginnings."

  The ICC\-. according to 11s. \\-itttt'r, is to rcaclt
children ah earl\. as possible. \\.e Ieart1 tnot-c ;I\ ( hildrett
than wc do during aiiv contparal~l~ pc~riotl of`out- lkc'4.
To make the most of` this fertile learning prriod. the
Parents as Teachers program promote4 the tlc\~~lop-
ment of a parent-school partnership. X home visitot
pt-ogratn bt-in<gs trained parent educators into the
children's homes to walk Ivith parents about opportuni-
ties for the child to learn, things the parents can do to
stimulate the child's imagination, and lzhat skills the

"As children's first and most
influential teachers, parents should
help their children learn all they can."

child should be dewloping. Home visitors also act as
listeners and offer the parents support and a s!mpa-
thetic ear. The Parents as Teachers program involves as
n~an~famil~tnembersaspossibte, including~~thet-sand
grandparents. .&I? f'amily is eligible to enroll in the
program. and special efforts are made to attract low-
income fatnilies and teenage mothers.
  To date, four independent el-aluations of the pro-
gram have been conducted; all have shown that children
whose families participated in the Parents as Teachers
program to score higher in language development. intel-
lectual de\-eloptnent. and social cle~elopment than chit-
drcn ~910 were not i>vol\-ed in the program.
  Thirteen states. ittctuding l\lissouri, have Parents ;is
Teachers p~-og~x~~is in place. .\Iatty use fundsfion~ Even Start,
(:hapter I. <:hapter II. childt-en's ttw+t hinds. private cotp~~t-
Con\ ;u~l fi~tuntlations. and public set~ice gwups such its the
Ki\\;utis Club. 111 closing. Ms. \$inters said that while the
Parents it\ Teachers proqtm does not solve all of the prob
lems that f&e chilclren ant1 their families today, she and her
organi/ation are proud to be part of the solution.
  Following Sk. Lj?nter's presentation, a member of the
audience [Sandra McElhany of the National Mental Health
Association] urged attendees to write their representatives in
(Congress to ask them to support an amendment to the Bill for
Educational Reseu-ch and Education thatwill be proposed b>
Senator Kitt Bond of Mssouri. The amendment, which has
the support of Senators Kennedy (Massachusetts), Dodd
(Connecticut), and Pell (Rhode Island), would grant States
fitnding-$20 million per year for .3 years-to start or expand
Parents as Teacher programs.

Mary Louise Alving, M.Ed.
Project Diwrtor, Pormt Ltmhhip Training
Citizms Educnfion Gnfpr

Ms. Aking presented a set of proven guidelines fot
setting up parent involvement programs. Although it is
widelv known that parent involvement improves
children's self-esteem and school performance. 73
percent of parents still do not get involved. Ms. Xlviug
offered wa\`s to increase parent itnvlvemen~ in school
programs. The Parent Leadership Training Project at
the (:iti/etts EdItcation (:enter begat1 in Seattle in 1986


"
. . .parent involvement improves
children's self-esteem and school
performance. . . ."

to address the needs of !&grant f'nmilies. Since then, it
has expanded to include families and schools of all
backgrounds.

  Ms. Ahing first talked about the four myths that
people use to sal'that parent involvement is not practical.
The first was that "parellt involvement" means volunteer-
illg for school activities. .\ls. .-\l\ing disap-eed, ca!ing that
a parent who helps his child with her home~\w-k. or who
takes an active role at school hoard meetings. is iit lea5t a4
involved as the volunteer. The second mvth is that pawllts
don't have time to participate in scl~ool activities. Sht
pointed out that parents do COIW to school \~Ix~n the\
have lvhat they think is a good reason (for example.
debates about cc?ndom distribution in high sc11oo1~).
"Parents are hard to reach"~vas the third nn.th. Yls. .\l\illg
asserted that it is the schools, not the parents. lvho are
m~welcoming. The fourth m\-th she confronted \vas the
"at risk" classification of families from certain csthliic
groups or economic levels. She said that all famil.ies are at
risk at some time. and that these kinds of classifications
promote division within the communiE.

  Ms. Alving presented eight "do`s" for successful
par(;nt involvement programs. These were repeated in
the video that \sas shown at the end of the session.

+ All activities and programs should be based on the
                                

idea that all families have something to shark.

* Parent im~olvement programs should include
members of other programs--such as Chapter I
and Head Start-and should collaborate with
other programs.

Ir Slost successful programs focus on the child's
teacher. Parents want to meet and get to know
their children's teachers. Teachers are often the

best way to reach parents.

