Why Medical Child Support is Important—and Complex

Courts resolving child support cases involving separated, divorced, and non‐marital children are charged with defining responsibility for health care coverage for the children under that order. This article explores historical and current medical child support requirements under Title IV‐D of the Social Security Act—the national child support enforcement (“IV‐D”) program. It analyzes legal requirements and policy recommendations, and provides a practical tool judges may use to determine whether health care coverage available to either or both parents is appropriate—that is, comprehensive, accessible, and affordable.     

Strengthening the Intergovernmental Grant System: Long-Term Lessons for the Federal–Local Relationship

This study investigates the longitudinal political and administrative problems associated with federal–local government relations. The findings demonstrate four primary challenges of the system of federal grants-in-aid that hinder the relationship of policy design at the federal level and policy implementation in local communities: the politics of decentralization, subnational capacity, program accountability and program adaptability. A case study of the Community Development Block Grant, as assessed by the Advisory Commission on Intergovernmental Relations and the General Accounting Office between 1974 and the present, is included to demonstrate the application of these problems within the system. Although the "evolution of devolution" can greatly benefit the recipients of public services at the local level, it often operates within an unorganized and ineffective system that public managers at all levels of government must continue to develop.     

A Judicial‐Mental Health Partnership to Heal Young Children in Juvenile Court

In this article, we describe the background and issues to be addressed related to dependent children in juvenile court. In an important effort to systematically examine developmental functioning and treatment needs in maltreated and violence‐exposed young children, the Prevention and Evaluation of Early Neglect and Trauma (PREVENT) initiative of the Dependency Court Intervention Program for Family Violence, a national demonstration project in the Miami‐Dade Juvenile Court, developed a program to evaluate all infants, toddlers, and preschoolers who are adjudicated dependent by the court. The goal of the intervention is to raise awareness of the needs of infants and toddlers in juvenile court and to work toward healing the child. The PREVENT program involved the evolution of a judicial‐mental health partnership designed to assist the court in making more informed decisions about the best interest of the child by adding scientific knowledge about development, prevention, intervention, evaluation, and treatment. The outcome of the partnership and multidisciplinary approach is illustrated through presenting a case vignette of a mother and baby showing the challenges and strengths of intervention. Finally, we consider overall outcomes of the intervention and directions for the future.     

Increasing access to rural maternal health services in Zambia through demand-side interventions

This paper examines a demand-side intervention that significantly increased access to maternal health services in rural Zambia in a context where skilled birth attendance rates had been stagnant for over two decades. Aspects of the intervention design that were crucial to the programme's success were the participatory and adult learning-centred approach used to mobilise intervention communities, the use of a community volunteer model, and the design's sensitivity and responsiveness to underlying social factors and problems. The demand-side intervention is already being scaled up in six districts, and is highly suitable for national level scale-up.