Community Clinical Systems Integration – Early Childhood Education Supports

Statement of Problem

There is clear evidence demonstrating how early child care environments can have long-term benefits for children, including increased cognitive abilities, improved language development, better peer relationships and less conflict with caregivers. Early childhood education (ECE) is a crucial part of these supportive environments for a young child and is a critical and complementary community support service to pediatric health services. Without access to quality child care, including center- and home-based care, and friend, family, and neighbor care, families are at risk for missing out on positive socioemotional supports for children and children are at risk for safety hazards from unprepared or inadequately trained caregivers.

As trusted care providers of infants and young children, both home visitors and pediatric primary care providers are frequently called upon to help families with decisions about quality child care. Beyond endorsing ECE as a healthy, safe, and developmentally appropriate learning environment, both sectors have struggled to provide more practical and comprehensive support. This is in part because ECE is not a single system, but a system made up of thousands of individual providers with complicated regulatory and funding policies.


With the generous support of the Vanguard Strong Start for Kids initiative, PolicyLab developed and began to pilot Community Clinical Systems Integration (CCSI), an initiative focused on reducing fragmentation to build a more efficient system and address the structural barriers that exist to build a higher-quality and more collaborative and trusted network of care for families across all family-serving systems. We also launched the CCSI ECE support strategy—a strategy that aims to create an integrated cross-sector early childhood support system for families that includes evidence-based home visiting services, pediatric primary care, and quality child care to improve the health, well-being, and service delivery to families with young children in Philadelphia

Over the last two years, CCSI has worked to identify and assess the gaps that create barriers to providing adequate ECE support and education to families and develop resources and infrastructure necessary to close those gaps. We have actively engaged families, leadership of early childhood systems across Philadelphia and Pennsylvania, the early childhood advocacy community, and an advisory council to ensure the framework developed for the CCSI model can be adequately supported by the various family-serving systems and sustainable long term. In this process, we learned three valuable lessons that have shaped CCSI’s continued work:  

  1. Families often serve as intermediaries between systems, which not only creates undue burden, but jeopardizes communication workflows that could best support children’s health needs.
  2. Families and providers (pediatricians, home visitors and child care providers) find communication challenging and duplicative, creating inefficiencies and additional burden.
  3. Families, as well as family-serving systems (including pediatric primary care and home visiting organizations), find the child care system incredibly complex and difficult to navigate.

Next Steps

Through the development of a multi-layered approach and continued engagement with critical stakeholders, we aim to build stronger coordination between systems and improve efficiency and effectiveness of the delivery of accurate, timely and trusted ECE information to families.  

Over the next three years, we aim to:

  • Establish processes to build and maintain the knowledge and skills of staff from Children’s Hospital of Philadelphia’s (CHOP) health system and Philadelphia home visiting providers to improve their capacity to serve as an informed, trusted resource for families regarding access and participation in quality ECE
  • Help families enroll their children in quality child care, with a special focus on high-needs children and/or families prioritized by the health system and families
  • Operationalize strategies that improve communication, exchange of health information, and workflows between primary care providers, families and child care

CCSI recognizes the unique perspective and voice that the health system brings to raising awareness about the importance of a robust, quality child care system. Our hope is that this work will be used to 1) influence policy, practice, and stakeholder support to expand the availability and accessibility of child care, 2) build out a more robust system of communication between systems that has the potential to improve overall quality of the child care system, and 3) positively influence family understanding of and decision-making towards quality, safe caregiving environments. 

This project page was last updated in January 2022. 

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Community Clinical Systems Integration – Early Childhood Education Supports [online]. Available at: [Accessed: plug in date accessed here]. 

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