Ir The program should he coordinated by a team; a
~oocl program lvill rapidf expand to a size where
it simple cannot be administered by only one
person. Teams should consist of the school prin-
cipal, two parents, tlvo teachers, a school district
represrntati\,e. a business/comlnulli~ represen-
tative, a social ser\-ices professional, and a cul-
ture/language specialist (as- required). Before
the team begins planning, they should attend a 5
day training session.

Ir

*

*

*

Succtwful prograrns ahvays allow room for adjust-
ment. Evcrv scl~ool is different. and programs
must be adapted to lit thrir audiences.

Teacher training is an important part of parent
iliwhwiicnt programs. Teachers often have no
training on ho\\- to pork \vitli parents.

Ongoing fiinding for parent involvement pro-
~T;lIll~ 410~11d be olmiJlrd.
.7                 Too often, when
funding rt111s out. the parent invol\.enient pro-
g:1-an1 goes with it. Begill to lvork for permanent
funding earl!-.

.

Buiiding a developmental e\-aluatioli process into
the program means that staff can evaluate their
progress at an!. point and can make any necesy
acljustm&ts.

Letitia Rennings, M.S.
Evrn $0 ft Coodiru7tor

Last to speak in this session was Ms. Rennings, who
discussed the Even Start program. This family literac)
program has ir?creased in Federal funding from

132 Parents Speak Out for America's Children


$14,820,000 in 1989 to $70 million in 1992. President
Bush is recommending that funding for the 1993 fiscal
vear be $90 million. There are c7trrrntl\- 240 f71nded
programs, including 9 Migrant progratns. Even Stat-t is
open to children front birth thro77gh agv wven living itt
a Chapter I elementat:, attendance area and a parent
who is eligible for adult basic education.

  Even Start is composed of three cow cotnpo-
nents-parenting education. early- cltildl7ood etl71ca-
tion, and adult education. The projtacts build OII tG;l-
ittg progratns in the cotntnltnit~.. i;71cl1 a Head Start,
Chapter I, Ch;7ptet- II, ad77lt education. progratn\ fot
children u-ith disabilities, .JTP.L and .JOBS.  Thy
progtwn's goal is to break the c\.cle of illiteracy tliar
plague5 so tnati~. .-\tiwt-icati fattiilirs.

  The brnefits of E\wi Start's foc714 on litety at-e
inativ. Parents \vho Icarn to read dcwlop att ititrrest in
school, and sonic of theni choow to go back to scl~ool

ac a result of their involvement. In additiott. cItiIdtx*tt

feel pro7tcl of their parents and \\orl\ to cw~ttlatc tItc.ir
parents acadeniic success. In somr projects, p;~tx~tIs
lrve f in-med their 0~11 support networks ;III(\ 11;1\x~
learned the importance of proper health c;w and
n7ttrition. talking and reading to their childrw. att(1
scning as good role nwdels. The self-estccwt ;71td
cotifidcttceofpxticipants-adults andchildt-rti alike-
is great]! increased.

  The results of first !-eat- ( 1989) pt-ograttt r~xl~~a-
tions sh01\ that `70 pet-cent of fxmilies set~td ltavc
ann71al ittcome\ of. less than 510,000. Evtv .St:ur ha\

rcacli~d 13.000 adults ant1 48.X)0 children acros4 tht
co7tntt-v. The nlajorit~-ofad7tlt participantsaw brt\vcac.tt
            
the ;lcrC% of 2 1 and 29.
   h
  To cloce her presentation. Ms. Reriningsoff~t-ctl rhr
a77dietice sonic specific ill7tstrations ofthr good Even Start
can do fix- fiumilies and for Ivhole conitn7tnities. She


