Early Childhood Comprehensive Systems

Early Childhood Comprehensive Systems, funded by MCHB since 2003, are partnerships between interrelated and interdependent agencies/organizations representing physical and mental health, social services, families and caregivers, and early childhood education to develop seamless systems of care for children from birth to kindergarten entry.

Early Childhood Comprehensive Systems Impact (ECCS Impact) Grant Program

Using a Collaborative Innovation and Improvement Network (CoIIN) approach, the Early Childhood Comprehensive Systems Impact (ECCS Impact) grant program works to enhance early childhood (EC) systems building and demonstrate improved outcomes in population-based children’s developmental health and family well-being indicators.

Additionally, these grants develop collective impact expertise, and implement and sustain efforts at the state, county and community levels.

How It Works

Grant recipients identified up to five place-based communities within their state or territory to participate in the Early Childhood Comprehensive Systems Collaborative Innovation and Improvement Network (ECCS CoIIN). At least one of the identified communities in each state receives state and/or tribal Maternal, Infant and Early Childhood Home Visiting (MIECHV) services.

Measuring Success

Within 60 months of the program start, the program’s primary aim is for participating communities to show a 25% increase in age-appropriate developmental skills among their communities’ three (3) year old children.

Secondary aims include:

  • strengthening leadership and expertise in continuous quality improvement (CQI);
  • achieving greater collective impact in early childhood systems at the state, county, and community level;
  • developing primarily two-generation approaches to drive integration of early childhood services vertically and horizontally;
  • developing and adopting core sets of indicators to measure Early Childhood (EC) system processes and outcome indicators to measure population impact around children’s developmental health and family well-being; and
  • testing innovative EC systems change ideas, developing spread strategies and adopting new EC policies for sustaining the systems.

ECCS CoIIN Coordination Center

The Early Childhood Comprehensive Systems Collaborative Innovation and Improvement Network Coordination Center (ECCS CoIIN CC) manages, coordinates, and executes the CoIIN process with the ECCS Impact recipients and communities and guides and facilitates three successive 18-month CoIIN cohorts of one to five place-based communities per participating ECCS Impact grantee.

To improve results for families, the ECCS CoIIN CC uses the following approaches:

  • collaborative learning,
  • identification of core indicators/benchmarks,
  • implementation of coordinated strategies,
  • rapid tests of change, and
  • real-time date and collective impact principles.

The ECCS CoIIN CC will provide intensive, targeted assistance to the ECCS Impact recipients in providing support to their identified place-based communities.


In July 2016, HRSA awarded 12 ECCS Impact grant recipients and one recipient of the ECCS Collaborative Innovation and Improvement Network Coordination Center Cooperative Agreement (ECCS CoIIN CC). The project period for both grants is 5 years (August 1, 2016-July 31, 2021).

Grant Name Award Amount Recipients
Early Childhood Comprehensive Systems Impact (ECCS Impact) Up to $426,600 per year, per grantee

10 state agencies: Alaska, Delaware, Hawaii, Indiana, Louisiana, Kansas, Massachusetts, New Jersey, New York and Utah; 2 organizations: Florida and Oklahoma.

Early Childhood Comprehensive Systems Collaborative Innovation and Improvement Network Coordination Center (ECCS CoIIN CC) Up to $1.1 million per year The National Institute for Children’s Health Quality, Inc., Boston, MA

Early Childhood Developmental Health System: Implementation in a High Need State

On September 18, 2017, HRSA awarded $3.5 million to the University of Mississippi Medical Center to support the Early Childhood Developmental Health System Program. This funding aims to improve population level early childhood developmental health outcomes in a state with significant risk factors for poor child health status. Major activities include the implementation of a high quality statewide early childhood developmental health system, the development and utilization of an early childhood cross-systems workforce program, and an evaluative study on best practices, polices and innovations that can serve as a model for other states with high needs.

Rural Health Integration Models for Parents and Children to Thrive (IMPACT) Program

HRSA has awarded $600K to West Virginia University Research Corporation through the Rural Health Integration Models for Parents and Children to Thrive (IMPACT) program. The funding will implement evidence-based, two-generational strategies that promote health and well-being of young rural children and create economic opportunities for their families through supporting implementation sites and providing technical assistance around:

  • ensuring rural children and their families have access to critical health, development, education, and family support services that are aligned and coordinated;
  • improving early identification of and intervention for high-risk families who have experienced or are at-risk for adverse childhood experiences, maternal depression and other mental health issues, substance use disorders including opioid use and related neonatal abstinence syndrome, as well as other factors that lead to poor health and social outcomes for rural families; and
  • developing, implementing, and expanding two-generational strategies that effectively link children and their families to services to encourage: a) children’s healthy development; and b) help families overcome barriers to achieving economic security and self-sufficiency.

The Rural Health IMPACT program will build on lessons learned from the initial Rural IMPACT demonstration, including providing direct support and tailored technical assistance to communities. The program prioritizes and facilitates coordination of programs and services needed to address the additive effects of poverty and geographic isolation on early childhood health and development. Performance measures will align with HRSA’s Maternal, Infant and Early Childhood Home Visiting program.

Infant-Toddler Court Program

The Infant-Toddler Court Program grant was awarded to Zero to Three in September 2018 at $3 million dollars per year for three years pending funding availability. The overall goal of the Infant-Toddler Court Program is to improve the health, safety, well-being and development of infants, toddlers and families in the child welfare system. The program will support implementation and quality improvement of infant-toddler court teams.

Infant-toddler court teams provide case management and family support to infants and toddlers in the child welfare system and work to strengthen and align the child welfare, health, and early childhood and community systems to strengthen the health and well-being of infants and toddlers and their families.

The Infant-Toddler Court Program will provide training, technical assistance (TA), implementation support, and evaluation research for infant-toddler court teams. Ten implementation sites will be directly supported. Each implementation site will serve as the backbone organization in the community implementing the infant-toddler court model.

The program will also:

  • Promote the spread of evidence-based infant-toddler courts to other jurisdictions
  • Build the evidence-base for infant-toddler courts
  • Promote the implementation of two-generation, trauma-informed, evidence-based early interventions in the court and child welfare systems and across child- and family-serving systems
  • Advance the ability to address parents’ past trauma and immediate service needs, and
  • Strengthen child welfare practices and early childhood systems to support the parent-child relationship and optimize the well-being of infants and toddlers in the child welfare system
Date Last Reviewed:  July 2019

Contact Us

Dina Lieser
Early Childhood Systems Programs Director and Team Lead

Sandy Sheehy
ECCS Impact Project Officer

Lynlee Tanner Stapleton
Infant-Toddler Court and Rural Health IMPACT Project Officer