llt-iefl\- drsctii~ed three stlcccssfitl pt-ogratns-one itt a
tt.;tiiet- park in Fort (Zoiiitls. (kAorado. one it1 a \.etT poot-
cotntnuttitv in Snt~arl~iile, Tennessee. and one in the town
of'Hidaigo, Texas. on the Mesican border. Each of thrse
prograni\ has tailored its set-\ices to fit the specific needs
of the cotntnttnit_\ and lamilies it sexes. Recognizing that
fanlilies' basic needs initst be nlet before the! can begin to
;tpph, thetnseives to stttd$lg, thr (Colorado progtxn
&et-s not oni!. (kneral Eqtti\-alettr!- Diploma (GEL))
trainingfot~patw~ts. btlt also teachesl);tt.etltitlg skills, basic
nutrition, and h@xie, anti coordinates a food donation
progratn. In Sneachiiie, where nxttn people hale never
been inside a school bttiiclit~g, 1.50 f:,\tniiies--ainlc)st t7xy-
otle in the count--is inwived it1 Even Start. 1lot-e than
.X0 people attended the progratn's spring picnic. rvith
rvenxme in the coti~tii7ttiitx participating.  The tmvn
sheriff cooked. and the staff of the bat-bershop gave free
haircuts-wine to 1vottttw \vho had tte\w had their hair
cut bv sotneotle outside their imtnediatc farnil!. .-\t the
end of the )`ear. -lH ~vottwn twroiied in Evm Start had
passed the GED and IO of them recei\wl drivers` licenses.
  In Hidaigo. Tesas. the Ewn Start progranl setTes
;I cotnttt7ttlity that is nlo\ti!- Hispanic and poor: the
faniiiies participatiti, 0 in Earn Start had no pitttmhin~o~
server svstetns. Their hotttrs t-esetnhlrd small toc~isi~ed~.
Seat+ 1'10 pat-etttsand 130 children atx~etiroilecl iii the
progratn. Before E\wl Start catne to Hidalgo. tnan!.
\vomrn. who had had evett less rdttcatiott than thrit
husbands. lvere completely illiterate. 51atl!, families
\\`ere entitled to food assistance, but could not negotiate
the system because they could not read. The Hidalgo
Even Stat-t home visit has proved the most effective
titeatis of`itiipro\~ing families ' iiterac\. skills iii ;I cttitrtr-
ally srnsiti\.e tnannt`r attd of'assistitlg families in dealing
uith social set-i-ice agencies.

CHILDCARE: TWO PERSPECTIVES

(:hiidcarr C;III be \ie\veci frotn two perspectives: that of
the parents and that of childcare providers. This panel.
tuodet-ated by Barbara A. M'iller, Ph.D., Public Affairs
Director for the National Xssociation for the Education
of Young Children (NXEYC), pt-esentrd the results of
t\vo national childcare s7113ty, one from each perspec-
tive. Dr. L\`iiier noted that these projects, which u'ere
separatei~ funded and designed, are ttttiqtte because
the!- highlight partnerships (collaborations). The first
stud\- \vas the National Childcare survey sponsored 1~1.
S.kE\rY: and the Xdtllittistlatiotl ott <~hiidt-en, Youth,
and Fanlilies. U.S. Departmrttt of Health and Human
Setlices. The stud!. ttwcl a tviephone sutTey of parettts
cleGgtted atttl anaivzeci 1~1. the Urbatl Institute. It ex-
piotwl gvnetxi clttrstionsahottt childcare at-rangetnents

134 Parents Speab Out for America'\ Children


and included substudies of low-income families and
militay families. The secottd stud!-. the Profile of
Childcare Settings, was sponsored by the Department
of Education. \ The study dealt with the supple of
childcare services, use by low-income families. range of
senices, and qualit!,.

Patricia Divine-Hawkins
Publir .4@iry Co-Dimtw

.Ycttionnl .-issociatio~~ ,Jor the Educntion cf kbuug CXiltiw,l
Ms. Divine-Hawkins reported imtnense change Gth
respect to childcare in this cotmtt-~ in this generatiott.
In the 1990s. man!' mothers are lvorking. resulting in a
large proportion of' children in preschool and ;I large
number of children caring for thernsel\~r~.  She also
reported a shift from informal toTGtt-d formal childc~art
centers and homes.  (ivi5us studies of part~nts and
national studies h>. the hdtttinistratiott on (:ttildrett,
Youth, attd Familirs point touwtl these conclusion\.
She noted that the cot~st~met- studie5 of 19% through
1976were prototvpesofour understandingofchildcare.
but the! did not include f:ntnily daycare providers.

  r\ccording to Ms. Divittc-Hawkins, social policies
of the 1990s are oriented more toward children and the
family. Childcare is a central component of etnplo!ve
benefits in many companies. Head Stat-t created nrv
partnerships between Federal, State. and local govern-
ments. The continuitv between earlv childhood educa-
tion programs and elementary school has enhanced
and eased the transition between early cltildhood and
kindergarten. However, these social factors create a
complex situation and thus a need to look at childcare
issues more holistically.

    Ms. Hawkins-Divine related that N;\EYC's research
examines how the supply of and demand for childcare
work together. It is the first research that (1) studies the

range ofoptions for different families in different types
of situations, (2) explores characteristics of individual
families, (3) develops a comprehensive database with
individual data tailored to individual circumstances.
and (4) examines socioeconometrics.  NXEYC also
emphasizes the importance of partnerships in addrew-
ing childcare issues.

Dt-. Hofferth was the principal investigator of. the ~a-
tional Childcare Sunny. which explored sttpplemettt;tl
caw for children (center care, family daycare, in-hotttc
cat-e. care b\. a relative. or no supplemental care). The
components of the sttt~e\. included the n~~tntbet- of
households l\ith children under certain ages, ttumbet-
of children enrolled itt da\care, a parent suney, and ;t
provider WIVV. The sttt~-c~ revealed a high pet-centagt
ofsttpplrttletttal c;w and a major shift in the provider\
of ~llpplelllental cat-(`:  more and more children ~vho

receive care out of' the home are enrolled at centers AS
opposed to wcei~iiig care at ltotiws of relatives. The
sunr! examined primat? care for the )wungest pre-
school child by income, for employed mothers. Enroll-
ment in center-based prograttts has increased particu-
larly among lolvest income families whose childrett are
placed in subsidized programs and who receive direct
financial assistance. etc. The \vorking poor and low- to
middle-income families, by contrast, are participating
at a louver rate in center-based programs.  Dr. Hofferth

said it is noteworthv that the cost of care has not
increased significantl!. relative to the cost of living. But,
she affirmed. 35 the high-income familiesget tax credits
and low-income families get assistance, the middle class
gets squeezed out.

  Dr. Hofferth's research shows that parenti learn
about childcare arrangements for the youngest child
through relatives. friends, and neighbors (informal nrt-
works) and ft-om referrals. The most important factors fi)t-
measuring daycare are quality (above all else), reliability.
teacher training, and student-ttrteacher ratios. The SIN-
veyfottnd thatparentsweregenet-allysatisfirdwith daycarr
arrangements. One-fourth oftheparentssrtrveyedwanted
to change arrangements. Of those, one-half wanted to
switch to childcare centers. Childcare centers are the
preferred alternative. Intel\iews wi\ith SII~TV\~OI~S S~OISXY~
that some centers were regulated, and others were ttot.
Sottrrgttlatrd cetttet-4 ottt~trtmberetl regulated centus.
S0ttre@ated ccntet-\ differed flrottt regulated one4 itt


that the!, lvere smaller. had shorter operating hours,
charged less. and bvt`re not run bv professionals. The
major findings were that, during the preschool years,
more and more children are in childcare centers and
some, especially the poor, mav be suffering.

Elizabeth Farquhar, Ph.D.
Ptyqwl tt1 `4 tz n!yst
lkf,ntfttifwt of Educntiott

Dr. Farquhar talked briefly about the Department of'
Education's role in creating policies and studies
concerning earl>- childhood education, childcare, and
family education.  The Department of Education
supports Chapter I creation of Even Start for adults in
need of literacy skills. Preparing Young Children fat
Success is a Department of Education program that
prepares children for schools. The Department also
sponsors the Profilr of Childcare Settings Studs. The
Department also collaborates efforts with the
Department of the Health and Hunlan SelTices. Since
the 198Os, the Department has lvorked \vith the States.
who became active in de\.eloping preschool programs.
"(:ollaboration." Dr. Farquhar stated. "is \`er\' effective in
these studies."

Ellen Eiiason Kisker, Ph.D.
.%tliot~ I&wc1rchrt
.\ln thma t im Poliry Knrcrt~rh, It1 c.

Dr. Kisker, who directed the Profile of (~hiltlcart~ Settiilg.\
Study, described her extensive research on the supply of`
childcare for preschool and school-age children and on
childcare utilization bv low-income mothers in terms of
two aspects: availability and qualiv. Dr. Kisker discussed
availabilit\ in trrms of formal earlI, education and care at
centers and at regulated farnil!. daycare progmms. She
found that the number of programs has tripled and
enrollments have quadrupled since the 1970s. She con-
firms that utilization rates are high and that most \-acan-
ties are concentrated in fewer than one-half of da\,care

facilities. Ho\ve\-er. more infornratioll is needed from
parents to determine if shortages exist in specific areas for
certain tl\-pes of children. Dr. Kisker noted that not all
programs provide all services. As a starting point, one can
l(,ok at adlnissions policies and determine whether the

f'ncility accepts infants, children who need futl-time ser-
tices. and handicapped and/or sick children.

  In terms of quality, Dr. Kisker noted, daycare
centers can take manv forms. "A davcare center that is
considered quality," said Dr. Kisker, "promotes child
development. . You can't assess childhood develop-
ment by individual child, but there are certain indica-
tors of qualit!,." These indicators include (1) average
group size, by various ages (look at the various laws
pertinent to the regulations); (2) average child-staff
ratios, bv various ages; (3) teacher qualifications, b\
type of degree; (4) teacher turnover (profit versus
nonprofit), and (-5) parental fees (not changed since
1970s if adjusted for inflation).

The Childcare Settings s&d? led to new childcare
policies. The 1990 baseline data lvere used to assess
what has happened since the early education initiatives
\vere developed, and programs have since been
implemrntrd. To illustrate Dr. Kisker's statement, Ms.
Divine-Halvkini; shared that 32 projects in 32 States have
e\.aluatcd the transition of Head Start graduates over
the nest three grades, assessed their progress, and
tlet~rmined under Ivhat conditions they progress.

HEALTHY START, HEAD START, EVEN START,
AND WIC: INTEGRATING HEALTH, EDUCATION,
AND SOCIAL SERVICE PROGRAMS

L\`ade Horn, (Commissioner of the Administration for

(Children, Youth and Families. sewed as moderator for
this session on collaboration among various health and
social senice agencies.

A. Kenton Williams, Ed.d
.-\ssociate Cornrnissionn
HPCMI Stcu-t Bu,ucc u

"Head Start is alive and kicking because itworks." So Dr.
M'illiams, the newly appointed Associate Commissioner
for the Head Start Bureau, opened his discussion of the

136  Parrnts Speak Out for America's Children


Head Start program. Head Start is a comprehensive
child development program that works lvith the whole
child to promote self-esteem, education and literac!-.
and health through four channels: education, health
services (including medical, dental, psychological, and
nutrition), social semices, and parent involvement.
President Bush has recommended that Head Start he
allocated $600 million for the coming fiscal \~ar. Head
Start is proud of its cooperative I-elationshipc\~ith other
programs and agencies. including the Health (:are
Financing Xdministration. the Public Health %I-\-ice.
and the Department of Edlwation.

  Dr. M'illiams said that he is happv to be tvorking
with cuch a successful p~-og~-am and nanwd the fi,llo\v-
in? priorities for Head Start in the coming yw

* To better se17.e prrgnant uw1ne11 and to provide
optimal prenatal care to keep mothers health!.
and to help them bear healthy children.

* To maintain continuing relationships with pri-
ma? care physicians.

* To improve clients' access to secondary care.

Ir To provide referrals to appropriate psychological
counseling, substance abuse treatment, etc.

* To reduce the number of low-birthweight babies
and to reduce the infant mortalitv rate.

* To improve clients' understanding of wellness
and increase personal responsibility for health,
including cessation of cigarette smoking, alcohol
or substance abuse, etc.

Donna F. LaVallee, M.S.
Nutrition Coorclinator

,Yew I'isions for.Vezuport County

Dividing her work week between M'IC and Head Start in her
job as nutrition coordinator for this program in Sewport
County, Rhode Island, Ms. LaVallee had man!- insights
about how to integrate efforts between these programs.
  Because N'IC and Head Start seme the same popu-
lation, both pro<qams and their clients benefitwhen the!
work together. his. L>aVallee offered many simple wggrs-

tions to help foster collaboration behveen local M7C and
Head Start offices, such as open houses, cross-referrals,
membership on each other's policy committees, guest
speaker exchanges, and assistance in program evaluation.
Because M7C and Head Start have so much in common,
they can share many things, including resources, cospon-
sored clinics and health fairs, joint newsletters, all-in-one
application forms, community needs assessment data,
and more. Ms. L.a\`allee urged program staff to "commu-
Ilicate, cooperate, and coordinate."

Thurma McCann, M.D., M.P.H.
Acting lAmfor, (?ffp of HecclthJ Stnrt
He<~lth Ke..tourre., nnd Swuires .-idminist,ntion

Dr. hIc(h~n described the Healthy Start program,
\vhich is based on recommendations from the
President's Commission on Infant Mortality. Nowin its
early stages. Healthy Start is being implemented in 13
communities lvith the aim of reducing infant mortalit)
in those communities by 30 percent.

  Program applicants were required to meet five
basic criteria to have their proposals considered:
( 1) innovation in deliverv svstems (e.g., user friendli-
                    
ness, etc.), (2) community commitment to Health>-
Start's goals, (3) the ability to offer increased access to
health care to reduce low birth weight and other causes
of infant mortality. (4) integration of medical and
social seIT.ices. and (.5) multiagency participation. As a
\vhole, the Healthy Start program is unique in that it
allocates unprecedented resources to prenatal and
perinatal care, mandates community choice and flex-
ibility. and empowers communities to build the kinds
of programs that will work best for them.

  Although Healthy Start funding lasts for only .5 years.
Dr. McCann stressed that a community that has "`bought into"
the program can find a way to keep it in place even after
Fedeml funding is withdrawn. Healthy Start encourages
communi?, involvement and has won support fi-om \zrious
churches, civic k~oups. tribal councils, schools, and business
orgmizatkms. Such agenciesas thePublic Health Senice, the
Health (Zare Financing .\dministration% the Department of
E~luc;~tio~~, ad tlw Department of Health and Human
Sri-\icc\ ;II*` also dcthv pmtm-rs in the national prygmm.


Patricia A. McKee

Now in its third year, the Even Start program is proud of
its cooperatit.e relationships with other agencies and
within the commux~ities it selves. W. WKee presented
a briefoveniew of what Even Start is doing in this area.

  Mrhen Even Start was mandated by (Congress 3 years
ago, part of that mandate required that Even Start work
with other agencies to achieve their common goals. The
76 programs established to date contain a total of 869
collaborative arrangements for prima? (or "core") ser-
\rices and 1,600 collaborative arrangements for support
senices. More than 67 percent of all Even Start programs
work with their local Head Start programs.

Howard T. Miller
Coordinator
Even Start Family Literq Procgrum
Ptinc~ George's Conrn~~ Publir Schools

Mr. Miller opened his presentation \vith a brief o\-eniew
of the statistics on illiteracy in America rued what it costs.
More than 40 percent of all milita? sellice enlistetls are
functionally illiterate. More than nvo-thiI-cls of all L.5;.
colleges must offer remedial English classes. SIore than
one-half of all prison inmates are functionally illiterate.
He stated that these and other data show that the
deleterious effects of illiteracy lead to financial losses,
crime, Liolence, poverty, and depression. Even Start's
approach in Prince George's Comnty is based on t\vo
important assumptions: (1) parents' level of educa-
tional achie\rement affects their children's success in
school and (2) a child raised in a literate home lvill
naturally learn to read,just as he will learn to talk and to
feed himself, through learning "reading behaviors."
The second assumption is called "emergent literacy."

  Mr. Miller stressed the importance of educators'
getting to know the families of the children they teach,
to form a cooperative partnership between the school
and the parent. Parents who are enrolled in the Even
Start program along with their children are able to go
to classwhen it is convenient for them, and transportation
is provided. Parents learn new skills in preparing for the

"If we can help the parent become
literate, these families can succeed."

GED, and they also learn parenting skills that help
them teach their children. General health and nutrition
sen-ices also play an important part in helping families
to learn and grow together; recognizing this importance.
Even Start coordinates closely with Head Start, M?C,
the Cooperative Extension, and schools. "If we can
help the parent become literate, "Mr. lfillersaid, "these
families can succeed."

138 Parents Speak Out for America's Children


a

closing Remark


chapter 7

Antonia C. Novello, M.D., M.P.H.

Su,rgeo,n General

I have onl)- a few comments. I think that toda!, you have
seen that when people get together, things work. But I
can also tell you I am proud of your three capable
I-epresentatives who communicated your wisdom about
what this counts needs and what this administration
can do to sohe our problems. This wz unrehearsed; it
was collectiveI\ put together; and I think it probabl)
represents us better than anyone talking from their own
pain. This is what makes this Conference unique.
Moreover, it's even more difficult for me to speak after
haying heard people like this. I also can tell you that.
when this Conference is done and Ivhen 1t.e all go our
separate ways back to the States and commmnities, rn\
impression will be that we ha\-e come together for onl\-
one purpose, and that's the purpose of taking care of
children and families.

  The President said his vision is that. in the !~ar
2000, this countn' and these children are going to mo~c`
forward. The children of tody will he the explorers.
lvriters, teachers, doctors, and imentors of tomorro\v.
President Bush said that, in America, families come
first, and that's what makes this conference unique.

   You are here from 50 States and from Territories
asfarawayasGuam. You are here from PuertoRico, and
VOLI are here from eveqlvhere. ContraIT to \\hat the
only reporter that has come aboard asked yesterday. yowl
are not all Republicans.  In this Conference, I have
taken great pain to make sure that we are not labeled b!
ethnicity, language, or gender. N'e are here with only
one mission, no matter where we come from and who
we are. That mission is to care for the children and
families of this count?.

  You have articulated what ~0~1 need, and I have
never heard it so well expressed. This Conference is
focused on our children, and we're working tolvard the
benefits of every child. I have been much more im-
pressed than ever by people who perhaps neyer knew

the\. col11d speak for others and be taken seriouslv. M'e
said this is about respect, respect across the board. I
think in these 3 days, we have shared the commonality
that, e\-en if !.oL~ don't speak the same language, it
doesn't mean that you are not intelligent. Most impor-
tantl!., \ve recognize that "poop " is a transient state of
mind: todal. it is ~011; tomorrow, it can be me. So let's
not only be culturallv sensitive, let's also be culturall!
responsive. I think this Conference has concentrated
on that.

  Whatever personal circumstances we brought
here-and I can assure you that some ofyour faces said,
"Show me," and some of your faces said, "One more
conference; don't bother me with trivia"-1 can assure
you that b\. having come here for whatelrer was the
message VOLL thought you \\.anted to bring, you have
adI,anced the field of every child, and you will perhaps
be as responsible for having made one more child part
of these Cnited States byjust having been here. For that
~OLI should be complimented.

  \Ve came here to deal with awareness, transition,
and participation. .-\fter ha\ing listened to the parents,
VOLI realize that parents do all three at once, and some-
times one parent does it all. I hope now that you realize
parents are crucial fol-\vhate\er\~e're going to do in this
countll. for the f:nnnilies. If I.011 don't believe me, then
I \\`ant to know where \-ou'\e been for the last 3 days.

  i\hen I charged !.ou on Monday, I told J.OLI I lt'as
going to ask the best ofyu. But I warn you. I'm going to
ask even more of you, even when you think you're going
to go home and forget about this Conference. I can tell
J-ou that \\-e'\,e heard the parents and the groups. I've felt
the pain, and I've talked to you. I've talked to every one
of 1~1 indi\iduall~ or coltectivelv.  M'hen we leave this
place, we will have everything that's been said included in
a proceedings compendium. We will complete the docu-
ment as quickly as possible, but remember we must go
through the General Services Administration and Gen-
eral Accormting Office to have it printed. We're going to
make sure that this goes to eve? Governor, every one of
you, and el-er) legislatorwho asks for it; right now the Hill
is also clamoring for it. So this is going to be a public
cloculllent for all of those who need it.

140 Parents Speak Out for America's Children


  But the document Lvill bc-just a docttmettt if`ytt
do not work with us to make it a reality. ji)ti \\w-t' able
to see that out- officials at-e committed. but don't evet
put the rights and the benefits of !uur famil!, only- on
some other people's shoulders. You have IO sl1at-e the
t-esponsihility: otherwise, it will not become a rtAit\-.
The reforms of this countt?- uill come fixwat-d through
the families; the parents spoke today, and the\ no
longer Irant to be silent partners. They want to he
activists and advocates, and to do that YOU also have to
speak for vowself. Othenvise, w.e't-e ttot going to get
amwhere. I also heard that parents, especiallv f:nthers.
have to be part of e\-et?,thing that NY do. I think. as I'vv
said beforr, we have to find \sax-s hv \\,hich \se bt-in<g
                         
fathers into the family., not wa!x b!,which 1l.e krep them
away. I know that parents have to he respected as
experts, and it is imperative that we do that.

  ;\nother big area is the. need for flexible hours,
and in itiitiiitiiiratioti, ~`e have dixovct-ed that rrprat-
edh.. Hours front X:30 [a.m.] to 3:OO [p.m.] is ;I bwttti-
fit1 protocol, hut 67 pi-cent of tlic pat c'tltsw)ik ii1 ;i jol,

they cannot atfht-d to leave for 1 hour and vaccinate a
kid. and 21 percent of this cotmtr)`s families are headed
b~.a single parent. Open the clinicwhen the parents can
come, if you realI!. are serious about immunizing. For
once, "Put ytt- tnone>' \vhere your mouth is."

  $Z'e must make sure that we write in the language
that proplc understand. Yesterday, I ~YBS in a transplan-
tation meeting, and the\- told me 1 need bilingual
pet-mits todonate m\.ot-gatts..&ld thel-salminoritiesdo
                             
not donate. \Vould you donate your organs b>. signing
a docttttirtit gi\wt to ~wii hv a pet-son who is not culttir-
                
all\- settGtivc. itt ;I lanp~age that \Y)U do not understand?
1fu~1 sign. I hi117 a bridge I want to talk to x'oit about.
This I~c~partntcnt is making sure that evet?thing is put
itt the latlgu;igc that people \\A1 understand. hlost
itttportantl\.. some of our groups have no tnore than an
8th grads education. So again YOU said it, "Put it in
wxds that people understand." In medicine, we't-e
ah\~~i~~s talkittg about EKG [electrocardiogram] and EEG
[el~ctroencepl~~tlogr~~t~~] . and I asked a doctor, "Mhat is
an EC;<;?" He didn't ktto~v, so I told him, "an egg."

  It's aIs;0 important to remember that the cottntt~
is ft~ll of' childt-rtt ha\.ing children. Lye have to wort-~
about them. too. The] do not love their children less
because the\ arc children themselves. The), at-e going
to tteed m~d~t~~tattdittg. and they are going to need us
to help them, too.

   Self-esteem \vas another issue raised here. Self-
estt'em is no longer just for the child. It also has to come
from the parents, and that is something that we cannot
by.. ;2Iedicare. Medicaid, not-Social Security can bu!,it.
That has to come from within. But \ve cannot only think
of self-rsteem for the children. 14-e have to give it for the
parents. Occasionalh., tak;t. vow time to tell us \vhen Eve
d<) good, and. occasionally-.just forget that xve did bad.
1 think positive is part of \vhere \\`e have to go.

  One \I-omati said wr have to help people to help
themsrlves. rather than offer programs that foster de-
pendrnc~~. I ~gwe. I h;nx~ the feeling that that should
be au+ \ve should mo\~ to1vat.d our goal. LZ'e might use
diffewttt \\oi-d\. \Ve might sa\ "ad\ ocac~" or "enipowcr-
mc3it." Eithczt- \~a!, \vv tit4 ;I little more positi\istii itt
;gcittittg togvthct-.


  The title of the Conference has been "Healthy
Children Ready to Learn: The Critical Role ofparents."
I do believe-and I hope you do, too-that this
Conference has done one thing beautifully: It has
vindicated the parents. It has helped people realize
that they can no longer be silent. No single program in
this country should be done in the absence of the
parents' participation; otherwise, it will be one more
useless piece of paper.

  I said in my opening remarks that this Conference
was the result of 18 months of planning. I believe that
is totally obsolete at the end of these 3 days. This is just
the beginning, not the end of 18 months. I have seen all
my Assistant Secretaries involved in this with me, and
we're going to make sure that whatever we plan will be
with families, parents, and children in mind. For that
reason, this is a success story.

  I know I told you not to ever get discouraged with
the Federal Government. It's a powerful one, and you
have to learn how to use it as a tool. Today you had
everyone at the top discussing how they see it. As I told
you, perception versus reality is the problem here. You
might perceive one thing, and the reality might not be
so bad, but I think it worked on both sides of the table.
You have heard from all of us-from the Secretary
of Health and Human Services, the Secretary of

Agriculture, the Secretary of Education, six Assistant
Secretaries, and the President of the United States. But
most importantly, we heard from you. That's what
makes this Conference unique. I think we should never
underestimate the power of a coalition. Alone, we are
not going to do anything, including the President
himself. We all have to be able to tell the Government
we're here. We're part of the solution. Please, let's not
be part of the problem. I want all of us to get together,
regardless of what we felt when we came here, because
united we can do a lot ofwork. I know that you probably
have thought, "She's going to repeat herself again." No
one alone can work. We have to unite.

  But I also told you to use anger if necessary. I can
tell you that I feel good that you did, because when you
used anger, you were collectively expressing something
that I hope the Conference has alleviated. Perhaps now
you at least know a place where you can find a solution
for your problem. I know that I have told you that we
have to be creative. Part of this world is discourage-
ment, but I'm not going to let anyone use it to take care
of you or me. Discouragement is a state of mind.
  I ask you to join me to share the responsibility for

making your family and your children well. Share with
us at the local and at the State and at the National levels
and in the public and the private sectors. It's no longer
one person's responsibility. There is too much at stake!

  So look at everything that works, and look at
everything you think needs to be replaced. Then call
and cajole and make sure that you get involved. I know
that we are "conferenced out," but I know also that we
are accelerated to the "max." You have to use that
momentum when you get back to work and to your
communities and say, `You know when the Surgeon
General, the Secretaries, and the President speak, they
are committed to make the family top priority." Let's
get real. Let's get real! I can tell you that when the
experts go home, they are not going to be devoid of
work because I am not going to be devoid of work. I
have your telephone numbers, your fax numbers, and
even your grandfather's numbers. So, rest assured that
this is not just the ending of 3 days, but it's the begin-
ning of a coalition of parents taken seriously, trying to

142 Parents Speak Out for America's Children


determine, through their collective actions, what
this government can do for you. I'm with you. Are
you with me?

  I want to bring six people to the podium because
without them I don't think we could have done this.
They are the three parents' representatives and the
three parents' alternates. I think we should give an
applause to our panel. We had six parents, three to
come forward and three to be available in case they
fainted. Obviously, we didn't need the other three, but
they were there and ready to go. So, I would like to do
something. There's not much I can do for you all, but
I can certainly give what I call the Surgeon General's
Certificate of Appreciation, and believe me, I do not
give that too freely. But, when people give of them-
selves, as they did to represent you, I think a Certificate
ofAppreciation from me isjust the first step. I think that
you should be able to thank these six people who
represented you so well. Because without them, and
you, this Conference would have never happened. So
how about if we applaud for all of us. Ellie Valdez-
Honeyman, Larry Bell-I am eating squash all my life-
Sandy Slavet, Rosa Palacious, and Jesus Sada. Sherlita
[Reeves] had to go and pick up her little child, so we'll
keep Sherlita's and mail it to her.

  We might be "conferenced out," but I think we are
motivated to go out there and do a lot for what we have
tried to accomplish. Most important, is that, collec-
tively, we will be able to do it. This document will not
stay on anybody's shelves; I guarantee you that. So
today's the beginning, but I need you. Remember,
united we will succeed.  Separated, we will not get
anywhere. Today's the first day. Thank you for coming,
and God bless you.

le program in this c

Report of the Surgeon General's Conference  143